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

社会经济环境和健康之间的相互作用对个人的生活和社会的人力资本投资具有重大意义。然而，现有的许多研究都是使用主观的、自我报告的健康指标进行的，这可能会造成重大偏见。除了常规的自我报告健康评估外，大型社会科学调查的最新进展还涉及收集来自生物样本的身体测量和标记。在这个项目中，我们重点关注最流行的自我报告健康衡量标准--自我评估健康(SAH)。我们利用了ESRC资助的国家小组-理解社会：英国家庭纵向研究(UKHLS)的一个独特功能，在WAVE中为每个受访者收集了两次关于SAH的纵向信息，并在短时间内采取了不同的调查模式(公开访谈和自我完成)。大约25%的受访者在同一波中改变了他们的反应，在UKHLS第二波报告不一致的人中，约25%的人在UKHLS波5也报告了不一致的SAH。利用调查设计的这一特点，以及所有成年家庭成员可获得的客观测量的生物标记物数据和丰富的纵向社会经济数据，我们的目标是为关于健康的社会科学研究、健康调查测量和健康政策做出一些独特的贡献。拟议的项目侧重于报告SAH中的不一致之处以及对社会科学研究和政策制定的潜在影响。虽然SAH是经济学、社会学、社会流行病学、医学研究中最常用的健康指标之一，也是临床试验中的工具，但与使用SAH作为健康衡量标准相比，评估SAH问题回答的一致性的研究很少。我们预计，我们的项目将说明生物社会数据源能力建设和进一步发展的重要性。具体地说，在这个项目中，我们将解决关于SAH反应一致性的研究问题，表征那些更有可能提供不一致的SAH报告的人的人口和社会经济概况，以及实地工作(访谈)阶段微社会环境在影响个人对SAH问题的反应方面的作用。我们还将讨论SAH中报告的不一致对现有研究的影响，这些研究涉及健康方面的社会经济不平等，以及健康不良对人们就业结果(如失业、工资和退休决定)的影响。科学合理、以证据为基础的社会和卫生政策的一个先决条件是获得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报告、座谈会和同行评议期刊上的四份出版物来进行，以提请注意我们的研究成果。我们将在学科特定的和多学科的期刊上很好地展示我们的发现。我们还将与政策制定者和第三方组织合作，传播和加强对我们的分析的政策影响的参与，以及使用更客观地衡量健康指标的稳健健康衡量的价值。

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.