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on Health Economics |
| By: | Nicolas R. Ziebarth; Joachim R. Frick |
| Abstract: | We show that the choice of the welfare measure has a substantial impact on the degree of welfare-related health inequality. Combining various income and wealth measures with different health measures, we calculate 80 health concentration indices. The influence of the welfare measure is more pronounced when using subjective health measures than when using objective health measures. |
| Keywords: | health inequality, concentration index, income measurement, SOEP |
| JEL: | D31 I10 I12 |
| Date: | 2010 |
| URL: | http://d.repec.org/n?u=RePEc:diw:diwsop:diw_sp274&r=hea |
| By: | Patrick Domingues (CES - Centre d'économie de la Sorbonne - CNRS : UMR8174 - Université Panthéon-Sorbonne - Paris I) |
| Abstract: | Survivors are the ones who bear the burden of reconstruction, thus the examination of the costs of civil conflicts to survivors health is crucial for the design of post-war economic policies. This paper investigates this question for the Mozambican civil war, using an original geo-referenced event dataset. I find that women exposed to the conflict during the early years of life have a weaker health, reflected by a lower height for age z-score (HAZ). Using the Infancy Childhood Puberty curves, a concept given by the medical literature studying the human growth process, I point out that this negative effect depends both on the age of entry into civil war and on the number of months spent in conflict. Furthermore, this study indicates that months of civil war before a woman's birth also have a negative impact on her health highlighting the importance of the prenatal conditions. |
| Keywords: | Civil war, health, nutrition, anthropometry. |
| Date: | 2010–01 |
| URL: | http://d.repec.org/n?u=RePEc:hal:cesptp:halshs-00461513_v1&r=hea |
| By: | Trifon I. Missov (Max Planck Institute for Demographic Research, Rostock, Germany) |
| Abstract: | In a population with Gamma-distributed individual frailty and Gompertz-distributed mortality there is a closed-form analytic expression for calculating the life-expectancy integral. Several simplifications of the resulting formula serve as plausible approximations. |
| JEL: | J1 Z0 |
| Date: | 2010–02 |
| URL: | http://d.repec.org/n?u=RePEc:dem:wpaper:wp-2010-020&r=hea |
| By: | Arseniy S. Karkach (Max Planck Institute for Demographic Research, Rostock, Germany); Alexei Romanioukha (Max Planck Institute for Demographic Research, Rostock, Germany); Anatoli I. Yashin (Max Planck Institute for Demographic Research, Rostock, Germany) |
| Abstract: | - |
| JEL: | J1 Z0 |
| Date: | 2010–02 |
| URL: | http://d.repec.org/n?u=RePEc:dem:wpaper:wp-2010-018&r=hea |
| By: | Peter Wagner (Max Planck Institute for Demographic Research, Rostock, Germany) |
| Abstract: | This paper is concerned with sensitivity analysis of life disparity with respect to changes in mortality rates. Recently Zhang and Vaupel introduced a ”threshold age”, such that averting deaths before that age reduces disparity, while averting deaths after that age increases disparity. We provide a refinement to this result by characterizing the ages at which averting deaths has an extremal impact on life disparity. A procedure is given for approaching the threshold age numerically. The results are illustrated using data for the female populations of Denmark, the US, Japan and France in 2005. [Keywords: life disparity, sensitivity analysis, mortality changes, threshold age] |
| JEL: | J1 Z0 |
| Date: | 2010–02 |
| URL: | http://d.repec.org/n?u=RePEc:dem:wpaper:wp-2010-016&r=hea |
| By: | Joshua R. Goldstein (Max Planck Institute for Demographic Research, Rostock, Germany) |
| Abstract: | This paper shows new evidence of a steady long-term decline in age of male sexual maturity since at least the mid-eighteenth century. A method for measuring the timing of male maturity is developed based on the age at which male young adult mortality accelerates. The method is applied to mortality data from Sweden, Denmark, Norway, the United Kingdom, and Italy. The secular trend toward earlier male sexual maturity parallels the trend toward earlier menarche for females, suggesting that common environmental cues influence the speed of both males’ and females’ sexual maturation. |
| JEL: | J1 Z0 |
| Date: | 2010–02 |
| URL: | http://d.repec.org/n?u=RePEc:dem:wpaper:wp-2010-022&r=hea |
| By: | Joshua R. Goldstein (Max Planck Institute for Demographic Research, Rostock, Germany) |
| Abstract: | In this paper, I re-introduce the Gompertz model of age-specific fertility. This model has been rejected by past authors as fitting poorly to cross-sectional, or period rates. However, I find that the model fits very well to recent medium and low fertility cohort schedules in France, Italy, and Japan. A distinct advantage of the Gompertz model is that it has a simple behavioral interpretation as the result of social diffusion of fertility behavior in a cohort competing with the fertility-depressing effects of older age. The Gompertz model, and further refinements that include a better specification of the biological limits of childbearing, offer a means for forecasting future fertility, describing temporal change, and assessing the fertility-limiting effects of older entry into motherhood. In addition, the Gompertz function allows for traditional uses of model age-schedules such as smoothing and correction of data. The model estimates the completed cohort fertility of French, Japanese, and Italian cohorts born in 1965 to be 2.0 , 1.6, and 1.6, respectively. For France, this represents only a minor decline from earlier cohorts, but for Japan the decline in cohort fertility is marked. The model with infertility suggests that recent decline in Italy is largely due to shifts to older ages of childbearing. |
| JEL: | J1 Z0 |
| Date: | 2010–02 |
| URL: | http://d.repec.org/n?u=RePEc:dem:wpaper:wp-2010-021&r=hea |
| By: | Vincent VANDENBERGHE (UNIVERSITE CATHOLIQUE DE LOUVAIN, Institut de Recherches Economiques et Sociales (IRES)); Fabio WALTENBERG (UNIVERSITE CATHOLIQUE DE LOUVAIN, Institut de Recherches Economiques et Sociales (IRES) and Centro de Estudos sobre Desigualdade e Desenvolvimento (CEDE), Universidade Federal Fluminense (UFF), Brazil) |
| Abstract: | The Belgian population is ageing due to demographic changes, so does the workforce of firms active in the country. Such a trend is likely to remain for the foreseeable future. And it will be reinforced by the willingness of public authorities to expand employment among individuals aged 50 or more. But are employers willing to employ older workers? The answer depends to a large extent on the ratio between older workersÕ productivity and their cost to employers. To address this question we tap into a unique firm-level panel data set to produce robust evidence on the causal effect of ageing on productivity and labour costs. Unobserved firm fixed-effects and short-term endogeneity of workforce age pose serious estimation challenges, which we try to cope with. Our results indicate a negative productivity differential for older workers ranging from 20 to 40% when compared with prime-age workers, and these productivity differentials are not compensated by lower relative labour costs. Furthermore, the (now dominant) service sector does not seem to offer working conditions that mitigate the negative age/productivity relationship. Finally, older workers in smaller firms (<100 workers) display a larger productivity differential and a productivity that is less aligned on labour costs. |
| Keywords: | Ageing, Labour Productivity, Panel Data Analysis |
| JEL: | J24 C52 D24 |
| Date: | 2010–02–12 |
| URL: | http://d.repec.org/n?u=RePEc:ctl:louvir:2010003&r=hea |
| By: | Bettina Becker (Department of Economics, Loughborough University); Silke Uebelmesser (CES, University of Munich) |
| Abstract: | In the 1990s, competition among health insurance funds (‘sickness funds’) was introduced in Germany. As one means of competition, free choice of initial health funds and subsequent switching between them was made available to all insured. Since then, the number of funds has decreased substantially, and funds have had to engage in competitive strategies to remain in the market. In this paper, we want to analyse the funds’ advertising activities in the face of the changed competitive environment. This has not been possible to date due to a lack of data. We use two new datasets to get a first insight into the potential effects of competition on funds’ advertising strategies; one of the volume and cost of advertisements and one of their contents. Our results suggest that competition has been associated with an increase in the amount of advertising. As to the adverts themselves, we find that there was a decrease in the share of advertisements of a ‘general’ content in favour of advertisements of a more ‘fund-specific’ content. The data therefore indicate that once the market was open to switching of funds by the insured, funds’ advertising efforts changed to differentiating their own perceived strengths from those of competitor funds. These observations allow us to draw some tentative conclusions about the relevance of (attempts of) risk selection by health funds via advertisements and about the general success of the pro-competitive legislation. |
| Keywords: | Regulated competition; health insurance market; risk selection; advertising; Germany |
| JEL: | I11 I18 G22 M37 |
| Date: | 2010–03 |
| URL: | http://d.repec.org/n?u=RePEc:lbo:lbowps:2010_05&r=hea |
| By: | Takao Asano (Faculty of Economics, Okayama University); Akihisa Shibata (Institute of Economic Research, Kyoto University) |
| Abstract: | Extending the Grossman [12] model of health capital into a stochastic one, we analyze how the presence of Knightian uncertainty about the efficacy of health care affects the optimal health investment behavior of individuals. Using Gilboa and Schmeidler’s [11] model of maxmin expected utility (MMEU) with multiple priors, we show that an agent retains the initial level of health capital if the price of health care lies within a certain range. We also show that the no-investment range expands as the degree of Knightian uncertainty rises. |
| Keywords: | Health Investment, Risk, Uncertainty |
| JEL: | D81 I11 |
| Date: | 2010–03 |
| URL: | http://d.repec.org/n?u=RePEc:kyo:wpaper:696&r=hea |
| By: | Andrew E. Clark; Fabrice Etilé |
| Abstract: | We use life satisfaction and Body Mass Index (BMI) information from three waves of the GSOEP to test for social interactions in BMI between spouses. Semi-parametric regressions show that partner's BMI is, beyond a certain level, negatively correlated with own satisfaction. Own BMI is positively correlated with satisfaction in thin men, and negatively correlated with satisfaction after some threshold. Critically, this latter threshold increases with partner's BMI when the individual is overweight. The negative well-being impact of own BMI is thus lower when the individual's partner is heavier. This is consistent with social contagion effects in weight. However, instrumental variable estimates suggest that the relationship is not causal, but rather reflects selection on the marriage market. |
| Date: | 2010 |
| URL: | http://d.repec.org/n?u=RePEc:pse:psecon:2010-07&r=hea |
| By: | Hirvonen, Lalaina (Swedish Institute for Social Research, Stockholm University) |
| Abstract: | This paper illustrates the difficulty in disentangling the underlying channels of intergenerational earnings persistence by means of path analysis and recursive models. On closer examination, these models manifest their shortcomings as regards accounting for how parental earnings have a direct impact on their offspring’s earnings, but also have an effect through other factors such as education, skills and health. The estimated effects of these mediating factors are likely to capture the influence of other mechanisms not taken into account in the analysis. Nonetheless, the results suggest that education is the most important mechanism in the earnings transmission process, although it is sensitive to the inclusion of other covariates and the order in which these are entered into the equation. Nonlinear specifications suggest that the effect of a father’s earnings on his son’s has the greatest impact primarily through education and IQ in the upper middle categories of the earnings distribution of the fathers, while health status is of secondary importance. |
| Keywords: | - |
| Date: | 2010–03–09 |
| URL: | http://d.repec.org/n?u=RePEc:hhs:sofiwp:2010_002&r=hea |
| By: | William Joe; Udaya S. Mishra |
| Abstract: | This paper uses the most recent wave of Consumer Expenditure Survey 2004-05 to examine the distribution of Out of Pocket (OOP) healthcare payments in India. [WP 418]. |
| Keywords: | Healthcare Expenditure, Consumer, Drugs Expenditure, Progressivity, Poverty, India, poor, |
| Date: | 2010 |
| URL: | http://d.repec.org/n?u=RePEc:ess:wpaper:id:2448&r=hea |
| By: | Giuseppe Tattara (Department of Economics, University Of Venice Cà Foscari) |
| Abstract: | Medical tourism is a term to describe the rapidly-growing practice of traveling across international borders to obtain health care. Services typically sought by travelers include elective procedures as well as complex specialized surgeries. Over 50 countries have identified medical tourism as a national industry. This article deals with the situation of India that is promoting the "high-tech healing" of its private healthcare sector as a tourist attraction. The government hopes to encourage a building trade in medical tourism, selling foreigners the idea of travelling to India for low-cost but world-class medical treatment and India is becoming a "global health destination". This policy however does not develops into better services for the local population as corporale hospitals are clustered in urban settings, their prices are out of reach to the locals and the quota of beds reserved free of charge to the domestic population is often disregarded. |
| Keywords: | Medical tourism, Corporale hospitals, Life expectacy, Economic development, Inequality |
| JEL: | I12 I18 I38 |
| Date: | 2010 |
| URL: | http://d.repec.org/n?u=RePEc:ven:wpaper:2010_02&r=hea |
| By: | N Powdthavee; S Wu; A Oswald |
| Abstract: | Little is known about why some human beings make risky life-choices. This paper provides evidence that people's health decisions and addictive actions are influenced by the gender of their children. Having a daughter leads individuals -- in micro data from Great Britain and the United States -- to reduce their smoking, drinking, and drug-taking. The paper's results are consistent with the hypothesis that human beings 'self-medicate' when under stress. |
| Keywords: | Addictive behaviour; gender; daughters; smoking; drinking; attitudes. |
| JEL: | D1 I1 |
| Date: | 2010–02 |
| URL: | http://d.repec.org/n?u=RePEc:yor:yorken:10/03&r=hea |
| By: | Mariano Bosch; Carlos Bozzoli; Climent Quintana |
| Abstract: | This paper presents new evidence on the evolution of adult height across Spanish regions for cohorts born between 1950 and 1980 using the available augmented sample of the European Community Household Panel (ECHP) for Spain. This augmented sample is available only for the year 2000, and collects self-reported height data representative at the Spanish region level (Comunidad Autónoma). Our main findings show that female average height experienced an increase of 4 cm between 1950 and 1980, while male average height increased by 5 cm. We also make available a new dataset of quinquennial mean heights across Spanish regions, in a conventionally accessible form, which allows researchers to study the determinants of population heights by means of a within-country analysis. |
| Date: | 2010–01 |
| URL: | http://d.repec.org/n?u=RePEc:fda:fdaddt:2010-01&r=hea |
| By: | Tsu-Yu Tsao; Andrew Pearlman |
| Abstract: | This paper proposes a difference-in-differences strategy to decompose the contributions of various types of discrimination to the black-white wage differential. The proposed estimation strategy is implemented using data from the Young Physicians Survey. The results suggest that potential discrimination plays a small role in the racial wage gap among physicians. At most, discrimination lowers the hourly wages of black physicians by 3.3 percent. Decomposition shows that consumer discrimination accounts for all of the potential discrimination in the physician market, and that the effect of firm discrimination may actually favor black physicians. Interpretations of the estimates, however, are complicated by the possibility that, relative to white physicians, black physicians negatively self-select into self-employment. |
| Keywords: | Discrimination; Physician Market; Wage Gaps |
| JEL: | J01 J7 J44 |
| Date: | 2010–03 |
| URL: | http://d.repec.org/n?u=RePEc:lev:wrkpap:wp_588&r=hea |
| By: | Edouard Debonneuil |
| Abstract: | The Lee Carter modelling framework is widely used because of its simplicity and robustness despite its inability to model specific cohort effects. A large number of extensions have been proposed that model cohort effects but there is no consensus. It is difficult to simultaneously account for cohort effects and age-adjusted improvements and we here test a simple model that accounts for both: we simply add a non age-adjusted cohort component to the Lee Carter framework. This is a trade-off between accuracy and robustness but, for various countries present in the Human Mortality Database and compared to various models, the model accurately fits past mortality data and gives good backtesting projections. |
| Date: | 2010–03 |
| URL: | http://d.repec.org/n?u=RePEc:arx:papers:1003.1802&r=hea |
| By: | Ahamad, Mazbahul Golam; Tasnima, Kaniz; Khaled, Nafisa; Bairagi, Subir Kanti; Deb, Uttam Kumar |
| Abstract: | District level trend of infant mortality rate (IMR) per thousand live births in Bangladesh influenced by some assorted form of socio-demographic determinants such as individual, household and community level factors. This paper examines the trend and annual rate of reduction from 1998-2007 time periods and correlates causal factors based on different data from Statistical Yearbook of Bangladesh 2008 and Sample Vital Registration System 2007. Seven explanatory variables are considered and the log-log specified ordinary least square and simultaneous quantile regression models are employed to investigate and compare the stochastic impacts of these predictors on changing infant mortality. Infant immunization is the most effective factor that reduces infant mortality especially at lower quantile districts. Most notably, lower poverty line implies increasing trend with upper quantile, indicates that districts with low infant mortality rate has low effect for any positive rate of change of it. The least square as well as simultaneous quantile regression result disclose that share of population lived in electricity accessed houses, road density, no. of female per family planning personnel has potential and statistically significant impacts on infant mortality rate that is -0.25%, -0.22% and -0.58% respectively. Likewise, infant mortality decreased with the increased percentage of household having television by 0.08%, on average. As infant mortality is an outcome from a variety of socio-economic disparity; reduction strategy should address the degree of severity of the risk factors on infant mortality, prioritizing the most effective reducing factors such as infant immunization and controlled population growth rate as well. |
| Keywords: | Infant Mortality Rate; Socio-demographic Determinants; Annual Rate of Reduction; Log linear Regression; Simultaneous Quantile Regression. |
| JEL: | I12 C21 |
| Date: | 2010–02–10 |
| URL: | http://d.repec.org/n?u=RePEc:pra:mprapa:21102&r=hea |