Inequality and Social Heterogeneity in Self-Reported Health Status in the Tunisian Population: An Analysis Using the MIMIC Model

Using a MIMIC model with structural equations and two synthetic health scores, this study attempts to explore the impact of the measurement of health status on socioeconomic inequalities in health. The results showed satisfactory internal consistency for both summary measures that are the Physical Component Summary (PCS) and the Mental Component Summary (MCS). A Physical Component Summary and Mental Component Summary calculated from the Short Form health survey (SF-12) items showed the same magnitude of health state and degree of change overtime; Cronbach’s α for PCS-12 and MCS-12 was .93 and .86, respectively. Known subgroups comparison showed that the SF-12 discriminated well between men and women and those who differed in age and educational status. In addition, results suggest the existence of reporting heterogeneity biases for a given latent health state, women and old people are more likely to report physical activity limitations; Mental health problems are over-reported by women and divorced people and under-reported by the oldest people; Clerks, farmers and retired as well as employees and homemakers in the top of the social hierarchy more often report physical activity limitations. Finally, highly educated and socially advantaged people more often report social activities limitations due to the problems of physical and mental health.