O'Doherty M G, French D, Steptoe A, Kee F
UKCRC Centre of Excellence for Public Health for Northern Ireland, Queens University Belfast, Belfast, Northern Ireland BT12 6BA, UK.
Queen's University Management School, Queens University Belfast, Belfast, Northern Ireland, BT9 5EE, UK.
Soc Sci Med. 2017 Apr;179:191-200. doi: 10.1016/j.socscimed.2017.03.006. Epub 2017 Mar 6.
Self-rated health (SRH) is commonly assessed in large surveys, though responses can be influenced by different individuals' perceptions of and beliefs about health. Therefore, instead of providing evidence of 'true' health disparities across groups, findings may actually reflect reporting heterogeneity. Using data from participants aged 50 years and older from the English Longitudinal Study of Ageing (ELSA) Wave 3 (2006/07; participation rate = 73%), associations between three dimensions of social capital (local area & trust, social support and social networks), deprivation and SRH were examined using the vignette methodology in 2341 individuals who completed both the self-report and at least one of the 18 vignettes. Analysis employed a hierarchical probit model (HOPIT). Individuals expressing low local area & trust social capital (beta = -0.276, p < 0.001) and those with poor social networks (beta = -0.280, p < 0.001) were more likely to report poor SRH in HOPIT models accounting for reporting heterogeneity, but unadjusted ordered probit analyses still correctly show a negative relationship between low local area & trust social capital (beta = -0.243, p < 0.001) and those with poor social networks (beta = -0.210, p < 0.01), though they somewhat tend to underestimate its strength. Neither social support nor deprivation appeared to have any effect on SRH regardless of reporting heterogeneity. Anchoring vignettes offer a relatively uncomplicated and cost-effective way of identifying and correcting for reporting heterogeneity to improve comparative validity of self-report measures of health. This analysis underlines the need for caution when using unadjusted self-reported measures to study the effects of social capital on health.
在大型调查中，自评健康状况（SRH）是一项常用的评估指标，不过不同个体对健康的认知和信念可能会影响其回答。因此，研究结果可能实际上反映的是报告的异质性，而非不同群体间“真正的”健康差异。利用英国老龄化纵向研究（ELSA）第3轮（2006/07年；参与率=73%）中50岁及以上参与者的数据，采用 vignette 方法，对2341名既完成了自我报告又完成了18个 vignette 中至少一个的个体进行分析，研究社会资本的三个维度（社区与信任、社会支持和社会网络）、贫困与 SRH 之间的关联。分析采用分层概率模型（HOPIT）。在考虑报告异质性的 HOPIT 模型中，社区与信任社会资本水平较低的个体（β=-0.276，p<0.001）以及社会网络较差的个体（β=-0.280，p<0.001）更有可能报告较差的 SRH，但未调整的有序概率分析仍正确显示，社区与信任社会资本水平较低（β=-0.243，p<0.001）以及社会网络较差的个体（β=-0.210，p<0.01）之间存在负相关，尽管它们在一定程度上往往会低估这种关联的强度。无论报告异质性如何，社会支持和贫困似乎都对 SRH 没有任何影响。Anchoring vignettes 提供了一种相对简单且经济高效地识别和校正报告异质性的方法，以提高健康自我报告指标的比较效度。该分析强调了在使用未调整的自我报告指标研究社会资本对健康的影响时需谨慎。
