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Health investment complementarities under competing risks


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  • William H. Dow
  • Tomas Philipson
  • Xavier Sala-i-Martin


  • Jessica Holmes


Applying the competing--risks model to multi--cause mortality, this paper provides a theoretical and empirical investigation of the positive complementarities that occur between disease--specific policy interventions. We argue that since an individual cannot die twice, competing risks imply that individuals will not waste resources on causes that are not the most immediate, but will make health investments so as to equalize cause--specific mortality. However, equal mortality risk from a variety of diseases does not imply that disease--specific public health interventions are a waste. Rather, a cause--specific intervention produces spillovers to other disease risks, so that the overall reduction in mortality will generally be larger than the direct effect measured on the targeted disease. The assumption that mortality from non--targeted diseases remains the same after a cause--specific intervention under--estimates the true effect of such programs, since the background mortality is also altered as a result of intervention. Analyzing data from one of the most important public health programs ever introduced, the Expanded Program on Immunization (EPI) of the United Nations, we find evidence for the existence of such complementarities, involving causes that are not biomedically, but behaviorally, linked.

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Bibliographic Info

Paper provided by Department of Economics and Business, Universitat Pompeu Fabra in its series Economics Working Papers with number 192.

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Date of creation: Jan 1997
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Handle: RePEc:upf:upfgen:192

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Keywords: Complementarities tetanus programs; endogenous mortality; public health;

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Cited by:
  1. Emily Oster & Ira Shoulson & E. Ray Dorsey, 2012. "Limited Life Expectancy, Human Capital and Health Investments: Evidence from Huntington Disease," NBER Working Papers 17931, National Bureau of Economic Research, Inc.
  2. Seema Jayachandran & Adriana Lleras-Muney, 2008. "Life Expectancy and Human Capital Investments: Evidence From Maternal Mortality Declines," NBER Working Papers 13947, National Bureau of Economic Research, Inc.


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