nep-hea New Economics Papers
on Health Economics
Issue of 2007‒01‒02
eight papers chosen by
Yong Yin
SUNY at Buffalo, USA

  1. Modern Health Standards for Peoples of the Past: Biological Conditions by Race in the American South, 1873 – 1919 By Scott A. Carson
  2. Mortality Risks, Education and Child Labour By Baland, Jean-Marie; Estevan, Fernanda
  3. Mortality, mass-layoffs, and career outcomes: an analysis using administrative data By Daniel G. Sullivan; Till von Wachter
  4. How did schooling laws improve long-term health and lower mortality? By Douglas Almond; Bhashkar Mazumder
  5. Health Insurance for the poor in India: An analytical study By Rajeev Ahuja
  6. Relative Efficiency of Health Provision: a DEA Approach with Non-discretionary Inputs By António Afonso; Miguel St. Aubyn
  7. Persistence in Infant Mortality: Evidence for the Indian States By Wiji Arulampalam; Sonia Bhalotra
  8. Poverty, Undernutrition, and Child Mortality: Some Inter-Regional Puzzles and their Implications for Research and Policy By Stephan Klasen

  1. By: Scott A. Carson
    Abstract: Recent modern life expectancy improvements rely heavily on medical intervention; however, before the mid-20th century, increased longevity was primarily the result of improved nutrition and less virulent disease environments. Moreover, 19th century health conditions varied by race, especially in the American South. The body mass index (BMI) reflects health conditions, and male BMIs in Texas State Prison reflected diseases associated with low BMI diseases, i.e., respiratory and infectious diseases, and tuberculosis. When able to work, Southern African-Americans in the 19th century acquired heavier BMIs during prime working ages; however, when they were no longer productive and exited the labor force, their BMIs declined, and older black males became more vulnerable to low BMI diseases.
    JEL: I10 I32 J15 N11 N30 N37
    Date: 2006
  2. By: Baland, Jean-Marie; Estevan, Fernanda
    Abstract: In this paper, we investigate the role of young adult mortality on child labour and educational decisions. We argue that mortality risks are a major source of risks in returns to education in developing countries. We show that, in the absence of appropriate insurance mechanisms, the level of child labour is inefficient, but it can be too high or too low. It is too high when parents are not very altruistic or anticipate positive transfers from their children in the future. Uncertain returns to education, endogenous mortality or imperfect capital markets unambiguously increase child labour. When the level of child labour is inefficiently high, we also show that a cash transfer conditional on child's schooling can always restore efficiency regarding child labour.
    Keywords: child labour; conditional cash transfers; education; mortality risks; old-age security motive
    JEL: D13 D81 H31 I00 O12
    Date: 2006–12
  3. By: Daniel G. Sullivan; Till von Wachter
    Abstract: Seemingly short-term labor market shocks, such as job displacements, can have persistent effects on workers’ earnings, employment, job stability, consumption, and access to health insurance. A long literature suggests such changes in workers’ socioeconomic conditions can have potentially important effects on health outcomes, but existing studies associating job loss to health status face several problems of measurement and identification. This paper uses a large longitudinal administrative data set of quarterly earnings and employer records matched to information on individual mortality outcomes to estimate the long-term effect of a job loss during a mass layoff on mortality. We find that a job loss leads to a 15-20% increase in the probability of dying in the 20 years following a job loss. The initial and the long-run responses are particular pronounced. To examine the channels of the mass layoff effect, we exploit the panel nature of our data – covering over 15 years of earnings – to analyze the correlation of long-run career conditions, such as the average and the variance of earnings, with mortality, something not possible with typical data sets. A lasting decrease in earnings and a rise in earnings instability due to mass layoffs have the potential to explain a significant fraction of the effect of a job loss on mortality.
    Date: 2006
  4. By: Douglas Almond; Bhashkar Mazumder
    Abstract: Although it is well known that there is a strong association between education and health much less is known about how these factors are connected, and whether the relationship is causal. Lleras-Muney (2005) provides perhaps the strongest evidence that education has a causal effect on health. Using state compulsory school laws as instruments, Lleras-Muney finds large effects of education on mortality. We revisit these results, noting they are not robust to state time trends, even when the sample is vastly expanded and a coding error rectified. We employ a dataset containing a broad array of health outcomes and find that when using the same instruments, the pattern of effects for specific health conditions appears to depart markedly from prominent theories of how education should affect health. We also find suggestive evidence that vaccination against smallpox for school age children may account for some of the improvement in health and its association with education. This raises concerns about using compulsory schooling laws to identify the causal effects of education on health.
    Date: 2006
  5. By: Rajeev Ahuja (Indian Council for Research on International Economic Relations)
    Date: 2005–06
  6. By: António Afonso; Miguel St. Aubyn
    Abstract: We estimate a semi-parametric model of health production process using a two-stage approach for OECD countries. By regressing data envelopment analysis output efficiency scores on non-discretionary variables, both using Tobit analysis and a single and double bootstrap procedure, we show that inefficiency is strongly related to GDP per head, the education level, and health behaviour such as obesity and smoking habits. The used bootstrapping procedure corrects likely biased DEA output scores taking into account that environmental variables are correlated to output and input variables.
    Keywords: technical efficiency; health; DEA; bootstrap; semi-parametric.
    JEL: C14 C61 H52 I11
  7. By: Wiji Arulampalam (University of Warwick and IZA Bonn); Sonia Bhalotra (University of Bristol, CSAE, QEH and CHILD)
    Abstract: This paper investigates the high correlation in infant mortality across siblings using microdata for each of the fifteen major states of India. The main finding is that, in thirteen of the fifteen states, there is evidence of a causal effect of a child death on the risk of death of the subsequent child in the same family (a scarring effect), which is identified after controlling for observed and unobserved heterogeneity at the family level. The two states in which evidence of scarring is weak are Punjab, the richest, and Kerala, the state that is most advanced in socio-economic terms. In the other states, scarring effects are large. Indeed, the only other covariate that has a marginal effect on mortality that is as big, or bigger, than the survival status of a preceding sibling is an indicator for mothers having attained secondary or higher levels of education. These results show that policies targeted at reducing infant mortality will have social multiplier effects through helping avoid the death of subsequent siblings. The size of the scarring effect depends upon the gender of the previous child in three states, in a direction consistent with son-preference. Comparison of other covariate effects across the states offers some new insights, there being no previous research that has compared the determinants of infant mortality across the Indian states.
    Keywords: persistence, siblings, infant mortality, state dependence, scarring, unobserved heterogeneity, dynamic random effects logit, gender, India
    JEL: J1 C1 I1 O1
    Date: 2006–12
  8. By: Stephan Klasen (University of Göttingen and IZA Bonn)
    Abstract: This paper examines the relationship between measures of income poverty, undernourishment, childhood undernutrition, and child mortality in developing countries. While there is, as expected, a close aggregate correlation between these measures of deprivation, the measures generate some inter-regional paradoxes. Income poverty and child mortality is highest in Africa, but childhood undernutrition is by far the highest in South Asia, while the share of people with insufficient calories (undernourishment) is highest in the Caribbean. The paper finds that standard explanations cannot account for these interregional paradoxes, particularly the ones related to undernourishment and childhood undernutrition. The paper suggests that measurement issues related to the way undernourishment and childhood undernutrition is measured might play a significant role in affecting these inter-regional puzzles and points to implications for research and policy.
    Keywords: millennium development goals, undernutrition, child mortality, poverty
    JEL: I1 I3 O1
    Date: 2006–12

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