How Much Might Universal Health Insurance Reduce Socioeconomic Disparities in Health? A Comparison of the US and Canada
AbstractA strong association between lower socioeconomic status (SES) and worse health-- the SES-health gradient-- has been documented in many countries, but little work has compared the size of the gradient across countries. We compare the size of the income gradient in self-reported health in the US and Canada. We find that being below median income raises the likelihood that a middle aged person is in poor or fair health by about 15 percentage points in the U.S., compared to less than 8 percentage points in Canada. We also find that the 7 percentage point gradient difference between the two countries is reduced by about 4 percentage points after age 65, the age at which the virtually all U.S. citizens receive basic health insurance through Medicare. Income disparities in the probability that an individual lacks a usual source of care are also significantly larger in the US than in Canada before the age of 65, but about the same after 65. Our results are therefore consistent with the availability of universal health insurance in the U.S, or at least some other difference that occurs around the age of 65 in one country but not the other, narrowing SES differences in health between the US and Canada.
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Bibliographic InfoPaper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 10715.
Date of creation: Aug 2004
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Publication status: published as Decker, Sandra L. and Dahlia K. Remler. “How Much Does Universal Health Insurance Reduce Socioeconomic Disparities in Health? A Comparison of the US and Canada.” Applied Health Economics and Health Policy 3, 4 (2005): 205-216.
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Find related papers by JEL classification:
- I1 - Health, Education, and Welfare - - Health
This paper has been announced in the following NEP Reports:
- NEP-ALL-2004-09-30 (All new papers)
- NEP-HEA-2004-09-30 (Health Economics)
- NEP-IAS-2004-09-30 (Insurance Economics)
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- Dwyer, Debra Sabatini & Mitchell, Olivia S., 1999.
"Health problems as determinants of retirement: Are self-rated measures endogenous?,"
Journal of Health Economics,
Elsevier, vol. 18(2), pages 173-193, April.
- Debra S. Dwyer & Olivia S. Mitchell, . "Health Problems as Determinants of Retirement: Are Self-Rated Measures Endogenous?," Pension Research Council Working Papers 98-7, Wharton School Pension Research Council, University of Pennsylvania.
- Debra Sabatini Dwyer & Olivia S. Mitchell, 1998. "Health Problems as Determinants of Retirement: Are Self-Rated Measures Endogenous?," NBER Working Papers 6503, National Bureau of Economic Research, Inc.
- John Bound, 1991. "Self-Reported Versus Objective Measures of Health in Retirement Models," Journal of Human Resources, University of Wisconsin Press, vol. 26(1), pages 106-138.
- Theodore Joyce & Robert Kaestner, 1995.
"State Reproductive Policies and Adolescent Pregnancy Resolution: The Case of Parental Involvement Laws,"
NBER Working Papers
5354, National Bureau of Economic Research, Inc.
- Joyce, Theodore & Kaestner, Robert, 1996. "State reproductive policies and adolescent pregnancy resolution: The case of parental involvement laws," Journal of Health Economics, Elsevier, vol. 15(5), pages 579-607, October.
- Adriana Lleras-Muney, 2002. "The Relationship Between Education and Adult Mortality in the United States," NBER Working Papers 8986, National Bureau of Economic Research, Inc.
- Jonathan Gruber & David A. Wise, 2002.
"Social Security Programs and Retirement Around the World: Micro Estimation,"
NBER Working Papers
9407, National Bureau of Economic Research, Inc.
- Jonathan Gruber & David A. Wise, 2004. "Social Security Programs and Retirement around the World: Micro-Estimation," NBER Books, National Bureau of Economic Research, Inc, number grub04-1, octubre-d.
- Gruber, Jonathan, 1994. "The Incidence of Mandated Maternity Benefits," American Economic Review, American Economic Association, vol. 84(3), pages 622-41, June.
- Meer, Jonathan & Miller, Douglas L. & Rosen, Harvey S., 2003.
"Exploring the health-wealth nexus,"
Journal of Health Economics,
Elsevier, vol. 22(5), pages 713-730, September.
- Michael Baker & Jonathan Gruber & Kevin Milligan, 2004. "Income Security Programs and Retirement in Canada," NBER Chapters, in: Social Security Programs and Retirement around the World: Micro-Estimation, pages 99-152 National Bureau of Economic Research, Inc.
- Ettner, Susan L., 1996. "New evidence on the relationship between income and health," Journal of Health Economics, Elsevier, vol. 15(1), pages 67-85, February.
- R. Kaestner, 2000. "A note on the effect of minimum drinking age laws on youth alcohol consumption," Contemporary Economic Policy, Western Economic Association International, vol. 18(3), pages 315-325, 07.
- Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-55, March-Apr.
- Steven G. Prus, 2001. "The Relationship between Age, Socio-Economic Status, and Health among Adult Canadians," Social and Economic Dimensions of an Aging Population Research Papers 57, McMaster University.
- Theodore Joyce & Robert Kaestner, 1996. "The effect of expansions in medicaid income eligibility on abortion," Demography, Springer, vol. 33(2), pages 181-192, May.
- Deaton, Angus S & Paxson, Christina H, 1998.
"Aging and Inequality in Income and Health,"
American Economic Review,
American Economic Association, vol. 88(2), pages 248-53, May.
- James P. Smith, 1999. "Healthy Bodies and Thick Wallets: The Dual Relation between Health and Economic Status," Journal of Economic Perspectives, American Economic Association, vol. 13(2), pages 145-166, Spring.
- van Doorslaer, Eddy & Wagstaff, Adam & van der Burg, Hattem & Christiansen, Terkel & De Graeve, Diana & Duchesne, Inge & Gerdtham, Ulf-G & Gerfin, Michael & Geurts, Jose & Gross, Lorna, 2000. "Equity in the delivery of health care in Europe and the US," Journal of Health Economics, Elsevier, vol. 19(5), pages 553-583, September.
- Denise Doiron & Glenn Jones & Elizabeth Savage, 2006. "Healthy, wealthy and insured? The role of self-assessed health in the demand for private health insurance, CHERE Working Paper 2006/2," Working Papers 2006/2, CHERE, University of Technology, Sydney.
- James Ted McDonald, 2005. "The Health Behaviors of Immigrants and Native-born People in Canada," Social and Economic Dimensions of an Aging Population Research Papers 144, McMaster University.
- June E. O'Neill & Dave M. O'Neill, 2007.
"Health Status, Health Care and Inequality: Canada vs. the U.S,"
NBER Working Papers
13429, National Bureau of Economic Research, Inc.
- O'Neill June E & O'Neill Dave M, 2008. "Health Status, Health Care and Inequality: Canada vs. the U.S," Forum for Health Economics & Policy, De Gruyter, vol. 10(1), pages 1-45, April.
- Batana, Yélé Maweki, 2010. "Evolution of social inequalities in health in Quebec?," MPRA Paper 20710, University Library of Munich, Germany.
- Komlos, John & Lauderdale, Benjamin E., 2004. "Spatial Correlates of U.S. Heights and BMIs, 2002," Discussion Papers in Economics 466, University of Munich, Department of Economics.
- Denise Doiron & Glenn Jones & Elizabeth Savage, 2008. "Healthy, wealthy and insured? The role of self-assessed health in the demand for private health insurance," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 317-334.
- Beraldo, Sergio & Montolio, Daniel & Turati, Gilberto, 2009. "Healthy, educated and wealthy: A primer on the impact of public and private welfare expenditures on economic growth," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 38(6), pages 946-956, December.
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