Reporting Heterogeneity Effects in Modelling Self Reports of Health

35 Pages Posted: 23 Dec 2016

See all articles by William H. Greene

William H. Greene

New York University Stern School of Business

Mark N. Harris

Curtin University

Bruce Hollingsworth

Lancaster University

Rachel J. Knott

Monash University - Centre for Health Economics

Nigel Rice

University of York - Derwent College

Date Written: September 23, 2016

Abstract

Self-assessed measures of health using Likert-type scales are widely used to assess the health and well-being of populations, and are a feature of household surveys throughout the world. However, the self-reported and subjective nature of these measures means that different people will inherently respond in different ways - a concept known as reporting heterogeneity. In this paper we consider two types of reporting heterogeneity. The first is differential item functioning, which results when individuals systematically differ in their interpretation and use of response categories. The second is middle-inflation bias, which arises when respondents adopt a ‘box-ticking’ strategy - for example, because they are unsure of how to answer survey questions, or because they do not take the surveys they are completing seriously. This type of reporting heterogeneity typically materializes in the form of an artificial build-up of responses in middling response categories. We consider approaches for adjusting for each type of reporting heterogeneity, both in isolation and in combination. The results suggest that self-assessed measures of health are susceptible to both types of reporting heterogeneity, and that failure to account for these nuances may lead to erroneous inference concerning the analysis of self-reported health.

Suggested Citation

Greene, William H. and Harris, Mark N. and Hollingsworth, Bruce and Knott, Rachel J. and Rice, Nigel, Reporting Heterogeneity Effects in Modelling Self Reports of Health (September 23, 2016). Available at SSRN: https://ssrn.com/abstract=2889496 or http://dx.doi.org/10.2139/ssrn.2889496

William H. Greene (Contact Author)

New York University Stern School of Business ( email )

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HOME PAGE: http://people.stern.nyu.edu/wgreene

Mark N. Harris

Curtin University ( email )

Kent Street
Bentley
Perth, WA WA 6102
Australia

HOME PAGE: http://business.curtin.edu.au/contact/staff_directory/?profile=Mark-Harris

Bruce Hollingsworth

Lancaster University ( email )

Lancaster LA1 4YX
United Kingdom

Rachel J. Knott

Monash University - Centre for Health Economics ( email )

Building 75, 15 Innovation Walk
Monash University
Clayton, Victoria 3800
Australia

Nigel Rice

University of York - Derwent College ( email )

Heslington
Centre for Health Research
York, YO10 5DD
United Kingdom

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