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Health Measurement in Population Surveys: Combining Information from Self-reported and Observer-Measured Health Indicators

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Demography

Abstract

Our primary aim is to develop and validate a population health metric for survey-based health assessment that combines information from both self-reported and observer-measured health indicators. A secondary objective is to use this index to examine gender and socioeconomic differentials in the health status of older people. We use data from the second wave of the English Longitudinal Study of Ageing (ELSA) conducted in 2004 (N = 8,870). Information from three observer-measured and three self-reported health indicators was combined, using a latent variable modeling approach. A model that decomposed the manifest health indicators to valid health, systematic error, and random error was found to fit the data best. The latent health dimension represented somatic health, and was tested against three external criteria: height, waist-hip ratio, and smoking status. We present the Latent Index of Somatic Health (LISH), as well as a procedure for deriving the LISH in surveys employing both self- and observer-measured health indicators. Observer-measured and self-reported indicators were found to be equally biased in indexing population somatic health, with the exception of self-reports of functional limitations, which was the most reliable somatic health indicator. As expected, results showed that women had worse health than men and that socioeconomic advantage is associated with better somatic health.

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References

  • Asao, K., Kao, W. H. L., Baptiste-Roberts, K., Bandeen-Roche, K., Erlinger, T. P., & Brancati, F. L. (2006). Short stature and the risk of adiposity, insulin resistance, and type 2 diabetes in middle age—TheThird National Health and Nutrition Examination Survey (NHANES III), 1988–1994. Diabetes Care, 29, 1632–1637.

    Article  Google Scholar 

  • Banks, J., Marmot, M., Oldfield, Z., & Smith, J. P. (2006). Disease and disadvantage in the United States and in England. Journal of the American Medical Association, 295, 2037–2045.

    Article  Google Scholar 

  • Barker, D. J. P., Osmond, C., & Golding, J. (1990). Height and mortality in the counties of England and Wales. Annals of Human Biology, 17, 1–6.

    Article  Google Scholar 

  • Barsky, A. J. (1988). The paradox of health. The New England Journal of Medicine, 318, 414–418.

    Article  Google Scholar 

  • Bennett, K. M. (2006). Does marital status and marital status change predict physical health in older adults? Psychological Medicine, 36, 1313–1320.

    Article  Google Scholar 

  • Benyamini, Y., Blumstein, T., Lusky, A., & Modan, B. (2003a). Gender differences in the self-rated health-mortality association: Is it poor self-rated health that predicts mortality or excellent self-rated health that predicts survival? The Gerontologist, 43, 396–305.

    Google Scholar 

  • Benyamini, Y., Leventhal, E. A., & Leventhal, H. (2003b). Elderly people’s ratings of the importance of health-related factors to their self-assessments of health. Social Science & Medicine, 56, 1661–1667.

    Article  Google Scholar 

  • Beresnevaite, M., Taylor, G. J., & Bagby, R. M. (2007). Assessing alexithymia and type A behavior in coronary heart disease patients: A multimethod approach. Psychotherapy and Psychosomatics, 76, 186–192.

    Article  Google Scholar 

  • Blaxter, M. (1990). Health and lifestyles. London: Routledge.

    Book  Google Scholar 

  • Bohannon, R. W. (2001). Dynamometer measurements of hand-grip strength predict multiple outcomes. Perceptual and Motor Skills, 93, 323–328.

    Google Scholar 

  • Boniface, D. R., & Tefft, M. E. (1997). The application of structural equation modelling to the construction of an index for the measurement of health-related behaviours. Statistician, 46, 505–514.

    Google Scholar 

  • Bowling, A. (1995). Measuring disease: A handbook for the assessment of quality of life. Milton Keynes, UK: Open University Press.

    Google Scholar 

  • Burstrom, B., & Fredlund, P. (2001). Self-rated health: Is it as good a predictor of subsequent mortality among adults in lower as well as in higher social classes? Journal of Epidemiology and Community Health, 55, 836–840.

    Article  Google Scholar 

  • Calnan, M., & Johnson, B. (1985). Health, health risks and inequalities: An exploratory study of women’s perceptions. Sociology of Health & Illness, 7, 55–75.

    Article  Google Scholar 

  • Carroll, R. J., Ruppert, D., Stefanski, L. A., & Crainiceanu, C. M. (2006). Measurement error in nonlinear models: A modern perspective. Boca Raton, FL: Chapman & Hall.

    Book  Google Scholar 

  • DeSalvo, K. B., Bloser, N., Reynolds, K., He, J., & Muntner, P. (2006). Mortality prediction with a single general self-rated health question. Journal of General Internal Medicine, 21, 267–275.

    Article  Google Scholar 

  • Desesquelles, A. F., Egidi, V., & Salvatore, M. A. (2009). Why do Italian people rate their health worse than French people do? An exploration of cross-country differentials of self-rated health. Social Science & Medicine, 68, 1124–1128.

    Article  Google Scholar 

  • Doll, R., Gray, R., Hafner, B., & Peto, R. (1980). Mortality in relation to smoking: 22 years’ observations on female British doctors. British Medical Journal, 280, 967–971.

    Article  Google Scholar 

  • Doll, R., Peto, R., Boreham, J., & Sutherland, I. (2004). Mortality in relation to smoking: 50 years’ observations on male British doctors. British Medical Journal, 328, 1519–1528.

    Article  Google Scholar 

  • Dowd, J. B., & Zajacova, A. (2007). Does the predictive power of self-rated health for subsequent mortality risk vary by socioeconomic status in the US? International Journal of Epidemiology, 36, 1214–1221.

    Article  Google Scholar 

  • Dunnell, K., Fitzpatrick, J., & Bunting, J. (1999). Making use of official statistics in research on gender and health status: Recent British data. Social Science & Medicine, 48, 117–127.

    Article  Google Scholar 

  • Elam, J. T., Graney, M. J., Beaver, T., Elderwi, D., Applegate, W. B., & Miller, S. T. (1991). Comparison of subjective ratings of function with observed functional ability of frail older persons. American Journal of Public Health, 81, 1127–1130.

    Article  Google Scholar 

  • Fayers, P. M., & Sprangers, M. A. G. (2002). Understanding self-rated health. Lancet, 359, 187–188.

    Article  Google Scholar 

  • Ferrer, M., Lamarca, R., Orfila, F., & Alonso, J. (1999). Comparison of performance-based and self-rated functional capacity in Spanish elderly. American Journal of Epidemiology, 149, 228–235.

    Google Scholar 

  • Grant, M. D., Piotrowski, Z. H., & Chappell, R. (1995). Self-reported health and survival in the Longitudinal study of Aging, 1984–1986. Journal of Clinical Epidemiology, 48, 375–387.

    Article  Google Scholar 

  • Groot, W. (2000). Adaptation and scale of reference bias in self-assessments of quality of life. Journal of Health Economics, 19, 403–420.

    Article  Google Scholar 

  • Grundy, E., & Sloggett, A. (2003). Health inequalities in the older population: The role of personal capital, social resources and socio-economic circumstances. Social Science & Medicine, 56, 935–947.

    Article  Google Scholar 

  • Hebert, J. R., Peterson, K. E., Hurley, T. G., Stoddard, A. M., Cohen, N., Field, A. E., & Sorensen, G. (2001). The effect of social desirability trait on self-reported dietary measures among multi-ethnic female health center employees. Annals of Epidemiology, 11, 417–427.

    Article  Google Scholar 

  • Huisman, M., Kunst, A. E., & Mackenbach, J. P. (2003). Socioeconomic inequalities in morbidity among the elderly; a European overview. Social Science & Medicine, 57, 861–873.

    Article  Google Scholar 

  • Huisman, M., van Lenthe, F., & Mackenbach, J. (2007). The predictive ability of self-assessed health for mortality in different educational groups. International Journal of Epidemiology, 36, 1207–1213.

    Article  Google Scholar 

  • Idler, E. L., & Benyamini, Y. (1997). Self-rated health and mortality: A review of twenty-seven community studies. Journal of Health and Social Behavior, 38, 21–37.

    Article  Google Scholar 

  • Jane, J. S., Oltmanns, T. F., South, S. C., & Turkheimer, E. (2007). Gender bias in diagnostic criteria for personality disorders: An item response theory analysis. Journal of Abnormal Psychology, 116, 166–175.

    Article  Google Scholar 

  • Jylha, M., Guralnik, J. M., Ferrucci, L., Jokela, J., & Heikkinen, E. (1998). Is self-rated health comparable across cultures and genders? The Journals of Gerontology. Series B: Psychological Sciences and Social Sciences, 53, S144–S152.

    Google Scholar 

  • Krause, N. M., & Jay, G. M. (1994). What do global self-rated health items measure. Medical Care, 32, 930–942.

    Article  Google Scholar 

  • Lawlor, D. A., Ebrahim, S., & Smith, G. D. (2002). The association between components of adult height and Type II diabetes and insulin resistance: British Women’s Heart and Health Study. Diabetologia, 45, 1097–1106.

    Article  Google Scholar 

  • Lillard, L., & Swaminathan, M. (2000, March). Health in Bangladesh, Indonesia and the United States: A MIMC model with threshold responses and person, family and community components. Presented at the annual meeting of the Population Association of America, Los Angeles.

  • Lindeboom, M., & van Doorslaer, E. (2004). Cut-point shift and index shift in self-reported health. Journal of Health Economics, 23, 1083–1099.

    Google Scholar 

  • Majdandzic, M., & van den Boom, D. C. (2007). Multimethod longitudinal assessment of temperament in early childhood. Journal of Personality, 75, 121–167.

    Article  Google Scholar 

  • Marmot, M., Banks, J., Blundell, R., Lessof, C., & Nazroo, J. (2002). Health, wealth and lifestyles of the older population in England: The 2002 English Longitudinal Study of Ageing. London: Institute for Fiscal Studies.

    Google Scholar 

  • McDowell, I., & Newell, C. (1996). Measuring health: A guide to rating scales and questionnaires. New York: Oxford University Press.

    Google Scholar 

  • Mokdad, A. H., Ford, E. S., Bowman, B. A., Dietz, W. H., Vinicor, F., Bales, V. S., & Marks, J. S. (2003). Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. Journal of the American Medical Association, 289, 76–79.

    Article  Google Scholar 

  • Murray, C. J. L. (2007). Towards good practice for health statistics: Lessons from the millennium development goal health indicators. Lancet, 369, 862–873.

    Article  Google Scholar 

  • Muthén, L. K., & Muthén, B. O. (1998–2007). Mplus User's Guide. Fourth Edition. Los Angeles, CA

  • Myers, A. M., Holliday, P. J., Harvey, K. A., & Hutchinson, K. S. (1993). Functional performance measures: Are they superior to self-assessments? Journals of Gerontology, 48, M196–M206.

    Google Scholar 

  • Nichter, M., Ritenbaugh, C., Vuckvoic, N., & Aickin, M. (1995). Dieting and watching behaviours among adolescent females: Report of a multimethod study. The Journal of Adolescent Health, 17, 153–162.

    Article  Google Scholar 

  • Palmer, R. F., Dwyer, J. H., & Semmer, N. (1994). A measurement model of adolescent smoking. Addictive Behaviors, 19, 477–489.

    Article  Google Scholar 

  • Peck, A. M. N., & Vagero, D. H. (1989). Adult body height, self perceived health and mortality in the Swedish population. Journal of Epidemiology and Community Health, 43, 380–384.

    Article  Google Scholar 

  • Pollack, C. E., Chideya, S., Cubbin, C., Williams, B., Dekker, M., & Braveman, P. (2007). Should health studies measure wealth? A systematic review. American Journal of Preventive Medicine, 33, 250–264.

    Article  Google Scholar 

  • Prinstein, M. J., Nock, M. K., Spirito, A., & Grapentine, W. L. (2001). Multimethod assessment of suicidality in adolescent psychiatric inpatients: Preliminary results. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 1053–1061.

    Article  Google Scholar 

  • Quesnel-Vallee, A. (2007). Self-rated health: Caught in the crossfire of the quest for “true” health? International Journal of Epidemiology, 36, 1161–1164.

    Article  Google Scholar 

  • Rabe-Hesketh, S., & Skrondal, A. (2008). Classical latent variable models for medical research. Statistical Methods in Medical Research, 17, 5–32.

    Article  Google Scholar 

  • Radloff, L. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.

    Article  Google Scholar 

  • Robine, J. M., Michel, J. P., & Branch, L. G. (1992). Measurement and utilization of healthy life expectancy: Conceptual issues. Bulletin of the World Health Organization, 70, 791–800.

    Google Scholar 

  • Robine, J. M., Jagger, C., & Euro, R. G. (2003). Creating a coherent set of indicators to monitor health across Europe: The Euro-REVES 2 project. European Journal of Public Health, 13, 6–14.

    Article  Google Scholar 

  • Samejima, F. (1969). Estimation of latent trait ability using a response pattern of graded scores (Psychometric Monograph No. 17). Richmond, VA: Psychometric Society.

  • Sen, A. (2002). Health: Perception versus observation—Self reported morbidity has severe limitations and can be extremely misleading. British Medical Journal, 324, 860–861.

    Article  Google Scholar 

  • Sigmon, S. T., Pells, J. J., Boulard, N. E., Whitcomb-Smith, S., Edenfield, T. M., Hermann, B. A.,.... Kubik, E. (2005). Gender differences in self-reports of depression: The response bias hypothesis revisited. Sex Roles, 53, 401–411.

    Google Scholar 

  • Silventoinen, K., Lahelma, E., & Rahkonen, O. (1999). Social background, adult body-height and health. International Journal of Epidemiology, 28, 911–918.

    Article  Google Scholar 

  • Singh-Manoux, A., Martikainen, P., Ferrie, J., Zins, M., Marmot, M., & Goldberg, M. (2006). What does self-rated health measure? Results from the British Whitehall II and French Gazel cohort studies. Journal of Epidemiology and Community Health, 60, 364–372.

    Article  Google Scholar 

  • Singh-Manoux, A., Dugravot, A., Shipley, M. J., Ferrie, J. E., Martikainen, P., Goldberg, M., & Zins, M. (2007). The association between self-rated health and mortality in different socioeconomic groups in the GAZEL cohort study. International Journal of Epidemiology, 36, 1222–1228.

    Article  Google Scholar 

  • Spearman, D. (1904). General intelligence objectively determined and measured. The American Journal of Psychology, 15, 201–293.

    Article  Google Scholar 

  • Svanborg, A. (1988). Practical and functional consequences of aging. Gerontology, 34(Suppl. 1), 11–15.

    Article  Google Scholar 

  • Tram, J. M., & Cole, D. A. (2006). A multimethod examination of the stability of depressive symptoms in childhood and adolescence. Journal of Abnormal Psychology, 115, 674–686.

    Article  Google Scholar 

  • van Doorslaer, E., & Gerdtham, U. G. (2003). Does inequality in self-assessed health predict inequality in survival by income? Evidence from Swedish data. Social Science & Medicine, 57, 1621–1629.

    Article  Google Scholar 

  • Vanitallie, T. B. (1985). Health implications of overweight and obesity in the United States. Annals of Internal Medicine, 103, 983–988.

    Google Scholar 

  • Waidmann, T., Bound, J., & Schoenbaum, M. (1995). The illusion of failure: Trends in the self-reported health of the US elderly. The Milbank Quarterly, 73, 253–287.

    Article  Google Scholar 

  • Wolf, D. A., Hunt, K., & Knickman, J. (2005). Perspectives on the recent decline in disability at older ages. The Milbank Quarterly, 83, 365–395.

    Article  Google Scholar 

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Authors and Affiliations

  1. Centre for Population Studies, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, University of London, 49/50 Bedford Square, London, WC1B3DP, England

    George B. Ploubidis & Emily Grundy

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  1. George B. Ploubidis
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  2. Emily Grundy
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Correspondence to George B. Ploubidis.

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Ploubidis, G.B., Grundy, E. Health Measurement in Population Surveys: Combining Information from Self-reported and Observer-Measured Health Indicators. Demography 48, 699–724 (2011). https://doi.org/10.1007/s13524-011-0028-1

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