DIFFERENCES IN THE MISREPORTING OF CHRONIC CONDITIONS, BY LEVEL OF EDUCATION - THE EFFECT ON INEQUALITIES IN PREVALENCE RATES

Objectives. Many studies of socioeconomic inequalities in the prevalen ce of chronic conditions rely on self-reports. For chronic nonspecific lung disease, heart disease, and diabetes mellitus, we studied the ef fects 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. Respo ndents' answers were compared with validated diagnostic questionnaires in the same survey and the diagnoses given by the respondents' genera l 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 .6 1 and .96 and the detection fractions between .13 and .93. Misreportin g varied by level of education, and although various patterns were obs erved, the dominant pattern was that of more underreporting among less educated persons. The effects on prevalence rates were to underestima te differences by level of education to a sometimes considerable degre e. Conclusions. Misreporting of chronic conditions differs by responde nts' level of education. Health interview survey data underestimate so cioeconomic inequalities in the prevalence of chronic conditions.