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The effect of dental care on cardiovascular disease outcomes: an application of instrumental variables in the presence of heterogeneity and self‐selection

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  • Timothy Tyler Brown
  • Erin Dela Cruz
  • Stephen Scott Brown

Abstract

Studies show a relationship between oral inflammatory processes and cardiovascular risk factors, suggesting that dental care may reduce the risk of cardiovascular disease (CVD) events. However, due to the differences between men and women in the development and presentation of CVD, such effects may vary by sex. We use a valid set of instrumental variables to evaluate these issues and include a test of essential heterogeneity. CVD events include new occurrences of heart attack (including death from heart attack), stroke (including death from stroke), angina, and congestive heart failure. Controls include age, race, education, marital status, foreign birthplace, and cardiovascular risk factors (health status, body mass index, alcohol use, smoking status, diabetes status, high‐blood‐pressure status, physical activity, and depression). Our analysis finds no evidence of essential heterogeneity. We find the minimum average treatment effect for women to be −0.01, but find no treatment effect for men. This suggests that women who receive dental care may reduce their risk of future CVD events by at least one‐third. The findings may only apply to married middle‐aged and older individuals as the data set is only representative for this group. Copyright © 2010 John Wiley & Sons, Ltd.

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  • Timothy Tyler Brown & Erin Dela Cruz & Stephen Scott Brown, 2011. "The effect of dental care on cardiovascular disease outcomes: an application of instrumental variables in the presence of heterogeneity and self‐selection," Health Economics, John Wiley & Sons, Ltd., vol. 20(10), pages 1241-1256, October.
    • Handle: RePEc:wly:hlthec:v:20:y:2011:i:10:p:1241-1256
    DOI: 10.1002/hec.1667
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    References listed on IDEAS

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    1. Andrews,Donald W. K. & Stock,James H. (ed.), 2005. "Identification and Inference for Econometric Models," Cambridge Books, Cambridge University Press, number 9780521844413.
    2. Mitchell A. Petersen, 2009. "Estimating Standard Errors in Finance Panel Data Sets: Comparing Approaches," The Review of Financial Studies, Society for Financial Studies, vol. 22(1), pages 435-480, January.
    3. 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.
    4. Joshua D. Angrist & Jörn-Steffen Pischke, 2009. "Mostly Harmless Econometrics: An Empiricist's Companion," Economics Books, Princeton University Press, edition 1, number 8769.
    5. Imbens, Guido W & Angrist, Joshua D, 1994. "Identification and Estimation of Local Average Treatment Effects," Econometrica, Econometric Society, vol. 62(2), pages 467-475, March.
    6. James J. Heckman & Sergio Urzua & Edward Vytlacil, 2006. "Understanding Instrumental Variables in Models with Essential Heterogeneity," The Review of Economics and Statistics, MIT Press, vol. 88(3), pages 389-432, August.
    7. Peter Adams & Michael D. Hurd & Daniel L. McFadden & Angela Merrill & Tiago Ribeiro, 2004. "Healthy, Wealthy, and Wise? Tests for Direct Causal Paths between Health and Socioeconomic Status," NBER Chapters, in: Perspectives on the Economics of Aging, pages 415-526, National Bureau of Economic Research, Inc.
    8. F. Thomas Juster & Richard Suzman, 1995. "An Overview of the Health and Retirement Study," Journal of Human Resources, University of Wisconsin Press, vol. 30, pages 7-56.
    9. Anirban Basu & James J. Heckman & Salvador Navarro-Lozano & Sergio Urzua, 2007. "Use of instrumental variables in the presence of heterogeneity and self-selection: an application to treatments of breast cancer patients," Health Economics, John Wiley & Sons, Ltd., vol. 16(11), pages 1133-1157.
    10. H. Shelton Brown & José A. Pagán & Elena Bastida, 2005. "The impact of diabetes on employment: genetic IVs in a bivariate probit," Health Economics, John Wiley & Sons, Ltd., vol. 14(5), pages 537-544, May.
    11. Anirban Basu & James J. Heckman & Salvador Navarro-Lozano & Sergio Urzua, 2007. "Use of instrumental variables in the presence of heterogeneity and self-selection: An application in breast cancer patients," Health, Econometrics and Data Group (HEDG) Working Papers 07/07, HEDG, c/o Department of Economics, University of York.
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    2. Shooshan Danagoulian & Thomas A. Wilk, 2022. "Locking out prevention: Dental care in the midst of a pandemic," Health Economics, John Wiley & Sons, Ltd., vol. 31(9), pages 1973-1992, September.
    3. Michael J. Peel, 2014. "Addressing unobserved endogeneity bias in accounting studies: control and sensitivity methods by variable type," Accounting and Business Research, Taylor & Francis Journals, vol. 44(5), pages 545-571, October.

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