Essays in Health and Demographic Economics

Le résumé en français n'a pas été communiqué par l'auteur.This dissertation consists of four essays on health and demographic economics. In the first chapter, I explore the implementation of the theory of equality of opportunity (EOp) developed by Roemer (1998) to health in a joint work with Guillem Lopez and Frederic Udina. A common impediment to the achievement of EOp applications with given resources constraints is that it is unlikely that public policies can fully compensate for existing unfair inequalities. This scenario is particularly relevant in the case of health policy, where public spending coexists with a large private spending component. We argue that if social justice is not attainable, social deliberation should not only focus on choosing the circumstances that ought to be compensated but also reflect on which groups suffering unfair inequalities should be prioritized. The second chapter examines the impact of income-related reporting heterogeneity on the measurement of health inequality. While most studies of health inequality rely on self-reported measures of health, recent research has studied the possibility that part of the existing differences in self-reported health could be due to systematic differences in reporting across socioeconomic groups. The concern is that part of the existing inequalities may not be founded on differences in the “true” health status of individuals. In particular, some studies have concluded that reliance on self-reported health might have resulted in an overstatement on the degree of health inequality of some countries. I study the income-related reporting heterogeneity hypothesis in the 2006 wave of the Catalan Survey of Health and I find that the main contributor to health inequality is the disproportionate concentration of the prevalence of reported conditions in lower income groups. The third chapter, joint with Hippolyte d'Albis and Loesse Jacques Esso, studies the trends in mortality convergence across developed countries from 1960 to 2008. While the epidemiological transition has provided a theory behind the expectation of convergence in mortality patterns, our results reject the convergence hypothesis for a sample of industrialized countries. We study the disparities across the mortality distributions of the countries and our sample and find no evidence of convergence towards a common mortality distribution.The fourth and final chapter of this dissertation examines the relationship between unemployment and fertility. I offer a possible explanation for the apparent contradiction between the empirical work that finds a negative relationship between unemployment and fertility and the theoretical work that emphasizes the lower opportunity cost of childbearing while unemployed. I reconcile these perspectives by distinguishing two forms of unemployment. The first form is structural unemployment while the second is cyclical unemployment, a less permanent component of unemployment that is linked to the economic cycle. I study both effects over the life cycle using cohort data on a panel of developed countries. I find that while structural unemployment has an unambiguous negative effect on fertility, reactions to cyclical unemployment depend on the age at which it is experienced

Essays in Health and Demographic Economics

Le résumé en français n'a pas été communiqué par l'auteur.This dissertation consists of four essays on health and demographic economics. In the first chapter, I explore the implementation of the theory of equality of opportunity (EOp) developed by Roemer (1998) to health in a joint work with Guillem Lopez and Frederic Udina. A common impediment to the achievement of EOp applications with given resources constraints is that it is unlikely that public policies can fully compensate for existing unfair inequalities. This scenario is particularly relevant in the case of health policy, where public spending coexists with a large private spending component. We argue that if social justice is not attainable, social deliberation should not only focus on choosing the circumstances that ought to be compensated but also reflect on which groups suffering unfair inequalities should be prioritized. The second chapter examines the impact of income-related reporting heterogeneity on the measurement of health inequality. While most studies of health inequality rely on self-reported measures of health, recent research has studied the possibility that part of the existing differences in self-reported health could be due to systematic differences in reporting across socioeconomic groups. The concern is that part of the existing inequalities may not be founded on differences in the “true” health status of individuals. In particular, some studies have concluded that reliance on self-reported health might have resulted in an overstatement on the degree of health inequality of some countries. I study the income-related reporting heterogeneity hypothesis in the 2006 wave of the Catalan Survey of Health and I find that the main contributor to health inequality is the disproportionate concentration of the prevalence of reported conditions in lower income groups. The third chapter, joint with Hippolyte d'Albis and Loesse Jacques Esso, studies the trends in mortality convergence across developed countries from 1960 to 2008. While the epidemiological transition has provided a theory behind the expectation of convergence in mortality patterns, our results reject the convergence hypothesis for a sample of industrialized countries. We study the disparities across the mortality distributions of the countries and our sample and find no evidence of convergence towards a common mortality distribution.The fourth and final chapter of this dissertation examines the relationship between unemployment and fertility. I offer a possible explanation for the apparent contradiction between the empirical work that finds a negative relationship between unemployment and fertility and the theoretical work that emphasizes the lower opportunity cost of childbearing while unemployed. I reconcile these perspectives by distinguishing two forms of unemployment. The first form is structural unemployment while the second is cyclical unemployment, a less permanent component of unemployment that is linked to the economic cycle. I study both effects over the life cycle using cohort data on a panel of developed countries. I find that while structural unemployment has an unambiguous negative effect on fertility, reactions to cyclical unemployment depend on the age at which it is experienced

Exposure-adjusted racial/ethnic disparities in mortality in the U.S.

Background: Racial mortality disparities in the U.S. are well-documented and central to the debate on social inequalities in health. We argue that standard measures that are used to describe the disparities, such as life expectancy or years of life lost, underestimate those disparities. Methods: We analyze contemporary U.S. mortality disparities comparing Blacks and Hispanics to Whites using CDC and NCHS data. We estimate mortality disparities using standard metrics and a novel approach that weights mortality inequalities by the population fraction that is exposed to the inequalities. We then express the magnitude of these inequalities by comparing them to the loss of life due to leading causes of death. Results: Based on the exposure-adjusted measure, the Black mortality disadvantage is as deadly or deadlier than circulatory diseases, the top cause of death in the U.S; and 43% (men) and 87% (women) larger than the disadvantage as measured by life expectancy. For Hispanics, the exposure-adjusted mortality advantage over Whites is over two times larger, for both men and women, than what life expectancy disparities would imply, and 21% (men) and 11% (women) larger than when measured using standard years of life lost. Conclusions: Mortality inequalities experienced by real populations can differ markedly from the inequalities that are calculated for synthetic populations that are used in standard calculations. We show that racial/ethnic disparities in the U.S. are underestimated if not adjusted for the populations experiencing the inequalities. For health policy the exposure-adjusted inequalities are likely to provide a more reasonable signal on where to allocate scarce resources

Essais sur l'économie démographique et de la santé

Le résumé en français n'a pas été communiqué par l'auteur.This dissertation consists of four essays on health and demographic economics. In the first chapter, I explore the implementation of the theory of equality of opportunity (EOp) developed by Roemer (1998) to health in a joint work with Guillem Lopez and Frederic Udina. A common impediment to the achievement of EOp applications with given resources constraints is that it is unlikely that public policies can fully compensate for existing unfair inequalities. This scenario is particularly relevant in the case of health policy, where public spending coexists with a large private spending component. We argue that if social justice is not attainable, social deliberation should not only focus on choosing the circumstances that ought to be compensated but also reflect on which groups suffering unfair inequalities should be prioritized. The second chapter examines the impact of income-related reporting heterogeneity on the measurement of health inequality. While most studies of health inequality rely on self-reported measures of health, recent research has studied the possibility that part of the existing differences in self-reported health could be due to systematic differences in reporting across socioeconomic groups. The concern is that part of the existing inequalities may not be founded on differences in the “true” health status of individuals. In particular, some studies have concluded that reliance on self-reported health might have resulted in an overstatement on the degree of health inequality of some countries. I study the income-related reporting heterogeneity hypothesis in the 2006 wave of the Catalan Survey of Health and I find that the main contributor to health inequality is the disproportionate concentration of the prevalence of reported conditions in lower income groups. The third chapter, joint with Hippolyte d'Albis and Loesse Jacques Esso, studies the trends in mortality convergence across developed countries from 1960 to 2008. While the epidemiological transition has provided a theory behind the expectation of convergence in mortality patterns, our results reject the convergence hypothesis for a sample of industrialized countries. We study the disparities across the mortality distributions of the countries and our sample and find no evidence of convergence towards a common mortality distribution.The fourth and final chapter of this dissertation examines the relationship between unemployment and fertility. I offer a possible explanation for the apparent contradiction between the empirical work that finds a negative relationship between unemployment and fertility and the theoretical work that emphasizes the lower opportunity cost of childbearing while unemployed. I reconcile these perspectives by distinguishing two forms of unemployment. The first form is structural unemployment while the second is cyclical unemployment, a less permanent component of unemployment that is linked to the economic cycle. I study both effects over the life cycle using cohort data on a panel of developed countries. I find that while structural unemployment has an unambiguous negative effect on fertility, reactions to cyclical unemployment depend on the age at which it is experienced

Lifespan variability from an overlapping cohorts perspective

An overlapping cohorts perspective of lifespan inequalit

Persistent differences in mortality patterns across industrialized countries.

The epidemiological transition has provided the theoretical background for the expectation of convergence in mortality patterns. We formally test and reject the convergence hypothesis for a sample of industrialized countries in the period from 1960 to 2008. After a period of convergence in the decade of 1960 there followed a sustained process of divergence with a pronounced increase at the end of the 1980's, explained by trends within former Socialist countries (Eastern countries). While Eastern countries experienced abrupt divergence after the dissolution of the Soviet Union, differences within Western countries remained broadly constant for the whole period. Western countries transitioned from a strong correlation between life expectancy and variance in 1960 to no association between both moments in 2008 while Eastern countries experienced the opposite evolution. Taken together, our results suggest that convergence can be better understood when accounting for shared structural similarities amongst groups of countries rather than through global convergence

Mortality Convergence Across High-Income Countries : An Econometric Approach

URL des Documents de travail : http://centredeconomiesorbonne.univ-paris1.fr/bandeau-haut/documents-de-travail/Documents de travail du Centre d'Economie de la Sorbonne 2012.76 - ISSN : 1955-611XThis work is devoted to the study of the variations of mortality patterns across a sample of high-income countries since 1960. We study changes in age-at-death distributions through two indicators, life expectancy and Gini coefficient, by applying econometric tools commonly used in the economic growth literature to assess the existence of convergence across the countries in our sample. We contribute to the ongoing debate over the existence of convergence amongst high-income countries in adult mortality by offering two main empirical regularities. First, our results show that the convergence hypothesis is rejected when we consider the entire sample of industrialized countries. Second, we provide evidence of convergence in both the life expectancy and Gini coefficient among a subset of countries and for some subperiods. This constitutes preliminary evidence against the convergence to a common age-at-death stationary distribution but of the existence of convergence clubs.Ce travail est consacré à l'étude dynamique de la mortalité au sein d'un ensemble de pays à haut revenu depuis 1960. Nous étudions les évolutions des distributions de l'âge au décès à l'aide de deux indicateurs, l'espérance de vie et le coefficient de Gini. Notre contribution au débat actuel sur la convergence de la mortalité adulte entre pays à haut revenu en proposant deux principales régularités empiriques. Premièrement, nous utilisons les techniques économétriques habituellement utilisées dans la littérature sur la croissance économique pour évaluer l'existence d'une convergence entre les pays de notre ensemble ; nous montrons que l'hypothèse de convergence est rejetée lorsque l'on considère tous les pays de l'ensemble. Deuxièmement, nous apportons des éléments de preuve d'une convergence au sein d'un sous-ensemble de pays. Ainsi, nous proposons une argumentation empirique de l'absence de convergence vers une unique distribution stationnaire des âges aux décès mais, au contraire, de l'existence de clubs de convergence