nep-hea New Economics Papers
on Health Economics
Issue of 2010‒03‒06
thirteen papers chosen by
Yong Yin
SUNY at Buffalo, USA

  1. Misperceptions of Body Mass: Analysis of NSW Health Survey 2003 By Paula Cronin; Marion Haas; Elizabeth Savage; Minh Vu
  2. Evidence for funding, organising and delivering health care services targeting secondary prevention and management of chronic conditions. CHERE Working Paper 2009/6 By Marion Haas; Jane Hall; Gisselle Gallego
  3. Obesity and Happiness By Marina-Selini Katsaiti
  4. Are Remittances More Effective Than Aid To Reduce Child Mortality? An Empirical Assessment using Inter and Intra-Country Data By Lisa Chauvet; Flore Gubert; Sandrine Mesplé-Somps
  5. How slowing senescence changes life expectancy By Joshua R. Goldstein; Thomas Cassidy
  6. Handedness, Health and Cognitive Development: Evidence from Children in the NLSY By Johnston, David W.; Nicholls, Michael E. R.; Shah, Manisha; Shields, Michael A.
  7. No Country for Fat Men? Obesity, Earnings, Skills, and Health among 450,000 Swedish Men By Lundborg, Petter; Nystedt, Paul; Rooth, Dan-Olof
  8. Health Cost Risk and Optimal Retirement Provision: A Simple Rule for Annuity Demand By Peijnenburg, J.M.J.; Nijman, T.E.; Werker, B.J.M.
  9. Labour Market, Obesity and Public Policy Considerations By Eleftheriou, Konstantinos; Athanasiou, George
  10. AIDing Contraception: HIV and Recent Trends in Abortion Rates By Hussey, Andrew; Nikolsko-Rzhevskyy, Alex; Walker, Jay
  11. The effects of the social norm on cigarette consumption: evidence from Japan using panel data By Yamamura, Eiji
  12. The Tax Exclusion for Employer-Sponsored Health Insurance By Jonathan Gruber
  13. Public Avoidance and the Epidemiology of novel H1N1 Influenza A By Byung-Kwang Yoo; Megumi Kasajima; Jay Bhattacharya

  1. By: Paula Cronin (CHERE, University of Technology,Sydney); Marion Haas (CHERE, University of Technology,Sydney); Elizabeth Savage (CHERE, University of Technology,Sydney); Minh Vu (CHERE, University of Technology,Sydney)
    Abstract: Overweight and obesity continue to contribute to increased risk of chronic diseases, including higher lifetime health expenditures and impacting on individuals? quality of life. Whilst international studies have compared individuals? perceptions of their body mass with more objective measures such as Body Mass Index (BMI) few Australian studies have examined this relationship in any detail. This study uses unit record data from the 2003 NSW Health Survey to identify factors associated with the accuracy of adults perceived body mass. Descriptive methods and logistical models are used to quantify the effects of a number of demographic, socio?economic, behavioural and health?related variables on the accuracy of self?assessed body mass. The results support earlier findings that there are large gender differences in perception of body mass. Women are most likely to report they are overweight. In contrast there is a pattern of underestimation of weight amongst men, particularly at the higher BMI deciles. Clearly these results have different policy implications. This information may be useful for public health programs to take into account the issue of whether individuals accurately perceive themselves at risk of developing weight?related health conditions.
    Keywords: Obesity, BMI, perceived weight
    JEL: I10
    Date: 2009–10
  2. By: Marion Haas (CHERE, University of Technology, Sydney); Jane Hall (CHERE, University of Technology, Sydney); Gisselle Gallego (CHERE, University of Technology,Sydney)
    Abstract: This paper is designed as an issues paper. Its aim is to set out what evidence is available regarding the effectiveness and efficiency of funding, organisation and delivery of services directed at preventing and managing chronic conditions, and identify what further information is required. The latter will then be used as a means of identifying gaps in information which can be addressed by research. The information is not presented as a comprehensive review of all available evidence but as a preliminary scoping of the results of the most recent literature.
    Keywords: chronic conditions, prevention, funding
    JEL: I10
    Date: 2009–10
  3. By: Marina-Selini Katsaiti
    Abstract: This paper provides insight on the relationship between obesity and happiness. Using the latest available cross sectional data from Germany (GSOEP 2006), UK (BHPS 2005), and Australia (HILDA 2007). We examine whether there is evidence on the impact of overweight on subjective well being. The Hausman test is employed in the univariate and multivariate specifications chosen and reveals evidence for the presence of endogeneity in the German and the Australian data. Instrumental variable analysis is performed under the presence of endogeneity whereas for the UK we run OLS regressions. Results indicate that in all three countries obesity has a negative and significant effect on the subjective well being of individuals. For Germany, using a differences-in-differences methodology, I find that non-overweight/non-obese individuals are on average 0.5 units happier than their overweight/obese counterparts. Our findings also have important implications for the effect of other socio-demographic, economic and individual characteristics on well being.
    Keywords: Happiness, obesity, instrumental variable analysis, subjective well-being
    JEL: D60 I31
    Date: 2010
  4. By: Lisa Chauvet (DIAL, IRD, Paris); Flore Gubert (DIAL, IRD, Paris); Sandrine Mesplé-Somps (DIAL, IRD, Paris)
    Abstract: This paper analyzes the respective impact of aid, remittances and medical brain drain on child mortality using panel and cross-country quintile-level data on respectively 84 and 46 developing countries. Our results show that remittances reduce child mortality and that the impact of health aid is non-linear, suggesting that health aid is more effective in the poorest countries. By contrast, medical brain drain is found to have a harmful impact on child mortality. Last, remittances seem to be more effective in reducing mortality for children belonging to the richest households, whereas neither propoor nor anti-poor effect is found for health aid.________________________________ Cet article examine l’impact respectif de l’aide, des transferts et du départ en migration du personnel médical sur la mortalité infantile à partir de données en panel et de données en coupe par quintile portant sur respectivement 84 et 46 pays en développement. Nos résultats suggèrent que les transferts contribuent à réduire la mortalité infantile et que l’impact de l’aide est non-linéaire, l’aide étant plus efficace dans les pays les plus pauvres. En revanche, le départ en migration du personnel médical paraît s’accompagner d’une augmentation des taux de mortalité infantile. Enfin, les analyses que nous avons conduites à partir de données par quintile montrent que l’impact des transferts sur la réduction de la mortalité infantile est plus fort pour les ménages les plus riches, tandis que l’impact de l’aide n’est ni pro-pauvres, ni pro-riches.
    Keywords: Child Mortality, Remittances, International Migration, Foreign Aid, Low and Middle Income Countries, Mortalité infantile, Transferts, Migration internationale, Aide, Pays à revenu faible et intermédiaire.
    JEL: I12 F22 F35
    Date: 2009–11
  5. By: Joshua R. Goldstein (Max Planck Institute for Demographic Research, Rostock, Germany); Thomas Cassidy (Max Planck Institute for Demographic Research, Rostock, Germany)
    Abstract: Mortality decline has historically been a result of reductions in the level of mortality at all ages. The slope of mortality increase with age has been remarkably stable. A number of leading researchers on aging, however, suggest that the next revolution of longevity increase will be the result of slowing down the rate of aging, lessening the rate at which mortality increases as we get older. In this paper, we show mathematically how varying the pace of senescence influences life expectancy. We provide a formula that holds for any baseline hazard function. Our result is analogous to Keyfitz's "entropy" relationship for changing the level of mortality. Interestingly, the influence of the shape of the baseline schedule on the effect of senescence changes is the complement of that found for level changes. We also provide a generalized formulation that mixes level and slope effects.
    JEL: J1 Z0
    Date: 2010–02
  6. By: Johnston, David W. (Queensland University of Technology); Nicholls, Michael E. R. (Melbourne Institute of Applied Economic and Social Research); Shah, Manisha (University of California, Irvine); Shields, Michael A. (University of Melbourne)
    Abstract: Using data from the US National Longitudinal Survey of Youth, and fitting family fixed-effects models of child health and cognitive development, we test if left-handed children do significantly worse than their right-handed counterparts. The health measures cover both physical and mental health, and the cognitive development test scores span (1) Memory, (2) Vocabulary, (3) Mathematics, (4) Reading and (5) Comprehension. We find that while left-handed children have a significantly higher probability of suffering an injury needing medical attention, there is no difference in their experience of illness or poor mental health. We also find that left-handed children have significantly lower cognitive development test scores than right-handed children for all areas of development with the exception of reading. Moreover, the left-handedness disadvantage is larger for boys than girls, and remains roughly constant as children grow older for most outcomes. We also find that the probability of a child being left-handed is not related to the socioeconomic characteristics of the family, such as income or maternal education. All these results tend to support a difference in brain functioning or neurological explanation for handedness differentials rather than one based on left-handed children living in a right-handed world.
    Keywords: handedness, children, health, cognitive development, family fixed-effects
    JEL: I12 J10
    Date: 2010–02
  7. By: Lundborg, Petter (Lund University); Nystedt, Paul (Linköping University); Rooth, Dan-Olof (Linneaus University)
    Abstract: The negative association between obesity and labor market outcomes has been widely documented, yet little is known about the mechanisms through which the association arises. Using rich and unique data on 450,000 Swedish men enlisting for the military, we find that the crude obesity penalty in earnings, which amounts to about 18 percent, is linked to supply-side characteristics that are associated with both earnings and obesity. In particular, we show that the penalty reflects negative associations between obesity, on the one hand, and cognitive skills, non-cognitive skills, and physical fitness, on the other. Our results suggest that employers use obesity as a marker for skill limitations in order to statistically discriminate.
    Keywords: obesity, overweight, earnings, cognitive ability, non-cognitive ability, health, physical fitness
    JEL: I10 J10 J70
    Date: 2010–02
  8. By: Peijnenburg, J.M.J.; Nijman, T.E.; Werker, B.J.M. (Tilburg University, Center for Economic Research)
    Abstract: We analyze the effect of health cost risk on optimal annuity demand and consumption/savings decisions. Many retirees are exposed to sizeable out-of-pocket medical expenses, while annuities potentially impair the ability to get liquidity to cover these costs and smooth consumption. We find that if out-of-pocket medical expenses can already be very sizeable early in retirement, full annuitization is suboptimal. In other cases, individuals take advantage of the mortality credit annuities provide and save out of the annuity income to build a buffer for health cost shocks at later ages. When comparing to empirically observed levels of annuitization, we find that sizeable health cost risk early in retirement may resolve the annuity puzzle. Moreover, we explain the observed pattern of annuitization as a function of initial wealth at retirement. For personal financial planning purposes, we develop a simple rule of thumb for annuity demand, based on expected health cost risk early in retirement, wealth at retirement, and subsistence consumption levels. We show that the welfare costs from using the rule compared to the life cycle model are small.
    Keywords: Optimal life cycle portfolio choice;health cost risk;annuity;retirement
    JEL: D14 D91 G11 I1
    Date: 2010
  9. By: Eleftheriou, Konstantinos; Athanasiou, George
    Abstract: This paper attempts to investigate the relation among wages, unemployment and obesity and to identify public policies to address the problem of over-weightness. To this purpose, a simple search and matching model of labour market is developed. Our framework tries to capture the relationship between obesity and employment/unemployment by assuming that the fraction of obese workers is a function of the ratio of vacant jobs to unemployment (labour market tightness). We argue that if obesity is positively related with employment, then social optimality dictates the imposition of a lump-sum tax on all individuals. In the opposite case a subsidy should be given.
    Keywords: Obesity; Taxation; Unemployment; Wages
    JEL: I18 J64 I10
    Date: 2010–02–23
  10. By: Hussey, Andrew; Nikolsko-Rzhevskyy, Alex; Walker, Jay
    Abstract: Since the onset of HIV/AIDS awareness in the early 1980s, much attention has centered around the substantial negative effects of the disease throughout the world. This paper provides evidence of a secondary effect the disease has had on sexual behavior in the United States. Using a difference-in-differences estimation framework and state level data, we show that the perceived threat of HIV resulted in a drop in unwanted pregnancies, as demonstrated by a lower incidence of abortions. Our results suggest that each additional reported case of HIV per 1,000 individuals resulted in 85.5 fewer abortions per 1,000 live births.
    Keywords: HIV; abortion; fertility
    JEL: I30 J13 I1
    Date: 2010–02–22
  11. By: Yamamura, Eiji
    Abstract: Using Japan’s prefecture-level panel data from 1989-2001, this paper examines the influence of the social norm on a person’s smoking behavior when the complementary relationship between smoking and drinking is taken into account. The key findings through a dynamic panel model controlling for unobserved prefecture-specific fixed effects are as follows: (1) Influence from others is stronger when people live more closely and cohesively. A tightly knit society results in a reduction of smoking through smoking-related interaction. (2) Smoking and drinking have a complementary relationship: greater initial consumption of alcohol results in larger consumption of cigarettes. (3) The complementary relationship between smoking and dinking is attenuated if the cost of committing the annoying conduct (i.e., smoking) is high. Overall, this empirical study provides evidence that the psychological effect of the presence of surrounding people has a direct significant effect upon smoking behavior and, furthermore, that it attenuates the complementary relationship between smoking and drinking, thereby reducing cigarette consumption. These results indicate that not only formal rules but also tacitly formed informal norms are effective deterrents to smoking.
    Keywords: Smoking behavior; Social norm
    JEL: I12 Z13 I10
    Date: 2010–02–18
  12. By: Jonathan Gruber
    Abstract: This paper reviews the issues around and impacts of the tax exclusion for employer-sponsored insurance. After reviewing the arguments for and against this policy, I present micro-simulation evidence on the federal revenue, insurance coverage, and distributional impacts of various reforms to the exclusion.
    JEL: H2 I1
    Date: 2010–02
  13. By: Byung-Kwang Yoo; Megumi Kasajima; Jay Bhattacharya
    Abstract: In June 2009, the World Health Organization declared that novel influenza A (nH1N1) had reached pandemic status worldwide. The response to the spread of this virus by the public and by the public health community was immediate and widespread. Among the responses included voluntary avoidance of public spaces, closure of schools, the ubiquitous placement of hand sanitizer, and the use of face masks in public places. Existing forecasting models of the epidemic spread of nH1N1, used by public health officials to aid in making many decisions including vaccination policy, ignore avoidance responses in the formal modeling. In this paper, we build a forecasting model of the nH1N1 epidemic that explicitly accounts for avoidance behavior. We use data from the U.S. summer and the Australian winter nH1N1 epidemic of 2009 to estimate the parameters of our model and forecast the course of the epidemic in the U.S. in 2010. We find that accounting for avoidance responses results in a better fitting forecasting model. We also find that in models with avoidance, the marginal return in terms of saved lives and reduced infection rates of an early vaccination campaign are higher.
    JEL: I1 I10
    Date: 2010–02

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