Recall Bias in Self‐reported Childhood Health: Differences by Age and Educational Level

Abstract

This study examines the impact of recall bias on self-reported childhood health. In a population of people aged from 25 to 74 years , childhood health was assessed retrospectively to explore its influence on socio-economic inequalities in adult health. Data were obtained from a postal survey in the baseline of a prospective cohort-study (the Longitudinal Study on Socio-Economic Health Differences in The Netherlands). Childhood health was measured as self-reported periods of severe disease in childhood. Relationships between childhood health on the one hand and adult educational level on the other were analysed using logistic regression models. A negative association between childhood health problems and adult educational level was found in the youngest age group (25-34 years). In the older age groups, however, a lower adult socio-economic status was not clearly associated with more health problems in childhood. In view of what we know about socio-economic inequalities in childhood health in the past, it is likely that the lack of association between educational level and childhood health in the older age groups is (partly) caused by a recall bias. Using simple questions on self-reported childhood health problems, the measurement of childhood health in older age groups will be biased by differential recall between socioeconomic groups. Other possibilities in the use of retrospective data in studying childhood health problems should be explored.

Why Do Older People Change Their Ratings of Childhood Health?

“…Drawing from the extant literature, we examined several reasons why persons might change their childhood health rating, falling into three themes: demographic and socioeconomic background, early-life events, and later-life events. Beginning with demographic and socioeconomic background, and consistent with prior research, we found that maintaining the same rating was more likely for women and those higher on socioeconomic status (Matthews and MacLeod 2005; Van de Mheen et al 1998; Zajacova and Dowd 2011). …”

“…Persons who experienced relatively little decline in memory and who had higher overall memory were more likely to maintain the same rating of their childhood health—a finding consistent with prior studies (Haas 2007; Van de Mheen et al 1998). Those who experienced the steepest declines in memory between survey waves altered their childhood health rating, either positively or negatively.…”

“…Although past studies have argued for the validity and reliability of retrospective ratings of childhood health (Haas 2007; Smith 2009), others have questioned these ratings on the basis of bias resulting from nonrandom error (Crossley and Kennedy 2002; Van de Mheen et al 1998; Zajacova and Dowd 2011). Our results demonstrated that there is indeed nonrandom error, particularly when examining changes in those ratings over a long time window.…”

“…To account for cognitive declines, previous research has shown that the reliability and frequency of reporting childhood disease decline with age (Haas 2007; Van de Mheen et al 1998). Unlike previous research, we examine memory as a key component of cognitive ability.…”

“…Some studies have found that the reliability of retrospective self-rated health measures is lower among nonwhites, men, and those with lower socioeconomic status (SES) (Van de Mheen et al 1998; Zajacova and Dowd 2011). On the other hand, one study found that although reliability varied by race and SES, there were no significant differences by sex (Haas 2007).…”