nep-hea New Economics Papers
on Health Economics
Issue of 2010‒03‒28
twelve papers chosen by
Yong Yin
SUNY at Buffalo, USA

  1. Life expectancy, economic prosperity and retirement preferences By Arnstein Aassve; Cristina Ruggeri; Zsolt Spéder
  2. The Effect of Education on Smoking Behavior: New Evidence from Smoking Durations of a Sample of Twins By Koning, Pierre; Webbink, Dinand; Martin, Nicholas G.
  3. On Geographic Inequality in Japanese Regional Health Insurance By Kumagai, Narimasa
  4. Wives, husbands and wheelchairs : Optimal tax policy under gender-specific health By LEROUX, Marie - Louise; PONTHIERE, GrŽgory
  5. On the public economics of annuities with differential mortality By BOMMIER, Antoine; LEROUX, Marie- Louise; LOZACHMEUR, Jean- Marie
  6. On the fiscal treatment of life expectancy related choices By DAVILA, Julio; LEROUX, Marie-Louise
  7. Quietly They Die: A Study of Malnourishment Related Deaths in Mumbai City By Neeraj Hatekar; Sanjay Rode
  8. Is there an Income Gradient in Child Health? It depends whom you ask By Johnston D; Propper C; Pudney S; Shields M
  9. Education and Body Mass Index: Evidence from ECHP By R Nakamura; L Siciliani
  10. The joint effect of human capital and income inequalities on HIV/AIDS prevalence: An exploratory investigation By Annim, Samuel Kobina; Dasmani, Isaac
  11. Public health spending, old-age productivity and economic growth: chaotic cycles under perfect foresight By Fanti, Luciano; Gori, Luca
  12. Mortality Crisis in Russia Revisited: Evidence from Cross-Regional Comparison By Popov, Vladimir

  1. By: Arnstein Aassve; Cristina Ruggeri; Zsolt Spéder
    Abstract: Increasing life expectancy coupled with declining birth rates is prompting European countries to revise their current pension schemes. The key elements of pension reforms are 1) introducing funded schemes as a means to supplement the current pay-as-you-go system, and 2) a lengthening of the working careers of European citizens. The policy reforms needed constitutes perhaps the biggest challenge facing European policy makers since the introduction of the welfare state after the Second World War. The urgency of the policy reforms are reflected by the European Council Summits of Stockholm (2001) and Barcelona (2002), where the attending policy makers agreed to both increase the labour force participation among older workers and to delay the retirement period. Notwithstanding the efforts, recent changes in the employment rates and the retirement age indicate that the great majority of countries are way off the targets set for 2010. On the backdrop of the policy challenges lying ahead, we consider in this paper individuals' preferences for work and retirement in 23 European countries. A deeper understanding of these preferences helps policy makers, not only informing them about the potential success of the planned pension reforms, but also to make adjustments to its design that may lead to efficiency gains in welfare provision. We find that on average individuals prefer to retire at a younger age than the current mean retirement age. However, there is huge variation in these preferences both at the individual and country levels. We find rather robust evidence to suggest that individuals are willing to work longer as the average life expectancy is increasing.
    Keywords: life expectancy, GDP, retirement preferences, pension reforms, European Social Survey, multilevel models
    Date: 2009–12
  2. By: Koning, Pierre (CPB Netherlands Bureau for Economic Policy Analysis); Webbink, Dinand (CPB Netherlands Bureau for Economic Policy Analysis); Martin, Nicholas G. (Queensland Institute of Medical Research)
    Abstract: This paper analyses the effect of education on starting and quitting smoking, using longitudinal data of Australian twins. The endogeneity of education, censoring of smoking durations and the timing of starting smoking versus that of completion of education are taken into account by the flexible Mixed Proportional Hazard specification. Unobserved effects are assumed to be twin specific and possibly correlated with completed education years. We find that one additional year of education reduces the duration of smoking with 9 months but has no effect on the decision to start smoking.
    Keywords: education, duration models, smoking
    JEL: C41 I21
    Date: 2010–03
  3. By: Kumagai, Narimasa
    Abstract: In Japan, economic stagnation due to the lack of aggregate demand has hit the regional health insurance system and this affects most retired pensioners. The fiscal state of insurers in rural areas deteriorated. This paper aims to investigate whether the regional disparities in medical levies per household make a contribution to income-related geographic inequalities in health care financing. Data of the central two regions of the Japanese National Health Insurance in 2005 were extracted. Their share of population was about 41.5 percent. Retired employees and self-employed individuals are covered by this insurance system. We conducted the geographic decomposition using the concentration index. The within-area inequality in medical levies mainly accounted for geographic inequality in medical levies per household. The hypothesis that there was no between-area inequality in medical levies was not rejected. We revealed the differences in the within-area inequality in medical levies in the central Kanto. This means such proportionality was not built into the NHI system through near constant contribution rates across the distribution of living standards. It can be considered that the differences in the within-area inequality were caused by the inequality in income per household and the multiplier of income levies. We found that income per household, the standard land price of residential districts and the size of an insurer are major determinants of the multiplier of income levies. The higher land price tends to greater the multiplier of income levies. The expansion of insurer's size increases the multiplier of income levies in most of districts. The inequality in the multiplier of income levies will reduce if local governments raise per-household levy in proportion to the size of an insurer and lower the multiplier of income levy.
    Keywords: Decomposition, Inequality, Japan, Medical Levies, National Health Insurance
    Date: 2010–02
  4. By: LEROUX, Marie - Louise (UniversitŽ catholique de Louvain, CORE, B-1348 Louvain-la-Neuve, Belgium); PONTHIERE, GrŽgory (Paris School of Economics and Ecole Normale SupŽrieure, Paris)
    Abstract: We study the optimal taxation problem in an economy composed of two-person households (men and women), where agents influence their own old-age dependency prospects through health spending. It is shown that the utilitarian social optimum can be decentralized by means of lump sum transfers from men to women, because women exhibit a higher disability-free life expectancy than men for a given level of health spending. Once self-oriented concerns for coexistence are introduced, the decentralization of the first-best requires also gender-specific subsidies on health spending aimed at internalizing the effect of each agent's health on the spouse's welfare. In the presence of singles in the population, the optimal policy requires also a differentiated subsidization of health spending for singles and couples. Finally, under imperfect observability of couples, the incentive compatibility constraints reinforce the need for subsidization of health spendings
    Keywords: long term care, optimal taxation, preventive health spending, gender differentials, old age dependency
    JEL: H51 I12 I18 J14 J16
    Date: 2009–11–01
  5. By: BOMMIER, Antoine; LEROUX, Marie- Louise (UniversitŽ catholique de Louvain (UCL). Center for Operations Research and Econometrics (CORE)); LOZACHMEUR, Jean- Marie
    Keywords: uncertain lifetime, redistribution, annuities, nonlinear taxation
    JEL: H55 H23 I31
    Date: 2009–04–01
  6. By: DAVILA, Julio (UniversitŽ catholique de Louvain (UCL). Center for Operations Research and Econometrics (CORE)); LEROUX, Marie-Louise (UniversitŽ catholique de Louvain (UCL). Center for Operations Research and Econometrics (CORE))
    Abstract: In an overlapping generations economy setup we show that, if individuals can improve their life expectancy by exerting some effort, costly in terms of either resources or utility, the competitive equilibrium steady state differs from the Þrst best steady state. This is due to the fact that under perfect competition individuals fail to anticipate the impact of their longevity-enhancing effort on the return of their annuitized savings. We identify the policy instruments required to implement the Þrst-best into a competitive equilibrium and show that they are speciÞc to the form, whether utility or resources, that the effort takes.
    Keywords: life expectancy, health expenditures, taxation
    JEL: H21 D91
    Date: 2009–09–01
  7. By: Neeraj Hatekar; Sanjay Rode
    Abstract: The attention of the media and planners has been focussed almost exclusively on rural and tribal malnutrition. However, malnutrition among urban children, particularly the economically vulnerable slum population has been almost entirely neglected, with the exception of a very few studies. A sample of 1000 households in eight kaccha settlements in Mumbai has been chosen for the study. Five of these settlements are in the Eastern suburbs whereas the other five are in the Western suburbs. This sample was taken in November -December 2002. In the study incidence of malnourishment among children under the age of five has been captured.
    Keywords: media, planners, Mumbai city, malnutrition, children, economically, suburbs, kaccha settlements, vulnerable slum population, tribal, rural, planners, urban, households, school, workforce, girls, boys, younger groups, healthy activities, weight, height, sex, age,
    Date: 2010
  8. By: Johnston D (Queensland University of Technology); Propper C (Imperial College London); Pudney S (Institute for Social and Economic Research); Shields M (University of Melbourne)
    Date: 2010–03–17
  9. By: R Nakamura; L Siciliani
    Abstract: We study the association between education and body mass index across ten European countries (Denmark, Belgium, Greece, Spain, Ireland, Italy, Austria, Portugal, Finland and Sweden) using the European Community Household Panel. OLS and Probit estimation suggest that on average education is associated with lower BMI and a lower probability of being obese. For women, the difference of BMI between the lowest education group and the highest one ranges between -7.15% (Austria) and -2.43% (Finland). The reduction in the probability of being obese ranges between -7.18% (Spain) and -3% (Italy). For men, the reduction of BMI ranges between -4.29%(Denmark) and zero (Greece). The reduction in the probability of being obese ranges between -7.84% (Austria) and zero (Greece). Quantile regression suggests that the effect of education is larger at the upper quantiles than at the lower ones. Higher education also reduces the dispersion of the BMI distribution.
    Keywords: Obesity, Body Mass Index, Education
    JEL: I12 I20 C21
    Date: 2010–03
  10. By: Annim, Samuel Kobina; Dasmani, Isaac
    Abstract: The evidence of higher income inequality leading to increased HIV prevalence through channels of coercion and migration has emerged. This coupled with previously established macroeconomic impact of HIV/AIDS connotes reverse causality that is likely to develop a cyclical effect. The plausible cyclicality can be identified through the mergence of a three stage relationship. Initially from income inequality to HIV prevalence; then from HIV prevalence to reduced human capital formation and subsequently generating human capital inequality via reduced investment in human capital of affected households and back to income inequality. We hypothesize that the effect of this plausible cyclicality is likely to increase the effect of income inequality on HIV prevalence. Our aim is to assess the effect of productivity gaps measured by human capital dispersion on the relationship between income inequality and HIV prevalence. Deriving 1999 dataset on human capital dispersion which is measured by years of schooling, quality of school system and rates of return for 99 countries, we estimate its linear dependence effect with income inequality on HIV prevalence. We find a more significant and increased effect of income inequality on HIV prevalence of more than three times. This study sets the platform for using current datasets and generates a policy discussion for addressing productivity gaps as one of HIV/AIDS interventions.
    Keywords: HIV/AIDS Prevalence; Human Capital; Inequality; Income ; Education
    JEL: I12 I10
    Date: 2010–02
  11. By: Fanti, Luciano; Gori, Luca
    Abstract: This paper analyses the dynamics of a double Cobb-Douglas economy with overlapping generations and public health investments that affect the supply of efficient labour of the old-aged. It is shown that the positive steady state of the economy is unique. Moreover, we provide necessary and sufficient conditions for the emergence of endogenous deterministic complex cycles when individuals are perfect foresighted. Interestingly, the equilibrium dynamics shows rather complicated phenomena such as a multiplicity of period-bubbling.
    Keywords: OLG model; Productivity; Perfect foresight; Public health expenditure
    JEL: O41 I18 C62
    Date: 2010–03–11
  12. By: Popov, Vladimir
    Abstract: This paper provides evidence from cross-regional comparisons that the Russian mortality crisis (mortality rate increased from 1.0% to 1.6% in 1989-94 and stayed at a level of 1.4-1.6% thereafter) was caused mostly by stress factors (increased unemployment, labor turnover, migration, divorces, income inequalities), and by the increase in unnatural deaths (murders, suicides, accidents), but not so much by the increase in alcohol consumption (even though it also increased due to the same stress factors). Health infrastructure of a region had a positive impact on life expectancy only in regions with high income inequalities (large share of highest income group).
    JEL: P36 I12 P27 J11
    Date: 2009–05

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