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on Health Economics |
| By: | Huffman, Wallace; Huffman, Sonya K.; Tegene, Abebayehu; Rickertsen, Kyrre |
| Abstract: | Health production and supply functions based on models for productive households are established. Data for 18 high income countries over 1971-2001 are used in the empirical analysis. In the health production function, mortality from cardiovascular diseases and diabetes is positively related to inputs of calories and sweeteners but not to input of fat or to national health care. In the health supply function, a high real price of food, real wage rate and non-labor income, a modest level of socialized medicine, and a low labor force participation rate decrease mortality. A cheap food policy erodes gains from reduced smoking and better treatments for high cholesterol levels and hypertension that have occurred over the last three decades. |
| Keywords: | health, household production, food prices, obesity, mortality, high income countries |
| JEL: | D1 I1 Q1 |
| Date: | 2006–11–17 |
| URL: | http://d.repec.org/n?u=RePEc:isu:genres:12699&r=hea |
| By: | David E. Bloom; David Canning; Michael Moore; Younghwan Song |
| Abstract: | We explore the proposition that expected longevity affects retirement decisions and accumulated wealth using micro data drawn from the Health and Retirement Study for the United States. We use data on a person's subjective probability of survival to age 75 as a proxy for their prospective lifespan. In order to control for the presence of measurement error and focal points in responses, as well as reverse causality, we instrument subjective survival probabilities using information on current age, or age at death, of the respondent's parents. Our estimates indicate that increased subjective probabilities of survival result in increased household wealth among couples, with no effect on the length of the working life. These findings are consistent with the view that retirement decisions are driven by institutional constraints and incentives and that a longer expected lifespan leads to increased wealth accumulation. |
| JEL: | D1 I1 J1 J22 |
| Date: | 2006–11 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:12688&r=hea |
| By: | Clive Bell (University of Heidelberg); Hans Gersbach (ETH Zurich and IZA Bonn) |
| Abstract: | What is the right balance among policy interventions in order to ensure economic growth over the long run when an epidemic causes heavy mortality among young adults? We argue that, in general, policies to combat the disease and promote education must be concentrated, in certain ways, on some subgroups of society, at first to the partial exclusion of others. This concentration involves what we term the macroeconomics of targeting. The central comparison is then between programs under which supported families enjoy the benefits of spending on health and education simultaneously (DT), and those under which the benefits in these two domains are sequenced (ST). When levels of human capital are uniformly low at the outbreak, DT is superior to ST if the subsequent mortality rate exceeds some threshold value. Outside aid makes DT more attractive; but DT restricts support to fewer families initially and so increases inequality. |
| Keywords: | epidemic diseases, HIV/AIDS, poverty traps, macroeconomics of targeting, education support, health policies, single and double targeting |
| JEL: | E62 H20 I10 I20 O11 |
| Date: | 2006–10 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp2393&r=hea |
| By: | Gerald Makepeace (Cardiff Business School and IZA Bonn); Sarmistha Pal (Brunel University) |
| Abstract: | Given the intrinsically sequential nature of child birth, timing of a child’s birth has consequences not only for itself, but also for its older and younger siblings. The paper argues that prior and posterior spacing between consecutive siblings are thus important measures of intensity of sibling competition for limited parental resources. While the available estimates of child mortality tend to ignore the endogeneity of sibling composition, we use a correlated recursive model of prior and posterior spacing and child mortality to correct it. There is evidence that uncorrected estimates underestimate the effects of prior and posterior spacing on child mortality. |
| Keywords: | sibling rivalry, birth spacing, endogeneity bias |
| JEL: | D13 I12 O15 |
| Date: | 2006–10 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp2390&r=hea |
| By: | Thomas F. Crossley; Jeremiah Hurley; Sung-Hee Jeon |
| Abstract: | This paper employs cohort analysis to examine the relative importance of different factors in explaining changes in the number of hours spent in direct patient care by Canadian general/ family practitioners (GP/FPs) over the period 1982 to 2002. Cohorts are defined by year of graduation from medical school. The results for male GP/FPs indicate that: there is little age effect on hours of direct patient care, especially among physicians aged 35 to 55; there is no strong cohort effect on hours of direct patient care; but there is a secular decline in hours of direct patient care over the period. The results for female GP/FPs indicate that: female physicians on average work fewer hours than male physicians; there is a clear age effect on hours of direct patient care; there is no strong cohort effect; there has been little secular change in average hours of direct patient care. The changing behaviour of male GP/FPs accounted for a greater proportion of the overall decline in hours of direct patient care from the 80’s through the mid 90’s than did the growing proportion of female GP/FPs in the physician stock. |
| Keywords: | physician, labour supply, hours, cohorts |
| JEL: | I11 J24 |
| Date: | 2006–09 |
| URL: | http://d.repec.org/n?u=RePEc:mcm:qseprr:410&r=hea |
| By: | Stephen A. Woodbury; James Marton |
| Abstract: | Employer-provided health benefits for workers who retire before age 65 has fallen over the last decade. We examine a cohort of male workers from the Health and Retirement Survey to explore the dynamics of retiree health benefits and the relationship between retiree health benefits and retirement behavior. A better understanding of this relationship is important to the policy debate over the best way to increase health coverage for older Americans without reducing work incentives. Concerning the dynamics at work, we find that, between 1992 and 1996, 24 percent of full-time workers who had retiree health benefits lost their coverage, while 15 percent of full-time workers who lacked coverage gained it. Also, of the full-time employed men who were covered by retiree health benefits in 1992 and had retired by 1996, 3 percent were uninsured, and 15 percent were covered by health insurance other than employer-provided insurance. On the relationship between retiree health benefits and retirement, we find that workers with retiree benefits were 29 to 55 percent more likely to retire than those without. We also find that workers who are eligible for retiree health benefits tend to take advantage of them when they are relatively young. |
| Date: | 2006–08 |
| URL: | http://d.repec.org/n?u=RePEc:lev:wrkpap:wp_470&r=hea |
| By: | Patrick Hamm; David Stuckler; Lawrence King |
| Abstract: | During the transition to capitalism, postcommunist countries have experienced unprecedented mortality crises, although there has been considerable variation within — and between — countries and regions. Much of this variation remains unexplained, although alcohol and psychological stress have been found to be major causes of declining life expectancy. We move beyond this finding by showing that the implementation of neoliberal-inspired rapid large-scale privatization programs (mass privatization) was a major determinant of the decline in life expectancy. We find that mass privatization also increased alcohol-related deaths, heart disease, and suicide rates, strong evidence that mass privatization created psychosocial stress that directly resulted in higher mortality. We also find that mass privatization modestly contributed to a decline in the number of physicians, dentists, and hospital beds per capita; however, we find only very weak evidence that this reduction in health resources directly contributed to the mortality crisis itself. By using “control function” and instrumental variable approaches to account for the potential endogeneity of mass privatization, we also demonstrate that the choice of mass privatization as a property-reform strategy was not economically determined, but was rather caused by ethnic politics and the mimicking of policies adopted by powerful neighboring countries. |
| Keywords: | postcommunist, mortality crisis, privatization, psychosocial stress |
| JEL: | I12 J18 L33 P36 |
| Date: | 2006 |
| URL: | http://d.repec.org/n?u=RePEc:uma:periwp:wp118&r=hea |
| By: | Hongbin Li; Junsen Zhang; Jie Zhang (MRG - School of Economics, The University of Queensland) |
| Abstract: | While earlier empirical studies found a negative saving effect of old-age dependency rates without considering longevity, recent studies have found that longevity has a positive effect on growth without considering old-age dependency rates. In this paper, we first justify the related yet independent roles of longevity and old-age dependency rates in determining saving and growth by using a growth model that encompasses both neoclassical and endogenous growth models as special cases. Using panel data from a recent World Bank data set, we then find that the longevity effect is positive and the dependency effect is negative in savings and investment regressions. The estimates indicate that the differences in the demographic variables across countries or over time can well explain the differences in aggregate savings rates. We also find that both population age structure and life expectancy are important contributing factors to growth. |
| URL: | http://d.repec.org/n?u=RePEc:qld:uqmrg6:11&r=hea |
| By: | Joshua S. Graff Zivin; Harsha Thirumurthy; Markus Goldstein |
| Abstract: | The provision of life-saving antiretroviral (ARV) treatment has emerged as a key component of the global response to HIV/AIDS, but very little is known about the impact of this intervention on the welfare of children in the households of treated persons. We estimate the impact of ARV treatment on children’s schooling and nutrition outcomes using longitudinal household survey data collected in collaboration with a treatment program in western Kenya. We find that children’s weekly hours of school attendance increase by over 20 percent within six months after treatment is initiated for the adult household member. For boys in treatment households, these increases closely follow their reduced market labor supply. Similarly, young children’s short-term nutritional status—as measured by their weight-for-height Z-score—also improves dramatically. We argue that these treatment effects will be considerably larger when compared to the counterfactual scenario of no ARV treatment. The results provide evidence on how intrahousehold resource allocation is altered in response to significant health improvements. Since the improvements in children’s schooling and nutrition at these critical early ages will affect their socio-economic outcomes in adulthood, the widespread provision of ARV treatment is likely to generate significant long-run macroeconomic benefits. |
| JEL: | I1 I2 O12 O15 |
| Date: | 2006–11 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:12689&r=hea |
| By: | Antony Chapoto; T.S. Jayne (Department of Agricultural Economics, Michigan State University) |
| Abstract: | This study estimates the impacts of prime-age (PA) adult morbidity and mortality on crop production and cropping patterns, household size, livestock and non-farm income in Zambia using nationally representative rural farm household longitudinal survey data. The findings provide important information to assist policy makers, donors, and development planners in designing interventions to mitigate the impacts of the AIDS on vulnerable households. |
| Keywords: | food security, food policy, Zambia, HIV/AIDS mortality |
| JEL: | Q18 |
| Date: | 2005 |
| URL: | http://d.repec.org/n?u=RePEc:msu:icpbrf:zm-fsrp-pb-012&r=hea |
| By: | Antony Chapoto; T.S. Jayne (Department of Agricultural Economics, Michigan State University) |
| Abstract: | Using comprehensive rural farm household longitudinal data from Zambia, this paper measures the impacts of prime-age (PA) adult morbidity and mortality on crop production and cropping patterns, household size, livestock and non-farm income. The paper adopts and extends the counterfactual (difference-in-difference) approach by controlling for initial (pre-death) household conditions that may influence the severity of the impacts of adult mortality. In particular, the study controls for initial poverty status, landholding size, effective dependency ratios, and the gender and position of the deceased person. Moreover, the possibility that PA death in the household is endogenous is taken into account by conceptualizing the measurement of effects of prime-age adult death on rural agricultural households’ welfare as a two stage process: first, by examining the characteristics of afflicted households; and second, conditional on being afflicted, determining the effects of morbidity and mortality on indicators of household welfare both prior to and after mortality. The findings from this study provide important information that may assist governments, donors, and development planners in developing specific policies or interventions to mitigate the impacts of the disease on vulnerable households. |
| Keywords: | food security, food policy, HIV/AIDS, prime-age mortality, endogeneity, rural livelihoods |
| JEL: | Q18 |
| Date: | 2005 |
| URL: | http://d.repec.org/n?u=RePEc:msu:icpwrk:zm-fsrp-wp-015&r=hea |
| By: | Antony Chapoto; T.S. Jayne (Department of Agricultural Economics, Michigan State University) |
| Abstract: | Studies conducted in Sub-Saharan Africa during the 1980s generally found a positive correlation between socioeconomic characteristics such as education, income, and wealth and subsequent contraction of HIV. However, as the disease has progressed, the relationship between socioeconomic status and HIV contraction may have changed in many areas of Sub Saharan Africa, although there is little hard evidence to support this. This paper seeks to determine the ex ante socioeconomic characteristics of individuals who die between the ages of 15 to 59 years of age, using nationally representative panel data on 18,821 individuals surveyed in 2001 and 2004 in rural Zambia. The findings from this study will help policy-makers and development agencies better understand current transmission pathways of HIV/AIDS, which should help in the formulation of AIDS prevention and mitigation strategies. |
| Keywords: | food security, food policy, HIV/AIDS, socioeconomic status, Zambia |
| JEL: | Q18 |
| Date: | 2005 |
| URL: | http://d.repec.org/n?u=RePEc:msu:icpwrk:zm-fsrp-wp-014&r=hea |
| By: | Antony Chapoto; T.S. Jayne (Department of Agricultural Economics, Michigan State University) |
| Abstract: | This study is designed to help policy-makers and development agencies in the formulation of AIDS prevention and mitigation strategies. The study determines the ex ante socioeconomic characteristics of individuals who die between the ages of 15 to 59 years of age (hereafter called “prime age” mortality), using nationally representative panel data of individuals surveyed in rural Zambia between 2001 and 2004. |
| Keywords: | food security, food policy, Zambia, prime-age mortality, HIV/AIDS |
| JEL: | Q18 |
| Date: | 2005 |
| URL: | http://d.repec.org/n?u=RePEc:msu:icpbrf:zm-fsrp-pb-010&r=hea |
| By: | John Maluccio; John Hoddinott, International Food Policy Research Institute; Jere R. Behrman, University of Pennsylvania; Reynaldo Martorell, Emory University; Agnes R. Quisumbing, International Food Policy Research Institute; Aryeh D. Stein, Emory University |
| Abstract: | Early childhood nutrition is thought to have important effects on education, broadly defined to include various forms of learning. We advance beyond previous literature on the effect of early childhood nutrition on education in developing countries by using unique longitudinal data begun during a nutritional experiment during early childhood with educational outcomes measured in adulthood. Estimating an intent-to-treat model capturing the effect of exposure to the intervention from birth to 36 months, our results indicate significantly positive, and fairly substantial, effects of the randomized nutrition intervention a quarter century after it ended: increased grade attainment by women (1.2 grades) via increased likelihood of completing primary school and some secondary school; speedier grade progression by women; a one-quarter SD increase in a test of reading comprehension with positive effects found for both women and men; and a one-quarter SD increase on nonverbal cognitive tests scores. There is little evidence of heterogeneous impacts with the exception being that exposure to the intervention had a larger effect on grade attainment and reading comprehension scores for females in wealthier households. The findings are robust to an array of alternative estimators of the standard errors and controls for sample attrition |
| Date: | 2006 |
| URL: | http://d.repec.org/n?u=RePEc:mdl:mdlpap:0614&r=hea |