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The Rich Live Longer: A Model of Income and Health Inequalities

Author

Listed:
  • Pablo Garcia-Sanchez

    (Banque centrale du Luxembourg, Departement Economie et Recherche)

  • Olivier Pierrard

    (Banque centrale du Luxembourg, Departement Economie et Recherche)

Abstract

Income and life expectancy are strongly correlated, yet the mechanisms underlying this relationship remain debated. This paper develops a structural model in which both variables are endogenous and jointly determined. Calibrated to U.S. data, the model replicates the income-longevity gradient and the distribution of age at death. It highlights the importance of both the health-to-income and income-to-health channels in accounting for these empirical patterns. Our model also offers a more cautious assessment of income redistribution policies than empirical studies, showing that redistribution can weaken incentives for preventive care and increase mortality risk. By contrast, lowering the price of preventive care through subsidies promotes better health and longer lives.

Suggested Citation

  • Pablo Garcia-Sanchez & Olivier Pierrard, 2025. "The Rich Live Longer: A Model of Income and Health Inequalities," LIDAM Discussion Papers IRES 2025016, Université catholique de Louvain, Institut de Recherches Economiques et Sociales (IRES).
  • Handle: RePEc:ctl:louvir:2025016
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    File URL: https://sites.uclouvain.be/econ/DP/IRES/2025016.pdf
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    References listed on IDEAS

    as
    1. Borgschulte, Mark & Vogler, Jacob, 2020. "Did the ACA Medicaid expansion save lives?," Journal of Health Economics, Elsevier, vol. 72(C).
    2. Sandra E. Black & Paul J. Devereux & Kjell G. Salvanes, 2007. "From the Cradle to the Labor Market? The Effect of Birth Weight on Adult Outcomes," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 122(1), pages 409-439.
    3. Ruhm, Christopher J., 2005. "Healthy living in hard times," Journal of Health Economics, Elsevier, vol. 24(2), pages 341-363, March.
    4. Beomsoo Kim & Christopher J. Ruhm, 2012. "Inheritances, health and death," Health Economics, John Wiley & Sons, Ltd., vol. 21(2), pages 127-144, February.
    5. Eric French & Elaine Kelly & Mariacristina Nardi & Eric French & John Bailey Jones & Jeremy McCauley, 2016. "Medical Spending of the US Elderly," Fiscal Studies, Institute for Fiscal Studies, vol. 37, pages 717-747, September.
    6. Capatina, Elena, 2015. "Life-cycle effects of health risk," Journal of Monetary Economics, Elsevier, vol. 74(C), pages 67-88.
    7. Newacheck, P.W. & Halfon, N., 1998. "Prevalence and impact of disabling chronic conditions in childhood," American Journal of Public Health, American Public Health Association, vol. 88(4), pages 610-617.
    8. David Cutler & Angus Deaton & Adriana Lleras-Muney, 2006. "The Determinants of Mortality," Journal of Economic Perspectives, American Economic Association, vol. 20(3), pages 97-120, Summer.
    9. Dragone, Davide & Strulik, Holger, 2020. "Negligible senescence: An economic life cycle model for the future," Journal of Economic Behavior & Organization, Elsevier, vol. 171(C), pages 264-285.
    10. David Cesarini & Erik Lindqvist & Robert Östling & Björn Wallace, 2016. "Wealth, Health, and Child Development: Evidence from Administrative Data on Swedish Lottery Players," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 131(2), pages 687-738.
    11. Grimard, Franque & Parent, Daniel, 2007. "Education and smoking: Were Vietnam war draft avoiders also more likely to avoid smoking?," Journal of Health Economics, Elsevier, vol. 26(5), pages 896-926, September.
    12. Blanchard, Olivier J, 1985. "Debt, Deficits, and Finite Horizons," Journal of Political Economy, University of Chicago Press, vol. 93(2), pages 223-247, April.
    13. Chandra, Amitabh & Vogl, Tom S., 2010. "Rising up with shoe leather? A comment on Fair Society, Healthy Lives (The Marmot Review)," Social Science & Medicine, Elsevier, vol. 71(7), pages 1227-1230, October.
    14. Atle Seierstad, 2009. "Stochastic Control in Discrete and Continuous Time," Springer Books, Springer, number 978-0-387-76617-1, January.
    15. Lukas Mahler & Minchul Yum, 2024. "Lifestyle Behaviors and Wealth‐Health Gaps in Germany," Econometrica, Econometric Society, vol. 92(5), pages 1697-1733, September.
    16. Janet Currie, 2009. "Healthy, Wealthy, and Wise: Socioeconomic Status, Poor Health in Childhood, and Human Capital Development," Journal of Economic Literature, American Economic Association, vol. 47(1), pages 87-122, March.
    17. Mishan, E J, 1971. "Evaluation of Life and Limb: A Theoretical Approach," Journal of Political Economy, University of Chicago Press, vol. 79(4), pages 687-705, July-Aug..
    18. Roozbei Hosseini & Karen Kopecky & Kai Zhao, 2022. "The Evolution of Health over the Life Cycle," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 45, pages 237-263, July.
    19. Sarah Miller & Norman Johnson & Laura R Wherry, 2021. "Medicaid and Mortality: New Evidence From Linked Survey and Administrative Data," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 136(3), pages 1783-1829.
    20. Scott, Andrew J., 2023. "The economics of longevity – An introduction," The Journal of the Economics of Ageing, Elsevier, vol. 24(C).
    21. Carl-Johan Dalgaard & Holger Strulik, 2014. "Optimal Aging And Death: Understanding The Preston Curve," Journal of the European Economic Association, European Economic Association, vol. 12(3), pages 672-701, June.
    22. O. Ashenfelter & D. Card (ed.), 1999. "Handbook of Labor Economics," Handbook of Labor Economics, Elsevier, edition 1, volume 3, number 3.
    23. Christopher J. Ruhm, 2000. "Are Recessions Good for Your Health?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 115(2), pages 617-650.
    24. 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.
    25. Menahem E. Yaari, 1965. "Uncertain Lifetime, Life Insurance, and the Theory of the Consumer," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 32(2), pages 137-150.
    26. Jere R. Behrman & Mark R. Rosenzweig, 2004. "Returns to Birthweight," The Review of Economics and Statistics, MIT Press, vol. 86(2), pages 586-601, May.
    27. Oscar Erixson, 2017. "Health responses to a wealth shock: evidence from a Swedish tax reform," Journal of Population Economics, Springer;European Society for Population Economics, vol. 30(4), pages 1281-1336, October.
    28. Sherry Glied & Adriana Lleras-Muney, 2008. "Technological innovation and inequality in health," Demography, Springer;Population Association of America (PAA), vol. 45(3), pages 741-761, August.
    29. repec:ucn:wpaper:10197/317 is not listed on IDEAS
    30. Ozkan, Serdar, 2025. "Income differences and health disparities: Roles of preventive vs. curative medicine," Journal of Monetary Economics, Elsevier, vol. 150(C).
    31. Adriana Lleras-Muney, 2005. "The Relationship Between Education and Adult Mortality in the United States," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 72(1), pages 189-221.
    32. Damien de Walque, 2010. "Education, Information and Smoking Decisions: Evidence from Smoking Histories in the United States, 1940–2000," Journal of Human Resources, University of Wisconsin Press, vol. 45(3).
    33. Roozbei Hosseini & Karen Kopecky & Kai Zhao, 2022. "The Evolution of Health over the Life Cycle," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 45, pages 237-263, July.
    34. Ehrlich, Isaac & Becker, Gary S, 1972. "Market Insurance, Self-Insurance, and Self-Protection," Journal of Political Economy, University of Chicago Press, vol. 80(4), pages 623-648, July-Aug..
    35. Hamish Low & Luigi Pistaferri, 2015. "Disability Insurance and the Dynamics of the Incentive Insurance Trade-Off," American Economic Review, American Economic Association, vol. 105(10), pages 2986-3029, October.
    36. Pashchenko, Svetlana, 2025. "Comments on “Income differences and health disparities: Roles of preventive vs. curative medicine” by Serdar Ozkan," Journal of Monetary Economics, Elsevier, vol. 150(C).
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    Keywords

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    JEL classification:

    • C60 - Mathematical and Quantitative Methods - - Mathematical Methods; Programming Models; Mathematical and Simulation Modeling - - - General
    • D15 - Microeconomics - - Household Behavior - - - Intertemporal Household Choice; Life Cycle Models and Saving
    • H24 - Public Economics - - Taxation, Subsidies, and Revenue - - - Personal Income and Other Nonbusiness Taxes and Subsidies
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality

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