I feel good! Gender differences and reporting heterogeneity in self-assessed health

For empirical analysis and policy-oriented recommendations, the precise measurement of individual health or well-being is essential. The difficulty is that the answer may depend on individual reporting behaviour. Moreover, if an individual's health perception varies with certain attitudes of the respondent, reporting heterogeneity may lead to index or cut-point shifts of the health distribution, causing estimation problems. An index shift is a parallel shift in the thresholds of the underlying distribution of health categories. In contrast, a cut-point shift means that the relative position of the thresholds changes, implying different response behaviour. Our paper aims to detect how socioeconomic determinants and health experiences influence the individual valuation of health. We analyse the reporting behaviour of individuals on their self-assessed health status, a five-point categorical variable. Using German panel data, we control for observed heterogeneity in the categorical health variable as well as unobserved individual heterogeneity in the panel estimation. In the empirical analysis, we find strong evidence for cut-point shifts. Our estimation results show different impacts of socioeconomic and health-related variables on the five categories of self-assessed health. Moreover, the answering behaviour varies between female and male respondents, pointing to gender-specific perception and assessment of health. Hence, in case of reporting heterogeneity, using self-assessed measures in empirical studies may be misleading and the information needs to be handled with care.