• Jose R Rubio-Valverde, Wilma J Nusselder, and Johan P Mackenbach.
• Department of Public Health, Erasmus Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, Netherlands. j.rubiovalverde@erasmusmc.nl.
• Int J Public Health. 2019 Apr 1; 64 (3): 461-474.

ObjectivesTo assess the sensitivity of prevalence and inequality estimates of Global Activity Limitation Indicator (GALI) to the choice of survey in European countries.MethodsWe use logistic regression to estimate adjusted risk ratios, quantifying differences in prevalence and educational inequalities, the impact of survey characteristics and Kendall's tau to assess similarity in country rankings between surveys. We include the European Health Interview Survey (EHIS), European Social Survey (ESS) and European Union Statistics on Income and Living Conditions (EU-SILC).ResultsEHIS estimates higher prevalence than EU-SILC 17% (men) and 23% (women), and ESS 24% (men) and 29% (women). Prevalence does not differ significantly between EU-SILC and ESS. EU-SILC estimates 52.5% (men) and 28.1% (women) higher inequalities than EHIS and 63.2% (men) and 32.7% (women) higher inequalities than ESS. Survey characteristics do not account for differences in prevalence or inequalities. Country rankings do not agree for prevalence or inequalities.ConclusionsSurvey choice strongly impacts estimates of GALI prevalence and educational inequalities. Further study is necessary to understand these discrepancies. Caution is required when using these surveys for cross-country comparisons of (educational inequalities in) GALI disability.

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