nep-hea New Economics Papers
on Health Economics
Issue of 2010‒05‒08
seven papers chosen by
Yong Yin
SUNY at Buffalo, USA

  1. The role of technology in health care expenditure in the EU By Kamil Dybczak; Bartosz Przywara
  2. SES Health Gradients during the Epidemiological Transition: The Case of China By Lei, Xiaoyan; Yin, Nina; Zhao, Yaohui
  3. Sexual Risk Taking among Young Adults in Cape Town - Effects of Expected Health and Income By Bezabih, Mintewab; Mannberg, Andréa; Visser, Martine
  4. Obesity, Affluence and Urbanisation in India By Raghav Gaiha; Raghbendra Jha; Vani S. Kulkarni
  5. Health Care and Health Outcomes of Migrants: Evidence from Portugal By Pedro Pita Barros; Isabel Medalho Pereira
  6. Binge Drinking and Risky Sex among College Students By Jeffrey S. DeSimone
  7. The Role of the District Public Health Nurses: A Study from Gujarat By Sharma Bharati; Roy Sweta; Mavalankar Dileep; Ranjan Pallavi; Trivedi Poonam

  1. By: Kamil Dybczak; Bartosz Przywara
    Abstract: Total health care expenditure in the EU countries accounts for between 4 and 11% of GDP, out of which between 3 and 9% of GDP is financed from public sources. As it accounts for between 10 and 18 % of total government spending, health care is therefore among the most significant items of social public expenditure. In addition, public expenditure on health care has been growing over most of the second half of the 20th century, not only in absolute terms, but also in relation to the national income.The paper analyses past developments of health care expenditure in EU Member States. The methodology used expands the set of standard explanatory variables, such as demographic structure, income and health status of the population, by a variable characterising the effect of the technological progress on health care spending.Subsequently the paper provides a projection of the long-term development of health care expenditure, with the methodology based on the EC-EPC model extended by the impact of technological development.
    Keywords: Baltic States financial accelerator dynamic general equilibrium Roeger Lendvai External Deficits in the Baltics 1995 to 2007 Catching Up or Imbalances
    JEL: I1 H51 J11
    Date: 2010–02
  2. By: Lei, Xiaoyan (Peking University); Yin, Nina (Toulouse School of Economics); Zhao, Yaohui (Peking University)
    Abstract: The epidemiological transition, which has already passed the developed world, is still progressing in many developing countries. A particular problem associated with this transition is the under-diagnosis and lack of treatment of chronic diseases, and these may exhibit SES gradients and exacerbate social inequality. Using hypertension as an example and data from China (CHNS), we find that the prevalence of hypertension in China is already close to levels in developed countries, under-diagnosis is pervasive, treatment is rare, and failure to control is widespread. Consistent with the literature, we find no income and education gradients in the prevalence of hypertension. However, there are strong education gradients in diagnosis and treatment in urban areas. The income gradients in all aspects of hypertension are relatively weak and sometimes nonexistent. Interestingly, we find that access to health care does not contribute to the diagnosis of hypertension, nor does it aid much in the treatment and control of hypertension. Our results suggest that the epidemiological transition has indeed occurred, but both the Chinese public and its health care system are ill-prepared. There is an urgent need to educate the public on chronic illnesses, and to raise the quality of health care so that patients receive proper diagnoses and guidance on how to treat and control those chronic illnesses.
    Keywords: epidemiological transition, under-diagnosis, SES health gradients
    JEL: I10
    Date: 2010–04
  3. By: Bezabih, Mintewab (University of Portsmouth); Mannberg, Andréa (Department of Economics, Umeå University); Visser, Martine (University of Cape Town)
    Abstract: This paper empirically assesses links between expectations of future health and income on sexual risk taking on a sample of young adults in Cape Town, South Africa. An important contribution of the paper lies in combining a wide range of variables measuring risky sexual behavior such that the maximum information possible is extracted from, and adequate weights are attached to each measure, as opposed to previous studies that are based on individual measures or arbitrary aggregations. The findings indicate that expected income and health and future uncertainty are significant determinants of current patterns of sexual risk taking. From a policy perspective, the results suggest that reducing poverty and improving social insurance as well as reducing the taboo related to talking about HIV may constitute important issues to be addressed.
    Keywords: HIV/AIDS; Health risk; Risk aversion
    JEL: D81 D84 D91 I10
    Date: 2010–04–30
  4. By: Raghav Gaiha; Raghbendra Jha; Vani S. Kulkarni
    Abstract: Based on data collected from a representative national sample, India Human Development Survey 2005, this paper investigates the links between obesity among children and among adults with a number of socio economic characteristics as well as household and location specific variables. Both child and adult obesity are far from negligible, which is a matter of concern, given the links between obesity and some diseases. There are strong links between socio-economic indicators and risk of obesity. In particular, affluence has a robust link to obesity. Among children, taller children in more affluent households are more prone to obesity. Some demographic characteristics matter too, for example, both child and adult obesity rise with age but at a diminishing rate. Location also influences chances of obesity. Relative food price effects matter too through calorie, protein, fat and other nutrient intakes. A number of policy conclusions are also advanced.
    Keywords: obesity, affluence, socio-economic characteristics, gender, India
    JEL: C25 D12 D31 E10
    Date: 2010
  5. By: Pedro Pita Barros (Departamento de Economia, Universidade Nova de Lisboa and CEPR); Isabel Medalho Pereira (Human Development Report Office (UNDP) and CEFAGE-UE)
    Abstract: This paper studies the performance of immigrants relative to natives, in terms of their health status, use of health care services, lifestyles, and coverage of health expenditures. We base the analysis on international evidence that identified a healthy immigrant effect, complemented by empirical research on the Portuguese National Health Survey. Furthermore, we assess whether differences in health performance depend on the personal characteristics of the individuals or can be directly associated with their migration experience.
    Keywords: Migration; Health status; Health care; Healthy immigrant effect; Portugal.
    Date: 2010
  6. By: Jeffrey S. DeSimone
    Abstract: This study examines the relationship between binge drinking and sexual behavior in nationally representative data on age 18–24 four-year college students. For having sex, overall or without condoms, large and significant positive associations are eliminated upon holding constant proxies for time-invariant sexual activity and drinking preferences. However, strong relationships persist for sex with multiple recent partners, overall and without condoms, even controlling for substance use, risk aversion, mental health, sports participation, and sexual activity frequency. Promiscuity is unrelated with non-binge drinking but even more strongly related with binge drinking on multiple occasions. Results from a rudimentary instrumental variables strategy and accounting for whether sex is immediately preceded by alcohol use suggest that binge drinking directly leads to risky sex. Some binge drinking-induced promiscuity seems to occur among students, especially males, involved in long-term relationships. Effects are concentrated among non-Hispanic whites and are not apparent for students in two-year schools.
    JEL: I1
    Date: 2010–04
  7. By: Sharma Bharati; Roy Sweta; Mavalankar Dileep; Ranjan Pallavi; Trivedi Poonam
    Abstract: The role of District Public Health Nurses (DPHN) and District Public Health Nurse Officers (DPHNOs) as supervisors of the Public Health nursing and midwifery staff in a district was investigated. Thirteen DPHNs and DPHNOs from six districts selected from six geographic zones of Gujarat were observed for one week using the time motion method. Their activities and time spent were noted and the DPHNs/DPHNOs and their supervisors were interviewed. The role of the DPHNs has reduced over the years because they have not been assigned new roles with change in programmes and policies. Most of the DPHNs have training for clinical work in hospitals. Their 10 month training to qualify for PHN is inadequate to develop knowledge and skills in public health. There is a gap between their training and posting due to delays in government procedures of promotion. The DPHN/DPHNOs spend majority of their time in the office (49%) where they have a limited role. Their supervisory role for nurses and midwives has lost its importance. They spend about 1/3rd of their time in field supervision mostly visiting centres accessible by public transport as they do not have an allotted government vehicle. As they do not submit any field report, there is no follow-up action from their visit. Nevertheless they seem to have an important role in solving problems of field workers as they are mediators between the district and peripheral facilities. To conclude the DPHNs are under utilized which affects the quality of maternal and child health services in the district.
    Date: 2010–02–17

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