nep-hea New Economics Papers
on Health Economics
Issue of 2015‒08‒30
25 papers chosen by
Yong Yin
SUNY at Buffalo

  1. Local Foods and Community Health: An Exploratory Analysis By Deller, Steven C.; Brown, Laura; Canto, Amber
  2. Povery, Public Health and Local Foods By Deller, Steven C.; Brown, Laura; Canto, Amber
  3. To Charge or Not to Charge: Evidence from a Health Products Experiment in Uganda By Fischer, Greg; Karlan, Dean; McConnell, Margaret; Raffler, Pia
  4. Does moving to a system with a more generous public health insurance increase medical care consumption? By Léa Toulemon; Laurent Davezies
  5. Longevity, Age-Structure, and Optimal Schooling By Noël Bonneuil; Raouf Boucekkine
  6. Health, Work and Working Conditions: A Review of the European Economic Literature By Thomas Barnay
  7. Hard to Forget: The Long-Lasting Impact of War on Mental Health By Bratti, Massimiliano; Mendola, Mariapia; Miranda, Alfonso
  8. Follow your Heart: Survival chances and costs after Heart Attacks – An instrumental Variable Approach By Alice Sanwald; Thomas Schober
  9. The Effect of Statutory Sick Pay Regulations on Workers’ Health By Martin Halla; Susanne Pech; Martina Zweimüller
  10. The Effect of Income on Mortality – New Evidence for the Absence of a Causal Link By Alexander Ahammer; G. Thomas Horvath; Rudolf Winter-Ebmer
  11. Testimony to the Interoperability Task Force of the Health IT Policy Committee, ONC By Ann S. O'Malley
  12. Small Businesses' Decisions to Offer Health Insurance to Employees By Catherine McLaughlin Adam Swinburn
  13. Risks to the Returns to Medical Innovation: The Case of Myriad Genetics By Jeffrey Clemens; Stan Veuger
  14. Family Spillovers of Long-Term Care Insurance By Norma B. Coe; Gopi Shah Goda; Courtney Harold Van Houtven
  15. The Impact of Social Security Income on Cognitive Function at Older Ages By Padmaja Ayyagari; David Frisvold
  16. "Transit Makes you Short": On Health Impact Assessment of Transportation and the Built Environment By Alireza Ermagun; David Levinson
  17. Achieving Universal Coverage; Lessons from the Experience of Other Countries for National Health Insurance Implementation in Indonesia By Misnaniarti, Misnaniarti; Ayuningtyas, Dumilah
  18. A Kink that Makes you Sick: the Effect of Sick Pay on Absence in a Social Insurance System By Petri Böckerman; Ohto Kanninen; Ilpo Suoniemi
  19. Does imperfect data privacy stop people from collecting personal health data? By Simeon Schudy; Verena Utikal
  20. ‘Cast back into the Dark Ages of Medicine’? The Challenge of Antimicrobial Resistance By Cormac Ó Gráda
  21. The Effect of Health Insurance on Workers' Compensation Filing: Evidence from the Affordable Care Act's Age-Based Threshold for Dependent Coverage By Marcus Dillender
  22. Price perversities in primary health care By Bronwyn Howell
  23. Late-Life Health Effects of Teenage Motherhood By Angelini, V.;; Mierau, J. O.;
  24. Do hospitals respond to increasing prices by supplying fewer services? By Salm, Martin; Wübker, Ansgar
  25. The long shadows of past insults intergenerational transmission of health over 130 years By Andreella, Claudia; Karlsson, Martin; Nilsson, Therese; Westphal, Matthias

  1. By: Deller, Steven C. (University of WI); Brown, Laura (University of WI); Canto, Amber (University of WI)
    Abstract: In this exploratory analysis we look for patterns in the relationship between local foods and community health using U.S. nonmetropolitan counties. We take an ecological approach using 2007 Census of Agriculture and "County Health Rankings & Roadmaps" data collected by the University of Wisconsin Population Health Institute program at the U.S. county level. In addition to the central question (are higher concentrations of characteristics of local food systems associated with healthier communities) we address the question of health modeling uncertainty by use a Spatial Bayesian Model Averaging (SBMA). As expected, our findings indicate that higher levels of activities associated with local foods are generally associated with higher levels of community health. Two problems with the analysis are (1) challenges around definitions and measurement of local foods and (2) direction of causation is unclear.
    Date: 2014–02
  2. By: Deller, Steven C. (University of WI); Brown, Laura (University of WI); Canto, Amber (University of WI)
    Abstract: In this exploratory analysis we explore the interplay between poverty, public health and access to local foods using data for U.S. counties. We ask one simple question: Does access to local foods dampen or mitigate the relationship between poverty and health? As expected we find a strong relationship between poverty and public health and we also find that access to higher levels of local foods activity is associated with higher levels of public health. The interaction between poverty and local foods, however, suggests that higher concentrations of both are associated with poorer, not better health. From a global perspective we find that the presence of local foods related activity tends to have a positive impact on health, but that relationship is not consistent across the United States. Our results suggest that the interplay between local foods, poverty and health is subtle and the resulting policy implications may make sense in some parts of the United States but not in others.
    Date: 2014–02
  3. By: Fischer, Greg (London School of Economics and Political Science); Karlan, Dean (Yale University and Innovations for Poverty Action); McConnell, Margaret (Harvard University); Raffler, Pia (Yale University)
    Abstract: In a field experiment in Uganda, we find that demand after a free distribution of three health products is lower than after a sale distribution. This contrasts with work on insecticide-treated bed nets, highlighting the importance of product characteristics in determining pricing policy. We put forward a model to illustrate the potential tension between two important factors, learning and anchoring, and then test this model with three products selected specifically for their variation in the scope for learning. We find the rank order of shifts in demand matches with the theoretical prediction, although the differences are not statistically significant.
    JEL: D11 D12 D83 I11 I18 O12
    Date: 2014–10
  4. By: Léa Toulemon (ECON - Département d'économie - Sciences Po); Laurent Davezies (ECON - Département d'économie - Sciences Po)
    Abstract: We evaluate the impact of reimbursement rates on health expenditures, using a natural experiment. For historical reasons, reimbursement rates of public health insurance are higher in the French region Alsace Moselle than in other French regions. For both systems, affiliation is compulsory. Individuals moving between Alsace-Moselle and the rest of France undergo an exogenous change in reimbursement rates. We use a difference-in-difference method on a panel datasets of individuals. Our treatment group consists of individuals changing systems, our control group consists of individuals who move between other French regions. We study the impact of reimbursement rates on a broad range of health care expenditures: for dentist and doctor visits, drug consumption, and sickness absenteeism. We find heterogeneous impacts of reimbursement rates on those items. Overall, higher public reimbursement rates do not lead to an increase in spending for medical care.
    Date: 2015–02
  5. By: Noël Bonneuil (EHESS - École des hautes études en sciences sociales, INED - Institut national d'études démographiques); Raouf Boucekkine (AMSE - Aix-Marseille School of Economics - EHESS - École des hautes études en sciences sociales - Centre national de la recherche scientifique (CNRS) - Ecole Centrale Marseille (ECM) - AMU - Aix-Marseille Université, IUF - Institut Universitaire de France - M.E.N.E.S.R. - Ministère de l'Éducation nationale, de l’Enseignement supérieur et de la Recherche)
    Abstract: The mechanism stating that longer life implies larger investment in human capital, is premised on the view that individual decision-making governs the relationship between longevity and education. This relationship is revisited here from the perspective of optimal period school life expectancy, obtained from the utility maximization of the whole population characterized by its age structure and its age-specific fertility and mortality. Realistic life tables such as model life tables are mandatory, because the age distribution of mortality matters, notably at infant and juvenile ages. Optimal period school life expectancy varies with life expectancy and mortality. Applications to stable population models and then to French historical data from 1806 to nowadays show that the population age structure has indeed modified the relationship between longevity and optimal schooling
    Date: 2015–02
  6. By: Thomas Barnay (ERUDITE - Equipe de Recherche sur l’Utilisation des Données Individuelles en lien avec la Théorie Economique - UPEM - Université Paris-Est Marne-la-Vallée - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12, TEPP - Travail, Emploi et Politiques Publiques - UPEM - Université Paris-Est Marne-la-Vallée - CNRS)
    Abstract: Economists have traditionally been very cautious when studying the interaction between employment and health because of the two-way causal relationship between these two variables: health status influences the probability of being employed and, at the same time, working affects the health status. Because these two variables are determined simultaneously,researchers control endogeneity skews (e.g., reverse causality, omitted variables) when conducting empirical analysis. With these cave at sin mind, the literature finds that a favourable work environment and high job security lead to better health conditions. Being employed with appropriate working conditions plays a protective role on physical health andpsychiatric disorders. By contrast, non-employment and retirement are generally worse for mental health than employment,and over employment has a negative effect on health. These findings stress the importance of employment and of a dequateworking conditions for the health of workers. In this context, it is a concern that a significant proportion of European workers(29%) would like to work fewer hours because unwanted long hours are likely to signal a poor level of job satisfaction andinadequate working conditions, with detrimental effects on health. Thus, in Europe, labour-market policy has increasingly paid attention to jobs ustainability and job satisfaction. The literature clearly invites employers to take better account of the worker preferences when setting the number of hours worked. Overall, a specific “flexicurity” (combination of high employment protection, job satisfaction and activelabour-market policies) is likely to have a positiveeffect on health.
    Date: 2014
  7. By: Bratti, Massimiliano (University of Milan); Mendola, Mariapia (University of Milan Bicocca); Miranda, Alfonso (CIDE, Mexico City)
    Abstract: War can have long-lasting effects on individual mental health through war trauma. In this paper, we explore the impact of constantly recalling painful episodes related to the 1992-1995 Bosnia and Herzegovina conflict on individual mental health in 2001 using the Center for Epidemiologic Studies Depression (CES-D) scale. Potential endogeneity and reverse causality issues are addressed using objective measures of war intensity recorded at the municipality level. We find that individuals experiencing war trauma have worse mental health six years after the end of the conflict. In particular, instrumental-variable estimates show that they score 16 points (more than 1.5 standard deviations) higher on the CES-D scale (with higher scores meaning more depression symptoms) and have a 60 percentage points higher probability of being at risk of depression. Our results are robust to a number of sensitivity checks accounting for individual geographical mobility and different treatment intensities, and suggest that the negative effects on mental health are not mainly mediated by physical health problems. Back-of-the envelope calculations show large economic costs of war-trauma.
    Keywords: war trauma, mental health, depression, Bosnia and Herzegovina
    JEL: I1 O1
    Date: 2015–08
  8. By: Alice Sanwald; Thomas Schober
    Abstract: We analyze mortality and follow-up costs of heart attack patients using administrative data from Austria from 2002-2011. As treatment intensity in a hospital largely depends on whether it has a catheterization laboratory, we focus on the effects of patients’ initial admission to these specialized hospitals. To account for the nonrandom selection of patients into hospitals, we exploit individuals’ place of residence as a source of exogenous variation in an instrumental variable framework. We find that the initial admission to specialized hospitals increases patients’ survival chances substantially. The effect on 3-year mortality is -9.5 percentage points. A separation of the sample into subgroups shows the strongest effects in relative terms for patients below the age of 65. We do not find significant effects on longterm inpatient costs and find only marginal increases in outpatient costs.
    Keywords: Acute myocardial infarction, mortality, costs, instrumental variables.
    JEL: I11 I12
    Date: 2014–10
  9. By: Martin Halla; Susanne Pech; Martina Zweimüller
    Abstract: Social insurance programs typically comprise sick leave insurance. An important policy parameter is how the cost of sick leave are shared between workers, firms, and the social security system. We show that this sharing rule affects not only absence behavior, but also workers’ subsequent health. To inform our empirical analysis we propose a simple model, where workers’ absence decision is taken conditional on the sharing rule, health, and a dismissal probability. Our empirical analysis is based on high-quality administrative data sources from Austria. Identification is guaranteed by idiosyncratic variation in the sharing rule (caused by different policy reforms and sharp discontinuities at certain tenure levels and firm sizes). An increase in either the workers’ or the firms’ cost share (both at the public expense) decrease the number of sick leave days. Variations in the workers’ cost are quantitatively more important (by a factor of about two). Policy-induced variation in sick leave has a significant effect on subsequent health (care cost). The average worker in our sample is in the domain of presenteeism, i. e. an increase in sick leave (due to reductions in the workers’ or the firms’ cost share) would reduce health care cost.
    Keywords: Statutory sick-pay regulations, sick leave, presenteeism, absenteeism, moral hazard, health care cost.
    JEL: I18 J22 J38
    Date: 2015–05
  10. By: Alexander Ahammer; G. Thomas Horvath; Rudolf Winter-Ebmer
    Abstract: We analyze the effect of income on mortality in Austria using administrative social security data. To tackle potential endogeneity concerns arising in this context, we estimate time-invariant firm-specific wage components and use them as instruments for actual wages. While we do find quantitatively small yet statistically significant effects in our naïve least squares estimations, IV regressions reveal a robust zero-effect of income on ten-year death rates for prime-age workers, both in terms of coefficient magnitude and statistical significance. These results are robust to a number of different sample specifications and both linear and non-linear estimation methods.
    Keywords: Income, mortality, wage decomposition.
    JEL: J14 J31 I10
    Date: 2015–07
  11. By: Ann S. O'Malley
    Abstract: Challenges to health information exchange are pervasive; they are not just a market-specific phenomenon.
    Keywords: Testimony, Interoperability Task Force, Health IT Policy Committee, ONC
    JEL: I
    Date: 2015–08–14
  12. By: Catherine McLaughlin Adam Swinburn
    Abstract: Employer-sponsored health insurance (ESI) is the dominant source of coverage for nonelderly adults in the United States. Virtually all businesses with 200 or more workers offer coverage to at least some of their employees, whereas many small businesses do not offer it to any. An important reason employers say they offer coverage is so they can recruit and retain workers with the desired skills and experience; the most common reason for not offering it is the cost.
    Keywords: Health Insurance, Employees, Small Businesses, Health
    JEL: I
    Date: 2014–06–01
  13. By: Jeffrey Clemens; Stan Veuger
    Abstract: We describe the broad range of uncertainties faced by the developers of medical technologies. Empirically, we estimate the asset market incidence of two realizations of uncertainties we classify as within-market policy risks. The events we analyze concern the intellectual property of Myriad Genetics, Inc., an American molecular diagnostics firm. In June 2013, the Supreme Court invalidated several of Myriad's intellectual property claims. Subsequently, the Center for Medicare and Medicaid Services (CMS) re-evaluated the reimbursements it pays for the services at issue in the Supreme Court's ruling. Each of these events moved Myriad's market capitalization by several hundred million dollars, or on the order of 20 percent. Myriad's exposure to the realization of these events reflected the concentration of its revenue streams among the affected services. We discuss the implications of the risks we analyze for the total volume of medical innovation and for its organization across firms.
    JEL: H51 H57 I18 O31 O32 O34
    Date: 2015–08
  14. By: Norma B. Coe; Gopi Shah Goda; Courtney Harold Van Houtven
    Abstract: We examine how long-term care insurance (LTCI) affects family outcomes expected to be sensitive to LTCI, including utilization of informal care and spillover effects on children. An instrumental variables approach allows us to address the endogeneity of LTCI coverage. LTCI coverage induces less informal caregiving, suggesting the presence of intra-family moral hazard. We also find that children are less likely to co-reside or live nearby parents with LTCI and more likely to work full-time, suggesting that significant economic gains from private LTCI could accrue to the younger generation.
    JEL: H5 H75 I13 J12 J14 J22
    Date: 2015–08
  15. By: Padmaja Ayyagari; David Frisvold
    Abstract: Prior literature has documented a positive association between income and cognitive function at older ages, however, the extent to which this association represents causal effects is unknown. In this study, we use an exogenous change in Social Security income due to amendments to the Social Security Act in the 1970s to identify the causal impact of Social Security income on cognitive function of elderly individuals. We find that higher benefits led to significant improvements in cognitive function and that these improvements in cognition were clinically meaningful. Our results suggest that interventions even at advanced ages can slow the rate of decline in cognitive function.
    JEL: H55 I12
    Date: 2015–08
  16. By: Alireza Ermagun; David Levinson (Nexus (Networks, Economics, and Urban Systems) Research Group, Department of Civil Engineering, University of Minnesota)
    Abstract: The current research provides a test framework to understand whether and to what extent increasing public transit use and accessibility by transit affect health. To this end, the effect of transit mode share and accessibility by transit on general health, body mass index, and height are investigated, while controlling for socioeconomic, demographic, and physical activity factors. The coefficient-p-value-sample-size chart is created and effect size analysis are conducted to explore whether the transit use is practically significant. Building on the results of the analysis, we found that the transit mode share and accessibility by transit are not practically significant, and the power of large-sample misrepresents the effect of transit on public health. The results, also, highlight the importance of data and variable selection by portraying a significant correlation between transit use and height in a multivariate regression analysis. What becomes clear from this study is that in spite of the mushrooming interdisciplinary studies in the nexus of transportation and health arena, researchers often propose short- and long-term policies blindly, while failing to report the inherent explanatory power of variables. We show that there is a thin line between false positive and true negative results. From the weakness of p-values perspective, further, we strove to alert both researchers and practitioners to the dangerous pitfall deriving from the power of large- samples. Building the results on just significance and sign of the parameter of interest is worthless, unless the magnitude of effect size is carefully quantified post analysis.
    Keywords: Public transit; BRFSS data; ACS data; Accessibility to jobs; p-hacking
    JEL: D12 I12 B23 C13 C18 R41 R42
    Date: 2015
  17. By: Misnaniarti, Misnaniarti; Ayuningtyas, Dumilah
    Abstract: Indonesia is not the only country that will lead to universal coverage. Several countries took an initiative to develop social security, through Universal Health Coverage (UHC) to achieve health insurance and welfare for all residents. Even, some countries have already reached universal health coverage since a few years ago. The purpose of this paper is to assess the achievement of universal coverage of the health insurance implementation in several countries. In general, some countries require considerable time to achieve universal coverage. Mechanisms and stages that need attention is on the univeral registration aspects that cover the entire population, progressive and continuous funding sources, comprehensive benefits package, the expansion of gradual coverage for diseases that can cause catastrophic expenditure, increasing capacity and mobilizing supporting resource. National Health Insurance policy in some countries can improve access to care, utilization and quality of quality health services to all citizens. Indonesia is expected to learn from the experience of other countries to achieve UHC, so that the projection of the entire population of Indonesia to have health insurance in 2019 will be reached soon.
    Keywords: Social Health Insurance, Health Policy, Universal Coverage
    JEL: H30
    Date: 2015–02
  18. By: Petri Böckerman (Turku School of Economics, Labor Institute for Economic Research and IZA); Ohto Kanninen (Labour Institute for Economic Research); Ilpo Suoniemi (Labour Institute for Economic Research)
    Abstract: We examine the effect of the replacement rule of a social insurance system on sickness absence. The elasticity of absence with respect to the benefit level is a critical parameter in defining the optimal sickness insurance scheme. A pre-determined, piecewise linear policy rule in which the replacement rate is determined by past earnings allows identification of the causal effect using a regression kink design. Using a large administrative dataset, we find a substantial and robust behavioral response. The statistically significant point estimate of the elasticity of the duration of sickness absence with respect to the replacement rate in a social insurance system is on the order of 1.
    Keywords: Sick pay, labor supply, sickness absence, paid sick leave, regression kink design
    JEL: C72 C73
    Date: 2014–12
  19. By: Simeon Schudy; Verena Utikal
    Abstract: Privacy regulations can affect the willingness to collect personal health data that may be disclosed to insurers. Perfect privacy cannot always be guaranteed. Consequently, people may refrain from collecting personal health data. This paper provides a theoretical and experimental analysis of the importance of privacy regulations for information acquisition and disclosure behavior. We contrast three institutional settings in a simple game of persuasion: Disclosure Duty of collected data, Perfect Privacy and Imperfect Privacy. Under Perfect Privacy there exists a unique proper equilibrium with complete information acquisition. For Disclosure Duty no information acquisition is predicted. Imperfect Privacy can result in multiple equilibria. Our laboratory experiment confirms the qualitative differences on information acquisition for Perfect Privacy and Disclosure Duty. Behavior under Imperfect Privacy turns out to be very similar to Perfect Privacy: Imperfect Privacy does not stop people from collecting personal information. We discuss possible reasons for the observed behavior.
    Keywords: data privacy, endogenous information acquisition, health, experiment, unraveling
    Date: 2015
  20. By: Cormac Ó Gráda
    Abstract: Antimicrobial resistance (AMR) is currently the focus of much media attention and policy discussion. A historical perspective on AMR suggests that although the challenge of AMR is real, the doomsday tone of most commentary is unwarranted. That is partly because most of the gains in life expectancy now deemed under threat preceded the antibiotics revolution. A combination of public health measures, rising living standards, and new medical knowledge all played their part in this. Even if AMR increases, the continuing effect of these factors and of new public health measures can limit the negative consequences. Moreover, recent developments suggest that the supply pipeline of new drugs is not quite as dry as usually claimed. The problem for now is not MRSA or malaria but carbapenem-resistant gram-negative bacteria, which pose an urgent threat and on which public funding for research on effective new therapies should concentrate.
    Keywords: Infectious disease; Health; Antimicrobial resistance; Economic history
    JEL: I N
    Date: 2015–05
  21. By: Marcus Dillender (W.E. Upjohn Institute for Employment Research)
    Abstract: This paper identifies the effect of health insurance on workers' compensation (WC) filing for young adults by implementing a regression discontinuity design using WC medical claims data from Texas. The results suggest health insurance factors into the decision to have WC pay for discretionary care. The implied instrumental variables estimates suggest a 10 percentage point decrease in health insurance coverage increases WC bills by 15.3 percent. Despite the large impact of health insurance on the number of WC bills, the additional cost to WC at age 26 appears to be small as most of the increase comes from small bills.
    Keywords: Workers’ compensation, Moral hazard, Health insurance, Affordable Care Act
    JEL: I13 J32 J38
    Date: 2015–07
  22. By: Bronwyn Howell
    Abstract: The processes for assessing acceptable increases in patient fees paid to New Zealand primary health care practices are inconsistent with the government’s subsidy policy intentions. Bronwyn Howell explains why.
    Date: 2013–11–01
  23. By: Angelini, V.;; Mierau, J. O.;
    Abstract: We study the causal impact of teenage motherhood on late-life health outcomes, using a retrospective survey of almost 12,000 women from 13 European countries containing detailed information on early-life circumstances. We find that, compared to other women, teenage mothers experience substantially lower self-reported latelife health and are more likely to display depressive symptoms. This effect is robust to controlling for early-life factors, both parametrically and through propensity score matching, and is unlikely to be driven by selection on unobservables. Studying potential transmission mechanisms by which teenage motherhood translates into adverse late-life health highlights the importance of life-cycle socio-economic conditions and societal values.
    Keywords: teenage motherhood; self-reported health; depression; retrospective data; Europe;
    JEL: I31 J13 J14
    Date: 2015–08
  24. By: Salm, Martin; Wübker, Ansgar
    Abstract: Medical providers often have a significant influence on treatment decisions which they can use in their own financial interest. Classical models of supplier-induced demand predict that medical providers will supply fewer services if they face increasing prices. We test this prediction based on a reform of hospital financing in Germany. Uniquely, this reform changed the overall level of reimbursement - with increasing prices for some hospitals and decreasing prices for others - without affecting the relative prices for different types of patients. Based on administrative data, we find that hospitals do indeed react to increasing prices by reducing service supply.
    Abstract: Anbieter von medizinischen Leistungen treffen häufig Behandlungsentscheidungen für ihre Patienten und haben die Möglichkeit, bei diesen Entscheidungen ihre eigenen finanziellen Interessen zu berücksichtigen. Klassische Modelle der Theorie der 'angebotsinduzierten Nachfrage' prognostizieren, dass medizinische Anbieter auf höhere Preise reagieren, indem sie weniger Leistungen erbringen. Wir testen diese Vorhersage auf Grundlage einer Reform der Krankenhausfinanzierung in Deutschland. Das Besondere an der Finanzierungsreform in Deutschland ist, dass die Reform die Preise für Krankenhäuser verändert hat - mit steigenden Preisen für einige Krankenhäuser und sinkenden Preisen für andere - ohne dabei die relativen Preise für die Behandlung unterschiedlicher Patientengruppen oder unterschiedlicher Krankheiten zu beeinflussen. Unter Nutzung administrativer Daten finden wir, dass Krankenhäuser tatsächlich weniger Leistungen erbringen, wenn die Preise steigen.
    Keywords: physician-induced demand,hospital care,prospective payment
    JEL: I11 L10 L21
    Date: 2015
  25. By: Andreella, Claudia; Karlsson, Martin; Nilsson, Therese; Westphal, Matthias
    Abstract: This paper investigates the intergenerational transmission of health in the very long run. Using a unique purpose-built administrative dataset on individuals born in Sweden between 1930-34 and their parents, we study the intergenerational transmission (IGT) of health and the impact of previous generations' health shocks on socioeconomic outcomes. Our results provide strong evidence in favour of IGT of health, in particular for males. In contrast to the existing literature that focuses on early life health outcomes, our paper shows that the effect on later-life mortality might be even more relevant. However, the story appears to be complex and multi-faceted: the IGT exhibits an inverted socioeconomic gradient, and the impact on socioeconomic outcomes is often very different from the effect on health.
    Abstract: In diesem Paper wird die Übertragung von Gesundheit zwischen Generationen untersucht, mit Berücksichtigung ihrer möglichen Auswirkungen über den gesamten Lebensverlauf. Im Gegensatz zur bisherigen Literatur, die sich auf die Auswirkungen in den ersten Lebensjahren konzentriert, zeigt dieses Paper, dass die langfristigen Effekte gegebenenfalls noch wichtiger sind. Als Datenbasis dient eine auf diesen Zweck abgestimmte Erhebung administrativer Einträge aus schwedischen Gemeinderegistern bestehend aus den Geburtskohorten 1930-34, die die Kindergeneration bilden. Hiermit analysieren wir die Übertragbarkeit von Gesundheit über zwei Generationen, denn die Daten erlauben es, auch die Elterngeneration zu identifizieren. Um diese Übertragbarkeit von anderen Störgrößen zu isolieren, werden Gesundheitsschocks der Müttergeneration benutzt. Untersucht wird der Einfluss dieser Schocks auf verschiedene Ergebnisgrößen der Kindergeneration: einerseits auf Mortalität und ihre Ursachen über den nahezu gesamten Lebensverlauf, andererseits auf Bildung und das Arbeitsangebot als sozioökonomische Größen. Die Ergebnisse weisen eindeutig nach, dass intergenerationale Übertragbarkeit vorliegt; dies gilt insbesondere und verstärkt für Männer. Allerdings deuten die Resultate auch darauf hin, dass die Übertragungskanäle über sozioökonomische Gruppen hinweg komplex und vielschichtig sind und auch mit Unterschieden im Gesundheits- und Ernährungsverhalten interagieren könnten.
    Keywords: early environment,intergenerational transmission,Barker hypothesis,maternal health,infant health,socioeconomic status
    JEL: I12 J13
    Date: 2015

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