nep-hea New Economics Papers
on Health Economics
Issue of 2011‒01‒23
seven papers chosen by
Yong Yin
SUNY at Buffalo, USA

  1. Broke, Ill, and Obese: The Effect of Household Debt on Health By Matthias Keese; Hendrik Schmitz
  2. The Long-Run Effects of Mortality Decline in Developing Countries By Lehmijoki, Ulla; Palokangas, Tapio K.
  3. Enrolment in Micro Life and Health Insurance: Evidences from Sri Lanka By Bendig, Mirko; Arun, Thankom
  4. Changes in Compulsory Schooling and the Causal Effect of Education on Health: Evidence from Germany By Daniel Kemptner; Hendrik Jürges; Steffen Reinhold
  5. Smoke Gets in Your Eyes: Cigarette Tax Salience and Regressivity By Jacob Goldin; Tatiana Homonoff
  6. Comparing the treatment provided by migrant and non-migrant health professionals: dentists in Scotland By Martin Chalkley; Colin Tilley; Shaolin Wang
  7. Obesity and Diabetes, the Built Environment, and the ‘Local’ Food Economy By Matthew, Salois

  1. By: Matthias Keese; Hendrik Schmitz
    Abstract: We analyze the effect of household indebtedness on different health outcomes using data from the German Socio-Economic Panel from 1999–2009. To establish a causal effect, we rely on (a) fixed-effects methods, (b) a subsample of constantly employed individuals, and (c) lagged debt variables to rule out problems of reverse causality. We apply different measures of household indebtedness, such as the percentage shares of household income spent on consumer credit and home loan repayments (which indicate the severity of household indebtedness) and a binary variable of relative overindebtedness (which indicates a precarious debt situation). We find all debt measures to be strongly correlated with health satisfaction, mental health, and obesity. Controlling for unobserved heterogeneity and reversed causality we find evidence that household debt also causally deteriorates physical and mental health. However, there is no causal effect on being obese.
    Keywords: Debt; health satisfaction; mental health; obesity; fixed-effects
    JEL: D12 D14 I12
    Date: 2010
  2. By: Lehmijoki, Ulla (University of Helsinki); Palokangas, Tapio K. (University of Helsinki)
    Abstract: Since World War II, mortality has declined in the developing world. This paper examines the effects of this mortality decline on demographic and economic growth by a family-optimization model, in which fertility is endogenous and wealth yields utility through its status. The decline in mortality stimulates investment and generates an income stream which promotes population growth, but the desire of status hampers fertility and prevents capital-diluting demographic expansion. If status-seeking is strong, then the decline of mortality decreases population growth below its original level.
    Keywords: mortality, population growth, economic growth
    JEL: O41 J13 J10 O10
    Date: 2011–01
  3. By: Bendig, Mirko (German Institute for Global and Area Studies); Arun, Thankom (University of Central Lancashire)
    Abstract: Microinsurance is an emerging concept protecting households from the potentially catastrophic expenditures associated with family related shocks. Therefore, this paper presents evidence on the determinants of insurance participation using probit models on household survey data from Sri Lanka, conditional on household's microfinance institution enrolment. Further, we employ multivariate probit regressions to analyse factors affecting the participation in different types of insurance. We find that the household’s experience of a family related shock is positively associated with the participation in micro health insurance schemes under study. There is strong evidence that microinsurance has not yet succeeded in proportionately reaching the most vulnerable households. Notably, education of the household head is a strong determinant of microinsurance participation.
    Keywords: microinsurance, household behaviour, Sri Lanka
    JEL: G22 O16 R22
    Date: 2011–01
  4. By: Daniel Kemptner; Hendrik Jürges; Steffen Reinhold (Mannheim Research Institute for the Economics of Aging (MEA))
    Abstract: In this paper we investigate the causal effect of years of schooling on health and health-related behavior in West Germany. We apply an instrumental variables approach using as natural experiments several changes in compulsory schooling laws between 1949 and 1969. These law changes generate exogenous variation in years of schooling both across states and over time. We find evidence for a strong and significant causal effect of years of schooling on long-term illness for men but not for women. Moreover, we provide somewhat weaker evidence of a causal effect of education on the likelihood of having weight problems for both sexes. On the other hand, we find little evidence for a causal effect of education on smoking behavior. Overall, our estimates suggest significant non-monetary returns to education with respect to health outcomes and not necessarily with respect to health-related behavior.
    JEL: I12 I21
    Date: 2010–07–05
  5. By: Jacob Goldin (Princeton University); Tatiana Homonoff (Princeton University)
    Abstract: Recent work suggests that consumers respond differently to taxes that are included in a good’s posted price and taxes that are added upon checking out at the register. This paper investigates how the government’s choice between these posted and register taxes affects the distribution of a tax’s burden. We show that when high- and low-income consumers differ in their attentiveness to register taxes, policymakers can lessen a tax’s regressivity by manipulating the fraction of a tax that is added at the register. We then turn to the case of cigarettes, and investigate whether high- and low-income consumers do in fact differ in their attentiveness to register taxes on that good. To answer that question, we link state and time variation in cigarette excise and sales tax rates to survey data about cigarette consumption from the Behavioral Risk Factor Surveillance System. Whereas both high- and low-income consumers respond to cigarette excise taxes (which appear in the posted price), we find that only low-income consumers respond to sales taxes on cigarettes (which are added at the register). Our results suggest that policymakers can ease the financial burden of cigarette taxes on the poor by levying such taxes at the register instead of including them in the cigarette’s posted price.
    Keywords: cigarette taxes, tax burden, smokers, consumer habits
    JEL: D12 D19 H25 I18
    Date: 2010–12
  6. By: Martin Chalkley; Colin Tilley; Shaolin Wang
    Abstract: Many OECD countries are increasingly relying on migrants to address shortages of trained health professionals. One key concern is whether migrant health professionals provide equivalent health care. We compare the treatment provided by migrant and non-migrant health professionals using administrative data from the Scottish dental system. A difference-in-differences model is estimated to examine whether migrant dentists respond differently to case mix and individual circumstances as compared with their non-migrant counterparts, and assess the extent to which any differences diminish over time. After controlling for both observed and unobserved differences between individual dentists and the cohort of patients that they treat, we find that migrant dentists have marginally different practice styles, and the variation diminishes over time within two years of practice.
    Keywords: Migrant health professionals, Treatment difference, Assimilation, British NHS, Administrative data
    JEL: C23 I11 I18 J61
    Date: 2011–01
  7. By: Matthew, Salois
    Abstract: Obesity and diabetes are increasingly attributed to environmental factors, however, little attention has been paid to influence of the 'local' food economy. This paper examines the association of measures relating to the built environment and the ‘local’ food economy with county-level prevalence of obesity and diabetes. Key indicators of the ‘local’ food economy include the density of farmers’ markets, volume of direct farm sales, and presence of farm-to-school programs. This paper employs a robust regression estimator to account for non-normality of the data and to accommodate outliers. Overall, the built environment is strongly associated with prevalence of obesity and diabetes and a strong 'local' food economy may play an important role in prevention. Results imply considerable scope for community-level interventions.
    Keywords: community-level intervention; diabetes; food environment; farmers market; leverage points; local food; robust regression; obesity; outliers
    JEL: C10 I12 I10 Q18
    Date: 2010–12–01

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