Cognitive Aspects of Health Survey Methodology: An Overview

Abstract

The past 25 years have seen the development of a wide variety of sample surveys dealing with the nature and distribution of illness and disability, and with the utilization of health care services. The sample survey is currently the most widespread and influential instrument for judging the health status of the nation and for guiding health policy. The knowledge, beliefs, and attitudes of survey respondents "subjectively" affect what the survey seeks to "objectively" measure. Even as statistical sampling has been refined, so is it important to reexamine what the cognitive sciences have to offer for survey interview structure and content.

Ageing and the relationship between functional status and self-rated health in elderly men

“…When the functional status deteriorates people might adapt to this with changing their expectations and norms (Idler, 1993). Another mechanism is comparison process: respondents might compare their current health with their health at previous times (Fienberg et al, 1985;Suls et al, 1991). Our finding that recent changes in disability level did not contribute to health ratings might be owing to the fact that the period between two measurements was too long to find an effect of change on self-ratings of health.…”

“…Box I, 3720 BA, Bilthoven, The Netherhmds. rated health is a more subjective health indicator, specifying one's perception and evaluation of one's own health, based on an interpretation of the objective physical and mental health status, and on expectations and comparisons (Cockerham et al, 1983: Fienberg et al, 1985Suls et al, 1991: Idler, 1993~ Krause and Jay, 1994. Functional status might be an important determinant of self-rated health.…”

“…The oldest old might be less inclined to base a judgement of their health on their physical functioning. When their functioning deteriorates, they might accept this as a phenomenon of ageing, and less as a phenomenon of deteriorating health (Fienberg et al, 1985;Idler, 1993;Koval and Dobie, 1996). Furthermore, older persons might base their health ratings more on attitudes or actual behaviours instead of on physical or functional aspects only (Borawski et al, 1996).…”

“…The impact of change in functional status on selfrated health might also be viewed in the light of the "comparison process". When people are asked to rate their health they often compare this with the health of (stereotype) others of the same age, or to their past health (Fienberg et al, 1985;Suls et al, 1991). When people rate their health on the basis of their past health, they will rate their health lower if their health status has changed over the last period.…”

The effects of race/ethnicity and income on early childhood asthma prevalence and health care use

“…Other studies are based on clinical samples that are not representative of all children at risk. 15 We used individual-level data from a population-based, nationally representative sample of children to study relations among poverty, race/ethnicity, and asthma prevalence and rates of hospitalization and emergency room use for asthma. Income was measured over the child's lifetime to identify more closely the groups at greatest risk.…”