The accuracy of self-report versus objective assessment for estimating socioeconomic inequalities in disease prevalence in Indonesia

Joko Mulyanto (), Dionne S. Kringos and Anton E. Kunst
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Joko Mulyanto: Universitas Jenderal Soedirman
Dionne S. Kringos: University of Amsterdam, Amsterdam Public Health Research Institute
Anton E. Kunst: University of Amsterdam, Amsterdam Public Health Research Institute

International Journal of Public Health, 2019, vol. 64, issue 8, No 14, 1233-1241

Abstract: Abstract Objectives To estimate socioeconomic inequalities in hypertension and asthma prevalence in Indonesia, to compare estimates based on self-report (SR) to those based on objective assessment (OA), and to assess the role of sensitivity and specificity of SR. Methods We used data from the 2014 Indonesia Family Life Survey (n = 34,257). We measured inequalities in hypertension and asthma prevalence in relation to educational level and income, using standardised prevalence rate and the relative index of inequality (RII). Using OA as standard, we calculated the sensitivity and specificity of SR. Results For hypertension, reversed inequalities were found when estimated by SR instead of OA (RII for education 0.86, 95% CI 0.74–0.99 vs. RII 1.29, 95% CI 1.16–1.44). For asthma, a similar but even larger reversal of inequalities was found. The sensitivity of SR was low overall, and especially for the lowest education or income group. Conclusions Results imply that the use of SR may lead to underestimation of socioeconomic inequalities in disease prevalence in a low-income country such as Indonesia. The use of OA is recommended for monitoring inequalities in non-communicable disease prevalence.

Keywords: Socioeconomic; Inequality; Self-reported health condition; Objective assessment; Hypertension; Asthma (search for similar items in EconPapers)
Date: 2019
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DOI: 10.1007/s00038-019-01301-5

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