nep-hea New Economics Papers
on Health Economics
Issue of 2007‒12‒15
thirteen papers chosen by
Yong Yin
SUNY at Buffalo, USA

  2. Women's Increasing Wage Penalties from Being Overweight and Obese By David Lempert
  3. Maternal Smoking During Pregnancy and Early Child Outcomes By Emma Tominey
  4. Cost-Benefit Analysis of Psychological Therapy By David Clark; Martin Knapp; Richard Layard; Guy Mayraz
  5. Substance Abuse Treatment and Motor Vehicle Fatalities By Beth A. Freeborn; Brian McManus
  6. Child Height and Maternal Health Care Knowledge in Mozambique By Katleen Van den Broeck
  7. The determinants of HIV infection and related sexual behaviors : evidence from Lesotho By de Walque, Damien; Corno, Lucia
  8. Death, Happiness, and the Calculation of Compensatory Damages By Oswald, Andrew J.; Powdthavee, Nattavudh
  9. Costing, Funding and Budgetary Control in UK Hospitals: An Historical Reflection By Robson, Neil
  10. Population Ageing, Taxation, Pensions and Health Costs By Patricia Apps; Ray Rees; Margi Wood
  11. The Adjusted Measure of Body Mass Index and its Impact on Health By Qiu, Tian
  12. Early Childbirth, Health Inputs and Child Mortality: Recent Evidence from Bangladesh By Pushkar Maitra; Sarmistha Pal
  13. Birth Spacing, Fertility Selection and Child Survival: Analysis using a Correlated Hazard Model By Pushkar Maitra; Sarmistha Pal

  1. By: Vladimir Ponczek
    Date: 2007
  2. By: David Lempert (U.S. Bureau of Labor Statistics)
    Abstract: This paper first utilizes annual surveys between the 1981 and 2000 waves of the National Longitudinal Survey of Youth to estimate the effect of being overweight on hourly wages. Previous studies have shown that white women are the only race-gender group for which weight has a statistically significant effect on wages. This paper finds a statistically significant continual increase in the wage penalty for overweight and obese white women followed throughout two decades. A supporting analysis from a cross-sectional dataset, comprised of the 1987 National Medical Expenditure Survey and the 2000 and 2004 waves of the Medical Expenditure Panel Survey, also shows an increasing wage penalty. The bias against weight has increased, despite drastic increases in the rate of obesity in the United States. Alternatively, the increasing rarity of thinness has led to its rising premium.
    Keywords: Obesity, Wages, Women, Beauty Premium
    JEL: I12 J71
    Date: 2007–12
  3. By: Emma Tominey
    Abstract: We estimate the harm from smoking during pregnancy upon child birth outcomes, using arich dataset on a cohort of mothers and their births. We exploit a fixed effects approach todisentangle the correlation between smoking and birth weight from the causal effect. We findthat, despite a detailed set of controls for maternal traits, around one-third of the harm fromsmoking is explained by unobservable traits of the mother. Smoking tends to reduce birthweight by 1.7%, but has no significant effect on the probability of having a low birth weightchild, pre-term gestation or weeks of gestation. Exploring heterogeneity in the effect on birthweight, it is mothers who smoke for the 9 months of gestation that suffer the harm, whereasthere is an insignificant effect for mothers who chose to quit by month 5. Additionally, thereis evidence of potential complementarity in investment of human capital, as the impact onbirth weight of smoking is much greater for low educated mothers, even controlling for thequantity of cigarettes they smoke. We suggest policy should target the low educated mothers,offering a more holistic approach to improving child health, as quitting smoking is only halfof the battle.
    Keywords: Smoking, Pregnancy, Child Health, Birth Weight
    JEL: I12 I18 J13 J24
    Date: 2007–10
  4. By: David Clark; Martin Knapp; Richard Layard; Guy Mayraz
    Abstract: At present six million people are suffering from clinical depression or anxiety disorders, but only aquarter of them are in treatment. NICE Guidelines prescribe the offer of evidence-basedpsychological therapy, but they are not implemented, due to lack of therapists within the NHS. Wetherefore estimate the economic costs and benefits of providing psychological therapy to people notnow in treatment.The cost to the government would be fully covered by the savings in incapacity benefits andextra taxes that result from more people being able to work. On our estimates the cost could berecovered within two years - and certainly within five. And the benefits to the whole economy aregreater still.This is not because we expect the extra therapy to be targeted especially at people withproblems about work. It is because the cost of the therapy is so small (£750 in total), the recoveryrates are so high (50%) and the cost of a person on IB is so large (£750 per month).These findings strongly reinforce the humanitarian case for implementing the NICEGuidelines. Current proposals for doing this would require some 8,000 extra psychological therapistswithin the NHS over the next six years.
    Keywords: depression, anxiety, cost-benefit analysis, cognitive behavioural therapy, psychologicaltherapists
    JEL: H5 I1
    Date: 2007–10
  5. By: Beth A. Freeborn (Department of Economics, College of William and Mary); Brian McManus (Olin School of Business at Washington University)
    Abstract: The danger of alcohol- and drug-impaired driving implies that policies that reduce substance abuse can save lives. Using several estimation approaches, we show that a US county’s supply of substance abuse treatment facilities is negatively and significantly related to the county’s number of motor vehicle deaths. We find that placing an additional treatment clinic in a county reduces the number of vehicle fatalities by 8%. An additional outpatient clinic, which specializes in treating the local population, can reduce the overall number of traffic deaths by 13% and the number of alcohol-related deaths by 24%.
    Keywords: substance abuse, alcohol, motor vehicle fatalities, drunk driving
    JEL: I1 I18 K42
    Date: 2007–12–07
  6. By: Katleen Van den Broeck (Department of Economics, University of Copenhagen)
    Abstract: Stunting prevalence rates in Mozambique are very high (41 percent), especially in rural areas (46 percent). Recent research shows that consumption growth alone will not be sufficient to solve the problem of malnutrition. To investigate the role of additional determinants I use a two-stage quantile regression approach with specific attention to the role of maternal preventive health care knowledge and schooling. Three different scores for health care knowledge are used and show similar results. For rural Mozambique, I find that maternal schooling has positive effects especially in the top quintile of the height-for-age distribution while health care knowledge has a positive effect on height-for-age of under two year old children especially at the lower end of the distribution where the severely stunted children are located. Improving health care knowledge of mothers could substitute for the low levels of education and community health care facilities in rural areas and positively affect the height of the most severely stunted children.
    Date: 2007–10
  7. By: de Walque, Damien; Corno, Lucia
    Abstract: This paper analyzes the socioeconomic determinants of HIV infection and related sexual behaviors using the 2004 Lesotho Demographic and Health Survey. The authors find that in Lesotho education appears to have a protective effect: it is negatively associated with HIV infection (although not always significantly) and it strongly predicts preventive behaviors. The findings also show that married women who have extra-marital relationships are less likely to use a condom than non-married women. This is an important source of vulnerability that should be addressed in prevention efforts. The paper also analyzes HIV infection at the level of the couple. It shows that in 41 percent of the infected couples, only one of the two partners is HIV infected. Therefore, there are still opportunities for prevention inside the couple.
    Keywords: Population Policies,HIV AIDS,Gender and Health,Disease Control & Prevention,Health Monitoring & Evaluation
    Date: 2007–12–01
  8. By: Oswald, Andrew J. (Department of Economics, University of Warwick); Powdthavee, Nattavudh (Institute of Education, University of London)
    Abstract: This paper studies the mental distress caused by bereavement. The largest emotional losses are from the death of a spouse; the second-worst in severity are the losses from the death of a child; the third-worst is the death of a parent. The paper explores how happiness regression equations might be used in tort cases to calculate compensatory damages for emotional harm and pain-and-suffering. We examine alternative well-being variables, discuss adaptation, consider the possibility that bereavement affects someone’s marginal utility of income, and suggest a procedure for correcting for the endogeneity of income. Although the paper’s contribution is methodological, and further research is needed, some illustrative compensation amounts are discussed
    Date: 2007
  9. By: Robson, Neil
    Abstract: This historical reflection traces the changes in accounting practice in UK hospitals, focussing on costing, funding and budgetary control. The paper finds that, contrary to many implicit assumptions in academic accounting studies, our accounting ancestors promoted, and sometimes used, accounting data in pursuit of similar objectives to those advocated in the 21st century. For example, cost comparison information, often prepared with the aim of rewarding 'efficient' hospitals, is a particular feature of accounting practice throughout the last hundred years. This cost information 'evolved', within its historical context, although the process of establishing standard costs was slow and controversial, and the use of such information for funding hospital activity was avoided. The paper also argues that information for control, particularly budgetary control, was central to the nationalised service, and achieved its primary aim of limiting expenditure (Lapsley, 2001a). Finally it is suggested that the devolution of financial control to lower level managers, was a slow but significant process often overlooked in the accounting literature.
    Keywords: hospital history; accounting change; costing; budgeting
    Date: 2007–09
  10. By: Patricia Apps; Ray Rees; Margi Wood
    Abstract: This paper argues against the policy position that begins with a doomsday scenario of publicly provided health insurance and pension systems threatened with collapse under the stresses imposed by population ageing, and instead contends that the threat of crisis in these systems is policy driven. The central thesis of the paper is that a range of policies lead to the creation of an ageing crisis by inhibiting the efficient reallocation of female labour from the home to the market in response to the decline in fertility. The analysis focuses on family support policies that create large effective tax burdens on female labour supply, by means testing the support on family income, or selectively on the second income. Examples include Family Tax Benefit Part A and Part B, the Medicare Levy and the Medicare Safety Net. The analysis draws on household survey data to show that female labour supply is strongly positively associated with household saving, the purchase of private health insurance and spending on family health generally. Policies that inhibit female labour supply therefore have the effect of reducing the tax base for funding public pensions and health care, while simultaneously reducing the capacity of families to fund them privately.
    Keywords: life cycle, health costs, pensions, household taxation
    JEL: D19 I18 J26
    Date: 2007–11
  11. By: Qiu, Tian
    Abstract: The aim of this paper is to examine the impact of socio-economic status (SES) on the Body Mass Index (BMI), a formula based on the ratio of height to weight, linked to health, using a four-year (1991, 1993, 1997 and 2000) panel data set which comes from the Physical Examination in China Health and Nutrition Survey. To an extent we confirm the results with respect to the linkage between SES and the documented healthy BMI found for other developing countries. Furthermore, apart from using the existing specification of BMI, we develop a little further the issue on how to define BMI with respect to the adjustment of gender and age. This leads to a slightly different formulation for the BMI and a substantially different healthy range based on self-reported health. We also find that the healthy BMI has a significant impact on health together with SES.
    JEL: I12
    Date: 2007
  12. By: Pushkar Maitra; Sarmistha Pal
    Abstract: This paper examines the relationship between early childbearing and child mortality in Bangladesh, a country where adolescent childbearing is of particular concern. We argue that effective use of specific health inputs could however significantly lower child mortality rates even among adolescent women. This offers an attractive policy option particularly when compared to the costly alternative of delaying age at marriage. In particular, we find that women having early childbirth tend to use health inputs differently from all other women. After correcting for this possible selectivity bias, the adverse effects of early childbirth on child mortality are reversed. The favourable effects of use of health inputs however continue remain statistically significant.
    Date: 2007–02
  13. By: Pushkar Maitra; Sarmistha Pal
    Abstract: If fertility reflects the choice of households, results of their choice (duration between successive births and health of the children) cannot be considered to be randomly determined. While most existing studies of child health tend to overlook the effects of fertility selection on child health, this paper argues that not accounting for this selection issue yields biased estimates. Additionally it is difficult to a priori predict the direction of this bias, thereby over or under estimating the effect of spacing on child survival. We find that the estimates of birth spacing on child mortality are different when we do not account for fertility selection. Additionally the correlated hazard estimates that we present here better fit our samples than the corresponding bivariate probit estimates used in the literature. A comparison of the fertility behaviour of households in the Indian and Pakistani Punjab highlights the differential nature of institutions on demographic transition in these neighbouring regions.
    Date: 2007–06

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