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IZA Discussion Paper No. 1286
September 2004
Cut-Point Shift and Index Shift in Self-Reported Health

published in: Journal of Health Economics, 2004, 23 (6), 1083-1099

There is a concern that ordered responses on health questions may differ across populations or even across subgroups of a population. This reporting heterogeneity may invalidate group comparisons and measures of health inequality. This paper proposes a test for differential reporting in ordered response models which allows us to distinguish between cut-point shift and index shift. The method is illustrated using Canadian National Population Health Survey data. The McMaster Health Utility Index (HUI) is used as a more objective health measure than the simple 5-point scale of self-assessed health. We find clear evidence of index shifting and cut-point shifting for age and gender, but not for income, education or language.

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Mark Fallak
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Olga Nottmeyer
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+352 585-855-501
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Christina Gathmann
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