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Modelling opportunity in health under partial observability of circumstances

Listed author(s):
  • Pedro Rosa Dias

    (Centre for Health Economics, The University of York, UK)

This paper proposes a behavioural model of inequality of opportunity in health that integrates John Roemer's framework of inequality of opportunity with the Grossman model of health capital and demand for health. The model generates a recursive system of equations for health and lifestyles, which is then jointly estimated by full information maximum likelihood with freely correlated error terms. The analysis innovates by accounting for the presence of unobserved heterogeneity, therefore addressing the partial-circumstance problem, and by extending the examination of inequality of opportunity to health outcomes other than self-assessed health, such as long-standing illness, disability and mental health. The results provide evidence for the existence of third factors that simultaneously influence health outcomes and lifestyle choices, supporting the empirical relevance of the partial-circumstance problem. Accounting for these factors, the paper corroborates that the effect of parental and early circumstances on adult health disparities is paramount. However, the particular set of circumstances that affect each of the analysed health outcomes differs substantially. The results also show that differences in educational opportunities, and in social development in childhood, are crucial determinants of lifestyles in adulthood, which, in turn, shape the observed health inequalities. Copyright © 2010 John Wiley & Sons, Ltd.

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File URL: http://hdl.handle.net/10.1002/hec.1584
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Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 19 (2010)
Issue (Month): 3 ()
Pages: 252-264

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Handle: RePEc:wly:hlthec:v:19:y:2010:i:3:p:252-264
DOI: 10.1002/hec.1584
Contact details of provider: Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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  1. Arnaud Lefranc & Nicolas Pistolesi & Alain Trannoy, 2006. "Equality of Opportunity: Definitions and Testable Conditions with an Application to Income in France," IDEP Working Papers 0609, Institut d'economie publique (IDEP), Marseille, France, revised 27 Sep 2006.
  2. Maarten Lindeboom & Ana Llena Nozal & Bas van der Klaauw, 2006. "Disability and Work: the Role of Health Shocks and Childhood Circumstances," Tinbergen Institute Discussion Papers 06-039/3, Tinbergen Institute.
  3. Valerie Lechene & Jerome Adda, 2004. "On the Identification of the Effect of Smoking on Mortality," Economics Series Working Papers 184, University of Oxford, Department of Economics.
  4. Trannoy, A & Tubeuf, S & Jusot, F & Devaux, M, 2008. "Inequality in Opportunities in Health in France: A first pass," Health, Econometrics and Data Group (HEDG) Working Papers 08/24, HEDG, c/o Department of Economics, University of York.
  5. Silvia Balia & Andrew M Jones, 2005. "Mortality, lifestyle and socio-economic status," Health, Econometrics and Data Group (HEDG) Working Papers 05/02, HEDG, c/o Department of Economics, University of York.
  6. Fernando Galindo-Rueda & Anna Vignoles, 2005. "The Declining Relative Importance of Ability in Predicting Educational Attainment," Journal of Human Resources, University of Wisconsin Press, vol. 40(2).
  7. FLEURBAEY, Marc & SCHOKKAERT, Erik, "undated". "Unfair inequalities in health and health care," CORE Discussion Papers RP 2141, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
  8. Mullahy, John & Portney, Paul R., 1990. "Air pollution, cigarette smoking, and the production of respiratory health," Journal of Health Economics, Elsevier, vol. 9(2), pages 193-205, September.
  9. Pedro Rosa Dias, 2009. "Inequality of opportunity in health: evidence from a UK cohort study," Health Economics, John Wiley & Sons, Ltd., vol. 18(9), pages 1057-1074.
  10. Dardanoni, Valentino & Wagstaff, Adam, 1990. "Uncertainty and the demand for medical care," Journal of Health Economics, Elsevier, vol. 9(1), pages 23-38, June.
  11. Pudney, Stephen & Shields, Michael A, 2000. " Gender and Racial Discrimination in Pay and Promotion for NHS Nurses," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 62(0), pages 801-835, Special I.
  12. 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.
  13. Pedro Carneiro & Claire Crawford & Alissa Goodman, 2007. "The Impact of Early Cognitive and Non-Cognitive Skills on Later Outcomes," CEE Discussion Papers 0092, Centre for the Economics of Education, LSE.
  14. Contoyannis, Paul & Jones, Andrew M., 2004. "Socio-economic status, health and lifestyle," Journal of Health Economics, Elsevier, vol. 23(5), pages 965-995, September.
  15. James J. Heckman & Jora Stixrud & Sergio Urzua, 2006. "The Effects of Cognitive and Noncognitive Abilities on Labor Market Outcomes and Social Behavior," NBER Working Papers 12006, National Bureau of Economic Research, Inc.
  16. Contoyannis, Paul & Forster, Martin, 1999. "The distribution of health and income: a theoretical framework," Journal of Health Economics, Elsevier, vol. 18(5), pages 603-620, October.
  17. Carbone, Jared C. & Kverndokk, Snorre & Rogeberg, Ole Jorgen, 2005. "Smoking, health, risk, and perception," Journal of Health Economics, Elsevier, vol. 24(4), pages 631-653, July.
  18. 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.
  19. Forster, Martin, 2001. "The meaning of death: some simulations of a model of healthy and unhealthy consumption," Journal of Health Economics, Elsevier, vol. 20(4), pages 613-638, July.
  20. John E. Roemer, 2002. "Equality of opportunity: A progress report," Social Choice and Welfare, Springer;The Society for Social Choice and Welfare, vol. 19(2), pages 455-471.
  21. David Roodman, 2009. "Estimating Fully Observed Recursive Mixed-Process Models with cmp," Working Papers 168, Center for Global Development.
  22. repec:dau:papers:123456789/268 is not listed on IDEAS
  23. Dardanoni, Valentino & Wagstaff, Adam, 1987. "Uncertainty, inequalities in health and the demand for health," Journal of Health Economics, Elsevier, vol. 6(4), pages 283-290, December.
  24. Kuh, D. J. L. & Wadsworth, M. E. J., 1993. "Physical health status at 36 years in a British national birth cohort," Social Science & Medicine, Elsevier, vol. 37(7), pages 905-916, October.
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