nep-hea New Economics Papers
on Health Economics
Issue of 2011‒04‒02
seven papers chosen by
Yong Yin
SUNY at Buffalo, USA

  1. Discrimination makes me Sick! Establishing a relationship between discrimination and health By Grace Lordan; David Johnston
  2. A decomposition of the black-white differential in birth outcomes By M. Melinda Pitts; Mary Beth Walker; Brian S. Armour
  3. To work or not to work: the economics of a mother's dilemma By Julie L. Hotchkiss; M. Melinda Pitts; Mary Beth Walker
  4. Applying logistic regression analysis to identify patient’s satisfaction predictors with general practitioner assistance: evidence from four Italian regions. By Anna Maria Murante; Cinzia Panero; Giovanni Perucca
  5. Impatience, Incentives, and Obesity By Courtemanche, Charles; McAlvanah, Patrick
  6. Body weight of Italians: the weight of Education By Vincenzo Atella; Joanna Kopinska
  7. Heterogeneous Credit Impacts of Healthcare Spending of the Poor in Peri-urban Areas, Vietnam: Quantile Treatment Effects Estimation By Tinh Doan; John Gibson; Mark Holmes

  1. By: Grace Lordan (School of Economics, The University of Queensland); David Johnston (Centre for Health Economics, Monash University, Australia)
    Abstract: The attitudes of the general British population towards Muslims changed post 2001, and this change led to a significant increase in Anti-Muslim discrimination. We use this exogenous attitude change to estimate the causal impact of increased discrimination on a range of objective and subjective health outcomes. The difference-in-differences estimates indicate that discrimination worsens blood pressure, cholesterol, BMI, self-assessed general health, and some dimensions of mental health. Thus, discrimination is a potentially important determinant of the large racial and ethnic health gaps observed in many countries. We also investigate the pathways through which discrimination impacts upon health, and find that discrimination has a negative effect on employment, perceived social support, and health-producing behaviours. Crucially, our results hold for different control groups and model specifications.
    Date: 2011
  2. By: M. Melinda Pitts; Mary Beth Walker; Brian S. Armour
    Abstract: Substantial racial disparities continue to persist in the prevalence of preterm births and low-birth-weight births. Health policy aimed at reducing these disparities could be better targeted if the differences in birth outcomes are better understood. This study decomposes these racial disparities in birth outcomes to determine the extent to which the disparities are driven by differences in measurable characteristics of black mothers and white mothers as well as the extent to which the gap results from differences in the impact of these characteristics. The analysis is focused on three adverse birth outcomes: preterm, early preterm birth (less than 32 weeks gestation), and low birth weight. The results suggest that differences in covariates accounted for approximately 25 percent of the gap in the incidence of preterm births. The specific characteristics that matter the most are marriage rates, father's characteristics, and prenatal care. For gestation-adjusted birth weight, approximately 16 percent of the racial gap for first births is explained by covariates; for subsequent births this covariate explanation rises to 22 percent of the gap. Furthermore, differences in coefficients explain about another quarter of the gap in preterm birth outcomes but very little of the gap in birth weight.
    Date: 2011
  3. By: Julie L. Hotchkiss; M. Melinda Pitts; Mary Beth Walker
    Abstract: Utilizing linked vital statistics, administrative employer, and state welfare records, the analysis in this paper investigates the determinants of a woman's intermittent labor force decision at the time of a major life event: the birth of a child. The results indicate that both direct and opportunity labor market costs of exiting the workforce figure significantly into that decision. Further, the analysis reveals the importance of including information about the mother's prebirth job when making inferences about the role various demographics play in the intermittent labor force decision.
    Date: 2011
  4. By: Anna Maria Murante (Laboratorio MeS, Scuola Superiore Sant’Anna, Pisa, Italy); Cinzia Panero (Laboratorio MeS, Scuola Superiore Sant’Anna, Pisa, Italy); Giovanni Perucca (Department of Economics and Public Finance “G.Prato”, University of Turin and DEAS, University of Milan)
    Abstract: In the last years the interest for patient experience with health care services largely increased. Several surveys have been conducted in order to observe if health care systems answer to the overall patient needs. In 2000 World Health Organization challenged modern health care providers to ensure responsiveness to patients, i.e. to deliver also non-health assistance (respect for dignity, confidentiality, prompt attention, quality of amenities, access to social support networks, choice of provider, etc.). Poor evidence is available in Italy about connections between perceived quality and the capability of the healthcare system to respond to patients’ needs. This work aims at investigating patient experience with General Practitioner (GP) assistance and at measuring the impact of personal and organizational characteristics on overall satisfaction and on willingness to recommend. In 2009 a sample survey was conducted in four regions of Italy (Tuscany, Piedmont, Umbria, and Liguria). About 15.000 citizens answered to a large questionnaire related to Primary Care services, including a section dedicated to General Practitioner (GP) assistance. A logistic regression analysis was applied to analyze which are the predictors of overall satisfaction with GP, focusing mainly on variables related to patient’s expectations, continuity of care and organizational aspects (e.g. scheduled access, waiting time, health case history, etc.) and if there are differences across the four Italian Regions. Econometric analysis has been carried out through both ordered logistic regression and generalised ordered logit models. The inhabitants of the four Italian Regions refer a nice experience with GP assistance: more than 85% of them judged excellent or good the overall service. Generally, in some regions patient expectations affect more the willingness to recommend GP to friends or family members than the overall judgement on service. Besides, the findings provide convincing evidence that GP is a nodal point in the continuity of care process .
    Keywords: : patient satisfaction, general practitioner, organizational aspects, continuity of care
    Date: 2010–05–01
  5. By: Courtemanche, Charles (University of North Carolina at Greensboro, Department of Economics); McAlvanah, Patrick (Federal Trade Commission)
    Abstract: This paper explores the relationship between time preference, food prices, and body mass index (BMI). We present a model predicting that impatient individuals should both weigh more than patient individuals and experience sharper increases in weight in response to falling food prices. We then provide evidence to support these predictions using data from the National Longitudinal Survey of Youth matched with local food prices from the Council for Community and Economic Research. Our findings suggest that the interaction of changing economic incentives with impatience can help to explain the shift to the right and thickening of the tails of the BMI distribution. Interestingly, we find no evidence of a relationship between time preference and weight loss attempts, suggesting that the observed effect on BMI represents rational intertemporal substitution rather than self-control problems.
    Keywords: Obesity; weight; body mass index; discount factor; discount rate; time preference; food prices
    JEL: D90 I10
    Date: 2011–03–24
  6. By: Vincenzo Atella (University of Rome "Tor Vergata"); Joanna Kopinska (University of Rome "Tor Vergata")
    Abstract: In this paper we empirically study the relationship between education attainment and Body Mass Index (BMI), using as theoretical reference an energy balance model. Our data consist of individual level data from eight waves of the Italian survey on life-styles. We use Quantile Regression (QR) technique to study the impact of education along the whole distribution of the BMI and provide evidence that the effect of education on BMI is greater in magnitude for the overweight and the obese. This effect is reinforced (three times greater) once we account for the endogeneity of some of the determinants of BMI (IVQTE). Finally, we adopt a model specification that allows us to test if education is likely to affect BMI indirectly, through channels such as the adoption of better life styles (healthier diet and more sport activities). Results seem to confirm this hypothesis, and this may reveal an important information for policymakers.
    Keywords: BMI, Instrumental variables, Quantile regression, IVQTE
    JEL: C23 I11 L23 I12 I21
    Date: 2011–03–23
  7. By: Tinh Doan (University of Waikato); John Gibson (University of Waikato); Mark Holmes (University of Waikato)
    Abstract: Quantile Treatment Effects are estimated to study the impacts of household credit access on health spending by poor households in one District of Ho Chi Minh City, Vietnam. There are significant positive effects of credit on the health budget shares of households with low healthcare spending. In contrast, when an Average Treatment Effect is estimated, there is no discernible impact of credit access on health spending. Hence, typical approaches to studying heterogeneous credit impacts that only consider between group differences and not differences over the distribution of outcomes may miss some heterogeneity of interest to policymakers.
    Keywords: credit; healthcare budget share; quantile treatment effects; Vietnam
    JEL: C21 I19
    Date: 2011–02–18

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