Estimation of Health Status Inequalities from Prevalence Data: A Risky Business

Palloni, Alberto, and Jason R. Thomas
Working paper no. 2011-09


Assessing the impact that socioeconomic determinants have on the prevalence of certain chronic conditions reported by respondents in population surveys must confront two problems. The first is that the self-reports could be in error (false positives and false negatives). The second is that those reporting are a selected sample of those who ever experience the problem, the selection being heavily influenced by excess mortality due to the condition being reported. In this paper, we use a combination of empirical data and microsimulation to (a) assess the magnitude of the biases due to the selection problem, and (b) suggest adjustment procedures that correct for biases.