(In)Consistency of responses to self-assessed health measures and implications for biosocial research

社会经济状况与健康之间的相互作用对个人生活和社会的人力资本投资至关重要。然而，现有的许多研究都是使用主观的、自我报告的健康代理人进行的，这可能会带来重大的偏见。大型社会科学调查的最新进展涉及收集从生物样本得出的物理测量和标记，以及传统的自我报告健康评估。在这个项目中，我们专注于最流行的自我报告的健康措施，自我评估的健康（SAH）。我们利用ESRC资助的国家小组，了解社会：英国家庭纵向研究（UKHLS）的一个显着特点，SAH纵向信息收集两次波内每个受访者，在很短的时间内采取不同的调查模式（开放式访谈与自我完成）。约25%的受访者在同一波内改变了他们的反应，约25%的人在UKHLS波2报告不一致，也在UKHLS波5报告SAH不一致。利用这一特点的调查的设计，沿着的可用性，客观测量的生物标志物数据和一套丰富的纵向社会经济数据的所有成年家庭成员，我们的目标是作出一些独特的贡献，社会科学研究的健康，健康和卫生政策的调查测量。拟议的项目侧重于报告SAH中的不一致性以及对社会科学研究和决策的潜在影响。尽管SAH是经济学、社会学、社会流行病学、医学研究和临床试验中最常用的健康指标之一，但与使用SAH作为健康指标相比，评估SAH问题反应一致性的研究很少。我们预计，我们的项目将说明能力建设和生物社会数据源的进一步发展的重要性。具体来说，在这个项目中，我们将解决的SAH反应的一致性的研究问题，表征那些更有可能提供不一致的SAH报告的人口和社会经济概况，以及在现场工作（采访）阶段的微观社会环境的作用，影响个人对SAH问题的反应。我们还将解决报告不一致的影响，在SAH现有的研究，社会经济不平等的健康，以及对人们的就业结果（如失业，工资和退休的决定）的健康状况不佳的后果。科学合理、基于证据的社会和卫生政策的一个先决条件是有可靠和公正的研究证据。与研究界的传播和沟通将通过会议演讲，研讨会和同行评审期刊上的四份出版物来吸引人们对我们研究成果的关注。我们将在特定学科和多学科期刊上很好地展示我们的研究结果。我们还将与政策制定者和第三方组织合作，传播和加强对我们分析的政策影响的参与，以及使用更客观测量的健康代理进行稳健健康测量的价值。

The interplay between socio-economic circumstances and health is of major importance for individuals' lives and the human capital investment of the society. However, much of the existing research is conducted using subjective, self-reported proxies of health, which may impose significant biases. Recent advances in the large social-science surveys involve the collection of physical measurements and markers derived from biological samples, in addition to the conventional self-reported health assessments. In this project, we focus on the most popular self-reported health measures, self-assessed health (SAH). We exploit a distinctive feature of the ESRC funded national panel, Understanding Society: the UK Household Longitudinal Study (UKHLS), with longitudinal information on SAH collected twice for each respondent within waves, with different survey modes (open interview versus self-completion) taken within a short space of time. About 25% of respondents changed their responses within the same wave, with about 25% of those with inconsistent reports at UKHLS wave 2 also reporting SAH inconsistently at UKHLS wave 5. Capitalising on this feature of the survey's design along with the availability of objectively measured biomarker data and a rich set of longitudinal socio-economic data for all adult household members we are aiming to make a number of distinct contributions to social science research on health, survey measurement of health and health policy. The proposed project focuses on reporting inconsistencies in SAH and the potential implications for the social science research and policymaking. Although SAH is one of the most popular health measures used in economics, sociology, social epidemiology, medical research and as instrument in clinical trials, research on assessing the consistency of responses to SAH questions is sparse compared to that using SAH as a measure of health. We anticipate that our project will illustrate the importance of capacity building and further development for biosocial data sources. Specifically, in this project we will address research questions on the consistency of the SAH responses, characterising the demographic and socio-economic profile of those who are more likely to provide inconsistent SAH reports as well as the role of the micro-social environment at the fieldwork (interview) stage in affecting individual responses to SAH questions. We will also address the implications of reporting inconsistency in SAH for existing research on socio-economic inequalities in health as well as on the ramifications of ill health for people's employment outcomes (such as unemployment, wages and retirement decisions). A prerequisite for scientifically-sound, evidence-based social and health policy is the availability of robust and unbiased research evidence. Dissemination and communication with the research community will operate through conference presentations, symposia and four publications in peer-reviewed journals to draw attention to our research findings. We will achieve a good representation of our findings in discipline-specific and multidisciplinary journals. We will also work with policymakers and third-party organisations to disseminate and enhance engagement to the policy implications of our analysis and the value of robust health measurement using more objectively measured health proxies.