Education-Related Inequity in Health Care with Heterogeneous Reporting of Health

Abstract

This discussion paper resulted in a publication in the 'Journal of the Royal Statistical Society' , Series A, 2011, 2011, 174, 639–664. Reliance on self-rated health to proxy medical need can bias estimation of education-related inequity in health care utilisation. We correct this bias both by instrumenting self-rated health with objective health indicators and by purging self-rated health of reporting heterogeneity identified from health vignettes. Using data on elderly Europeans, we find that instrumenting self-rated health shifts the distribution of doctor visits in the direction of inequality favouring the better educated. There is a further, and typically larger, shift the same direction when correction is made for the tendency of the better educated to rate their health more negatively.