nep-hea New Economics Papers
on Health Economics
Issue of 2009‒01‒10
eight papers chosen by
Yong Yin
SUNY at Buffalo, USA

  1. Social learning, selection, and HIV infection: Evidence from Malawi By Yamauchi, Futoshi; Ueyama, Mika
  2. From Theory to Practice: Translating Research into Health Outcomes By PLoS Medicine
  3. Race, obesity, and the puzzle of gender specificity By Mary A. Burke; Frank Heiland
  4. Birth cohort and the black-white achievement gap: the role of health soon after birth By Kenneth Y. Chay; Jonathan Guryan; Bhashkar Mazumder
  5. Life expectancy and old age savings By Mariacristina De Nardi; Eric French; John Bailey Jones
  6. Can Soft Drink Taxes Reduce Population Weight? By Jason M. Fletcher; David Frisvold; Nathan Tefft
  7. Higher Education and Health Investments: Does More Schooling Affect Preventive Health Care Use? By Jason M. Fletcher; David Frisvold
  8. Hospitals As Hotels: The Role of Patient Amenities in Hospital Demand By Dana Goldman; John A. Romley

  1. By: Yamauchi, Futoshi; Ueyama, Mika
    Abstract: "This paper examines social learning regarding HIV infection, using HIV test results and sibling death data from Malawi. In the analysis, we compare hypotheses on social learning, selection. and common factors. Empirical results show that young women are less likely to be HIV-infected if they observed prime-age deaths among their siblings, whereas HIV infection is found to be positively related to prime-age sibling deaths among older women. This supports the social-learning hypothesis. Notably, schooling reinforces the social-learning effect of sibling deaths on HIV infection in women regardless of age. The above findings are robust to age (cohort) effects and unobserved location factors." from authors' abstract
    Keywords: Social learning, HIV infection, AIDS (Disease) Africa, Sub-Saharan, siblings,
    Date: 2008
  2. By: PLoS Medicine
    Abstract: Commenting on recent research articles which look at the potential health benefits of behaviour change, the PLoS Medicine Editors say that publication of the findings of such research is only one part of the behaviour-change process.
    Keywords: outcomes, theory, UK, United Kingdom, media, observational studies, public health, government, obesity, United States, US, women, HIV, cancer, life style, research articles, health benefits, behaviour,
    Date: 2008
  3. By: Mary A. Burke; Frank Heiland
    Abstract: Obesity is significantly more prevalent among non-Hispanic African-American (henceforth “black”) women than among non-Hispanic white American (henceforth “white”) women. These differences have persisted without much alteration since the early 1970s, despite substantial increases in the rates of obesity among both groups. Over the same time period, however, we observe little to no significant differences in the prevalence of obesity between black men and white men. Using data from the National Health and Nutrition Examination Surveys (NHANES) and the Behavioral Risk Factor Surveillance System (BRFSS) pertaining to the past two decades, we evaluate an extensive list of potential explanations for these patterns, including race and gender differences in economic incentives, in body size ideals, and in biological factors. We find that the gaps in mean BMI and in obesity prevalence between black women and white women do not narrow substantially after controlling for educational attainment, household income, occupation, location, and marital status—nor do such controls eliminate the gender-specificity of racial differences in obesity. Following these results, we narrow down the list of explanations to two in particular, both of which are based on the idea that black women (but not also black men) face weaker incentives than white women to avoid becoming obese; one explanation involves health-related incentives, the other, sociocultural incentives. While the data show qualified support for both explanations, we find that the sociocultural incentives hypothesis has the potential to reconcile a greater number of stylized facts.
    Keywords: Obesity
    Date: 2008
  4. By: Kenneth Y. Chay; Jonathan Guryan; Bhashkar Mazumder
    Abstract: A large literature documents the significant gap in average test scores between blacks and whites, while a related literature finds a substantial narrowing of the gap during the 1980’s, and a stagnation in convergence during the 1990’s. We use two data sources the Long Term Trends NAEP and AFQT scores for the universe of applicants to the U.S. military between 1976 and 1991 to show that most of the racial convergence in the 1980’s is explained by relative improvements across successive cohorts of blacks born between 1963 and the early 1970’s and not by a secular narrowing in the gap over time. Furthermore, these across-cohort test score gains occurred almost exclusively among blacks in the South. We then examine the potential causes of these large composition effects in the test score gap and their significant variation across U.S. states. We demonstrate that the timing of the cohort-based AFQT convergence closely tracks the convergence in measures of black and white infant health for those cohorts. For example, the cohort- specific AFQT gaps (adjusted for age and year effects and selection into test taking) and the racial gaps in post- neonatal mortality rates deaths between one month and one year of birth exhibit very similar patterns across states and birth cohorts. We show that the black-white convergence in AFQT scores appears to have been more closely linked with post- neonatal mortality rates than with earlier health measures such as neonatal mortality (deaths within one month of birth) and low birthweight. We also find little evidence that other potential confounders (e.g., schooling desegregation, family background) can explain these patterns in AFQT scores. Investments in health at very early ages after birth appear to have large, long-term effects on human capital accumulation. We also discuss preliminary evidence that the staggered timing of hospital integration across the South is consistent with the patterns of gains in black test scores 17 to 18 years after birth more so than other hypotheses for progress in black infant health (e.g., Food Stamps, AFDC, Medicaid).
    Date: 2008
  5. By: Mariacristina De Nardi; Eric French; John Bailey Jones
    Abstract: Rich people, women, and healthy people live longer. We document that this heterogeneity in life expectancy is large. We use an estimated structural model to assess the impact of life expectancy variation on the elderly’s savings. We find that the differences in life expectancy related to observable factors such as health, gender, and income have large effects on savings, and that these factors contribute by simi- lar amounts. We also show that the risk of outliving one’s expected lifespan has a large effect on the elderly’s saving behavior.
    Date: 2008
  6. By: Jason M. Fletcher; David Frisvold; Nathan Tefft
    Abstract: Soft drink consumption has been hypothesized as one of the major factors in the growing rates of obesity in the US. Nearly two-thirds of all states currently tax soft drinks using excise taxes, sales taxes, or special exemptions to food exemptions from sales taxes to reduce consumption of this product, raise revenue, and improve public health. In this paper, we evaluate the impact of changes in state soft drink taxes on body mass index (BMI), obesity, and overweight. Our results suggest that soft drink taxes influence BMI, but that the impact is small in magnitude.
    Date: 2008–10
  7. By: Jason M. Fletcher; David Frisvold
    Abstract: While it is well-known that individuals with higher levels of education consume more preventive medical care, there are several potential explanations for this stylized fact. These explanations include causal and non-causal mechanisms, and distinguishing among explanations is relevant for accessing the importance of educational spillovers on lifetime health outcomes as well as uncovering the determinants of preventive care. In this paper, we use regression analysis, sibling fixed effects, and matching estimators to attempt to distinguish between causal and non-causal explanations of the impact of education on preventive care. In particular, we use a cohort of 10,000 Wisconsin high school graduates that has been followed for nearly 50 years and find evidence that attending college increases the likelihood of using several types of preventive care by approximately five to fifteen percent for college attendees in the early 1960s. This effect of greater education operates partly through occupational channels and access to care. These findings suggest that increases in education have the potential to spillover on long-term health choices.
    Date: 2008–11
  8. By: Dana Goldman; John A. Romley
    Abstract: Amenities such as good food, attentive staff, and pleasant surroundings may play an important role in hospital demand. We use a marketing survey to measure amenities at hospitals in greater Los Angeles and analyze the choice behavior of Medicare pneumonia patients in this market. We find that the mean valuation of amenities is positive and substantial. From the patient perspective, hospital quality therefore embodies amenities as well as clinical quality. We also find that a one-standard-deviation increase in amenities raises a hospital's demand by 38.4% on average, whereas demand is substantially less responsive to clinical quality as measured by pneumonia mortality. These findings imply that hospitals may have an incentive to compete in amenities, with potentially important implications for welfare.
    JEL: I11
    Date: 2008–12

This nep-hea issue is ©2009 by Yong Yin. It is provided as is without any express or implied warranty. It may be freely redistributed in whole or in part for any purpose. If distributed in part, please include this notice.
General information on the NEP project can be found at For comments please write to the director of NEP, Marco Novarese at <>. Put “NEP” in the subject, otherwise your mail may be rejected.
NEP’s infrastructure is sponsored by the School of Economics and Finance of Massey University in New Zealand.