Systematic measurement error in self-reported health: is anchoring vignettes the way out?

Aparajita Dasgupta

doi:10.1186/s40176-018-0120-z

Abstract

This paper studies systematic reporting heterogeneity in self-assessed health in India using World Health Survey (WHS)-SAGE survey that has subjective assessments on own health and hypothetical vignettes as well as objective measures like measured anthropometrics and performance tests on a range of health domains. The study implicitly tests and validates the assumption of response consistency in a developing country setting, thus lending support to the use of vignettes. Additionally, we are able to control for unobservable heterogeneities of reporting behavior at the individual level by employing individual fixed-effects estimation using multiple ratings on a set of vignettes by the same person. The study confirms identical pattern of systematic bias by the socioeconomic subgroups as is indicated by vignette technique. It further highlights that substantial amount of reporting heterogeneity remains unexplained after controlling for the usual socioeconomic control variables. The finding has potentially broader implications for research based on self-reported data in a developing country.JEL Classification: C83, D91, I12, I18, I15, I32, J10

Highlights

Self-assessed health (SAH) is one of the most widely used measures in policy design which is convenient and informative instrument often shown to be correlated with actual health, mortality, morbidity, and health access (Rohrer 2009)
Any variation in reported health status can come from the following possible sources: variation related to differences in true health and/or variation in reporting which is driven by the respondent’s personal characteristics
This paper provides a formal framework to test the existing pattern of reporting behavior in SAH and offers a simple methodological technique to check the assumption of response consistency used in vignette approach2in a developing country setting which has important implications for informing survey design using self-assessed responses

Summary

Introduction

Self-assessed health (SAH) is one of the most widely used measures in policy design which is convenient and informative instrument often shown to be correlated with actual health, mortality, morbidity, and health access (Rohrer 2009). We examine systematic reporting heterogeneity using two ways: first using responses from vignette ratings across different health domains and second using a method that combines data on objective and self-reported health indicators In this process, we implicitly test the validity of the “response consistency” assumption. This paper provides a formal framework to test the existing pattern of reporting behavior in SAH and offers a simple methodological technique to check the assumption of response consistency used in vignette approach2in a developing country setting which has important implications for informing survey design using self-assessed responses. We claim that the battery of “objective” health measures is sufficient to ensure that our second approach holds that lets us test whether the response consistency assumption holds in this data As we have both the objective and subjective counterpart on the particular health domain of mobility, functioning, cognition, and memory, we are able to precisely control and condition for the “observable” health counterpart and run this specification.

Data and summary statistics

Results

Objective memory tests

Conclusions