Self-assessed health: What does it mean and what does it hide?
Self-assessed health: What does it mean and what does it hide?
复制标题
DOI：
10.1016/j.socscimed.2014.10.007
复制
发表时间：
2014-11-01
影响因子：
5.4
通讯作者：
Johnston, David W.
中科院分区：
文献类型：
--
作者：
Au, Nicole;Johnston, David W.
自评一般健康(SAH)是社会科学研究中最常用的健康指标之一。它的一般性意味着它捕捉到了更多指导性措施无法捕捉到的健康要素，而且它的简洁性使卫生信息有可能被纳入拥挤的多方面调查。然而，SAH的一个缺点是，它几乎不能为研究人员提供什么指导，让他们在评估自己的健康时--当调查受访者报告他们的健康状况“不佳”时，是因为他们感到疼痛、疲倦、抑郁、无法爬楼梯，还是完全是其他什么原因？这限制了来自实证研究的可能推论。这还意味着，如果健康的重要决定因素和后果在SAH中只有微弱的反映，就可能被忽视。鉴于SAH的持续使用，更好地了解其结构是很重要的。在这篇论文中，我们使用澳大利亚的家庭面板数据来回答两个相关的问题：(I)SAH最强烈地代表了健康的哪些组成部分？以及(Ii)SAH的使用是否掩盖了对健康的重要影响？为了回答第一个问题，我们使用了一个详细的健康工具，并采取了严格的计量经济学方法来确定SAH中反映最强烈的健康层面。为了回答第二个问题，我们使用工具变量模型估计了收入对SAH和分类卫生措施的因果影响。我们发现，当一个人评估自己的健康时，一些健康维度--特别是活力--对他们来说一直是重要的，而其他维度则无关紧要。我们证明，这一事实为为什么一些研究发现SAH的收入梯度较弱提供了洞察力。工具变量回归结果表明，家庭收入的冲击对SAH没有影响，但强烈改善了健康的几个较少测量的维度。(C)2014爱思唯尔有限公司。保留所有权利。
Self-assessed general health (SAH) is one of the most frequently employed health measures in social science research. Its generic nature means it captures elements of health that more guided measures cannot, and its brevity makes it possible for health information to be included in crowded multifaceted surveys. However, a shortcoming of SAH is that it provides little guidance to researchers as to what individuals are thinking of when they assess their health - when a survey respondent reports that their health is "poor", is it because they are in pain, tired, depressed, unable to climb stairs, or something else entirely? This limits the possible inference from empirical research. It also means that important determinants and consequences of health can be missed if they are only weakly reflected in SAH. Given the continued use of SAH, it is important to better understand its structure. In this paper we use household panel data from Australia to answer two related questions: (i) what components of health does SAH most strongly represent? and (ii) does the use of SAH conceal important health effects? To answer the first question, we use a detailed health instrument and take a rigorous econometric approach to identify the health dimensions most strongly reflected in SAH. To answer the second question, we estimate the causal effects of income on SAH and on disaggregated health measures using instrumental-variables models. We find that some health dimensions - especially vitality - are consistently important to an individual when they assess their health, while other dimensions are inconsequential. We demonstrate that this fact provides insight in to why some studies find weak income gradients in SAH. Instrumental-variable regression results show that shocks to household income have no effect on SAH, but strongly improve several dimensions of health that are less commonly measured. (C) 2014 Elsevier Ltd. All rights reserved.