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What determines health: a causal analysis using county level data

  • Andrew Rettenmaier
  • Zijun Wang


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    This article revisits the long-standing issue of the determinants of health outcomes. We make two contributions to the literature. First, we use a large and comprehensive US county level health data set that has only recently become available. This data set includes five measures of health outcomes and 24 health risk factors in the categories of health behaviors, clinical care, social and economic factors, and physical environment. Second, to distinguish causality from correlation, we implement an emerging data-driven method to study the causal factors of health outcomes. Among all included potential health risk factors, we identify adult smoking, obesity, motor vehicle crash death rate, the percent of children in poverty, and violent crime rate to be major causal factors of premature mortality. Adult smoking, preventable hospital stays, college or higher education, employment, children in poverty, and adequacy of social support determine health-related quality of life. Finally, the Chlamydia rate, community safety, and liquor store density are three important factors causally related to low birth weight. Policy implications of these findings are discussed. Copyright Springer-Verlag 2013

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    Article provided by Springer in its journal The European Journal of Health Economics.

    Volume (Year): 14 (2013)
    Issue (Month): 5 (October)
    Pages: 821-834

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    Handle: RePEc:spr:eujhec:v:14:y:2013:i:5:p:821-834
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    1. David Bessler & Zijun Wang, 2012. "D-separation, forecasting, and economic science: a conjecture," Theory and Decision, Springer, vol. 73(2), pages 295-314, August.
    2. Wang, Zijun & Yang, Jian & Li, Qi, 2007. "Interest rate linkages in the Eurocurrency market: Contemporaneous and out-of-sample Granger causality tests," Journal of International Money and Finance, Elsevier, vol. 26(1), pages 86-103, February.
    3. Pierre-Carl Michaud & Arthur van Soest, 2004. "Health and Wealth of Elderly Couples: Causality Tests Using Dynamic Panel Data Models," Working Papers 191, RAND Corporation Publications Department.
    4. Haigh, Michael S. & Bessler, David A., 2002. "Causality And Price Discovery: An Application Of Directed Acyclic Graphs," Working Papers 28588, University of Maryland, Department of Agricultural and Resource Economics.
    5. Christopher J. Ruhm, 2000. "Are Recessions Good For Your Health?," The Quarterly Journal of Economics, MIT Press, vol. 115(2), pages 617-650, May.
    6. Jérome Adda & James Banks & Hans-Martin von Gaudecker, 2007. "The Impact of Income Shocks on Health: Evidence from Cohort Data," MEA discussion paper series 07146, Munich Center for the Economics of Aging (MEA) at the Max Planck Institute for Social Law and Social Policy.
    7. Robert Moffitt, 2005. "Remarks on the analysis of causal relationships in population research," Demography, Springer, vol. 42(1), pages 91-108, February.
    8. Clive W. J. Granger, 2005. "Modeling, Evaluation, and Methodology in the New Century," Economic Inquiry, Western Economic Association International, vol. 43(1), pages 1-12, January.
    9. David A. Bessler & Derya G. Akleman, 1998. "Farm Prices, Retail Prices, and Directed Graphs: Results for Pork and Beef," American Journal of Agricultural Economics, Agricultural and Applied Economics Association, vol. 80(5), pages 1144-1149.
    10. John Nixon & Philippe Ulmann, 2006. "The relationship between health care expenditure and health outcomes," The European Journal of Health Economics, Springer, vol. 7(1), pages 7-18, March.
    11. Alessio Moneta, 2008. "Graphical causal models and VARs: an empirical assessment of the real business cycles hypothesis," Empirical Economics, Springer, vol. 35(2), pages 275-300, September.
    12. Selva Demiralp & Kevin D. Hoover & Stephen J. Perez, 2008. "A Bootstrap Method for Identifying and Evaluating a Structural Vector Autoregression," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 70(4), pages 509-533, 08.
    13. Frijters, Paul & Haisken-DeNew, John P. & Shields, Michael A., 2005. "The causal effect of income on health: Evidence from German reunification," Journal of Health Economics, Elsevier, vol. 24(5), pages 997-1017, September.
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