nep-hea New Economics Papers
on Health Economics
Issue of 2016‒04‒30
twenty-one papers chosen by
Yong Yin
SUNY at Buffalo

  1. Birth Order and Health of Newborns: What Can We Learn from Danish Registry Data? By Anne Ardila Brenøe; Ramona Molitor
  2. Interaction, Protection and Epidemics By Sanjeev Goyal; Adrien Vigier; ;
  3. Schooling, skills, and self-rated health: A test of conventional wisdom on the relationship between educational attainment and health By Naomi Duke; Ross Macmillan
  4. The price Ain’t right? hospital prices and health spending on the privately insured By Zack Cooper; Stuart Craig; Martin Gaynor; John Van Reenen
  5. Life Expectancy and its Determinants in the Czech Republic By Vojtech Korbelius; Michal Paulus; Tomas Troch
  6. Agriculture-nutrition linkages and child health in the presence of conflict in Nepal: By Bageant, Elizabeth; Liu, Yanyan; Diao, Xinshen
  7. Health, Work and Working Conditions: A Review of the European Economic Literature By Thomas Barnay
  8. The Economics of Healthy Ageing in China By Heshmati, Almas
  9. Should I Stay or Should I Go? Hospital Emergency Department Waiting Times and Demand By Peter Sivey
  10. Mental Health and Productivity at Work: Does What You Do Matter? By Melisa Bubonya; Deborah Cobb-Clark; Mark Wooden
  11. Canary in a Coal Mine: Infant Mortality, Property Values, and Tradeoffs Associated with Mid-20th Century Air Pollution By Clay, Karen; Lewis, Joshua; Severnini, Edson R.
  12. US Child Safety Seat Laws: Are they Effective, and Who Complies? By Jones, Lauren E.; Ziebarth, Nicolas R.
  13. Information and Disease Prevention: Tuberculosis Dispensaries By Casper Worm Hansen; Peter Sandholt Jensen; Peter Egedesø Madsen
  14. Using the Fragile Families and Child Wellbeing Study in Life Course Health Development Research By Amanda Geller; Kate Jaeger; Garrett Pace
  15. Choosing from multiple alternatives in cost-effectiveness analysis with fuzzy willingness-to-pay/accept and uncertainty By Michal Jakubczyk
  16. The impact of firms' expectations & adjustments on the productivity cost of illness By Michal Jakubczyk; Beata Kon
  17. Evaluating the Role of Media in Averting Heat Stroke Mortality: A Daily Panel Data Analysis By Saudamini Das
  18. Why Income Inequalities Matter for Young People’s Health: A look at the evidence By Goran Holmqvist; Emilia Toczydlowska; Aixa Y. Alemán-Díaz; Joanna Mazur; Diana Frasquilho; Marina Melkumova; UNICEF Innocenti Research Centre
  19. Family Affluence and Inequality in Adolescent Health and Life Satisfaction: Evidence from the HBSC study 2002-2014 By Yekaterina Chzhen; Emilia Toczydlowska; Irene Moor; William Pickett; Gonneke Stevens; UNICEF Innocenti Research Centre
  20. Tall, Active, and Well Made? Maori Stature and Health in New Zealand By Kris Inwood; Les Oxley; Evan Roberts
  21. Population aging in healthcare - a minor issue? Evidence from Switzerland By Colombier, Carsten

  1. By: Anne Ardila Brenøe; Ramona Molitor
    Abstract: Research has shown a strong negative correlation between birth order and cognitive test scores, IQ, and educational outcomes. We ask whether birth order differences in health are present at birth using matched administrative data for more than 1,000,000 children born in Denmark between 1981 and 2010. Using family fixed effects models, we find a positive and robust birth order effect; lower parity children are less healthy at birth. Looking at the potential mechanisms, we find that during earlier pregnancies women have higher labor market attachment, behave more risky in terms of smoking, receive more prenatal care, and are diagnosed with more medical pregnancy complications. Yet, none of these factors explain the birth order differences at birth. This positive birth order effect at birth stands in stark contrast to a negative birth order effect in educational performance. Once we control for health at birth, the negative birth order effect in educational performance further increases.
    Keywords: Birth order, parity, child health, fetal health, health at birth, education
    JEL: I10 I12 J12 J13
    Date: 2015–10
  2. By: Sanjeev Goyal; Adrien Vigier; ;
    Abstract: Individuals respond to the risk of infectious diseases by restricting interaction and by investing in protection. We develop a model that examines the trade-off between these two actions and the consequences for disease prevalence. There exists a unique equilibrium: individuals who invest in protection choose to interact more relative to those who do not invest in protection. Changes in the contagiousness of the disease have nonmonotonic effects: as a result interaction initially falls and then rises, while disease prevalence too may initial increase and then decline. We then consider a society with two communities that differ in their returns from interaction - High and Low. Individuals in isolated communities exhibit different behavior: the High community has a higher rate of protection and interaction and a lower rate of infection. Integration amplifies these differences.
    Date: 2014–06–10
  3. By: Naomi Duke; Ross Macmillan
    Abstract: Education is a key sociological variable in the explanation of health and health disparities. Conventional wisdom emphasizes a life course-human capital perspective with expectations of causal effects that are quasi-linear, large in magnitude for high levels of educational attainment, and reasonably robust in the face of measured and unmeasured explanatory factors. In this paper, we challenge this wisdom by offering an alternative theoretical account and an empirical investigation organized around the role of measured and unmeasured cognitive and non-cognitive skills as confounders in the association between educational attainment and health. Based on longitudinal data from the National Longitudinal Survey of Youth Ð 1997 spanning mid adolescence through early adulthood, results indicate that a) effects of educational attainment are very vulnerable to issues of omitted variable bias; b) that measured indicators of cognitive and non-cognitive skills account for a significant proportion of the traditionally observed effect of educational attainment; c) that such skills have effects larger than that of even the highest levels of educational attainment when appropriate controls for unmeasured heterogeneity are incorporated; and d) that models that most stringently control for such time-stable abilities show little evidence of a substantive association between educational attainment and health. Implications for theory and research are discussed. Length: 52 pages
    Keywords: Education, health, life-course epidemiology, cognitive and non-cognitive skills, causality
    Date: 2016–04
  4. By: Zack Cooper; Stuart Craig; Martin Gaynor; John Van Reenen
    Abstract: We use insurance claims data for 27.6 percent of individuals with private employer-sponsored insurance in the US between 2007 and 2011 to examine the variation in health spending and in hospitals’ transaction prices. We document the variation in hospital prices within and across geographic areas, examine how hospital prices influence the variation in health spending on the privately insured, and analyze the factors associated with hospital price variation. Four key findings emerge. First, health care spending per privately insured beneficiary varies by a factor of three across the 306 Hospital Referral Regions (HRRs) in the US. Moreover, the correlation between total spending per privately insured beneficiary and total spending per Medicare beneficiary across HRRs is only 0.14. Second, variation in providers’ transaction prices across HRRs is the primary driver of spending variation for the privately insured, whereas variation in the quantity of care provided across HRRs is the primary driver of Medicare spending variation. Consequently, extrapolating lessons on health spending from Medicare to the privately insured must be done with caution. Third, we document large dispersion in overall inpatient hospital prices and in prices for seven relatively homogenous procedures. For example, hospital prices for lower-limb MRIs vary by a factor of twelve across the nation and, on average, two-fold within HRRs. Finally, hospital prices are positively associated with indicators of hospital market power. Even after conditioning on many demand and cost factors, hospital prices in monopoly markets are 15.3 percent higher than those in markets with four or more hospitals.
    Keywords: healthcare; health spending; prices; price dispersion; competition; market structure
    JEL: J1
    Date: 2015–12
  5. By: Vojtech Korbelius (Institute of Economic Studies, Faculty of Social Sciences, Charles University in Prague, Smetanovo nabrezi 6, 111 01 Prague 1, Czech Republic); Michal Paulus (Institute of Economic Studies, Faculty of Social Sciences, Charles University in Prague, Smetanovo nabrezi 6, 111 01 Prague 1, Czech Republic); Tomas Troch (Institute of Economic Studies, Faculty of Social Sciences, Charles University in Prague, Smetanovo nabrezi 6, 111 01 Prague 1, Czech Republic)
    Abstract: We model the life expectancy function for the Czech Republic using three types of explanatory variables: socio-economic, healthcare and environmental pollution factors. The paper presents the first life expectancy model of the Czech Republic and contributes to the existing literature also by the analysis of district level data and inclusion of environmental pollution variables. We found two qualitatively different life expectancy functions where one is applicable for men at the age of 45 and 65 and women at the age of 45 and the other is suitable for women at the age of 65. Key findings can be summarized as follows: only one healthcare factor was significant in all models simultaneously and environmental pollution factors were revealed as significant and should be included in other models of life expectancy function.
    Date: 2016–03
  6. By: Bageant, Elizabeth; Liu, Yanyan; Diao, Xinshen
    Abstract: Much policy and research attention has focused on the relationship between agriculture and nutrition. We extend this analysis to the context of Nepal’s decade-long civil conflict. Understanding how conflict or similar stress mitigates the agriculture-nutrition linkage is essential to developing impactful agriculture and nutrition policy in potential conflict zones. To our knowledge, there is no prior empirical work on the link between agriculture and nutrition in the context of conflict. We find a robust relationship between milk consumption and anthropometric outcomes. We also show a positive link between milk production and milk consumption at the household level. We find significant negative relationships between conflict and milk consumption for households owning few livestock while such relationships do not exist for larger holders. We attribute these heterogeneous effects to conflict-related productivity declines and milk price increases, both of which disproportionately affect households with fewer livestock and lower milk-production capacity. Among rural households in Nepal, milk production could serve as a nutritional buffer in times of conflict or other stress, and thus, policies that promote households’ livestock production could be effective measures in improving resilience of the rural poor against shocks that negatively affect child health outcomes.
    Keywords: nutrition, children, dairy, livestock, agriculture, conflict, agricultural policies, nutrition policies, health, milk, milk production, food consumption, poverty, resilience, shocks, economic shocks,
    Date: 2016
  7. By: Thomas Barnay (TEPP - Travail, Emploi et Politiques Publiques - UPEM - Université Paris-Est Marne-la-Vallée - CNRS - Centre National de la Recherche Scientifique, 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)
    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 caveats in 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 and psychiatric disorders. By contrast, non-employment and retirement are generally worse for mental health than employment, and overemployment has a negative effect on health. These findings stress the importance of employment and of adequate working 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 and inadequate working conditions, with detrimental effects on health. Thus, in Europe, labour-market policy has increasingly paid attention to job sustainability 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 active labour-market policies) is likely to have a positive effect on health.
    Keywords: work, health, working conditions, employment
    Date: 2015–08–01
  8. By: Heshmati, Almas (Jönköping International Business School (JIBS), Centre of Excellence for Science and Innovation Studies (CESIS),& Department of Economics, Sogang University, Seoul, South Korea)
    Abstract: Healthy ageing is a challenge for many countries with significant shares of elderly people. Literature refers to China’s ageing population as a ticking time bomb which paradoxically is both a challenge and an opportunity for the country. Health is considered an important determinant of economic growth and competitiveness. The health of the elderly population determines its need for resources and care. Thus, investing in healthy ageing contributes to economic and social well-being. This study is a review of literature on the social and economic aspects of healthy ageing. It summarizes alternative approaches presented in literature to ease pressures of a rapidly growing ageing population. The main focus is on strategies for healthy ageing, policy practices and measures, organization, finances and manpower resources to promote healthy ageing in China. Up-to-date theories and methods applied to household surveys and population statistics are used to quantify the problem, resource requirements and estimating the social and economic benefits of having policies and measures for healthy ageing. Conclusions are drawn with respect to conditions of healthy ageing in China and about the state policy in this regard.
    Keywords: Healthy ageing; ageing in China; active ageing; challenges and opportunities; economics of healthy ageing
    JEL: H75 I15 I18 I38 P36
    Date: 2016–04–05
  9. By: Peter Sivey (Department of Economics and Finance, La Trobe University)
    Abstract: In the absence of the price mechanism hospital emergency departments rely on waiting times, alongside prioritisation mechanisms, to restrain demand and clear the market. This paper aims to estimate the relationship between waiting times and demand: by how much is the number of treatments demanded reduced by a higher waiting time, other things equal? I use variation in waiting times for low-urgency patients caused by rare and resource-intensive high-urgency patients to estimate the relationship. I find that when waiting times are higher, more low-urgency patients are deterred from treatment and leave the hospital during the waiting period without being treated. The waiting time elasticity of demand for low-urgency patients is approximately -0.25, and is highest for the lowest-urgency patients and when more substitute forms of care are available. The results imply waiting times play a substantial role in reducing demand from low-urgency patients and large increases in hospital capacity will be necessary to reduce emergency department waiting times. Classification-I11
    Keywords: Hospital emergency departments, waiting times, demand
    Date: 2016–03
  10. By: Melisa Bubonya (Melbourne Institute of Applied Economic and Social Research, The University of Melbourne); Deborah Cobb-Clark (School of Economics, The University of Sydney; Institute for the Study of Labour (IZA); and ARC Centre of Excellence for Children and Families Over the Life Course); Mark Wooden (Melbourne Institute of Applied Economic and Social Research, The University of Melbourne; and Institute for the Study of Labour (IZA))
    Abstract: Much of the economic cost of mental illness stems from workers’ reduced productivity. We analyze the links between mental health and two alternative workplace productivity measures – absenteeism and presenteeism (i.e., lower productivity while attending work) – explicitly allowing these relationships to be moderated by the nature of the job itself. We find that absence rates are approximately five percent higher among workers who report being in poor mental health. Moreover, job conditions are related to both presenteeism and absenteeism even after accounting for workers’ self-reported mental health status. Job conditions are relatively more important in understanding diminished productivity at work if workers are in good rather than poor mental health. The effects of job complexity and stress on absenteeism do not depend on workers’ mental health, while job security and control moderate the effect of mental illness on absence days. Classification-I12, J22, J24
    Keywords: Mental health, presenteeism, absenteeism, work productivity
    Date: 2016–04
  11. By: Clay, Karen (Carnegie Mellon University); Lewis, Joshua (University of Montreal); Severnini, Edson R. (Carnegie Mellon University)
    Abstract: Pollution is a common byproduct of economic activity. Although policymakers should account for both the benefits and the negative externalities of polluting activities, it is difficult to identify those who are harmed and those who benefit from them. To overcome this challenge, our paper uses a novel dataset on the mid-20th century expansion of the U.S. power grid to study the costs and the benefits of coal-fired electricity generation. The empirical analysis exploits the timing of coal-fired power plant openings and annual variation in plant-level coal consumption from 1938 to 1962, when emissions were virtually unregulated. Pollution from the burning of coal for electricity generation is shown to have quantitatively important and nonlinear effects on county-level infant mortality rates. By 1962, it was responsible for 3,500 infant deaths per year, over one death per thousand live births. These effects are even larger at lower levels of coal consumption. We also find evidence of clear tradeoffs associated with coal-fired electricity generation. For counties with low access to electricity in the baseline, increases in local power plant coal consumption reduced infant mortality and increased housing values and rental prices. For counties with near universal access to electricity in the baseline, increases in coal consumption by power plants led to higher infant mortality rates, and lower housing values and rental prices. These results highlight the importance of considering both the costs and benefits of polluting activities, and suggest that demand for policy intervention may emerge only when the negative externalities are significantly larger than the perceived benefits.
    Keywords: mid-20th century air pollution, coal-fired electricity generation, infant mortality, housing values, tradeoffs
    JEL: N32 N52 N72 N92 Q40 Q48 Q53 Q56 I15 J24 J30 R11
    Date: 2016–04
  12. By: Jones, Lauren E. (Cornell University); Ziebarth, Nicolas R. (Cornell University)
    Abstract: This paper assesses the effectiveness of child safety seat laws. These laws progressively increased the mandatory age up to which children must be restrained in safety seats in cars. We use US Fatality Analysis Reporting System (FARS) data from 1978 to 2011 and rich state-time level variation in the implementation of these child safety seat laws for children of different ages. Increasing legal age thresholds is effective in increasing the actual age of child safety seat use. Across the child age distribution, restraint rates increase by about 30ppt in the long-run when the legal minimum age increases. However, we cannot reject the null hypothesis that restraining older children in safety seats does not reduce their likelihood to die in fatal accidents. We estimate that parents of 8.6M young children are "legal compliers." They compose an important target group for policymakers because these parents alter their parenting behavior when laws change.
    Keywords: child safety seats, age requirements, fatalities, FARS
    JEL: I18 K32 R41
    Date: 2016–04
  13. By: Casper Worm Hansen (Department of Economics, University of Copenhagen); Peter Sandholt Jensen (Department of Business and Economics, University of Southern Denmark); Peter Egedesø Madsen (Department of Business and Economics, University of Southern Denmark)
    Abstract: Tuberculosis (TB) is a leading cause of death worldwide according to the WHO. This paper estimates the effect of TB dispensaries, designed to prevent the spread of the disease before the advent of modern medicine. Our difference-in-differences estimation reveals that the roll-out of the TB dispensaries across Danish cities led to a 16 percent decline in the TB mortality rate, but no signifficant impacts on other diseases when performing placebo regressions. We obtain very similar estimates from a triple-differences setup, warranting a causal interpretation of our findings. Overall, our conclusion suggests, contrary to McKeown (1976), that public policy played an important role for the decline in TB mortality. It also suggests that dispensaries are of policy relevance for developing countries today as a measure to counter the externalities created by TB and modern drug resistant strains.
    Keywords: Tuberculosis mortality, public health, information, disease prevention, infection externality
    JEL: D62 H23 I15 I18 N34
    Date: 2016–02–01
  14. By: Amanda Geller (New York University); Kate Jaeger (Princeton University); Garrett Pace (Princeton University)
    Abstract: The Fragile Families and Child Wellbeing Study (FFCWS) is a nationally representative birth cohort study of approximately 4,900 children born in large U.S. cities between 1998 and 2000. Nonmarital childbearing increased dramatically in the second half of the 20th century, raising questions about the capabilities of unmarried parents, the nature of parental relationships and their implications for child health development and well being. The FFCWS has become a leading source of information about unmarried parents and their children, and about child health development more generally. The study contains biological and social indicators of children’s cognitive health development, as well as social determinants of health and children’s broader social environment. This rich measurement, coupled with a longitudinal design and multilevel structure make it an ideal resource for life course health development research. This chapter describes the demographic, scholarly and policy context in which the FFCWS was designed, as well as technical details that will enable new users to use the study effectively. We include details of sampling, data availability, variable structure and content, as well as features of the data that enable it to be used in longitudinal research. Finally, the chapter provides information about resources that will be available in the future, and institutional resources available for users of the data.
    Date: 2015–08
  15. By: Michal Jakubczyk
    Abstract: Cost-effectiveness analysis of medical technologies requires valuing health, an uneasy task, as confirmed by variability of published estimates. Treating the willingness-to-pay/accept (WTP/WTA) as fuzzy seems an intuitive solution. Based on this premise, I construct a framework allowing to compare multiple health technologies using choice functions. The final choice must be crisp, so I discuss various defuzzification methods and show that using indecisiveness point (IP) for WTP/WTA (the value the decision maker equally approves/disapproves) has desirable properties: satisfying the independence of irrelevant alternatives and not treating the Likert scale as interval. I suggest three approaches to infer about IP with Likert-based surveys in random samples (hypothesis testing, Bayesian or frequentist estimation). No difference between IPs for WTP/WTA is found, and an explanation of the WTP-WTA disparity is provided. Estimating IP results in stochastic uncertainty, and I show how to conduct sensitivity analysis in the framework and what new insight is gained.
    Keywords: Willingness-to-pay/accept, Fuzzy sets, Preference elicitation, Cost-effectiveness analysis, Sensitivity analysis
    JEL: C44 C13 D81 D61
    Date: 2016–04
  16. By: Michal Jakubczyk; Beata Kon
    Abstract: Sickness-related absenteeism hinders firms' productivity and reduces output, an effect referred to as indirect cost (IC) and often included when assessing the burden of an illness or cost-effectiveness of a treatment. The companies may, however, foresee this risk and modify hiring or contracting policies. We present a model of a firm allowing to estimate IC while accounting for such adjustments. We show that the risk of illness does not change the general shape and properties of the (expected) marginal productivity function. We apply our model to several illustrative examples and show that firm's adjustments impact IC in an ambiguous way, depending on detailed company/market characteristics. Sometimes the company reduces the employment (further increasing IC), yet sometimes the opposite (even generating indirect gains). Contrary to previous literature findings, teamwork and shortfall penalties may reduce IC in some settings. Our analysis highlights that IC should be split into the result of companies preparing for and actually experiencing sick leaves, at least when friction cost approach is taken. To what extent the former counts as IC may depend on the (labour and good) market structure and the interpretation of equilibrium values. These considerations are usually not addressed in applied IC assessment, which may bias the results.
    Keywords: Absenteeism, Productivity, Indirect cost, Teamwork, Output Shortfall, Friction Cost Method
    JEL: D21 J24 J21 L23
    Date: 2016–04
  17. By: Saudamini Das
    Abstract: This used by the state government of Odisha, India to disseminate Information, Education and Communication (IEC) material to avert heat stroke mortality in the state. The government adopted awareness campaigns as an adaptation strategy for heat waves in the year 2003 and intensified the use of public media from 2007, when multiple newspapers, radio and television channels were used for dissemination. I analyze the districtlevel daily death occurrences due to heat stroke using count models and examine the role of media use in averting such mortality. Media used on the same day or on previous days are represented in the models by grouping them as either print, audio or video media. The estimated models account for the gap in data and the multidimensional nature of the panel (days, months, years). Media use on any day was not found to be affecting same day mortality, but repeated advertisements were estimated to decrease deaths significantly over the long run, but not within week, one month, or even one year. Of the three categories of media, repeated use of TV had the most robust effect in reducing deaths followed by newspapers and radio.
    Keywords: Climate change adaptation, Daily panel data, Heat waves, Media use, Awareness campaign, Public health communication, Odisha
  18. By: Goran Holmqvist; Emilia Toczydlowska; Aixa Y. Alemán-Díaz; Joanna Mazur; Diana Frasquilho; Marina Melkumova; UNICEF Innocenti Research Centre
    Abstract: Although child and adolescent inequalities are still less understood than those of adults, we have made progress in understanding the pathways that lead to negative outcomes and the limitations of some ‘adult-specific’ indicators as proxies of young people’s health and well-being. Nonetheless, the academic literature has been able to establish a clear negative relationship between a person’s material circumstances and their health outcomes and behaviours such as being overweight, lack of physical activity, higher levels of smoking and mental health problems, all of which persist throughout a person’s life. The personal and societal toll of these effects is clear, yet policies are still lagging behind, tackling proximal causes rather than ‘the causes of the causes’ of these health inequalities. This paper aims to summarise relevant knowledge on the socio-economic causes of health inequalities in children. It will not only provide a foundation to the Innocenti Report Card 13 in terms of outlining our knowledge regarding the drivers of health inequality but it will also help us shed light on its consequences.
    Keywords: adolescent health; income; inequality;
    Date: 2016
  19. By: Yekaterina Chzhen; Emilia Toczydlowska; Irene Moor; William Pickett; Gonneke Stevens; UNICEF Innocenti Research Centre
    Abstract: A large body of literature has established socio-economic gradients in adolescent health, but few studies have investigated the extent to which these gradients are associated with very poor health outcomes. The current analysis examined the extent to which the socio-economic background of adolescents relates to very poor self-reported health and well-being (the so-called ’bottom end’). We examined the following as indicators of adolescent health: psychosomatic health complaints; physical activity; healthy eating; unhealthy eating; and life satisfaction. Adolescents who scored below the mean of the lower half of the distribution of a given indicator fall in the “bottom group” on this indicator. The largest, most persistent and widespread socio-economic gradients are in life satisfaction, physical activity and healthy eating, while the findings are mixed for unhealthy eating and psychosomatic health. Socio-economic inequalities were largely stable, but in a sizeable minority of the countries, socio-economic inequalities in physical activity and healthy eating have widened between 2001/02 and 2013/14, while inequalities in unhealthy eating and life satisfaction have narrowed in several countries.
    Keywords: adolescent health; nutrition indicators; physical development; socio-economic background;
    Date: 2016
  20. By: Kris Inwood (University of Guelph); Les Oxley (University of Waikato); Evan Roberts (University of Minnesota)
    Abstract: We examine physical well-being among New Zealand Maori from the 1700s to the mid-twentieth century. After colonization Maori stature declined slowly. Late nineteenth century Maori and Pakeha (European settlers) stood equally tall, but Maori stature lagged between 1900 and World War II. Stature increased after the 1920s for Pakeha and 1950s for Maori. Convergence has re-established comparable stature. Fertility decline, improvements in socio-economic status and health policy may explain convergence of stature and infant mortality. We hypothesize that the early twentieth century divergence reflects cumulative land loss, disease incidence, rural-urban migration and labour market segregation.
    JEL: I14 J15 N30 O57
    Date: 2016–03–29
  21. By: Colombier, Carsten
    Abstract: Our study shows that population aging substantially affects healthcare expenditure (HCE). This conclusion supports the popular, but recently strongly contested, view that the coming population aging will threaten the fiscal sustainability of health systems. We contribute to this debate, first by estimating the determinants of Swiss healthcare expenditure (HCE) with outlier-robust dynamic regressions, and second, by projecting Swiss HCE based on the estimates produced and new population scenarios. Medical advances and GDP per capita also play a decisive role. Governments can mitigate HCE growth by improving the health status of the population and by stimulating cost-effective and productive medical advances.
    Abstract: In diesem Papier wird gezeigt, dass eine alternde Bevölkerung zu einem zunehmenden Kostendruck im Gesundheitswesen führt. Unsere Analyse stützt die weit verbreitete, aber in letzter Zeit sehr umstrittene Hypothese, dass die absehbare Alterung der Bevölkerung die finanzielle Nachhaltigkeit des Gesundheitswesens gefährdet. Dieses Papier leistet einen Beitrag zur Diskussion über die Bedeutung der Alterung für das Gesundheitswesen, indem wir (i) die Determinanten der Schweizer Gesundheitsausgaben mit Hilfe Ausreißer-robuster dynamischer Regressionen schätzen und (ii) die Gesundheitsausgaben auf Basis dieser empirischen Schätzungen und der jüngsten Bevölkerungsszenarien für die Schweiz projizieren. Unsere Ergebnisse legen auch nahe, dass der medizinischtechnische Fortschritt und das BIP pro Kopf wesentliche Faktoren für das Ausgabenwachstum im Gesundheitswesen sind. Die Gesundheitspolitik kann das Ausgabenwachstum insbesondere durch Maßnahmen zur Verbesserung des Gesundheitszustands der Bevölkerung sowie eine gezielte Förderung von kostensparenden und effizienten medizinischen Innovationen dämpfen
    Keywords: healthcare expenditure,population ageing,fiscal sustainability,advances in medical technology,robust MM estimator,long-term projections,bootstrap simulations,Gesundheitsausgaben,Alterung,finanzielle Nachhaltigkeit,medizinisch-technischer Fortschritt,robuster MM Schätzer,langfristige Ausgabenprojektionen,Bootstrapsimulationen
    JEL: H51 I18 C22
    Date: 2016

This nep-hea issue is ©2016 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.