Age differences in self-assessed health in Russia

Abstract

Empirical literature demonstrates the existence of age differences in self-assessed health (SAH), which are manifested in an increase in SAH for the elderly or as a slowdown in the decline in SAH and health-related quality of life indicators. The paper studies phenomenon of age differences in SAH through description, analysis and econometric modeling of the influence of psychological, socio-economic characteristics and health-related determinants of health on SAH and health-related quality of life (HRQoL) for different ages. Based on RLMS survey, the average probabilities of SAH were studied in the generalized order probit model with random effects, considering an objective disease index as a proxy for true health. We observe increase in the average probability of choosing bad SAH category for men (90–94 years) and women (95–104 years) and a simultaneous increase in the average probability of choosing good SAH. In old and old-old ages SAH is polarized: respondents tend to rate their health as either bad or good avoiding in their assessment an average category. The age differences in SAH indicates that individuals tend to adapt to lower objective true health, linking health in old and old-old ages not only with presence or absence of chronic illnesses, but also with psychological factors such as optimism and positive attitude towards life. This is important for understanding the concept of aging in health economics and for introducing HTA in health care. HTA uses indicators of self-assessed health and HRQoL when deciding on different ways of treatment. Due to the innovative approach, this study is of a great value to health economics research.