What is a limitation of morbidity data obtained from surveys or insurance records?

• A. Insurance data are always representative of the entire population.
• B. They may be unrepresentative and over-represent healthier individuals.
• C. They include only mortality data.
• D. They provide precise data on health status for all conditions.

Answer: (B)

Sampling bias is a key limitation of morbidity data from surveys or insurance records. These sources only capture people who participate or who are enrolled in coverage, so they may not reflect the whole population. Surveys rely on who responds and can be affected by nonresponse or the inability of sick individuals to participate, which can lead to undercounting illness and an appearance of more healthy individuals. Insurance records include only those with coverage and who seek services, excluding uninsured groups and others who don’t access care; among insured people, healthier individuals are often overrepresented because they maintain coverage and engage with preventive services, while sicker individuals without continuous care or insurance may be missed. This lack of representativeness biases estimates of how common morbidity truly is in the population, limiting generalizability and potentially distorting public health decisions.