nep-hea New Economics Papers
on Health Economics
Issue of 2011‒03‒05
twelve papers chosen by
Yong Yin
SUNY at Buffalo, USA

  1. The Effect of Prenatal Stress on Birth Weight: Evidence from the al-Aqsa Intifada By Hani Mansour; Daniel I. Rees
  2. Income inequality and population health: a panel data analysis on 21 developed countries By Roberta Torre; Mikko Myrskylä
  3. A Fuzzy Approach to the Measurement of Leakages for North American Health Systems By Paul Makdissi; Myra Yazbeck; Hugo Coldeboeuf
  4. Long-term Effects of Famine on Life Expectancy: A Re-analysis of the Great Finnish Famine of 1866-1868 By Doblhammer-Reiter, Gabriele; van den Berg, Gerard J.; Lumey, Lambert H.
  5. Long-term Effects of Early Childhood Malaria Exposure on Education and Health: Evidence from Colonial Taiwan By Chang, Simon; Fleisher, Belton M.; Kim, Seonghoon; Liu, Shi-yung
  6. The Effect of Prenatal Stress on Birth Weight: Evidence from the al-Aqsa Intifada By Mansour, Hani; Rees, Daniel I.
  7. Market Inefficiency, Insurance Mandate and Welfare: U.S. Health Care Reform 2010 By Juergen Jung; Chung Tran
  8. Accounting for the Effects of AIDS on Growth in Sub-Saharan Africa. By Paul Cahu; Falilou Fall
  9. Racial Disparities in the Cognition-Health Relationship By Owen Thompson
  10. Are Recessions Really Good for Your Health? Evidence from Canada By Ariizumi, Hideki; Schirle, Tammy
  11. A study on the socio-economic determinants of suicide: Evidence from 13 European OECD countries By Okada, Keisuke; Samreth, Sovannroeun
  12. The Gender Weight Gap: Sons, Daughters, and Maternal Weight By Pham-Kanter, Genevieve

  1. By: Hani Mansour; Daniel I. Rees
    Abstract: No previous study has attempted to estimate the effect of intrauterine exposure to armed conflict, a potential source of stress, on pregnancy outcomes. Drawing on data from the 2004 Palestinian Demographic and Health Survey, we examine the relationship between fatalities caused by Israeli security forces (a measure of conflict intensity) and birth weight. Our estimates suggest that first-trimester fatalities are positively related to the probability that a child weighed less than 2,500 grams at birth. This result is consistent with medical studies showing a strong negative correlation between self-reported stress during the first trimester of pregnancy and birth weight.
    Keywords: Birth weight, prenatal stress, Israeli-Palestinian conflict
    JEL: I10 I12
    Date: 2011
  2. By: Roberta Torre (Max Planck Institute for Demographic Research, Rostock, Germany); Mikko Myrskylä (Max Planck Institute for Demographic Research, Rostock, Germany)
    Abstract: The relative income-health hypothesis postulates that income distribution is one of the key determinants of population health. The discussion on the age and gender patterns of this association is still open. We test the relative income-health hypothesis using a panel data covering 21 developed countries for over 30 years. We find that net of trends in GDP per head and unobserved period and country factors, income inequality, measured by the Gini index, is strongly and positively associated with male and female mortality up to age 15. For women the association vanishes at older ages, but for men persists up to age 50. These findings suggest that policies decreasing income inequality may improve the health of children and young- to middle-aged men. The mechanisms behind the income inequality-mortality association are not known, but may be related to parental stress and male competition. Future research could focus on unravelling these mechanisms
    Keywords: OECD countries, income distribution, mortality, panmixia
    JEL: J1 Z0
    Date: 2011–02
  3. By: Paul Makdissi; Myra Yazbeck; Hugo Coldeboeuf
    Abstract: This paper uses a fuzzy-fuzzy stochastic dominance approach to compare patients’ leakages in the Canadian and the U.S. health care systems. Leakages are defined in terms of individuals who are in bad health and could not have access to health care when needed. To carry his comparison we rely on the assumption that Canada is a strong counterfactual for the U.S. We first develop a class of fuzzy leakages indices and incorporate them in a stochastic dominance framework to derive the dominance criterion. We then use the derived criterion to perform inter-country comparisons on the global level. To provide more insight, we decompose the analysis with respect to gender, ethnicity, income and education. Intra-country comparisons reveal the presence of income based leakage inequalities in both countries yet, gender, ethnic and education based disparities appear to be present in the U.S. only. As for inter-country comparisons, results are in general consistent with the hypothesis that leakages are less important under the Canadian health care system.
    Keywords: Health care resources, Fuzzy sets, Leakage
    JEL: D63 I18 I19
    Date: 2011
  4. By: Doblhammer-Reiter, Gabriele (University of Rostock); van den Berg, Gerard J. (University of Mannheim); Lumey, Lambert H. (Columbia University)
    Abstract: Famines are extreme cases of environmental stress, and have been used by a series of studies to explore the long-term consequences of the fetal or childhood environment. Results are inconsistent and do not support negative long-term effects on mortality. The authors test the hypothesis that selection during famine changes the frailty distributions of cohorts and may hide negative long-term effects. They use death counts from age 60+ from the Human Mortality Data Base for the birth cohorts 1850-1854, 1855-1859, 1860-1865, 1866-1868, 1869-1874, 1875-1879, 1880-1884 and 1885-1889 to explore the effect of being born during the Great Finnish Famine 1866-1868. Swedish cohorts without famine exposure are analysed as a control group. Cohorts born in Finland during the Great Finnish Famine are highly heterogeneous in their distribution of deaths after age 60. By contrast, cohorts born in the years immediately after the famine are particularly homogeneous. Accounting for these differences results into a lower remaining life expectancy at age 60 for cohorts born during the famine. Statistically, long-term effects of famine on mortality become only visible when changes in the frailty distribution of cohorts are explicitly considered.
    Keywords: old-age mortality, selection, debilitation, early life circumstances
    JEL: I12 J11 C41
    Date: 2011–02
  5. By: Chang, Simon (Central University of Finance and Economics); Fleisher, Belton M. (Ohio State University); Kim, Seonghoon (Ohio State University); Liu, Shi-yung (Academia Sinica)
    Abstract: We estimate the effects of early childhood malaria exposure on education and health at older ages by exploiting variations in malaria exposure risk around birth that resulted from a universal malaria eradication campaign in colonial Taiwan in the early 20th century. We find that malaria exposure around birth leads to lower life-time educational attainment and to worse mental and physical health outcomes in old age as reflected in particular in worse cognitive function, a higher likelihood of cardiovascular diseases and a higher mortality hazard, compared to those who were not exposed.
    Keywords: malaria, early childhood, education, health, Taiwan
    JEL: I12 I18 I21 O15 O18
    Date: 2011–02
  6. By: Mansour, Hani (University of Colorado Denver); Rees, Daniel I. (University of Colorado Denver)
    Abstract: No previous study has attempted to estimate the effect of intrauterine exposure to armed conflict, a potential source of stress, on pregnancy outcomes. Drawing on data from the 2004 Palestinian Demographic and Health Survey, we examine the relationship between fatalities caused by Israeli security forces (a measure of conflict intensity) and birth weight. Our estimates suggest that first-trimester fatalities are positively related to the probability that a child weighed less than 2,500 grams at birth. This result is consistent with medical studies showing a strong negative correlation between self-reported stress during the first trimester of pregnancy and birth weight.
    Keywords: birth weight, prenatal stress, Israeli-Palestinian conflict
    JEL: I10 I12
    Date: 2011–02
  7. By: Juergen Jung (Department of Economics, Towson University); Chung Tran (School of Economics, University of New South Wales)
    Abstract: In this paper we develop a stochastic dynamic general equilibrium overlapping generations (OLG) model with endogenous health capital to study the macroeconomic effects of the Affordable Care Act of March 2010 also known as the Obama health care reform. We find that the insurance mandate enforced with fines and premium subsidies successfully reduces adverse selection in private health insurance markets and subsequently leads to almost universal coverage of the working age population. On other hand, spending on health care services increases by almost 6 percent due to moral hazard of the newly insured. Notably, this increase in health spending is partly financed by the larger pool of insured individuals and by government spending. In order to finance the subsidies the government needs to either introduce a 2.7 percent payroll tax on individuals with incomes over $200,000, increase the consumption tax rate by about 1.1 percent, or cut government spending about 1 percent of GDP. A stable outcome across all simulated policies is that the reform triggers increases in health capital, decreases in labor supply, and decreases in the capital stock due to crowding out effects and tax distortions. As a consequence steady state output decreases by up to 2 percent. Overall, we find that the reform is socially beneficial as welfare gains are observed for most generations along the transition path to the new long run equilibrium.
    Keywords: Affordable Care Act 2010; Endogenous Health Capital; Life-Cycle Health Spending and Financing; Dynamic Stochastic General Equilibrium
    JEL: H51 I18 I38 E21 E62
    Date: 2010–12
  8. By: Paul Cahu (The World Bank); Falilou Fall (Centre d'Economie de la Sorbonne)
    Abstract: In this paper, we first, perform a quantitative assessment of the impact of the HIV/AIDS epidemic on growth. Second, we precisely account for the effects of the epidemic on income per capita through human and physical capital accumulations, population and labor force. That is, we disentangle the effect on the different sources of short and long run growth. Using a dynamic panel of 46 Sub-Saharan African countries over the period 1981-2007, we show that HIV/AIDS has negative, significant and long-lasting effects on demography and growth. According to the estimates presented, GDP per working age population will be 12% lower in the long-run for the average African country than it should be if the epidemic had not spread out. However, the impact is huge for the countries experiencing a high prevalence rate. To tackle the endogeneity issue of HIV/AIDS, we provide a new series of HIV prevalence rate build from the estimation of the propagation dynamic of the epidemic.
    Keywords: Health, AIDS epidemic, human capital, growth, Sub-Saharan Africa.
    JEL: I10 J11 O15 O40 O55
    Date: 2011–01
  9. By: Owen Thompson (University of Massachusetts Amherst)
    Abstract: This paper investigates how the association between cognitive achievement and self-rated health in middle age differs by race, and attempts to explain these differences. The role of cognition in health determination has received only limited empirical attention, and even less is known about how race may affect this relationship. Using data from the NLSY, I find that while whites with higher cognitive achievement scores tend to report substantially better general health, this relationship is far weaker or wholly absent among blacks. Further tests suggest that about 35% of this racial difference can be explained by behavioral decisions during adulthood, and that another portion of the disparity may trace back to prenatal and early childhood experiences. The paper closes by noting that its results are broadly consistent with explanations of the racial health gap that emphasize entrenched forms of racial discrimination. JEL Categories:
    Keywords: Cognition, Health, Race, AFQT, Birth Weight
    Date: 2011–02
  10. By: Ariizumi, Hideki; Schirle, Tammy
    Abstract: This study investigates the relationship between business cycle fluctuations and health in the Canadian context, given that a procyclical relationship between mortality rates and unemployment rates has already been well established in the U.S. literature. Using a fixed effects model and provincial data over the period 1977--â€2009, we estimate the effect of unemployment rates on Canadian age and gender specific mortality rates. Consistent with U.S. results, there is some evidence of a strong procyclical pattern in the mortality rates of middle--â€aged Canadians. We find that a one percentage point increase in the unemployment rate lowers the predicted mortality rate of individuals in their 30s by nearly 2 percent. In contrast to the U.S. data, we do not find a significant cyclical pattern in the mortality rates of infants and seniors.
    Keywords: Unemployment, Business Cycles, Health, Mortality
    JEL: I10 J20 E32
    Date: 2011–02–22
  11. By: Okada, Keisuke; Samreth, Sovannroeun
    Abstract: This paper examines the factors affecting suicide in 13 European OECD countries from a socio-economic perspective. We use the autoregressive distributed lag approach to cointegration as the estimation methodology. Our results reveal that an increasing impact of divorce rates and a decreasing effect of per capita real GDP on suicide are confirmed in 9 countries. However, the evidence on the effects of fertility rates and per capita alcohol consumption are relatively less. For fertility rates, the results reveal that its increase leads to a decrease in suicide rates in four countries and a rise in suicide rates in one country. As for per capita alcohol consumption, the evidence supporting its significantly increasing effects on suicide rates is only confirmed in three countries. In addition, the tests of the cumulative sum and the cumulative sum of squares of the recursive residuals provide evidence indicating the stability of the estimated model.
    Keywords: Suicide; European OECD Countries; Socio-economic Factors
    JEL: I12 J17 C22
    Date: 2011–02
  12. By: Pham-Kanter, Genevieve
    Abstract: Although the effect of parents on their children has been the focus of much research on health and families, the influence of children on their parents has not been well studied. In this paper, I examine the effect of the sex composition of children on mothers' physical condition, as proxied by their weight. Using two independent datasets, I find that, many years after the birth of their children, women who have first-born daughters weigh on average 2-6 pounds less than women who have first-born sons. This weight gap emerges around the time that the first-born child is in his or her pre-teen years and is largest during the child's teen years. I find indirect evidence that this gender weight gap is associated with bargaining power shifts and with mothers' appearance-centered behaviors in the presence of daughters, but find no support for the hypothesis that mothers with sons weigh more because sons eat more than daughters and induce mothers to eat more. I also show that it is unlikely that underlying biological factors like a Trivers-Willard effect are significantly biasing these estimates. Although this weight gap may appear small, weight gains of this magnitude may contribute to increased risk of breast cancer. This study is the first to show that children can have real impacts on the physical condition of their parents and points to a novel channel through which policy makers may be able to influence health.
    Keywords: gender; daughters; obesity; body weight
    JEL: I12 J12 D1
    Date: 2010–11

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