IDEAS home Printed from https://ideas.repec.org/p/zbw/esprep/342195.html

Ranking Reliably in Health Inequality Measurement: Anchor-Calibrated Economic Ranking for Correcting Survey Measurement Error in Income and Wealth Values Among Older Adults in India

Author

Listed:
  • Tiwari, Shubham
  • Goli, Srinivas
  • Skirbekk, Vegard

Abstract

This paper investigates whether survey measurement error in welfare rankings conceals the true extent of socioeconomic health inequality among older adults in India, using nationally representative LASI Wave 1 data. We develop an anchor-calibrated composite economic ranking that corrects systematic underreporting in self-reported income and gross asset values using consumption and a PCA wealth index as stable anchors. Probit models, doubly robust IPWRA estimators, and Erreygers-corrected concentration indices are estimated across five health outcomes and seven welfare specifications. Raw income produces null or directionally misleading gradient estimates for most outcomes, including a sign reversal in the income–self-rated health association. Anchor calibration consistently recovers larger and more plausible gradients, with concentration index amplification ranging from 12% to 46% across outcomes, while for multimorbidity, raw income entirely masks a statistically significant pro-rich gradient. Decomposition analysis reveals that education is the dominant driver of functional and subjective health inequality, whereas direct SES is the dominant driver of nutritional inequality. Results survive robustness checks across alternative anchor weights, thresholds, and estimators and imply that inequality-monitoring systems based on raw income systematically understate health disparities among older Indians.

Suggested Citation

  • Tiwari, Shubham & Goli, Srinivas & Skirbekk, Vegard, 2026. "Ranking Reliably in Health Inequality Measurement: Anchor-Calibrated Economic Ranking for Correcting Survey Measurement Error in Income and Wealth Values Among Older Adults in India," EconStor Preprints 342195, ZBW - Leibniz Information Centre for Economics.
  • Handle: RePEc:zbw:esprep:342195
    as

    Download full text from publisher

    File URL: https://www.econstor.eu/bitstream/10419/342195/1/Ranking-reliably-in-health-inequality-measurement-1.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Wagstaff, Adam & Paci, Pierella & van Doorslaer, Eddy, 1991. "On the measurement of inequalities in health," Social Science & Medicine, Elsevier, vol. 33(5), pages 545-557, January.
    2. John Strauss & Duncan Thomas, 1998. "Health, Nutrition, and Economic Development," Journal of Economic Literature, American Economic Association, vol. 36(2), pages 766-817, June.
    3. Bruce D. Meyer & James X. Sullivan, 2003. "Measuring the Well-Being of the Poor Using Income and Consumption," NBER Working Papers 9760, National Bureau of Economic Research, Inc.
    4. Umakanta Sahoo & Suraj Maiti & Sanjay K Mohanty, 2025. "Care cascade of hypertension across stages among older adults in India," PLOS ONE, Public Library of Science, vol. 20(12), pages 1-22, December.
    5. Erreygers, Guido, 2009. "Correcting the Concentration Index: A reply to Wagstaff," Journal of Health Economics, Elsevier, vol. 28(2), pages 521-524, March.
    6. Bruce D. Meyer & Wallace K. C. Mok & James X. Sullivan, 2015. "Household Surveys in Crisis," Journal of Economic Perspectives, American Economic Association, vol. 29(4), pages 199-226, Fall.
    7. Subramanian, S.V. & Subramanyam, Malavika A. & Selvaraj, Sakthivel & Kawachi, Ichiro, 2009. "Are self-reports of health and morbidities in developing countries misleading? Evidence from India," Social Science & Medicine, Elsevier, vol. 68(2), pages 260-265, January.
    8. Bound, John & Brown, Charles & Mathiowetz, Nancy, 2001. "Measurement error in survey data," Handbook of Econometrics, in: J.J. Heckman & E.E. Leamer (ed.), Handbook of Econometrics, edition 1, volume 5, chapter 59, pages 3705-3843, Elsevier.
    9. repec:wbk:wbpubs:6896 is not listed on IDEAS
    10. Martin Browning & Thomas F. Crossley & Joachim Winter, 2014. "The Measurement of Household Consumption Expenditures," Annual Review of Economics, Annual Reviews, vol. 6(1), pages 475-501, August.
    11. Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-255, March-Apr.
    12. S V Subramanian & George Davey Smith & Malavika Subramanyam, 2006. "Indigenous Health and Socioeconomic Status in India," PLOS Medicine, Public Library of Science, vol. 3(10), pages 1-11, October.
    13. Sukumar Vellakkal & S V Subramanian & Christopher Millett & Sanjay Basu & David Stuckler & Shah Ebrahim, 2013. "Socioeconomic Inequalities in Non-Communicable Diseases Prevalence in India: Disparities between Self-Reported Diagnoses and Standardized Measures," PLOS ONE, Public Library of Science, vol. 8(7), pages 1-12, July.
    14. Peter Adams & Michael D. Hurd & Daniel L. McFadden & Angela Merrill & Tiago Ribeiro, 2004. "Healthy, Wealthy, and Wise? Tests for Direct Causal Paths between Health and Socioeconomic Status," NBER Chapters, in: Perspectives on the Economics of Aging, pages 415-526, National Bureau of Economic Research, Inc.
    15. Erik Hurst & Geng Li & Benjamin Pugsley, 2014. "Are Household Surveys Like Tax Forms? Evidence from Income Underreporting of the Self-Employed," The Review of Economics and Statistics, MIT Press, vol. 96(1), pages 19-33, March.
    16. Clarke, Philip & Van Ourti, Tom, 2010. "Calculating the concentration index when income is grouped," Journal of Health Economics, Elsevier, vol. 29(1), pages 151-157, January.
    17. Angus Deaton and Jean Drèze & Jean Drèze, 2002. "Poverty and Inequality in India: A Reexamination," Working papers 107, Centre for Development Economics, Delhi School of Economics.
    18. repec:wbk:wbpubs:25338 is not listed on IDEAS
    19. van Doorslaer, Eddy & Wagstaff, Adam & Bleichrodt, Han & Calonge, Samuel & Gerdtham, Ulf-G. & Gerfin, Michael & Geurts, Jose & Gross, Lorna & Hakkinen, Unto & Leu, Robert E., 1997. "Income-related inequalities in health: some international comparisons," Journal of Health Economics, Elsevier, vol. 16(1), pages 93-112, February.
    20. Bruce D. Meyer & James X. Sullivan, 2011. "Consumption and Income Poverty Over the Business Cycle," Research in Labor Economics, in: Who Loses in the Downturn? Economic Crisis, Employment and Income Distribution, pages 51-82, Emerald Group Publishing Limited.
    21. Wooldridge, Jeffrey M., 2007. "Inverse probability weighted estimation for general missing data problems," Journal of Econometrics, Elsevier, vol. 141(2), pages 1281-1301, December.
    22. repec:eme:rlec11:s0147-9121(2011)0000032005 is not listed on IDEAS
    23. Mark Montgomery & Michele Gragnolati & Kathleen Burke & Edmundo Paredes, 2000. "Measuring living standards with proxy variables," Demography, Springer;Population Association of America (PAA), vol. 37(2), pages 155-174, May.
    24. Jennifer Beam Dowd & Megan Todd, 2011. "Does Self-reported Health Bias the Measurement of Health Inequalities in U.S. Adults? Evidence Using Anchoring Vignettes From the Health and Retirement Study," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 66(4), pages 478-489.
    25. Wagstaff, Adam & van Doorslaer, Eddy & Watanabe, Naoko, 2003. "On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam," Journal of Econometrics, Elsevier, vol. 112(1), pages 207-223, January.
    26. Erreygers, Guido, 2009. "Correcting the Concentration Index," Journal of Health Economics, Elsevier, vol. 28(2), pages 504-515, March.
    27. Magnus Lindelow, 2006. "Sometimes more equal than others: how health inequalities depend on the choice of welfare indicator," Health Economics, John Wiley & Sons, Ltd., vol. 15(3), pages 263-279, March.
    28. Rebecca R. Andridge & Roderick J. A. Little, 2010. "A Review of Hot Deck Imputation for Survey Non‐response," International Statistical Review, International Statistical Institute, vol. 78(1), pages 40-64, April.
    29. Anne Schlotheuber & Ahmad Reza Hosseinpoor, 2022. "Summary Measures of Health Inequality: A Review of Existing Measures and Their Application," IJERPH, MDPI, vol. 19(6), pages 1-25, March.
    30. L. Dwight Israelsen & James B. McDonald, 2003. "Measurement Error and the Distribution of Income," Journal of Income Distribution, Ad libros publications inc., vol. 12(1-2), pages 2-2, June.
    31. Anne Case & Angus S. Deaton, 2005. "Broken Down by Work and Sex: How Our Health Declines," NBER Chapters, in: Analyses in the Economics of Aging, pages 185-212, National Bureau of Economic Research, Inc.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Costa-Font, Joan & Hernández-Quevedo, Cristina, 2012. "Measuring inequalities in health: What do we know? What do we need to know?," Health Policy, Elsevier, vol. 106(2), pages 195-206.
    2. Makate, Marshall & Makate, Clifton, 2016. "The Evolution of Socioeconomic-Related Inequalities in Maternal Healthcare Utilization: Evidence from Zimbabwe, 1994-2011," MPRA Paper 72718, University Library of Munich, Germany, revised 24 Jul 2016.
    3. van Kippersluis, Hans & Van Ourti, Tom & O'Donnell, Owen & van Doorslaer, Eddy, 2009. "Health and income across the life cycle and generations in Europe," Journal of Health Economics, Elsevier, vol. 28(4), pages 818-830, July.
    4. Martin Siegel & Karl Mosler, 2014. "Semiparametric Modeling Of Age‐Specific Variations In Income Related Health Inequalities," Health Economics, John Wiley & Sons, Ltd., vol. 23(7), pages 870-878, July.
    5. Martin Siegel & Andreas Mielck & Werner Maier, 2015. "Individual Income, Area Deprivation, and Health: Do Income‐Related Health Inequalities Vary by Small Area Deprivation?," Health Economics, John Wiley & Sons, Ltd., vol. 24(11), pages 1523-1530, November.
    6. Kjell Arne Brekke & Snorre Kverndokk, 2012. "Inadequate Bivariate Measures of Health Inequality: The Impact of Income Distribution," Scandinavian Journal of Economics, Wiley Blackwell, vol. 114(2), pages 323-333, June.
    7. Mohammad Habibullah Pulok & Kees Gool & Mohammad Hajizadeh & Sara Allin & Jane Hall, 2020. "Measuring horizontal inequity in healthcare utilisation: a review of methodological developments and debates," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(2), pages 171-180, March.
    8. Buhong Zheng, 2011. "A new approach to measure socioeconomic inequality in health," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 9(4), pages 555-577, December.
    9. Clifton Makate & Marshall Makate & Nelson Mango, 2019. "Wealth-related inequalities in adoption of drought-tolerant maize and conservation agriculture in Zimbabwe," Food Security: The Science, Sociology and Economics of Food Production and Access to Food, Springer;The International Society for Plant Pathology, vol. 11(4), pages 881-896, August.
    10. Chiao-Lee Chu & Nozuko Lawana, 2021. "Decomposition of income-related inequality in health check-ups services participation among elderly individuals across the 2008 financial crisis in Taiwan," PLOS ONE, Public Library of Science, vol. 16(6), pages 1-14, June.
    11. Nesson, Erik T. & Robinson, Joshua J., 2019. "On the measurement of health and its effect on the measurement of health inequality," Economics & Human Biology, Elsevier, vol. 35(C), pages 207-221.
    12. Peng Nie & Andrew E. Clarck & Conchita D'Ambrosio & Lanlin Ding, 2020. "Income-related health inequality in urban China (1991-2015): The role of homeownership and housing conditions," Working Papers 524, ECINEQ, Society for the Study of Economic Inequality.
    13. Guido Erreygers & Roselinde Kessels & Linkun Chen & Philip Clarke, 2016. "Decomposing Socioeconomic Inequality of Health," EcoMod2016 9574, EcoMod.
    14. Bruce D. Meyer & Derek Wu & Victoria R. Mooers & Carla Medalia, 2019. "The use and misuse of income data and extreme poverty in the United States," AEI Economics Working Papers 1018925, American Enterprise Institute.
    15. Quinn C, 2009. "Measuring income-related inequalities in health using a parametric dependence function," Health, Econometrics and Data Group (HEDG) Working Papers 09/24, HEDG, c/o Department of Economics, University of York.
    16. Laura Rossouw & Hana Ross, 2021. "Understanding Period Poverty: Socio-Economic Inequalities in Menstrual Hygiene Management in Eight Low- and Middle-Income Countries," IJERPH, MDPI, vol. 18(5), pages 1-14, March.
    17. Solmi, Francesca & Von Wagner, Christian & Kobayashi, Lindsay C. & Raine, Rosalind & Wardle, Jane & Morris, Stephen, 2015. "Decomposing socio-economic inequality in colorectal cancer screening uptake in England," Social Science & Medicine, Elsevier, vol. 134(C), pages 76-86.
    18. Hermann Pythagore Pierre Donfouet & Shukri F. Mohamed & Eric Malin, 2021. "Socioeconomic inequality in tobacco use in Kenya: a concentration analysis," International Journal of Health Economics and Management, Springer, vol. 21(2), pages 247-269, June.
    19. Gustav Kjellsson & Dennis Petrie & Tom (T.G.M.) van Ourti, 2018. "Measuring income-related inequalities in risky health prospects," Tinbergen Institute Discussion Papers 18-007/V, Tinbergen Institute.
    20. Ricardo Rodrigues & Stefania Ilinca & Andrea E. Schmidt, 2018. "Income‐rich and wealth‐poor? The impact of measures of socio‐economic status in the analysis of the distribution of long‐term care use among older people," Health Economics, John Wiley & Sons, Ltd., vol. 27(3), pages 637-646, March.

    More about this item

    Keywords

    ;
    ;
    ;
    ;
    ;
    ;
    ;
    ;

    JEL classification:

    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • D31 - Microeconomics - - Distribution - - - Personal Income and Wealth Distribution
    • C81 - Mathematical and Quantitative Methods - - Data Collection and Data Estimation Methodology; Computer Programs - - - Methodology for Collecting, Estimating, and Organizing Microeconomic Data; Data Access
    • J14 - Labor and Demographic Economics - - Demographic Economics - - - Economics of the Elderly; Economics of the Handicapped; Non-Labor Market Discrimination
    • C21 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Cross-Sectional Models; Spatial Models; Treatment Effect Models

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:zbw:esprep:342195. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: ZBW - Leibniz Information Centre for Economics (email available below). General contact details of provider: https://edirc.repec.org/data/zbwkide.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.