nep-hea New Economics Papers
on Health Economics
Issue of 2007‒02‒24
eight papers chosen by
Yong Yin
SUNY at Buffalo, USA

  1. The impact of income shocks on health: evidence from cohort data By Jerome Adda; James Banks; Hans-Martin von Gaudecker
  2. Long Run Health Impacts of Income Shocks: Wine and Phylloxera in 19th Century France By Abhijit Banerjee; Esther Duflo; Gilles Postel-Vinay; Timothy M. Watts
  3. Diabetes and the Rise of the SES Health Gradient By James Smith
  4. Anti-depressants and Suicide By Jens Ludwig; Dave E. Marcotte; Karen Norberg
  5. Medicaid Expansions and Fertility in the United States By Thomas DeLeire; Leonard M. Lopoo; Kosali I. Simon
  6. Catastrophic Payment and Health Protection in Rural China - Impact of New Cooperative Medical Scheme in Shandong Province By Dr Sukhan Jackson; Xiaoyun Sun1; Gordon Carmichael; Adrian C. Sleigh1.
  7. Does social capital determine health? Evidence from eight transition countries By d'Hombres, Beatrice; Rocco, Lorenzo; Suhrcke, Marc; McKee, Martin
  8. Global patterns of income and health: facts, interpretations, and policies By Angus Deaton

  1. By: Jerome Adda (Institute for Fiscal Studies and University College London); James Banks (Institute for Fiscal Studies and University College London); Hans-Martin von Gaudecker
    Abstract: <p><p>We study the effect of permanent income innovations on health for a prime-aged population. Using information on more than half a million individuals sampled over a twenty-five year period in three different cross-sectional surveys we aggregate data by date-of-birth cohort to construct a 'synthetic cohort' dataset with details of income, expenditure, socio-demographic factors, health outcomes and selected risk factors. We then exploit structural and arguably exogenous changes in cohort incomes over the eighties and nineties to uncover causal effects of permanent income shocks on health. We find that such income innovations have little effects on health, but do affect health behaviour and mortality.</p></p>
    Date: 2007–01
  2. By: Abhijit Banerjee; Esther Duflo; Gilles Postel-Vinay; Timothy M. Watts
    Abstract: This paper provides estimates of the long-term effects on height and health of a large income shock experienced in early childhood. Phylloxera, an insect that attacks the roots of grape vines, destroyed 40% of French vineyards between 1863 and 1890, causing major income losses among wine growing families. Because the insects spread slowly from the southern coast of France to the rest of the country, Phylloxera affected different regions in different years. We exploit the regional variation in the timing of this shock to identify its effects. We examine the effects on the adult height, health, and life expectancy of children born in the years and regions affected by the Phylloxera. The shock decreased long run height, but it did not affect other dimensions of health, including life expectancy. We find that, at age 20, those born in affected regions were about 1.8 millimeters shorter than others. This estimate implies that children of wine-growing families born when the vines were affected in their regions were 0.6 to 0.9 centimeters shorter than others by age 20. This is a significant effect since average heights grew by only 2 centimeters in the entire 19th century. However, we find no other effect on health, including infant mortality, life expectancy, and morbidity by age 20.
    JEL: I12 N32 O12
    Date: 2007–02
  3. By: James Smith
    Abstract: This paper investigates the salient diabetes prevalence patterns across key SES indicators, and how they changed over time. The investigation spans both the conventional concept of diagnosed diabetes and a more comprehensive measure including those whose diabetes is undiagnosed. By doing so, I separate the distinct impact of covariates on disease onset, better self-management, and the probability of disease diagnosis. Emphasis is given to SES correlates of undiagnosed diabetes and how these changed as those with undiagnosed diabetes plummeted over the last 25 years. I estimate the differential ability by education to successful self-manage diabetes, especially when disease self-management became more complicated.
    JEL: I1
    Date: 2007–02
  4. By: Jens Ludwig; Dave E. Marcotte; Karen Norberg
    Abstract: Does drug treatment for depression with selective serotonin reuptake inhibitors (SSRIs) increase or decrease the risk of completed suicide? The question is important in part because of recent government warnings that question the safety of SSRIs, one of the most widely prescribed medications in the world. While there are plausible clinical and behavioral arguments that SSRIs could have either positive or negative effects on suicide, randomized clinical trials have not been very informative because of small samples and other problems. In this paper we use data from 26 countries for up to 25 years to estimate the effect of SSRI sales on suicide mortality using just the variation in SSRI sales that can be explained by cross-country variation in the growth of drug sales more generally. We find that an increase in SSRI sales of 1 pill per capita (about a 12 percent increase over 2000 sales levels) is associated with a decline in suicide mortality of around 5 percent. These estimates imply a cost per statistical life far below most other government interventions to improve health outcomes.
    JEL: I12 I18
    Date: 2007–02
  5. By: Thomas DeLeire; Leonard M. Lopoo; Kosali I. Simon
    Abstract: Beginning in the mid 1980s and extending through the early to mid 1990s, a substantial number of women and children gained eligibility for Medicaid through a series of income-based expansions. Using natality data from the National Center for Health Statistics, we estimate fertility responses to these eligibility expansions. We measure changes in state Medicaid eligibility policy by simulating the fraction of a standard population that would qualify for benefits. From 1985 to 1996, the fraction of women aged 15 to 44 who were eligible for Medicaid coverage for a pregnancy increased on average by 24 percentage points. However, contrary to findings in the extant literature, our results do not indicate that this expansion in coverage had a statistically discernible effect on fertility.
    JEL: I18 I28
    Date: 2007–02
  6. By: Dr Sukhan Jackson; Xiaoyun Sun1; Gordon Carmichael; Adrian C. Sleigh1. (School of Economics, The University of Queensland)
    Abstract: In 2005, from a stratified cluster sample of 3,101 rural households we identified 375 households that might be at risk of catastrophic payments, by searching through NCMS claims and interviewing key informants. We interviewed these 375 households and confirmed that 239 had had catastrophic payments (= 40% of the household’s capacity to pay) during 2004. A validity test of our screening method found another 8 cases among immediate neighbours of these 375 households; by extrapolation, we obtained an adjusted total of 289 catastrophic households in the sample of 3,101. We measured the impact of the NCMS on hardship alleviation by counterfactual analysis, comparing catastrophic payments before and after NCMS reimbursements.
    Date: 2007
  7. By: d'Hombres, Beatrice; Rocco, Lorenzo; Suhrcke, Marc; McKee, Martin
    Abstract: This paper starts from an empirical assessment of different dimensions of social capital in the transition countries of Central and Eastern Europe (CEE) and the Commonwealth of Independent States (CIS). The level of social capital is lower in CEE-CIS countries compared to other countries in Europe and beyond. We then use a unique data source to carefully investigate the impact of social capital on individual self-reported health for eight countries from the Commonwealth of Independent States (Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, Ukraine). We rely on three indicators for social capital – individual degree of trust, participation in local organisations, social isolation – and employ alternative procedures to consistently estimate the impact of social capital on health. We attempt to circumvent the endogeneity problems by using instrumental variable estimates. Our results show that, in the overall sample comprising all eight countries, the individual degree of trust is positively and significantly correlated with health, either in pooling estimation or when we rely on IV estimators with community fixed effects. Similarly, social isolation is negatively and significantly associated with health, irrespective of the procedure of estimation. On the other hand, the effect of being member of a Putnamesque organisation is more ambiguous and usually not significantly related to health. Finally, country-estimates suggest that the impact of social capital on health varies across the eight countries. We argue that the positive effect of membership on health is conditional on the quality of the political institutions and civil liberties, while trust and social isolation seem to influence health independently of those institutional factors.
    Keywords: Health; social capital; instrumental variables; transition countries
    JEL: P20 I12
    Date: 2006
  8. By: Angus Deaton (Princeton University)
    Abstract: People in poor countries live shorter lives than people in rich countries so that, if we scale income by some index of health, there is more inequality in the world than if we consider income alone. Such international inequalities in life expectancy decreased for many years after 1945, and the strong correlation between income and life-expectancy might lead us to hope that economic growth will improve people’s health as well as their material living conditions. I argue that the apparent convergence in life expectancies is not as beneficial as might appear, and that, while economic growth is the key to poverty reduction, there is no evidence that it will deliver automatic health improvements in the absence of appropriate conditions. The strong negative correlation between economic growth on the one hand and the proportionate rate of decline of infant and child mortality on the other vanishes altogether if we look at the relationship between growth and the absolute rate of decline in infant and child mortality. In effect, the correlation is between the level of infant mortality and the growth of real incomes, most likely reflecting the importance of factors such as education and the quality of institutions that affect both health and growth.
    Date: 2006–10

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