Feeling Sick or Being Sick: The Predictive Structure of Later-Life Health
Published:
Abstract
Social science research relies extensively on subjective assessments of health and increasingly on objective indicators, yet whether these measures capture interchangeable or distinct dimensions of health over time remains unclear. Using Health and Retirement Study (HRS), I compare held-out predictions from models incorporating subjective and objective health histories and their discrepancies. Results reveal strong domain-specific continuity: subjective histories substantially outperform objective histories in predicting subsequent subjective health, whereas objective histories better predict subsequent objective health burden. Adding the alternate domain yields negligible predictive improvement. Subjective–objective discrepancies differentiate subsequent health risk but add little predictive information once both histories are modelled. Despite pronounced educational gradients in subsequent health, predictive performance remains broadly stable across educational groups, suggesting that educational heterogeneity in health reporting does not translate into corresponding differences in predictive validity. Overall, subjective and objective health capture distinct but complementary dimensions of later-life health, underscoring the importance of preserving rather than collapsing these measures.
Recommended citation: Wang, W.J. (2026). Feeling sick or being sick: The predictive structure of later-life health. Working paper.