Peer effects in health valuation: the relation between rating of contemporaries\u2019 health and own health

Arthur E Attema,Werner B F Brouwer,Jose Luis Pinto Prades

doi:10.1186/s12955-018-0978-8

Abstract

BackgroundMost health valuation studies assume that individuals’ health valuations do not depend on social comparisons. However, there is some evidence that this assumption is not satisfied in practice. This paper tests whether self-rated health by means of a Visual Analogue Scale (VAS) is related to how one perceives the health of one’s contemporaries, while accounting for one’s health as classified by the EQ-5D classification system.MethodsIn a large sample (n = 1500), representative of the general public, we use a VAS to rate respondents’ own health and their assessment of their contemporaries’ health. In addition, we directly ask them whether they perceive their health to be better, the same, or worse than their contemporaries, and we measure their own health according to the EQ-5D-5 L.ResultsWe find a positive relationship between own health rating and contemporaries’ health rating, after controlling for the respondents’ own health as classified according to the EQ-5D. Furthermore, we observe a discrepancy between relative health vis-à-vis age peers as measured by an ordinal comparison and relative health as measured by a VAS. Finally, respondents, especially women, tended to overestimate the health of other people of their age.ConclusionsWe provide evidence that people’s own health rating is related to the perception of health of contemporaries. Our results indicate that knowledge about a respondent’s perception of others’ health is useful in explaining health state valuations.

Highlights

It is increasingly recognized that reference points, a crucial element in prospect theory, play an important role in valuations, including health state valuations
This paper studies the extent to which own health valuations using a Visual Analogue Scale (VAS) depend on how people perceive their health to be in relation to that of others
We find a negative correlation between age and VAS_OWN, confirming the common finding that health feelings deteriorate with age, the size of the correlation coefficient is low (Kendall’s τ = − 0.055, p < 0.01)

Summary

Introduction

It is increasingly recognized that reference points, a crucial element in prospect theory, play an important role in valuations, including health state valuations. Reference group theory, which assumes that subjective assessment of health depends on the individual’s comparison group, is often used to explain elderly persons’ positive health assessments According to this theory, elderly adults adopt to their situation by maintaining positive health perceptions when confronting illness; they adjust their perceptions of health in relation to peers of their age [14, 15], or to their past health [16, 17]. The other process is the accommodative mode, which “comprises mechanisms and processes by which goals and projects are adjusted to available resources of action” [19] According to this theory, health deteriorations due to age can be regarded as losses in resources, leading people to favor the accommodative process over the assimilative one as they get older [21]

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