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Does inequality in self-assessed health predict inequality in survival by income? - Evidence from Swedish data

van Doorslaer, E and Gerdtham, Ulf LU (2003) In Social Science and Medicine 57(9). p.1621-1629
Abstract
This paper empirically addresses two questions using a large, individual-level Swedish data set which links mortality data to health survey data. The first question is whether there is an effect of an individual's self-assessed health (SAH) on his subsequent survival probability and if this effect differs by socioeconomic factors. Our results indicate that the effect of SAH on mortality risk declines with age-probably because of adjustment towards 'milder' overall health evaluations at higher ages-but does not seem to differ by indicators of socioeconomic status (SES) like income or education. This finding suggests that there is no systematic adjustment of SAH by SES and therefore that any measured income-related inequality in SAH is... (More)
This paper empirically addresses two questions using a large, individual-level Swedish data set which links mortality data to health survey data. The first question is whether there is an effect of an individual's self-assessed health (SAH) on his subsequent survival probability and if this effect differs by socioeconomic factors. Our results indicate that the effect of SAH on mortality risk declines with age-probably because of adjustment towards 'milder' overall health evaluations at higher ages-but does not seem to differ by indicators of socioeconomic status (SES) like income or education. This finding suggests that there is no systematic adjustment of SAH by SES and therefore that any measured income-related inequality in SAH is unlikely to be biased by reporting error. The second question is: how much of the income-related inequality in mortality can be explained by income-related inequality in SAH? Using a decomposition method, we find that inequality in SAH accounts for only about 10% of mortality inequality if interactions are not allowed for, but its contribution is increased to about 28% if account is taken of the reporting tendencies by age. In other words, omitting the interaction between age and SAH leads to a substantial underestimation of the partial contribution of SAH inequality by income. These results suggest that the often observed inequalities in SAH by income do have predictive power for the-less often observed-inequalities in survival by income. (C) 2003 Elsevier Science Ltd. All rights reserved. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
health inequality, mortality risk, survival, Sweden, self-assessed health
in
Social Science and Medicine
volume
57
issue
9
pages
1621 - 1629
publisher
Elsevier
external identifiers
  • wos:000185452300008
  • pmid:12948571
  • scopus:0042388495
ISSN
1873-5347
DOI
10.1016/S0277-9536(02)00559-2
language
English
LU publication?
yes
id
39f75463-2208-4d4b-bd1c-ad42ae115092 (old id 899935)
date added to LUP
2008-01-16 11:04:39
date last changed
2018-01-21 03:22:38
@article{39f75463-2208-4d4b-bd1c-ad42ae115092,
  abstract     = {This paper empirically addresses two questions using a large, individual-level Swedish data set which links mortality data to health survey data. The first question is whether there is an effect of an individual's self-assessed health (SAH) on his subsequent survival probability and if this effect differs by socioeconomic factors. Our results indicate that the effect of SAH on mortality risk declines with age-probably because of adjustment towards 'milder' overall health evaluations at higher ages-but does not seem to differ by indicators of socioeconomic status (SES) like income or education. This finding suggests that there is no systematic adjustment of SAH by SES and therefore that any measured income-related inequality in SAH is unlikely to be biased by reporting error. The second question is: how much of the income-related inequality in mortality can be explained by income-related inequality in SAH? Using a decomposition method, we find that inequality in SAH accounts for only about 10% of mortality inequality if interactions are not allowed for, but its contribution is increased to about 28% if account is taken of the reporting tendencies by age. In other words, omitting the interaction between age and SAH leads to a substantial underestimation of the partial contribution of SAH inequality by income. These results suggest that the often observed inequalities in SAH by income do have predictive power for the-less often observed-inequalities in survival by income. (C) 2003 Elsevier Science Ltd. All rights reserved.},
  author       = {van Doorslaer, E and Gerdtham, Ulf},
  issn         = {1873-5347},
  keyword      = {health inequality,mortality risk,survival,Sweden,self-assessed health},
  language     = {eng},
  number       = {9},
  pages        = {1621--1629},
  publisher    = {Elsevier},
  series       = {Social Science and Medicine},
  title        = {Does inequality in self-assessed health predict inequality in survival by income? - Evidence from Swedish data},
  url          = {http://dx.doi.org/10.1016/S0277-9536(02)00559-2},
  volume       = {57},
  year         = {2003},
}