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The impact of childhood obesity on health and health service use: an instrumental variable approach

Author

Listed:
  • Kinge, Jonas Minet

    (Norwegian Institute of Public Health)

  • Morris, Stephan

    (University College London)

Abstract

In the following paper we estimate the impact of obesity in childhood on health and health service use in England using instrumental variables. We use data on children and adolescents aged 3-18 years old from fifteen rounds of the Health Survey for England (1998-2012), which has measures of self-assessed health, primary care use, prescribed medication use, and nurse-measured height and weight. We use instruments for child obesity using genetic variation in weight. We detect a few potential issues with the validity of the instrument; however further testing does not suggest that this has an effect on our results. We find that obesity has a statistically significant and negative impact on self-rated health and a positive impact on health service use in girls, boys, younger children (aged 3-10) and adolescents (aged 11-18). We detect significant endogeneity, which suggest that previous studies underestimate the impact of childhood obesity on health and health service use. For example, obesity is associated with and increased probability of doctor utilisation of 2%, but the IV results show that obesity increase the probability of use by 10%. This suggests that obesity has consequences for health and health service use when the children are still young.

Suggested Citation

  • Kinge, Jonas Minet & Morris, Stephan, 2015. "The impact of childhood obesity on health and health service use: an instrumental variable approach," HERO Online Working Paper Series 2015:2, University of Oslo, Health Economics Research Programme.
  • Handle: RePEc:hhs:oslohe:2015_002
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    References listed on IDEAS

    as
    1. Hansen, Lars Peter, 1982. "Large Sample Properties of Generalized Method of Moments Estimators," Econometrica, Econometric Society, vol. 50(4), pages 1029-1054, July.
    2. van Doorslaer, Eddy & Gerdtham, Ulf-G., 2003. "Does inequality in self-assessed health predict inequality in survival by income? Evidence from Swedish data," Social Science & Medicine, Elsevier, vol. 57(9), pages 1621-1629, November.
    3. Jones, A., 2007. "Applied Econometrics for Health Economists: A Practical Guide," Monographs, Office of Health Economics, number 000262.
    4. repec:pri:cheawb:case_paxson_economic_status_paper is not listed on IDEAS
    5. Finkelstein, E.A. & Trogdon, J.G., 2008. "Public health interventions for addressing childhood overweight: Analysis of the business case," American Journal of Public Health, American Public Health Association, vol. 98(3), pages 411-415.
    6. Mary Zimmerman Murphy, 1987. "The Importance of Sample Selection Bias in the Estimation of Medical Care Demand Equations," Eastern Economic Journal, Eastern Economic Association, vol. 13(1), pages 19-29, Jan-Mar.
    7. Janet Currie & Mark Stabile, 2003. "Socioeconomic Status and Child Health: Why Is the Relationship Stronger for Older Children?," American Economic Review, American Economic Association, vol. 93(5), pages 1813-1823, December.
    8. Rothe, Christoph, 2009. "Semiparametric estimation of binary response models with endogenous regressors," Journal of Econometrics, Elsevier, vol. 153(1), pages 51-64, November.
    9. Borghans, Lex & Golsteyn, Bart H.H., 2006. "Time discounting and the body mass index: Evidence from the Netherlands," Economics & Human Biology, Elsevier, vol. 4(1), pages 39-61, January.
    10. Minet Kinge, Jonas & Morris, Stephen, 2010. "Socioeconomic variation in the impact of obesity on health-related quality of life," Social Science & Medicine, Elsevier, vol. 71(10), pages 1864-1871, November.
    11. repec:pri:cheawb:case_paxson_economic_status_paper.pdf is not listed on IDEAS
    12. Terza, Joseph V. & Basu, Anirban & Rathouz, Paul J., 2008. "Two-stage residual inclusion estimation: Addressing endogeneity in health econometric modeling," Journal of Health Economics, Elsevier, vol. 27(3), pages 531-543, May.
    13. Trogdon, Justin G. & Nonnemaker, James & Pais, Joanne, 2008. "Peer effects in adolescent overweight," Journal of Health Economics, Elsevier, vol. 27(5), pages 1388-1399, September.
    14. Oecd & Nea, 2012. "Intergovernmental organisation activities," Nuclear Law Bulletin, OECD Publishing, vol. 2011(2), pages 99-106.
    15. Rosanna M. Coffey, 1983. "The Effect of Time Price on the Demand for Medical-Care Services," Journal of Human Resources, University of Wisconsin Press, vol. 18(3), pages 407-424.
    16. Ocde & Aen, 2012. "Activités des organisations intergouvernementales," Bulletin de droit nucléaire, Éditions OCDE, vol. 2011(2), pages 107-114.
    17. John Cawley, 2004. "The Impact of Obesity on Wages," Journal of Human Resources, University of Wisconsin Press, vol. 39(2).
    18. Andrew M. Jones, 2012. "health econometrics," The New Palgrave Dictionary of Economics,, Palgrave Macmillan.
    19. Morris, Stephen & Sutton, Matthew & Gravelle, Hugh, 2005. "Inequity and inequality in the use of health care in England: an empirical investigation," Social Science & Medicine, Elsevier, vol. 60(6), pages 1251-1266, March.
    20. Unknown, 2011. "Organized Symposia SAEA 2011 Annual Meetings," Journal of Agricultural and Applied Economics, Southern Agricultural Economics Association, vol. 43(3), pages 1-2, August.
    21. Brendan Kline & Justin L. Tobias, 2008. "The wages of BMI: Bayesian analysis of a skewed treatment-response model with nonparametric endogeneity," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 23(6), pages 767-793.
    22. Smith, Patricia K. & Bogin, Barry & Bishai, David, 2005. "Are time preference and body mass index associated?: Evidence from the National Longitudinal Survey of Youth," Economics & Human Biology, Elsevier, vol. 3(2), pages 259-270, July.
    23. Morris, Stephen, 2007. "The impact of obesity on employment," Labour Economics, Elsevier, vol. 14(3), pages 413-433, June.
    24. Eric Johnson & Melayne Morgan McInnes & Judith A. Shinogle, 2006. "What is the Economic Cost of Overweight Children?," Eastern Economic Journal, Eastern Economic Association, vol. 32(1), pages 171-187, Winter.
    25. Lindeboom, Maarten & Lundborg, Petter & van der Klaauw, Bas, 2010. "Assessing the impact of obesity on labor market outcomes," Economics & Human Biology, Elsevier, vol. 8(3), pages 309-319, December.
    26. Anne Case & Darren Lubotsky & Christina Paxson, 2002. "Economic Status and Health in Childhood: The Origins of the Gradient," American Economic Review, American Economic Association, vol. 92(5), pages 1308-1334, December.
    27. John Cawley & Euna Han & Edward C. Norton, 2011. "The validity of genes related to neurotransmitters as instrumental variables," Health Economics, John Wiley & Sons, Ltd., vol. 20(8), pages 884-888, August.
    28. Wardle, J. & Waller, J. & Jarvis, M.J., 2002. "Sex differences in the association of socioeconomic status with obesity," American Journal of Public Health, American Public Health Association, vol. 92(8), pages 1299-1304.
    29. Burkhauser, Richard V. & Cawley, John, 2008. "Beyond BMI: The value of more accurate measures of fatness and obesity in social science research," Journal of Health Economics, Elsevier, vol. 27(2), pages 519-529, March.
    30. Cawley, John & Meyerhoefer, Chad, 2012. "The medical care costs of obesity: An instrumental variables approach," Journal of Health Economics, Elsevier, vol. 31(1), pages 219-230.
    31. Currie, Alison & Shields, Michael A. & Price, Stephen Wheatley, 2007. "The child health/family income gradient: Evidence from England," Journal of Health Economics, Elsevier, vol. 26(2), pages 213-232, March.
    32. Michael P. Murray, 2006. "Avoiding Invalid Instruments and Coping with Weak Instruments," Journal of Economic Perspectives, American Economic Association, vol. 20(4), pages 111-132, Fall.
    33. Monheit, Alan C. & Vistnes, Jessica P. & Rogowski, Jeannette A., 2009. "Overweight in adolescents: Implications for health expenditures," Economics & Human Biology, Elsevier, vol. 7(1), pages 55-63, March.
    34. Torben Heien Nielsen, 2016. "The Relationship Between Self‐Rated Health and Hospital Records," Health Economics, John Wiley & Sons, Ltd., vol. 25(4), pages 497-512, April.
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    More about this item

    Keywords

    Children; Adolescents; Obesity; Body Mass Index; Self-assessed health; Doctor visits; Medication use;
    All these keywords.

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I10 - Health, Education, and Welfare - - Health - - - General
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior

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