OBJECTIVES: Many studies of socio-economic inequalities in the prevalence
of chronic conditions rely on self-reports. For chronic nonspecific lung
disease, heart disease, and diabetes mellitus, we studied the effects of
misreporting on variations in prevalence rates by respondents' level of
education. METHODS: In 1991, a health interview survey was conducted in
the southeastern Netherlands with 2867 respondents. Respondents' answers
were compared with validated diagnostic questionnaires in the same survey
and the diagnoses given by the respondents' general practitioners.
RESULTS: Misreporting of chronic lung disease, heart disease, and diabetes
may be extensive. Depending on the condition and the reference data used,
the confirmation fractions ranged between .61 and .96 and the detection
fractions between .13 and .93. Misreporting varied by level of education,
and although various patterns were observed, the dominant pattern was that
of more underreporting among less educated persons. The effects on
prevalence rates were to underestimate differences by level of education
to a sometimes considerable degree. CONCLUSIONS: Misreporting of chronic
conditions differs by respondents' level of education. Health interview
survey data underestimate socioeconomic inequalities in the prevalence of
chronic conditions
