IDEAS home Printed from https://ideas.repec.org/a/eee/ememar/v70y2026ics1566014125001542.html

The impact of health status on household portfolio efficiency: Insights from medical insurance

Author

Listed:
  • Dong, Jingxuan
  • Li, Qiang
  • Cheung, Adrian (Wai Kong)

Abstract

This paper explores how health status influences household portfolio efficiency using pooled cross-sectional data from the 2021 and 2023 waves of the China Household Finance Survey (CHFS). Findings show that healthier households are more likely to engage in risky financial markets, leading to improved portfolio efficiency. Our findings also suggest that the positive impact of good health on investment portfolios is more pronounced among urban households and those with higher educational attainment. Mechanism analysis indicates that good health can increase household portfolio efficiency through enhancing risk tolerance and alleviating liquidity constraints. Moreover, medical insurance plays a critical role in moderating the relationship between health status and household portfolio efficiency.

Suggested Citation

  • Dong, Jingxuan & Li, Qiang & Cheung, Adrian (Wai Kong), 2026. "The impact of health status on household portfolio efficiency: Insights from medical insurance," Emerging Markets Review, Elsevier, vol. 70(C).
    • Handle: RePEc:eee:ememar:v:70:y:2026:i:c:s1566014125001542
    DOI: 10.1016/j.ememar.2025.101405
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S1566014125001542
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.ememar.2025.101405?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to

    for a different version of it.

    References listed on IDEAS

    as
    1. James Poterba & Steven Venti & David Wise, 2013. "Correction: The Composition and Drawdown of Wealth in Retirement," Journal of Economic Perspectives, American Economic Association, vol. 27(4), pages 219-222, Fall.
    2. Atella, Vincenzo & Brunetti, Marianna & Maestas, Nicole, 2012. "Household portfolio choices, health status and health care systems: A cross-country analysis based on SHARE," Journal of Banking & Finance, Elsevier, vol. 36(5), pages 1320-1335.
    3. French, Declan & McKillop, Donal, 2016. "Financial literacy and over-indebtedness in low-income households," International Review of Financial Analysis, Elsevier, vol. 48(C), pages 1-11.
    4. Hubbard, R Glenn & Skinner, Jonathan & Zeldes, Stephen P, 1995. "Precautionary Saving and Social Insurance," Journal of Political Economy, University of Chicago Press, vol. 103(2), pages 360-399, April.
    5. Jacobsen, Ben & Lee, John B. & Marquering, Wessel & Zhang, Cherry Y., 2014. "Gender differences in optimism and asset allocation," Journal of Economic Behavior & Organization, Elsevier, vol. 107(PB), pages 630-651.
    6. Fan, Elliott & Zhao, Ruoyun, 2009. "Health status and portfolio choice: Causality or heterogeneity?," Journal of Banking & Finance, Elsevier, vol. 33(6), pages 1079-1088, June.
    7. Liu, Yaxuan & Hao, Yu & Lu, Zhi Nan, 2022. "Health shock, medical insurance and financial asset allocation: evidence from CHFS in China," LSE Research Online Documents on Economics 117277, London School of Economics and Political Science, LSE Library.
    8. Thomas Dohmen & Armin Falk & David Huffman & Uwe Sunde, 2010. "Are Risk Aversion and Impatience Related to Cognitive Ability?," American Economic Review, American Economic Association, vol. 100(3), pages 1238-1260, June.
    9. Harry Markowitz, 1952. "Portfolio Selection," Journal of Finance, American Finance Association, vol. 7(1), pages 77-91, March.
    10. Amy Finkelstein & Erzo F. P. Luttmer & Matthew J. Notowidigdo, 2013. "What Good Is Wealth Without Health? The Effect Of Health On The Marginal Utility Of Consumption," Journal of the European Economic Association, European Economic Association, vol. 11, pages 221-258, January.
    11. Farinelli, Simone & Ferreira, Manuel & Rossello, Damiano & Thoeny, Markus & Tibiletti, Luisa, 2008. "Beyond Sharpe ratio: Optimal asset allocation using different performance ratios," Journal of Banking & Finance, Elsevier, vol. 32(10), pages 2057-2063, October.
    12. Greg Kaplan & Giovanni L. Violante & Justin Weidner, 2014. "The Wealthy Hand-to-Mouth," Brookings Papers on Economic Activity, Economic Studies Program, The Brookings Institution, vol. 45(1 (Spring), pages 77-153.
    13. Rui Li & Yanhong Qian, 2021. "How does entrepreneurship influence the efficiency of household portfolios?," The European Journal of Finance, Taylor & Francis Journals, vol. 27(13), pages 1282-1302, September.
    14. Margarida Abreu & Victor Mendes, 2010. "Financial literacy and portfolio diversification," Quantitative Finance, Taylor & Francis Journals, vol. 10(5), pages 515-528.
    15. Laurent E. Calvet & John Y. Campbell & Paolo Sodini, 2009. "Measuring the Financial Sophistication of Households," American Economic Review, American Economic Association, vol. 99(2), pages 393-398, May.
    16. Dong, Jingxuan, 2024. "Digital finance’s impact on household portfolio diversity: Evidence from Chinese households," Finance Research Letters, Elsevier, vol. 70(C).
    17. Christina Paxson, 1990. "Borrowing Constraints and Portfolio Choice," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 105(2), pages 535-543.
    18. Berkowitz, Michael K. & Qiu, Jiaping, 2006. "A further look at household portfolio choice and health status," Journal of Banking & Finance, Elsevier, vol. 30(4), pages 1201-1217, April.
    19. Shum, Pauline & Faig, Miquel, 2006. "What explains household stock holdings?," Journal of Banking & Finance, Elsevier, vol. 30(9), pages 2579-2597, September.
    20. Edwards, Ryan D, 2008. "Health Risk and Portfolio Choice," Journal of Business & Economic Statistics, American Statistical Association, vol. 26, pages 472-485.
    21. Zhang, Dayong & Hu, Min & Ji, Qiang, 2020. "Financial markets under the global pandemic of COVID-19," Finance Research Letters, Elsevier, vol. 36(C).
    22. Haan, Peter & Myck, Michal, 2009. "Dynamics of health and labor market risks," Journal of Health Economics, Elsevier, vol. 28(6), pages 1116-1125, December.
    23. Greg Kaplan & Giovanni L. Violante & Justin Weidner, 2014. "The Wealthy Hand-to-Mouth," Brookings Papers on Economic Activity, Economic Studies Program, The Brookings Institution, vol. 48(1 (Spring), pages 77-153.
    24. Ryan D. Edwards, 2010. "Optimal portfolio choice when utility depends on health," International Journal of Economic Theory, The International Society for Economic Theory, vol. 6(2), pages 205-225, June.
    25. Yaxuan Liu & Yu Hao & Zhi-Nan Lu, 2022. "Health shock, medical insurance and financial asset allocation: evidence from CHFS in China," Health Economics Review, Springer, vol. 12(1), pages 1-14, December.
    26. Pelizzon, Loriana & Weber, Guglielmo, 2008. "Are Household Portfolios Efficient? an Analysis Conditional on Housing," Journal of Financial and Quantitative Analysis, Cambridge University Press, vol. 43(2), pages 401-431, June.
    27. David E. Bloom & David Canning & Bryan Graham, 2003. "Longevity and Life‐cycle Savings," Scandinavian Journal of Economics, Wiley Blackwell, vol. 105(3), pages 319-338, September.
    28. Guo, Fusen & Li, Feng & Lu, Xiaomeng, 2024. "Does financial advisors improve portfolio efficiency for individual investors? Evidence from large-scale microdata," International Review of Economics & Finance, Elsevier, vol. 91(C), pages 400-412.
    29. Yong Cai & Wang Feng & Ke Shen, 2018. "Fiscal Implications of Population Aging and Social Sector Expenditure in China," Population and Development Review, The Population Council, Inc., vol. 44(4), pages 811-831, December.
    30. David A. Love & Paul A. Smith, 2010. "Does health affect portfolio choice?," Health Economics, John Wiley & Sons, Ltd., vol. 19(12), pages 1441-1460, December.
    31. van Rooij, Maarten & Lusardi, Annamaria & Alessie, Rob, 2011. "Financial literacy and stock market participation," Journal of Financial Economics, Elsevier, vol. 101(2), pages 449-472, August.
    32. Tansel Yilmazer & Stephen Lich, 2015. "Portfolio choice and risk attitudes: a household bargaining approach," Review of Economics of the Household, Springer, vol. 13(2), pages 219-241, June.
    33. Gourieroux, C. & Monfort, A., 2005. "The econometrics of efficient portfolios," Journal of Empirical Finance, Elsevier, vol. 12(1), pages 1-41, January.
    34. 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 223-255, March-Apr.
    35. Ce Guo & Xijian Wang & Gecheng Yuan, 2022. "Digital Finance and the Efficiency of Household Investment Portfolios," Emerging Markets Finance and Trade, Taylor & Francis Journals, vol. 58(10), pages 2895-2909, August.
    36. Rosen, H.S.Harvey S. & Wu, Stephen, 2004. "Portfolio choice and health status," Journal of Financial Economics, Elsevier, vol. 72(3), pages 457-484, June.
    37. Cheng, Zhiming & Smyth, Russell & Zhang, Le, 2024. "Does childhood adversity affect household portfolio decisions? Evidence from the Chinese Great Famine," China Economic Review, Elsevier, vol. 87(C).
    38. Laurent E. Calvet & John Y. Campbell & Paolo Sodini, 2007. "Down or Out: Assessing the Welfare Costs of Household Investment Mistakes," Journal of Political Economy, University of Chicago Press, vol. 115(5), pages 707-747, October.
    39. Wagstaff, Adam & Lindelow, Magnus, 2008. "Can insurance increase financial risk?: The curious case of health insurance in China," Journal of Health Economics, Elsevier, vol. 27(4), pages 990-1005, July.
    40. Courtney Coile & Kevin Milligan, 2009. "How Household Portfolios Evolve After Retirement: The Effect Of Aging And Health Shocks," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 55(2), pages 226-248, June.
    41. Ding, Guodong & Marazzina, Daniele, 2022. "The impact of liquidity constraints and cashflows on the optimal retirement problem," Finance Research Letters, Elsevier, vol. 49(C).
    42. Igal Hendel & Alessandro Lizzeri, 2003. "The Role of Commitment in Dynamic Contracts: Evidence from Life Insurance," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 118(1), pages 299-328.
    43. Finkelstein, Amy & McKnight, Robin, 2008. "What did Medicare do? The initial impact of Medicare on mortality and out of pocket medical spending," Journal of Public Economics, Elsevier, vol. 92(7), pages 1644-1668, July.
    44. Marjorie Flavin & Takashi Yamashita, 2011. "Owner-Occupied Housing: Life-Cycle Implications for the Household Portfolio," American Economic Review, American Economic Association, vol. 101(3), pages 609-614, May.
    45. Jessica A. Wachter & Motohiro Yogo, 2010. "Why Do Household Portfolio Shares Rise in Wealth?," The Review of Financial Studies, Society for Financial Studies, vol. 23(11), pages 3929-3965, November.
    46. Mark Grinblatt & Matti Keloharju & Juhani Linnainmaa, 2011. "IQ and Stock Market Participation," Journal of Finance, American Finance Association, vol. 66(6), pages 2121-2164, December.
    47. Cheung, Diana & Padieu, Ysaline, 2015. "Heterogeneity of the Effects of Health Insurance on Household Savings: Evidence from Rural China," World Development, Elsevier, vol. 66(C), pages 84-103.
    48. Yogo, Motohiro, 2016. "Portfolio choice in retirement: Health risk and the demand for annuities, housing, and risky assets," Journal of Monetary Economics, Elsevier, vol. 80(C), pages 17-34.
    49. Annamaria Lusardi & Olivia S. Mitchell, 2014. "The Economic Importance of Financial Literacy: Theory and Evidence," Journal of Economic Literature, American Economic Association, vol. 52(1), pages 5-44, March.
    50. Raj Chetty & László Sándor & Adam Szeidl, 2017. "The Effect of Housing on Portfolio Choice," Journal of Finance, American Finance Association, vol. 72(3), pages 1171-1212, June.
    51. Yongbo Ge & Hongyu Chen & Liping Zou & Zhuojun Zhou, 2021. "Political Background and Household Financial Asset Allocation in China," Emerging Markets Finance and Trade, Taylor & Francis Journals, vol. 57(4), pages 1232-1246, March.
    52. Chung-Hua Shen & Jun-Yu Ren & Yu-Li Huang & Jun-Guo Shi & An-Qi Wang, 2018. "Creating Financial Cycles in China and Interaction with Business Cycles on the Chinese Economy," Emerging Markets Finance and Trade, Taylor & Francis Journals, vol. 54(13), pages 2897-2908, October.
    53. Cardak, Buly A. & Wilkins, Roger, 2009. "The determinants of household risky asset holdings: Australian evidence on background risk and other factors," Journal of Banking & Finance, Elsevier, vol. 33(5), pages 850-860, May.
    54. Deng, Xin & Yu, Mingzhe, 2021. "Does the marginal child increase household debt? – Evidence from the new fertility policy in China," International Review of Financial Analysis, Elsevier, vol. 77(C).
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Lu, Xiaomeng & Guo, Jiaojiao & Gan, Li, 2020. "International comparison of household asset allocation: Micro-evidence from cross-country comparisons," Emerging Markets Review, Elsevier, vol. 43(C).
    2. Amitabh Chandra & Courtney Coile & Corina Mommaerts, 2023. "What Can Economics Say about Alzheimer's Disease?," Journal of Economic Literature, American Economic Association, vol. 61(2), pages 428-470, June.
    3. Francisco Gomes & Michael Haliassos & Tarun Ramadorai, 2021. "Household Finance," Journal of Economic Literature, American Economic Association, vol. 59(3), pages 919-1000, September.
    4. Raslan Alzuabi & Sarah Brown & Mark N. Harris & Karl Taylor, 2024. "Modelling the composition of household portfolios: A latent class approach," Canadian Journal of Economics/Revue canadienne d'économique, John Wiley & Sons, vol. 57(1), pages 243-275, February.
    5. Xinxin Ma, 2022. "Medical Insurances and Financial Portfolio Choice," Springer Books, in: Public Medical Insurance Reforms in China, chapter 0, pages 193-215, Springer.
    6. Xinxin Ma, 2022. "Social Insurances and Risky Financial Market Participation: Evidence from China," Emerging Markets Finance and Trade, Taylor & Francis Journals, vol. 58(10), pages 2957-2975, August.
    7. Duraj, Kamila & Grunow, Daniela & Chaliasos, Michael & Laudenbach, Christine & Siegel, Stephan, 2024. "Rethinking the stock market participation puzzle: A qualitative approach," IMFS Working Paper Series 210, Goethe University Frankfurt, Institute for Monetary and Financial Stability (IMFS).
    8. Dong, Jingxuan, 2024. "Digital finance’s impact on household portfolio diversity: Evidence from Chinese households," Finance Research Letters, Elsevier, vol. 70(C).
    9. Duraj, Kamila & Grunow, Daniela & Chaliasos, Michael & Laudenbach, Christine & Siegel, Stephan, 2024. "Rethinking the stock market participation puzzle: A qualitative approach," SAFE Working Paper Series 441, Leibniz Institute for Financial Research SAFE.
    10. Kronenberg, C. & van Kippersluis, H. & Rohde, K.I.M., 2014. "What drives the association between health and portfolio choice?," Health, Econometrics and Data Group (HEDG) Working Papers 14/27, HEDG, c/o Department of Economics, University of York.
    11. Julien Hugonnier & Florian Pelgrin & Pascal St‐Amour, 2020. "Closing down the shop: Optimal health and wealth dynamics near the end of life," Health Economics, John Wiley & Sons, Ltd., vol. 29(2), pages 138-153, February.
    12. Julien Hugonnier & Florian Pelgrin, 2013. "Health and (Other) Asset Holdings," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 80(2), pages 663-710.
    13. Rui Yao & Yilan Xu & Jie Zhang, 2023. "Financial resilience of two‐worker households from a health perspective," Journal of Consumer Affairs, Wiley Blackwell, vol. 57(3), pages 1258-1280, July.
    14. Kaustia, Markku & Conlin, Andrew & Luotonen, Niilo, 2023. "What drives stock market participation? The role of institutional, traditional, and behavioral factors," Journal of Banking & Finance, Elsevier, vol. 148(C).
    15. Zhongda Li & Lu Liu & Jiayu Shi & Yubing Sui, 2021. "Health insurance, risk attitudes, and household financial behavior," Health Economics, John Wiley & Sons, Ltd., vol. 30(5), pages 1239-1246, May.
    16. David A. Love & Paul A. Smith, 2010. "Does health affect portfolio choice?," Health Economics, John Wiley & Sons, Ltd., vol. 19(12), pages 1441-1460, December.
    17. Kamila Duraj & Daniela Grunow & Michael Haliassos & Christine Laudenbach & Stephan Siegel, 2025. "Rethinking the Stock Market Participation Puzzle: A Qualitative Approach," CESifo Working Paper Series 11980, CESifo.
    18. Dana Goldman & Nicole Maestas, 2013. "Medical Expenditure Risk And Household Portfolio Choice," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 28(4), pages 527-550, June.
    19. Døskeland, Trond & Kværner, Jens, 2022. "Cancer and portfolio choice: Evidence from Norwegian register data," Other publications TiSEM 9efe1b52-789e-496a-84de-4, Tilburg University, School of Economics and Management.
    20. Pak, Tae-Young & Babiarz, Patryk, 2018. "Does cognitive aging affect portfolio choice?," Journal of Economic Psychology, Elsevier, vol. 66(C), pages 1-12.

    More about this item

    Keywords

    ;
    ;
    ;
    ;

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:ememar:v:70:y:2026:i:c:s1566014125001542. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/inca/620356 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.