Health Measures and Health Inequality Over the Life Course

累积优势/劣势（CAD）假说预测教育在健康方面的差异会随着年龄的增长而增加。之前对这一假设的所有测试都是基于自我报告的健康测量。最近的研究表明，自我报告的健康措施可能无法充分反映关键分析结构的差异，包括教育、年龄、队列、性别和国家背景。这引起了对先前关于教育差异对身体健康轨迹的研究结果的可靠性的怀疑，正如被调查者的自我评估所衡量的那样。该项目的总体目标是通过探索自我报告和客观健康措施在生命过程中健康不平等研究中的作用来解决这一问题。为了实现这一目标，该项目将分三步进行。首先，该项目将揭示有关CAD假设的结论在多大程度上受到健康措施选择的影响。具体而言，该项目将通过比较自我报告（如自我评估健康状况、自我报告功能限制）和客观测量（如握力、肺容量）来评估CAD假设。第二，该项目将审查卫生措施的有效性和可靠性是否以及在多大程度上是社会分层的。具体而言，拟议的研究将比较(a)客观和自我报告的健康措施与常见健康风险和死亡率的相关性有多强，以及(b)这些关系如何因教育、年龄、性别、队列和国家背景而不同。第三，该项目旨在开发自我报告和客观身体健康的新型通用措施。具体而言，该项目将使用潜在变量建模，根据10多个观察者测量的健康结果的信息构建一个客观的健康衡量标准，根据组间效度评估这一衡量标准，并将其与自我报告和混合的一般健康衡量标准进行比较。最后，该项目将使用这种新的健康措施为CAD假设提供证据。该项目将使用来自SOEP， ELSA和SHARE的纵向数据，不仅为德国和英国的背景提供证据，而且为16个欧洲国家提供直接的国际比较。

The cumulative advantage/disadvantage (CAD) hypothesis predicts educational differences in health to increase with age. All previous tests of this hypothesis were based on self-reported health measures. Recent research has suggested that self-reported health measures may not adequately capture differences in key analytical constructs, including education, age, cohort, gender, and country context. This raises doubts about the robustness of previous findings on educational differences in physical health trajectories, as measured by respondents’ self-assessments. The overarching goal of this project is to address this issue by exploring the role of self-reported and objective health measures in research on health inequality over the life course. To reach this goal, the project will proceed in three steps. First, the project will uncover the extent to which conclusions about the CAD hypothesis are affected by the choice of health measures. Specifically, the project will evaluate the CAD hypothesis by comparing self-reported (e.g. self-rated health, self-reported functional limitations) and objective measures (e.g. grip strength, lung capacity) of health.Second, the project will examine whether and to what extent the validity and reliability of health measures are socially stratified. Specifically, the proposed research will compare (a) how strongly objective and self-reported measures of health are related to common health risks and mortality, and (b) how these relationships differ by education, age, gender, cohort, and national context.Third, the project aims to develop novel generic measures of self-reported and objective physical health. Specifically, the project will use latent variable modelling to construct an objective measure of health on the basis of information on more than 10 observer-measured health outcomes, evaluate this measure in terms of intergroup validity, and compare it with self-reported and mixed generic measures of health. Finally, the project will provide evidence on the CAD hypothesis using this novel health measure.The project will use longitudinal data from SOEP, ELSA and SHARE, providing evidence not only for the German and British context, but also for 16 European countries in direct international comparison.