Comparing subjective and objective measures of health: Evidence from hypertension for the income/health gradient

J Health Econ. 2009 May;28(3):540-52. doi: 10.1016/j.jhealeco.2009.02.010. Epub 2009 Apr 5.


Economists rely heavily on self-reported measures of health to examine the relationship between income and health. We directly compare survey responses of a self-reported measure of health that is commonly used in nationally representative surveys with objective measures of the same health condition. We focus on hypertension. We find no evidence of an income/health gradient using self-reported hypertension but a sizeable gradient when using objectively measured hypertension. We also find that the probability of false negative reporting is significantly income graded. Our results suggest that using commonly available self-reported chronic health measures might underestimate true income-related inequalities in health.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bias
  • England / epidemiology
  • Female
  • Health Status*
  • Health Surveys
  • Humans
  • Hypertension / economics
  • Hypertension / epidemiology*
  • Interviews as Topic
  • Male
  • Middle Aged
  • Self Disclosure*
  • Social Class*