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Evaluating inconsistency in health responses: evidence from elderly in India

Dona Ghosh (Department of Economics, Thiagarajar School of Management, Madurai, India)

Working with Older People

ISSN: 1366-3666

Article publication date: 25 March 2022

Issue publication date: 28 November 2022




This paper explored the reliability of self-reported health and the impact of the social position in determining the inconsistent health response (IHR), in late life. Reliability of self-reported health is important to evaluate, as it is the primary step for asking health-care facility. As self-reported health is a subjective measure, elderly people might have a tendency of under-reporting the health problem because of lower socioeconomic status. This incidence can cause inaccurate estimate of the health problem of the aged at the time of formulating health policy or providing health-care infrastructure. Therefore, the purpose of this study is to explore the sources of inconsistent responses of self-reported health by comparing it with the existence of chronicle ailment and to identify the vulnerable group that health care supports.


The study uses nationally representative unit-level data from the National Sample Survey of India. Using the bi-variate probit model, joint estimation of reported health and IHRs is determined. The study compares perceived and actual health status and explores how individual characteristics and socioeconomic position contributes to IHRs among the elderly population.


Major findings of this study are as follows: firstly, self-reported health has little reliability, as it is compared with the existence of chronicle ailment. Older people in the rural areas have greater tendency to under-estimate the health problem, whereas urban elders tend to over-estimate it; and secondly, the inconsistency in health response is significantly associated with social caste, economic status and attainment of education.

Social implications

The results of this study from bivariate probit model offer deeper understandings about the reliability of self-reported health and provide further insights to improve policy design formulated to mitigate the health inequality among the elders. This study might be helpful to design an inexpensive and easily available health measure, which is very important for a highly populated aging country with limited health-care resources.


To the best of author’s knowledge, it is the first study that has identified the sources of inconsistent health and direction of inconsistency that is where self-reported health over- or under-estimates the actual health response among the elderly in a developing country like India, where the growth rate of population aging is faster than the world.



The author is thankful to the ICSSR Data Service for the second dataset that is used in the article. The author is also thankful to the unknown reviewers who had given valuable comments for the improvement of the research paper.


Ghosh, D. (2022), "Evaluating inconsistency in health responses: evidence from elderly in India", Working with Older People, Vol. 26 No. 4, pp. 258-274.



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