nep-hea New Economics Papers
on Health Economics
Issue of 2012‒09‒30
24 papers chosen by
Yong Yin
SUNY at Buffalo, USA

  1. Out-of-Pocket Health Care Expenditure in Turkey: Analysis of the Household Budget Surveys 2002-2008 By Dilek Basar; Sarah Brown; Arne Risa Hole
  2. Political Decentralization, Women's Reservation and Child Health Outcomes: A Case Study of Rural Bihar By Santosh Kumar; Nishith Prakash
  3. Firm Insurance and Sickness Absence of Employees By Westergård-Nielsen, Niels C.; Pertold, Filip
  4. Impact of China's Urban Resident Basic Medical Insurance on Health Care Utilization and Expenditure By Liu, Hong; Zhao, Zhong
  5. Willingness to Accept Equals Willingness to Pay for Labor Market Estimates of the Value of Statistical Life By Kniesner, Thomas J.; Viscusi, W. Kip; Ziliak, James P.
  6. The Impact of Physical Education on Obesity among Elementary School Children By Cawley, John; Frisvold, David; Meyerhoefer, Chad D.
  7. Healthy Habits: The Connection between Diet, Exercise, and Locus of Control By Cobb-Clark, Deborah A.; Kassenböhmer, Sonja C.; Schurer, Stefanie
  8. The Gorbachev Anti-Alcohol Campaign and Russia's Mortality Crisis By Bhattacharya, Jay; Gathmann, Christina; Miller, Grant
  9. The Intergenerational Transmission of Human Capital. The Role of Skills and Health By Lundborg, Petter; Nordin, Martin; Rooth, Dan Olof
  10. Specification of financial incentives for quality in health care contracts By Eleonora Fichera; Hugh Gravelle; Mario Pezzino; Matt Sutton
  11. Health costs and benefits of ddt use in malaria control and prevention By Blankespoor, Brian; Dasgupta, Susmita; Lagnaoui, Abdelaziz; Roy, Subhendu
  12. Human capital and longevity. Evidence from 50,000 twins. By Petter Lundborg;; Carl Hampus Lyttkens;; Paul Nystedt;
  13. The effects of price regulation of pharmaceutical industry margins: A structural estimation for anti-ulcer drugs in France. By Pierre Dubois;; Laura Lasio;
  14. An analysis of mammography decisions with a focus on educational differences. By Aniko Biro;
  15. Explaining variations in breast cancer screening across European countries By Wuebker, A.;
  16. Spillovers of health education at school on parents' physical activity. By Lucila Berniell;; Dolores de la Mata;; M. Nieves Valdes
  17. Evidence on the long shadow of poor mental health across three generations. By David W. Johnston;; Stefanie Schurer;; Michael Shields;
  18. The effect of unemployment on the mental health of spouses - Evidence from plant closures in Germany. By Jan Marcus;
  19. Assessing inequalities in preventive care use in Europe: A special case of health-care inequalities? By Carrieri, V.;; Wuebker, A.;
  20. Non-linear price schedules, demand for health care and response behavior. By Helmut Farbmacher;; Joachim Winter
  21. Saving Lives at Birth: The Impact of Home Births on Infant Outcomes By N. Meltem Daysal; Mircea Trandafir; Reyn van Ewijk
  22. The Effect of Medicaid Physician Fees on Take-up of Public Health Insurance among Children in Poverty By Youjin Hahn
  23. Health and Christianity: Controlling for Omitted Variable Bias by Using the Data of Twins and Siblings By HONG, DING
  24. Projecting the Effect of Changes in Smoking and Obesity on Future Life Expectancy in the United States By Samuel H. Preston; Andrew Stokes; Neil K. Mehta; Bochen Cao

  1. By: Dilek Basar (Department of Economics, Hacettepe University); Sarah Brown (Department of Economics, The University of Sheffield); Arne Risa Hole (Department of Economics, The University of Sheffield)
    Abstract: This paper analyses the prevalence of ‘catastrophic’ out-of-pocket health expenditure in Turkey and identifies the factors which are associated with its risk using the Turkish Household Budget Surveys from 2002 to 2008. A sample selection approach based on Sartori (2003) is adopted to allow for the potential selection problem which may arise if poor households choose not to seek health care due to concerns regarding its affordability. The results suggest that poor households are less likely to seek health care as compared to non-poor households and that a negative relationship between poverty and experiencing catastrophic health expenditure remains even after allowing for such selection bias. Our findings, which may assist policy-makers concerned with health care system reforms, also highlight factors such as insurance coverage, which may protect households from the risk of incurring catastrophic health expenditure.
    Keywords: catastrophic health expenditure; health care financing; sample Selection
    JEL: I10 C25
    Date: 2012
    URL: http://d.repec.org/n?u=RePEc:shf:wpaper:2012020&r=hea
  2. By: Santosh Kumar (University of Washington); Nishith Prakash (University of Connecticut)
    Abstract: In this paper, we investigate the impact of political decentralization and gender quota in local governance on different measures of health outcomes and behaviors. We use multiple waves of District Level Household Survey (DLHS) for two states in India, Bihar and Jharkhand, and employ differences-in-differences (DID) methodology to estimate the impacts. We find that political decentralization is positively associated with higher probabilities of institutional births, safe delivery, and births in public health facilities. We also find increased survival rate of children belonging to richer households. We argue that our results are consistent with local leaders having better information or greater concern for women and child health as argued in the literature (Bhalotra and Figuera, 2012). JEL Classification: I38, J15, J78 Key words: Affirmative Action, Woman, Ante-Natal Care, Institutional Delivery, Child Mortality, India
    Date: 2012–09
    URL: http://d.repec.org/n?u=RePEc:uct:uconnp:2012-18&r=hea
  3. By: Westergård-Nielsen, Niels C. (Aarhus University); Pertold, Filip (Aarhus University)
    Abstract: We investigate the effect of firms' participation in an insurance scheme on the long-term sickness absence of their employees, using administrative records. In Denmark and several other European countries, firms are obliged to cover the first two weeks of sickness. The insurance scheme is provided by government authority and is designed to help small firms with the financial burden related to sickness absence of their workers. We use an exogenously-set threshold for the eligibility as a policy experiment. Using regression discontinuity in the fuzzy form, we show that sickness absence in insured firms is much more prevalent than in uninsured firms. Sickness spells in insured firms are shorter and the conditional probability to return back to work from sickness is much higher in insured firms. These results suggest that employees in insured firms are less monitored during the first two weeks and that their sickness is less serious. We demonstrate in the paper that the minimum cost of the present insurance scheme is similar to about 1100 man-years. On top of that comes a substantial cost to more short time sickness.
    Keywords: sickness absence, moral hazard, insurance for employers
    JEL: I12 J28
    Date: 2012–08
    URL: http://d.repec.org/n?u=RePEc:iza:izadps:dp6782&r=hea
  4. By: Liu, Hong (Central University of Finance and Economics); Zhao, Zhong (Renmin University of China)
    Abstract: In 2007, China launched a subsidized voluntary public health insurance program, the Urban Resident Basic Medical Insurance, for urban residents without formal employment, including children, the elderly, and other unemployed urban residents. We estimate the impact of this program on health care utilization and expenditure using 2006 and 2009 waves of the China Health and Nutrition Survey. We find that this program has significantly increased the utilization of formal medical services. This result is robust to various specifications and multiple estimation strategies. However, there is no evidence that it has reduced out-of-pocket expenditure and some evidence suggesting that it has increased the total health care expenditure. We also find that this program has improved medical care utilization more for the elderly, for the low- and middle-income families, and for the residents in the relatively poor western region.
    Keywords: urban China, health insurance, health care utilization, health expenditure
    JEL: G22 H43
    Date: 2012–07
    URL: http://d.repec.org/n?u=RePEc:iza:izadps:dp6768&r=hea
  5. By: Kniesner, Thomas J. (Syracuse University); Viscusi, W. Kip (Vanderbilt University); Ziliak, James P. (University of Kentucky)
    Abstract: Our research clarifies the conceptual linkages among willingness to pay for additional safety, willingness to accept less safety, and the value of statistical life (VSL). We present econometric estimates that in the important case of workers' decisions concerning exposure to fatal injury risk there is no statistically significant divergence between willingness to accept and willingness to pay. Our focal result contrasts with the literature documenting a considerable asymmetry in tradeoff rates for increases and decreases in risk. An important implication for policy is that it is reasonable to use labor market estimates of VSL as a measure of the willingness to pay for additional safety.
    Keywords: willingness to pay, willingness to accept, value of statistical life, VSL, CFOI, panel data, PSID
    JEL: C23 I10 J17 J28 K00
    Date: 2012–08
    URL: http://d.repec.org/n?u=RePEc:iza:izadps:dp6816&r=hea
  6. By: Cawley, John (Cornell University); Frisvold, David (Emory University); Meyerhoefer, Chad D. (Lehigh University)
    Abstract: In response to the dramatic rise in childhood obesity, the Centers for Disease Control (CDC) and other organizations have advocated increasing the time that elementary school children spend in physical education (PE) classes. However, little is known about the effect of PE on child weight. This paper measures that effect by instrumenting for child PE time with state policies, using data from the Early Childhood Longitudinal Study, Kindergarten Cohort (ECLS-K) for 1998-2004. Results from IV models indicate that PE lowers BMI z-score and reduces the probability of obesity among 5th graders (in particular, boys), while the instrument is insufficiently powerful to reliably estimate effects for younger children. This represents some of the first evidence of a causal effect of PE on youth obesity, and thus offers at least some support to the assumptions behind the CDC recommendations. We find no evidence that increased PE time crowds out time in academic courses or has spillovers to achievement test scores.
    Keywords: obesity, physical activity, physical education, children, health
    JEL: I12 I18 I21 H75 K32
    Date: 2012–08
    URL: http://d.repec.org/n?u=RePEc:iza:izadps:dp6807&r=hea
  7. By: Cobb-Clark, Deborah A. (University of Melbourne); Kassenböhmer, Sonja C. (Melbourne Institute of Applied Economic and Social Research); Schurer, Stefanie (Victoria University of Wellington)
    Abstract: This paper analyzes the relationship between individuals' locus of control and their decisions to exercise regularly, eat well, drink moderately, and avoid tobacco. Our primary goal is to assess the relative importance of the alternative pathways that potentially link locus of control to healthy habits. We find that individuals with an internal locus of control are more likely to eat well and exercise regularly. This link cannot be explained by the extent to which they are future-orientated and value their health, however. There are important gender differences in explaining the link between perceptions of control and healthy habits. Men with an internal locus of control expect to have higher health returns to their investments in diet and exercise. In contrast, women with an internal locus of control maintain healthy habits because they derive greater satisfaction from those activities than women with external control tendencies.
    Keywords: non-cognitive skills, locus of control, health behavior, health diet, exercise
    JEL: I14 J3 C18
    Date: 2012–08
    URL: http://d.repec.org/n?u=RePEc:iza:izadps:dp6789&r=hea
  8. By: Bhattacharya, Jay (Stanford University); Gathmann, Christina (University of Heidelberg); Miller, Grant (Stanford University)
    Abstract: Political and economic transition is often blamed for Russia's 40% surge in deaths between 1990 and 1994 (the "Russian Mortality Crisis"). Highlighting that increases in mortality occurred primarily among alcohol related causes and among working-age men (the heaviest drinkers), this paper investigates an alternative explanation: the demise of the 1985-1988 Gorbachev Anti-Alcohol Campaign. We use archival sources to build a new oblast-year data set spanning 1970-2000 and find that: (1) The campaign was associated with substantially fewer campaign year deaths, (2) Oblasts with larger reductions in alcohol consumption and mortality during the campaign experienced larger transition era increases, and (3) Other former Soviet states and Eastern European countries exhibit similar mortality patterns commensurate with their campaign exposure. The campaign's end explains a large share of the mortality crisis, suggesting that Russia's transition to capitalism and democracy was not as lethal as commonly suggested.
    Keywords: mortality, transition, alcohol, Russia
    JEL: I18 I15 P35 P36 P37
    Date: 2012–08
    URL: http://d.repec.org/n?u=RePEc:iza:izadps:dp6783&r=hea
  9. By: Lundborg, Petter (Department of Economics, Lund University); Nordin, Martin (Department of Economics, Lund University); Rooth, Dan Olof (Linnaeus University)
    Abstract: We provide new evidence on the causal mechanisms reflected in the intergenerational transmission of human capital. Applying both an adoption and a twin design to rich data from the Swedish military enlistment, we show that greater parental education increases son's cognitive and non-cognitive skills, as well as their health. The estimates are in many cases similar across research designs and suggest that a substantial part of the effect of parental education on the children's education works through improving children's skills and health.
    Keywords: Intergenerational Transmission; Human Capital; Education; Health
    JEL: C41 I11 I12 J12 J14
    Date: 2012–09–12
    URL: http://d.repec.org/n?u=RePEc:hhs:lunewp:2012_022&r=hea
  10. By: Eleonora Fichera; Hugh Gravelle; Mario Pezzino; Matt Sutton
    Date: 2012
    URL: http://d.repec.org/n?u=RePEc:man:sespap:1218&r=hea
  11. By: Blankespoor, Brian; Dasgupta, Susmita; Lagnaoui, Abdelaziz; Roy, Subhendu
    Abstract: The Millennium Development Goal of achieving near-zero malaria deaths by 2015 has led to a re-examination of wider use of DDT (dichloro-diphenyl-trichloro-ethane) in indoor residual spraying as a prevention tool in many countries. However, the use of DDT raises concerns of potential harm to the environment and human health, mainly because of the persistent and bio-accumulative nature of DDT and its potential to magnify through the food chain. This paper quantifies the adverse effects of DDT on human health based on treatment costs and indirect costs caused by illnesses and death in countries that use or are expected to re-introduce DDT in their disease vector control programs. At the global level where the total population exposed to DDT is estimated around 1.25 billion, the findings indicate that while the use of DDT can lead to a significant reduction in the estimated $69 billion in 2010 U.S. dollars economic loss caused by malaria, it can also add more than $28 billion a year in costs from the resulting adverse health effects. At the country level, the results suggest that Sub-Saharan African countries with high malaria incidence rates are likely to see relatively larger net benefits from the use of DDT in malaria control. The net health benefits of reintroducing DDT in malaria control programs could be better understood by weighing the costs and benefits of DDT use based on a country's circumstances.
    Keywords: Disease Control&Prevention,Health Monitoring&Evaluation,Population Policies,Health Systems Development&Reform,Climate Change Mitigation and Green House Gases
    Date: 2012–09–01
    URL: http://d.repec.org/n?u=RePEc:wbk:wbrwps:6203&r=hea
  12. By: Petter Lundborg;; Carl Hampus Lyttkens;; Paul Nystedt;
    Abstract: Why do well-educated people live longer? We use unique and high-quality data on about 50,000 monozygotic and same-sex dizygotic twins, born between 1886-1958, to address this question. We demonstrate a positive and statistically signiÂ…cant relation between years of schooling and longevity, which remains when we exploit the twin design. This result is robust to controlling for speciÂ…c within-twin-pair differences in early life factors, such as birth weight and proxies for ability and health in the form of body height, as well as to restricting the sample to monozygotic twins.
    Keywords: death, longevity, education, endogeneity, stratiÂ…ed partial likelihood, duration analysis; twins
    JEL: I12 I11 J14 J12 C41
    Date: 2012–07
    URL: http://d.repec.org/n?u=RePEc:yor:hectdg:12/19&r=hea
  13. By: Pierre Dubois;; Laura Lasio;
    Abstract: The objective of this paper is to study the effects of price regulation on competition in the pharmaceutical industry. We provide a method allowing to identify margins in an oligopoly price competition game even when prices may not be freely chosen by Â…firms. We use our identiÂ…cation strategy to study the effects of regulatory constraints on prices in the pharmaceutical industry which is heavily regulated in particular in France. We use data from the US, Germany and France to identify country speciÂ…c demand models and then recover price cost margins under the regulated price setting constraints on the French market. To do so, we estimate a structural model on the market for anti-ulcer drugs in France that allows us to explore the drivers of demand, to identify whether regulation really affects margins and prices and to relate regulatory reforms to industry pricing equilibrium. We provide the fiÂ…rst structural estimation of price-cost margins on a regulated market with price constraints and show how to identify unknown possibly binding constraints thanks to three different markets (US, German and France) with varying regulatory constraints. The identiÂ…ed margins show that margins have increased over time in France but that fiÂ…rms were specially constrained in price setting after 2004.
    Keywords: empirical IO, regulation, price constraints, pharmacy, antiulcer drugs.
    JEL: L10 I18
    Date: 2012–07
    URL: http://d.repec.org/n?u=RePEc:yor:hectdg:12/18&r=hea
  14. By: Aniko Biro;
    Abstract: I analyze the decisions on undertaking breast screening by women aged 50-64 in the UK. I provide estimation results on the discounting of the potential future benefits of screening. I also analyze the education di¤erences in mammography decisions,and examine the underlying mechanism how education in‡uences breast screening attendance. The reduced form estimation results suggest that the observed education gradient is mainly due to di¤erences in health behaviors and health care attitudes.Using the institutional settings of the UK, I estimate a structural model, which reveals that although there are di¤erences in the disutility of breast screening along the education level, there is no such di¤erence in the estimated discount factor. I also …nd some evidence that women are forward looking when deciding on mammography attendance,and might even overestimate the potential bene…ts of mammography.
    Keywords: mammography, health discount rate, education gradient
    JEL: C25 I11 I12
    Date: 2012–07
    URL: http://d.repec.org/n?u=RePEc:yor:hectdg:12/11&r=hea
  15. By: Wuebker, A.;
    Abstract: This paper explores variations in the uptake of breast cancer screening and associated factors influencing utilisation of mammography screening among women aged 50 to 69 years in 13 European countries. We focus on the relative importance of individual (e.g. age, education, etc.) and institutional (e.g. public screening program) factors in explaining cross-country variation in the utilisation of mammograms. We take advantage of (a) newly available individual level data from the SHARE as well as (b) regional and country level data on institutional factors. We find that observed individual factors like age, education, health status, etc. are associated with screening uptake within countries but cannot statistically explain cross-country differences. In contrast, observed institutional factors like the availability of an organized screening program can statistically explain about 40 per cent of the between country differences in screening rates.
    Keywords: health economics, prevention, multilevel models, SHARE, cross country differences
    JEL: C I I
    Date: 2012–08
    URL: http://d.repec.org/n?u=RePEc:yor:hectdg:12/26&r=hea
  16. By: Lucila Berniell;; Dolores de la Mata;; M. Nieves Valdes
    Abstract: To prevent modern health conditions like obesity, cancer, cardiovascular illness, and diabetes, which have reached epidemic-like proportions in recent decades, many health experts argue that students should receive Health Education (HED) at school. Although this type of education aims mainly to improve children's health proles, it might affect other family members as well. This paper exploits state HED reforms as quasi-natural experiments to estimate the causal impact of HED received by children on their parents' physical activity. We use data from the Panel Study of Income Dynamics (PSID) for the period 1999-2005 merged with data on state HED reforms from the National Association of State Boards of Education (NASBE) Health Policy Database, and the 2000 and 2006 School Health Policies and Programs Study (SHPPS). To identify the spillover effects of HED requirements on parents' behavior we use a "differences-in-differences in- differences" (DDD) methodology in which we allow for different types of treatments. We find a positive effect of HED reforms at the elementary school on the probability of parents doing light physical activity. Introducing major changes in HED increases the probability of fathers engaging in physical activity by 12.4 percentage points, while this probability for mothers does not seem to be affected. We find evidence of two channels that may drive these spillovers. We conclude that the gender specialization of parents in childcare activities, as well as information sharing between children and parents, may play a role in generating these indirect effects and in turn, in shaping healthy lifestyles within the household.
    Keywords: physical activity; healthy lifestyles; indirect treatment effects; health education; triple differences.
    JEL: I12 I18 I28 C21
    Date: 2012–07
    URL: http://d.repec.org/n?u=RePEc:yor:hectdg:12/13&r=hea
  17. By: David W. Johnston;; Stefanie Schurer;; Michael Shields;
    Abstract: Individuals suffering from mental health problems are often severely limited in their social and economic functioning. Mental health problems can develop early in life, are frequently chronic in nature, and have an established hereditary component. The extent to which mental illness runs in families could therefore help explain the widely discussed intergenerational transmission of socioeconomic disadvantage. Using data from three generations contained in the 1970 British Cohort Study, we estimate the intergenerational correlation of mental health between mothers, their children, and their grandchildren. We find that the intergenerational correlation in mental health is about 0.2, and that the probability of feeling depressed is 63 percent higher for children whose mothers reported the same symptom 20 years earlier. Moreover, grandmother and grandchild mental health are strongly correlated, but this relationship appears to work fully through the mental health of the parent. Using grandmother mental health as an instrument for maternal mental health in a model of grandchild mental health confirms the strong intergenerational correlation. We also find that maternal and own mental health are strong predictors of adulthood socioeconomic outcomes. Even after controlling for parental socioeconomic status, own educational attainment, and own mental health (captured in childhood and adulthood), our results suggest that a one standard deviation reduction in maternal mental health reduces household income for their adult offspring by around 2 percent.
    Keywords: Intergenerational transmission, mobility, mental health, economic outcomes
    JEL: I12 I14 J62
    Date: 2012–07
    URL: http://d.repec.org/n?u=RePEc:yor:hectdg:12/20&r=hea
  18. By: Jan Marcus;
    Abstract: Studies on health effects of unemployment usually neglect spillover effects on spouses. This study specifically investigates the effect of an individual’s unemployment on the mental health of their spouse. In order to allow for causal interpretation of the estimates, it focuses on an exogenous entry into unemployment (i.e. plant closure), and combines difference-in-difference and matching based on entropy balancing to provide robustness against observable and time-invariant unobservable heterogeneity. Using German Socio- Economic Panel Study data the paper reveals that unemployment decreases the mental health of spouses almost as much as for the directly affected individuals. The findings highlight that previous studies underestimate the public health costs of unemployment as they do not account for the potential consequences for spouses.
    Keywords: unemployment, mental health, plant closure, entropy balancing, matching, job loss
    JEL: I12 J65
    Date: 2012–07
    URL: http://d.repec.org/n?u=RePEc:yor:hectdg:12/17&r=hea
  19. By: Carrieri, V.;; Wuebker, A.;
    Abstract: This paper presents the first cross-country estimation of needs-adjusted income and education-related inequalities in the use of a whole set of preventive care treatments. Analysis is based on the last three waves of the Survey of Health, Ageing and Retirement (SHARE) for individuals aged 50 and over living in 13 European countries. We employ alternative concentration indices based on the CI-corrections for binary outcomes to compute inequalities in the use of breast cancer screening, of colorectal cancer screening, of influenza vaccination, and of routine prevention tests, such as blood pressure, cholesterol, and blood sugar tests. After controlling for needs, we find that in many European countries strong pro-rich and educational inequalities exist with respect to breast cancer screening, cholesterol and blood sugar tests. Furthermore, we find that poor and less educated people are more likely than the better off to use preventive care late, e.g. when health shocks occurred or health problems display already symptoms. Finally, results suggest that access to treatments within a specialist setting is generally less equal than access to treatments provided within a GP setting. Equity implications of the results are then discussed according to different possible theories of distributive justice in health care delivery.
    Keywords: Preventive care; socio-economic related inequalities; concentration indices
    JEL: I14 D63
    Date: 2012–08
    URL: http://d.repec.org/n?u=RePEc:yor:hectdg:12/25&r=hea
  20. By: Helmut Farbmacher;; Joachim Winter
    Abstract: When health insurance reforms involve non-linear price schedules tied to payment periods (for example, a quarter or a year), the empirical analysis of its effects has to take the within-period time structure of incentives into account. The analysis is further complicated when demand data are obtained from a survey in which the reporting period does not coincide with the payment period. We illustrate these issues using as an example a health care reform in Germany which imposed a perquarter fee of e10 for doctor visits and additionally set an out-of-pocket maximum. This co-payment structure results in an effective "spot" price for a doctor visit which decreases over time within each payment period. Using this variation, we find a substantial effect of the new fee, in contrast to earlier studies of this reform. Overall, the probability of visiting a physician decreased by around 2.5 percentage points in response to the new fee for doctor visits. We verify the key assumptions of our approach using a separate data set of insurance claims in which the reporting period effects are absent by construction.
    Keywords: health economics; non-linear pricing; response behavior; natural experiment
    JEL: I11 I18 D12
    Date: 2012–07
    URL: http://d.repec.org/n?u=RePEc:yor:hectdg:12/15&r=hea
  21. By: N. Meltem Daysal (Tilburg University and IZA); Mircea Trandafir (Université de Sherbrooke); Reyn van Ewijk (University Medical Centre Mainz and University of Mainz)
    Abstract: Many developed countries have recently experienced sharp increases in home birth rates. This paper investigates the impact of home births on the health of low-risk newborns using data from the Netherlands, the only developed country where home births are widespread. To account for endogeneity in location of birth, we exploit the exogenous variation in distance from a mother’s residence to the closest hospital. We find that giving birth in a hospital leads to substantial reductions in newborn mortality. We provide suggestive evidence that proximity to medical technologies may be an important channel contributing to these health gains.
    Keywords: Medical technology, birth, home birth, mortality
    JEL: I11 I12 I18 J13
    Date: 2012–09
    URL: http://d.repec.org/n?u=RePEc:shr:wpaper:12-11&r=hea
  22. By: Youjin Hahn
    Abstract: I investigate how changes in fees paid to Medicaid physicians affect take-up among children in low-income families. The existing literature suggests that the low level of Medicaid fee payments to physicians reduces their willingness to see Medicaid patients, thus creating an access-to-care problem for these patients. For the identical service, current Medicaid reimbursement rates are only about 65 percent of those covered by Medicare. Increasing the relative payments of Medicaid would increase its perceived value, as it would provide better access to health care for Medicaid beneficiaries. Using variation in the timing of the changes in Medicaid payment across states, I find that increasing Medicaid generosity is associated with both an increase in take-up and a reduction in uninsured rate. These results provide a partial answer to the puzzling question of why many low-income children who are eligible for Medicaid remain uninsured.
    Keywords: Medicaid; Take-up; Medicaid payment; Medicaid reimbursement; Access to care
    JEL: I11 I18
    Date: 2012–09
    URL: http://d.repec.org/n?u=RePEc:mos:moswps:2012-29&r=hea
  23. By: HONG, DING
    Abstract: To account for potential bias from heterogeneity in hereditary factors or family background, I use the within-twin and within-siblings differences to estimate the effects of Christian faith on three health outcome variables by applying fixed effect model to the data of twins and siblings from the first wave of the National Survey of Midlife in the United States (1995). Both this model and other statistical tests and model without controlling for omitted variable bias confirm significant positive health effects of religiosity of Christianity. The results also support the three explanatory mechanisms of religion on health proposed by Son and Wilson (2011): 1) behaviors and lifestyles, 2) social networks and 3) social support and psychological resources. However, the data also suggests that either other channels through which religiosity affects health may exist or the mechanism of psychological resources goes far beyond of “good moods” and contains much more plentiful and profound connotations that is relevant to health.
    Keywords: Christian; health; religiosity; omitted variable bias; twins; within estimation
    JEL: Z12 N30
    Date: 2012–08–02
    URL: http://d.repec.org/n?u=RePEc:pra:mprapa:41334&r=hea
  24. By: Samuel H. Preston; Andrew Stokes; Neil K. Mehta; Bochen Cao
    Abstract: We project the effects of declining smoking and increasing obesity on mortality in the United States over the period 2010-2040. Data on cohort behavioral histories are integrated into these projections. Future distributions of body mass indices are projected using transition matrices applied to the initial distribution in 2010. In addition to projections of current obesity, we project distributions of obesity when cohorts were age 25. To these distributions we apply death rates by current and age-25 obesity status observed in the National Health and Nutrition Examination Survey, 1988-2006. Projections of the effects of smoking are based on observed relations between cohort smoking patterns and cohort death rates from lung cancer. We find that both changes in smoking and in obesity are expected to have large effects on mortality. For males, the reductions in smoking have larger effects than the rise in obesity throughout the projection period. By 2040, male life expectancy at age 40 is expected to have gained 0.92 years from the combined effects. Among women, however, the two sets of effects largely offset one another throughout the projection period, with a small gain of 0.26 years expected by 2040.
    JEL: I0 I1 I12 I18 J1 J11 J18
    Date: 2012–09
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:18407&r=hea

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 http://nep.repec.org. For comments please write to the director of NEP, Marco Novarese at <director@nep.repec.org>. 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.