Can Patient Self-Management Explain the Health Gradient? Goldman and Smith (2002) Revisited
AbstractUsing the Health and Retirement Study, Goldman and Smith (2002) [“Can patient self-management help explain the SES health gradient?”, PNAS, 99(16), 10929-34] find that poor self-management of health has significant effects on health deterioration and that such poor behavior is less likely to occur among the more educated. They conclude that self-management of health is an explanation for the much-documented positive correlation between education and health outcomes—the education-health gradient. In this paper, I show, using the same data, that controlling for poor self-management behavior has little impact on the education-health gradient, raising doubt about whether such behavior can be said to explain the gradient at all. I also show that Goldman and Smith's results—both the effect of adherence on health and that of education on adherence—depend on how poor self-maintenance behavior is defined. Lastly, using another component of socioeconomic status, viz. resources, I find that a gradient in resources and health does exist, but this too is not impacted much by self-maintenance. These findings cast doubt on whether self-management can explain the gradient in health and socioeconomic status, when the latter is represented by education or resources.
Download InfoIf you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
Bibliographic InfoPaper provided by York University, Department of Economics in its series Working Papers with number 2006_11.
Length: 15 pages
Date of creation: Nov 2006
Date of revision:
Health gradient; Education; Patient self-management;
Find related papers by JEL classification:
- I12 - Health, Education, and Welfare - - Health - - - Health Production
- I21 - Health, Education, and Welfare - - Education - - - Analysis of Education
This paper has been announced in the following NEP Reports:
You can help add them by filling out this form.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Support).
If references are entirely missing, you can add them using this form.