Abstract
PurposeStudies on self-rated health outcomes are fraught with problems when individuals’ reporting behaviour is systematically biased by demographic, socio-economic, or cultural factors. Analysing the data drawn from the Indonesia Family Life Survey 2007, this paper aims to investigate the extent of differential health reporting behaviour by demographic and socio-economic status among Indonesians aged 40 and older (N = 3735).MethodsInterpersonal heterogeneity in reporting style is identified by asking respondents to rate a number of vignettes that describe varying levels of health status in targeted health domains (mobility, pain, cognition, sleep, depression, and breathing) using the same ordinal response scale that is applied to the self-report health question. A compound hierarchical ordered probit model is fitted to obtain health differences by demographic and socio-economic status. The obtained regression coefficients are then compared to the standard ordered probit model.ResultsWe find that Indonesians with more education tend to rate a given health status in each domain more negatively than their less-educated counterparts. Allowing for such differential reporting behaviour results in relatively stronger positive education effects.ConclusionThere is a need to correct for differential reporting behaviour using vignettes when analysing self-rated health measures in older adults in Indonesia. Unless such an adjustment is made, the salutary effect of education will be underestimated.
Highlights
Both resource constraints and the multidimensionality of health concepts being studied often necessitate the collection of self-rated health (SRH) data
Analysing the data drawn from the Indonesia Family Life Survey 2007, this paper aims to investigate the extent of differential health reporting behaviour by demographic and socio-economic status among Indonesians aged 40 and older (N 1⁄4 3735)
Interpersonal heterogeneity in reporting style is identified by asking respondents to rate a number of vignettes that describe varying levels of health status in targeted health domains using the same ordinal response scale that is applied to the self-report health question
Summary
Both resource constraints and the multidimensionality of health concepts being studied often necessitate the collection of self-rated health (SRH) data. In addition to the belief that SRH can capture aspects of health that cannot be tapped by objective measure [35], research has shown that SRH is highly correlated with assessments provided by health professionals [9] and that is a strong predictor of mortality [15] as well as health care utilisation [30]. Notwithstanding these benefits, the use of SRH in the study of socio-economic inequalities in health becomes fraught with serious problems when individuals have different expectations, knowledge, or standards of what constitutes a good health. This is known in the literature as ‘reporting heterogeneity’ [29], ‘differential item functioning’ [19], ‘response
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