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A Theory of Socio-economic Disparities in Health over the Life Cycle

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Abstract

Motivated by the observation that medical care explains only a relatively small part of the socio-economic status (SES)-health gradient, we present a life-cycle model that incorporates several additional behaviours that potentially explain (jointly) a large part of observed disparities. As a result, the model provides not only a conceptual framework for the SES-health gradient but more generally an improved framework for the production of health. We derive novel predictions from the theory by performing comparative dynamic analyses. More generally, our comparative dynamic method can be applied to models of similar form, e.g. human capital, health deficits, firm investment, to name a few.

Original languageEnglish
Pages (from-to)338-374
Number of pages37
JournalEconomic Journal
Volume129
Issue number617
DOIs
Publication statusPublished - 2019
Externally publishedYes

Funding

Research reported in this publication was supported by the National Institute on Aging of the National Institutes of Health under Award Numbers K02AG042452, R01AG037398, R01AG030824, RF1AG055654, P30AG012815 and P01AG022481. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Van Kippersluis thanks Netspar (Health and Income, Work and Care across the Life cycle II), and the Netherlands Organization of Scientific Research (NWO Veni grant 016.145.082) for support. Galama is grateful to the School of Economics of Erasmus University Rotterdam for a Visiting Professorship in the Economics of Human Capital. We thank the Editor, two anonymous reviewers, Mauricio Avendano, Megan Beckett, Dan Belsky, Jan Brinkhuis, Eileen Crimmins, Michael Grossman, Bas Jacobs, Arie Kapteyn, Valter Longo, Joao Pedro Magalhaes, Erik Meijer, Owen O’Donnell, Rosalie Pacula, Bastian Ravesteijn, Peter Savelyev, Eddy van Doorslaer, Tom Van Ourti, Arthur van Soest and participants in the Health Inequality Network (HINet) meeting at the University of Chicago, the 8th iHEA World Congress on Health Economics in Toronto, the 12th Viennese Workshop on Optimal Control, Dynamic Games and Nonlinear Dynamics, the‏ 9th‏ Ann‏ual SHESG Co‏nference at the University of Memphis and the 2011 RAND Conference on Health, Aging and Human Capital, as well as seminar participants at Erasmus University, the Harvard Center for Population ‏and ‏Deve‏lo‏pment Studies, the London School of Economics, the RAND Corporation, the University of Chicago, the University of Lausanne, the University of Southern California and the University of Tilburg, for useful discussions and comments. We thank Timothy Halliday and Hui He for generously sharing their health investment estimates from the Medical Expenditure Panel Survey. Research reported in this publication was supported by the National Institute on Aging of the National Institutes of Health under Award Numbers K02AG042452, R01AG037398, R01AG030824, RF1AG055654, P30AG012815 and P01AG022481. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Van Kippersluis thanks Netspar (Health and Income, Work and Care across the Life cycle II), and the Netherlands Organization of Scientific Research (NWO Veni grant 016.145.082) for support. Galama is grateful to the School of Economics of Erasmus University Rotterdam for a Visiting Professorship in the Economics of Human Capital. We thank the Editor, two anonymous reviewers, Mauricio Avendano, Megan Beckett, Dan Belsky, Jan Brinkhuis, Eileen Crimmins, Michael Grossman, Bas Jacobs, Arie Kapteyn, Valter Longo, Joao Pedro Magalhaes, Erik Meijer, Owen O’Donnell, Rosalie Pacula, Bastian Ravesteijn, Peter Savelyev, Eddy van Doorslaer, Tom Van Ourti, Arthur van Soest and participants in the Health Inequality Network (HINet) meeting at the University of Chicago, the 8th iHEA World Congress on Health Economics in Toronto, the 12th Viennese Workshop on Optimal Control, Dynamic Games and Nonlinear Dynamics, the 9th Annual SHESG Conference at the University of Memphis and the 2011 RAND Conference on Health, Aging and Human Capital, as well as seminar participants at Erasmus University, the Harvard Center for Population and Development Studies, the London School of Economics, the RAND Corporation, the University of Chicago, the University of Lausanne, the University of Southern California and the University of Tilburg, for useful discussions and comments. We thank Timothy Halliday and Hui He for generously sharing their health investment estimates from the Medical Expenditure Panel Survey.

FundersFunder number
Work and Care across the Life cycle II
National Institutes of Health
National Institute on AgingK02AG042452, R01AG037398, R01AG030824, P01AG022481, P30AG012815, RF1AG055654
University of Southern California
University of Chicago
University of Memphis
Erasmus Universiteit Rotterdam
Nederlandse Organisatie voor Wetenschappelijk Onderzoek016.145.082
Université de Lausanne

    UN SDGs

    This output contributes to the following UN Sustainable Development Goals (SDGs)

    1. SDG 10 - Reduced Inequalities
      SDG 10 Reduced Inequalities

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