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Unraveling the SES-Health Connection

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Author Info
James P. Smith (RAND Corporation)

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Abstract

While a debate rages on about competing reasons why SES may affect health, there is little recognition that the so-called reverse causation from health to economic status may be pretty fundamental as well. Even if the direction of causation is that SES mainly affects health, what dimensions of SES actually matter—the financial aspects such as income or wealth or non-financial dimensions like education? Finally, is there a life course component to the health gradient so that we may be mislead in trying to answer these questions by only looking at people of a certain age—say those past 50. This paper, which is divided into four sections, provides my answers to these questions. The first section examines the issue of reverse causation or whether a new health event has a significant impact on four dimensions of SES—out-of-pocket medical expenses, labor supply, household income, and household wealth. The next section switches the perspective by asking whether the so-called direct causation from SES to health really matters all that much. If the answer is yes and it will be, a sub-theme in this section concerns which dimensions of SES—income, wealth, or education—matter for individual health. Since the answer to that question turns out to be education, Section 3 deals with the very much more difficult issue of why education matters so much. The evidence in these first three sections relies on data for people above age 50. In the final section of the paper, I test the robustness of my answers to these basic questions of the meaning of the SES-health gradient using data that span the entire life-course.

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Paper provided by EconWPA in its series Labor and Demography with number 0505018.

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Length: 25 pages
Date of creation: 19 May 2005
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Handle: RePEc:wpa:wuwpla:0505018

Note: Type of Document - pdf; pages: 25. Published in Aging, Health, and Public Policy: Demographic and Economic Perspectives, a supplement to Population and Development Review, Volume 30, New York: Population Council, 2005.
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J - Labor and Demographic Economics

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References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
  1. Dana P. Goldman & James P. Smith, 2004. "Can Patient Self-Management Help Explain the SES Health Gradient?," HEW 0403004, EconWPA. [Downloadable!]
  2. Anne Case & Darren Lubotsky & Christina Paxson, 2002. "Economic Status and Health in Childhood: The Origins of the Gradient," American Economic Review, American Economic Association, vol. 92(5), pages 1308-1334, December. [Downloadable!]
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  3. James P. Smith, 2003. "Consequences and Predictors of New Health Events," NBER Working Papers 10063, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
    Other versions:
  4. James P. Smith, 2004. "Why is Wealth Inequality Rising?," Macroeconomics 0402012, EconWPA. [Downloadable!]
  5. Smith, J-P & Kington, R, 1997. "Demographic and Economic Correlates of Health in Old Age," Papers 97-06, RAND - Reprint Series.
    Other versions:
  6. Anne C. Case & Angus Deaton, 2003. "Broken Down by Work and Sex: How Our Health Declines," NBER Working Papers 9821, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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  7. Adams, Peter & Hurd, Michael D. & McFadden, Daniel & Merrill, Angela & Ribeiro, Tiago, 2003. "Healthy, wealthy, and wise? Tests for direct causal paths between health and socioeconomic status," Journal of Econometrics, Elsevier, vol. 112(1), pages 3-56, January. [Downloadable!] (restricted)
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  8. Case, Anne & Fertig, Angela & Paxson, Christina, 2005. "The lasting impact of childhood health and circumstance," Journal of Health Economics, Elsevier, vol. 24(2), pages 365-389, March. [Downloadable!] (restricted)
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Cited by:
(explanations, Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.)

  1. David M. Cutler & Adriana Lleras-Muney & Tom Vogl, 2008. "Socioeconomic Status and Health: Dimensions and Mechanisms," NBER Working Papers 14333, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  2. Karsten Hank & Hendrik Jürges & Jürgen Schupp & Gert G. Wagner, 2006. "Die Messung der Greifkraft als objektives Gesundheitsmaß in sozialwissenschaftlichen Bevölkerungsumfragen: erhebungsmethodische und inhaltliche Befunde auf der Basis von SHARE und SOEP," Discussion Papers of DIW Berlin 577, DIW Berlin, German Institute for Economic Research. [Downloadable!]
    Other versions:
  3. Matthew D. Rablen & Andrew J. Oswald, 2007. "Mortality and Immortality," IZA Discussion Papers 2560, Institute for the Study of Labor (IZA). [Downloadable!]
    Other versions:
  4. Dana Goldman & James P. Smith, 2005. "Socioeconomic Differences in the Adoption of New Medical Technologies," NBER Working Papers 11218, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
    Other versions:
  5. James Banks & Michael Marmot & Zoë Oldfield & James P. Smith, 2007. "The SES Health Gradient on Both Sides of the Atlantic," Social and Economic Dimensions of an Aging Population Research Papers 175, McMaster University. [Downloadable!]
    Other versions:
  6. Hans-Martin von Gaudecker & Rembrandt D. Scholz, 2006. "Lifetime earnings and life expectancy," MPIDR Working Papers WP-2006-008, Max Planck Institute for Demographic Research, Rostock, Germany. [Downloadable!]
    Other versions:
  7. Hans-Martin von Gaudecker & Rembrandt D. Scholz, 2007. "Differential mortality by lifetime earnings in Germany," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 17(4), pages 83-108, August. [Downloadable!]
  8. Christopher J. Ruhm, 2005. "Maternal Employment and Adolescent Development," IZA Discussion Papers 1673, Institute for the Study of Labor (IZA). [Downloadable!]
    Other versions:
  9. Juan Miguel Gallego & Manuel Ramírez Gómez & Carlos Sepúlveda, 2005. "The Determinants of The Health Status in a Developing Country: results from the Colombian Case," Lecturas de Economía, Universidad de Antioquia, Departamento de Economía, issue 63, pages 111-135, Julio-Dic. [Downloadable!]
    Other versions:
  10. Jürgen Maurer, 2007. "Modelling socioeconomic and health determinants of health care use: A semiparametric approach," MEA discussion paper series 07145, Mannheim Research Institute for the Economics of Aging (MEA), University of Mannheim. [Downloadable!]
  11. Jürgen Maurer, 2007. "Modelling socioeconomic and health determinants of health-care use: a semiparametric approach," Health Economics, John Wiley & Sons, Ltd., vol. 16(9), pages 967-979. [Downloadable!]
  12. James Smith, 2007. "Diabetes and the Rise of the SES Health Gradient," NBER Working Papers 12905, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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