Subjective Perspectives (f)or Objective Truths? Quantifying the Impact of Health Changes on Individuals and Families using Survey Data

Research output: Types of ThesisDoctoral ThesisInternal

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This dissertation explores the complex relationship between declining health and its implications for those who experience it directly, their families, and society more broadly. Through the lens of large-scale observational survey data and subjective outcome measures such as life satisfaction or self-perceived health, it aims to quantify the multi-dimensional impact of declining health. The dissertation is structured around three topics: The first topic, “Valuing Health Changes using Survey Data”, investigates how subjective well-being measures, like life satisfaction, can inform health economic evaluations and health policy through empirically estimated monetary equivalent values of health changes. The second topic, “The Impact of Health Changes on Perceptions and Behaviours”, focuses on the stability and comparability of self-reported outcomes over time, particularly in the context of long-term disability and the onset of health shocks. It explores how individuals adapt to disability and examines the causal relationship between health shocks and subsequent changes in health perceptions and behaviours. The third topic, “Spillover Effects of Declining Health”, considers the implications of health changes on immediate family members who do not experience these changes themselves. It investigates the impact of health events on the health perceptions and behaviours of spouses and the potential health consequences of informal caregiving for the mental and physical health of caregivers themselves. The chapters of this dissertation emphasize the value of using survey-based subjective outcome measures as a tool for quantifying the multi-dimensional impacts of declining health over the life-course but also highlight the distinct methodological challenges such measures can pose. Survey-based subjective outcome measures contribute to estimating the monetary value of health changes, revealing adaptive processes over time, shedding light on individual-level decision-making in response to health events, and highlighting the often-overlooked spillover effects on the physical and mental well-being of family caregivers. The findings offer valuable insights for health policymakers and researchers striving to better understand the consequences of deteriorating health through the lens of observational survey data.
Original languageEnglish
Awarding Institution
  • Erasmus University Rotterdam
  • van Exel, Job, Supervisor
  • Brouwer, Werner, Supervisor
  • Grob, Esther, Supervisor
Award date19 Jan 2024
Place of PublicationRotterdam
Print ISBNs978-94-6483-647-9
Publication statusPublished - 19 Jan 2024


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