nep-hea New Economics Papers
on Health Economics
Issue of 2012‒01‒18
fifteen papers chosen by
Yong Yin
SUNY at Buffalo, USA

  1. Health Expenditures And Life Expectancy Around The World: A Quantile Regression Approach By Maksym Obrizan; George L. Wehby
  2. Evidence on the Efficacy of School-Based Incentives for Healthy Living By Harold E. Cuffe; William T. Harbaugh; Jason M. Lindo; Giancarlo Musto; Glenn R. Waddell
  3. Children’s health opportunities and project evaluation: Mexico’s Oportunidades program By D. VAN DE GAER; J. VANDENBOSSCHE; J. L. FIGUEROA
  4. The Effects of Female Labor Force Participation on Obesity By Pedro Gomis-Porqueras; Oscar Mitnik; Adrian Peralta-Alva; Maximilian D. Schmeiser
  5. Chronic Illnesses and Injuries: An Evaluation of their Impact on Occupation and Revenues By Emmanuel Duguet; Christine le Clainche
  6. Working-Age Adult Mortality, Orphan Status, and Child Schooling in Rural Mozambique By Mather, David
  7. Poverty, AIDS, Orphanhood, Gender, and Child Schooling in Sub-Saharan Africa: A Review of the Evidence By Mather, David
  8. Perception of HIV risk and the quantity and quality of children: The case of rural Malawi By Rubén Castro; Jere Behrman; Hans-Peter Kohler
  9. About the role of chronic conditions onto the US educational differences on mortality By Rubén Castro
  10. Health Reform, Health Insurance, and Selection: Estimating Selection into Health Insurance Using the Massachusetts Health Reform By Martin B. Hackmann; Jonathan T. Kolstad; Amanda E. Kowalski
  11. Cost-Effectiveness Analysis of Education and Health Interventions in Developing Countries By Patrick J. McEwan
  12. A gravity model of mortality rates for two related populations By Dowd, Kevin; Cairns, Andrew; Blake, David; Coughlan, Guy; Khalaf-Allah, Marwa
  13. Valuing financial, health, and environmental benefits of Bt cotton in Pakistan By Shahzad Kouser; Matin Qaim
  14. Education and Health: Insights from International Comparisons By David M. Cutler; Adriana Lleras-Muney
  15. Optimal Aging with Uncertain Death By Strulik, Holger

  1. By: Maksym Obrizan (Kyiv School of Economics, Kyiv Economic Institute); George L. Wehby (University of Iowa)
    Abstract: Previous literature has produced mixed results on the effects of country health expenditures on longevity. More importantly, all previous studies have evaluated the expenditure effects on the mean of the life expectancy distribution, ignoring the possibility that the expenditure returns may not be the same for countries that differ in their life expectancies. In this paper, we evaluate the heterogeneity in country health expenditure effects throughout the life expectancy distribution applying quantile regression to an assembled dataset of 177 countries. We find significant heterogeneities in expenditures effects on life expectancy that are completely masked by ordinary least squares (OLS), which underestimates (overestimates) the expenditure returns for countries ranking at low (high) life-expectancy quantiles. The largest returns from increased spending are for countries at the left margin of the life expectancy distribution (mainly at quantiles 0.25 and lower), for which a $100 increase in per capita spending leads to 11.5 and 11 months of life for males and females, respectively. The results suggest that increasing healthcare spending in these countries may have significant population-wide life expectancy returns.
    Keywords: Health Expenditures, Life Expectancy, Quantile Regression
    JEL: I1 C2
    Date: 2012–01
  2. By: Harold E. Cuffe (Université d'Oregon - University of Oregon); William T. Harbaugh (Université d'Oregon - University of Oregon); Jason M. Lindo (Université d'Oregon - University of Oregon); Giancarlo Musto (GATE Lyon Saint-Etienne - Groupe d'analyse et de théorie économique - CNRS : UMR5824 - Université Lumière - Lyon II - École Normale Supérieure de Lyon); Glenn R. Waddell (Université d'Oregon - University of Oregon)
    Abstract: This article reveals and studies the connections between Bentham's Defence of Usury (1787) and Saint-Amand Bazard (1791-1832), a founder of Saint-Simonianism. We first traces Bazard's exposure to Bentham through his unknown friendship with Bentham's publisher Etienne Dumont. After introducing in details the Saint-Simonian views on interest and money, we examines the significance of Bazard's translation of Defence of Usury and his shared opposition against usure laws. We explain why the puzzling reference to Benthamite utilitarianism is not fortuitous but appears to justify a common ground between Bentham's utilitarism and Saint-Simonianism. This connection did not survive the July Revolution.
    Keywords: health; exercise; children; school; incentives; active commuting
    Date: 2011–12–23
    Abstract: We propose a methodology to evaluate social projects from an (equality of) opportunity perspective by looking at their effect on (parts of) the distribution of outcomes conditional on morally irrelevant characteristics, taken here to be parental education level and indigenous background. The methodology is applied to evaluate the effects on children’s health outcomes of Mexico’s Oportunidades program, one of the world’s largest conditional cash transfer programs for poor households. The evidence shows that the gains in health opportunities for children from indigenous background are substantial and situated in crucial parts of the distribution, while the gains for children from nonindigenous backgrounds are more limited.
    Keywords: project evaluation, opportunities, oportunidades program.
    JEL: I18 I38 D63
    Date: 2011–10
  4. By: Pedro Gomis-Porqueras (Department of Economics, University of Miami); Oscar Mitnik (Department of Economics, University of Miami); Adrian Peralta-Alva (Federal Reserve Bank of St. Louis); Maximilian D. Schmeiser (Federal Reserve Bank of St. Louis)
    Abstract: This paper assesses whether a causal relationship exists between recent increases in female labor force participation and the increased prevalence of obesity amongst women. The expansions of the Earned Income Tax Credit (EITC) in the 1980s and 1990s have been established by prior literature as having generated variation in female labor supply, particularly amongst single mothers. Here, we use this plausibly exogenous variation in female labor supply to identify the effect of labor force participation on obesity status. We use data from the National Health Interview Survey (NHIS) and replicate labor supply effects of the EITC expansions found in previous literature. This validates employing a difference-in-differences estimation strategy in the NHIS data, as has been done in several other data sets. Depending on the specification, we find that increased labor force participation can account for at most 19% of the observed change in obesity prevalence over our sample period. Our preferred specification, however, suggests that there is no causal link between increased female labor force participation and increased obesity.
    Keywords: Female Labor Force Participation, Obesity, Earned Income Tax Credit
    JEL: H31 I12 J22
  5. By: Emmanuel Duguet; Christine le Clainche
    Abstract: This paper investigates whether chronic illnesses and injuries have a significant impact on the individual’s performance in the labor market. We use the “Santé et Itinéraires Professionnels” (SIP, “Health and Labor Market Histories”) survey, conducted in France in 2006-2007. We use the propensity score method in order to evaluate the impact of chronic illnesses and accidents on labor market participation and earnings. We find that both health events have a negative effect on professional careers and earnings, and that accidents have a greater impact on women’s earnings
    Date: 2012–01
  6. By: Mather, David
    Abstract: Replaced with revised version January 11, 2012.
    Keywords: AIDS, Mozambique, adult mortality, Child Schooling, Food Security and Poverty,
    Date: 2011–11
  7. By: Mather, David
    Abstract: There is growing concern that the HIV/AIDS epidemic may reduce long-term human capital development through reductions in child schooling in SSA, thus severely limiting the longterm ability of orphans and their extended families to escape poverty. In response, some have called for targeted schooling subsidies for orphans and other children made vulnerable by HIV/AIDS, on the assumption that such children are under-enrolled. This paper provides an overview of the data sources used by existing empirical studies that test for orphan schooling deficits and the methodological challenges that they face. It then reviews the empirical evidence on the effects of orphan status or adult mortality on child schooling, as well as the prevalence of orphans in SSA and their living arrangements.
    Keywords: HIV/AIDS, child schooling, Poverty, Sub-Saharan Africa, Food Security and Poverty,
    Date: 2011–11
  8. By: Rubén Castro (Facultad de Economía y Empresa, Universidad Diego Portales); Jere Behrman (Department of Economics, University of Pennsylvania); Hans-Peter Kohler (Department of Sociology, University of Pennsylvania)
    Date: 2011–05
  9. By: Rubén Castro (Facultad de Economía y Empresa, Universidad Diego Portales)
    Date: 2011–05
  10. By: Martin B. Hackmann (Dept. of Economics, Yale University); Jonathan T. Kolstad (Wharton School, University of Pennsylvania); Amanda E. Kowalski (Cowles Foundation, Yale University)
    Abstract: We implement an empirical test for selection into health insurance using changes in coverage induced by the introduction of mandated health insurance in Massachusetts. Our test examines changes in the cost of the newly insured relative to those who were insured prior to the reform. We find that counties with larger increases in insurance coverage over the reform period face the smallest increase in average hospital costs for the insured population, consistent with adverse selection into insurance before the reform. Additional results, incorporating cross-state variation and data on health measures, provide further evidence for adverse selection.
    Keywords: Adverse selection, Massachusetts, Health reform
    JEL: H51 I18
    Date: 2012–01
  11. By: Patrick J. McEwan
    Abstract: High-quality impact evaluations, including randomized experiments, are increasingly popular, but cannot always inform resource allocation decisions unless the costs of interventions are considered alongside their effects. Cost-effectiveness analysis is a straightforward but under-utilized tool for determining which, of two or more interventions provides a (non-pecuniary) unit of effect at least cost. This paper reviews the framework and methods of cost-effectiveness analysis,emphasizing education and health interventions, and discusses how the methods are applied in the literature.
    Keywords: Cost-Effectiveness, Cost-Benefit, Impact Evaluation
    JEL: H43 I25
    Date: 2011–12
  12. By: Dowd, Kevin; Cairns, Andrew; Blake, David; Coughlan, Guy; Khalaf-Allah, Marwa
    Abstract: The mortality rate dynamics between two related but different-sized populations are modeled consistently using a new stochastic mortality model that we call the gravity model. The larger population is modeled independently, and the smaller population is modeled in terms of spreads (or deviations) relative to the evolution of the former, but the spreads in the period and cohort effects between the larger and smaller populations depend on gravity or spread reversion parameters for the two effects. The larger the two gravity parameters, the more strongly the smaller population’s mortality rates move in line with those of the larger population in the long run. This is important where it is believed that the mortality rates between related populations should not diverge over time on grounds of biological reasonableness. The model is illustrated using an extension of the Age-Period-Cohort model and mortality rate data for English and Welsh males representing a large population and the Continuous Mortality Investigation assured male lives representing a smaller related population.
    Keywords: Gravity model; mortality rates; related populations
    JEL: J11
    Date: 2011
  13. By: Shahzad Kouser (Georg-August-University Göttingen); Matin Qaim (Georg-August-University Göttingen)
    Abstract: Data from a farm survey and choice experiment are used to value the benefits of Bt cotton in Pakistan. Unlike previous research on the economic impacts of Bt, which mostly concentrated on financial benefits in terms of gross margins, we also quantify and monetize positive externalities associated with technology adoption. Due to lower chemical pesticide use on Bt cotton plots, there are significant health advantages in terms of reduced incidence of acute pesticide poisoning, and environmental advantages in terms of higher biodiversity and lower soil and groundwater contamination. These positive externalities are valued at US$ 79 per acre, of which half is attributable to health and the other half to environmental improvements. Adding average gross margin gains of US$ 204 results in an aggregate benefit of US$ 283 per acre of Bt, or US$ 1.7 billion for the total Bt cotton area in Pakistan.
    Keywords: Bt cotton; Pesticide use; Health and environmental benefits; Choice experiment; Pakistan
    JEL: D62 I15 Q51 Q57
    Date: 2012–01–10
  14. By: David M. Cutler; Adriana Lleras-Muney
    Abstract: In this review we synthesize what is known about the relationship between education and health. A large number of studies from both rich and poor countries show that education is associated with better health. While previous work has thought of the effect of education separately for rich and poor countries, we argue that there are insights to be gained by integrating the two. For example, education is associated with lower malnutrition in most countries, but in richer countries the educated have lower BMIs whereas in poor countries the educated have higher BMIs. This suggests that the behaviors associated with better health differ depending on the level of development. We illustrate this approach by comparing the effects of education on various health and health behaviors around the world, to generate hypotheses about why education is so often (but not always) predictive of health. Finally, we review the empirical evidence on the relationship between education and health, paying particular attention to causal evidence and evidence on mechanisms linking education to better health.
    JEL: I1 I12 I15
    Date: 2012–01
  15. By: Strulik, Holger
    Abstract: This note extends the theory of optimal aging and death (Dalgaard and Strulik, 2010) towards uncertain death. Specifically, it is assumed that at any age the probability to survive depends on the number of health deficits accumulated. It is shown that the results in Dalgaard and Strulik (2011) on the foundation of the Preston curve (the association between income and life-expectancy across countries) are robust against this extension. While results virtually coincide at high income levels, the stochastic version predicts somewhat more curvature of the Preston curve at low income levels. Taking uncertain death and a precautionary motive for health investment into account thus further improves a bit the anyway good fit of the Preston curve.
    Keywords: Aging, Longevity, Health, Savings, Preston Curve
    JEL: D91 J17 J26 I12
    Date: 2011–12

This nep-hea issue is ©2012 by Yong Yin. It is provided as is without any express or implied warranty. It may be freely redistributed in whole or in part for any purpose. If distributed in part, please include this notice.
General information on the NEP project can be found at For comments please write to the director of NEP, Marco Novarese at <>. Put “NEP” in the subject, otherwise your mail may be rejected.
NEP’s infrastructure is sponsored by the School of Economics and Finance of Massey University in New Zealand.