There exists a lot of difference in the way in which different populations value their own, self-assessed health. These differences in reporting (reporting heterogeneity) are most notable between countries and have different reasons. By using surveys including anchoring vignettes, comparability between health measures between countries and populations is made possible. Within these surveys, respondents not only report their own health, but also report health of a hypothetical person with a certain health state. As the vignettes are identical for all respondents, individual variation in the rating of health must be due to reporting heterogeneity. Differences in health have been indicated for six general health domains (breathing, sleeping, pain, memory/cognition, depression and mobility) between England and the US, using data from the English Longitudinal Survey of Ageing (for England) and the Health retirement Study (for the US). The data includes information on respondents’ self-assessed health, together with vignette ratings, rated by those individuals. The data is used to estimate an ordered probit model and a HOPIT model for all health domains. By doing this, an examination is possible between the two models, and the impact of reporting heterogeneity is measured. It is clear that from the results that reporting heterogeneity is existent between the two countries when correcting for a selection of socio-demographic indicators. From a population point of view, English residents are generally better off than American individuals in the sense that they have a lower probability of reporting more health problems across all health domains except sleep, where no difference is found. Also, the conclusion can be drawn that true health differences between the countries are larger when considering heterogeneity in reporting and that certain health effects of socio-demographics could be underestimated or not found at all when not taking reporting heterogeneity into account. Further, certain effects of some socio-demographic factors are present for America but not for England, and vice versa. Concluding, it is necessary to correct for reporting heterogeneity when making comparisons in health between the US and England. When not correcting for this bias, true health differences are not generated.

reporting, heterogeneity, health, self-reported
Marreiros Bago d'Uva, T.M.
Master Health Economics, Policy and Law
Erasmus School of Health Policy & Management

Slager, T.J. (2013, October 31). Reporting heterogeneity across the Atlantic. Master Health Economics, Policy and Law. Retrieved from