IDEAS home Printed from https://ideas.repec.org/p/kud/epruwp/17-05.html
   My bibliography  Save this paper

Family Health Behaviors

Author

Listed:
  • Itzik Fadlon

    (Department of Economics, University of California)

  • Torben Heien Nielsen

    (Department of Economics, University of Copenhagen)

Abstract

This paper studies how health behaviors and investments are shaped through intra- and inter-generational family spillovers. Specffically, leveraging administrative healthcare data, we identify the effects of health shocks to individuals on their family members' consumption of preventive care and utilization indicative of health-related behaviors. Our identification strategy relies on the timing of shocks by constructing counterfactuals to affected households using households that experience the same shock but a few years in the future. We find that spouses and adult children immediately increase their health investments and improve their health behaviors in response to family shocks, and that these effects are both significant and persistent for at least several years. Notably, we find that these spillover effects in consumption of healthcare are far-reaching and cascade to siblings, stepchildren, sons and daughters in-law, and even "close" coworkers. Using different strategies we show that while a variety of mechanisms seem to be at play, including learning new information about one's own health, there is consistent evidence in support of salience as a major operative explanation, even when the family shock was likely uninformative. Our results have implications for models of health behaviors, by underscoring the importance of one's family and social network in their determination, and are potentially informative for policies that aim to improve population health.

Suggested Citation

  • Itzik Fadlon & Torben Heien Nielsen, 2017. "Family Health Behaviors," EPRU Working Paper Series 17-05, Economic Policy Research Unit (EPRU), University of Copenhagen. Department of Economics.
  • Handle: RePEc:kud:epruwp:17-05
    as

    Download full text from publisher

    File URL: http://web.econ.ku.dk/eprn_epru/Workings_Papers/WP-2017-05.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Chad Cotti & Erik Nesson & Nathan Tefft, 2019. "Impacts of the ACA Medicaid expansion on health behaviors: Evidence from household panel data," Health Economics, John Wiley & Sons, Ltd., vol. 28(2), pages 219-244, February.
    2. Heather Royer & Mark Stehr & Justin Sydnor, 2015. "Incentives, Commitments, and Habit Formation in Exercise: Evidence from a Field Experiment with Workers at a Fortune-500 Company," American Economic Journal: Applied Economics, American Economic Association, vol. 7(3), pages 51-84, July.
    3. Jayachandran N. Variyam & John Cawley, 2006. "Nutrition Labels and Obesity," NBER Working Papers 11956, National Bureau of Economic Research, Inc.
    4. Marika Cabral & Mark R. Cullen, 2017. "The Effect Of Insurance Coverage On Preventive Care," Economic Inquiry, Western Economic Association International, vol. 55(3), pages 1452-1467, July.
    5. Raj Chetty & Adam Looney & Kory Kroft, 2009. "Salience and Taxation: Theory and Evidence," American Economic Review, American Economic Association, vol. 99(4), pages 1145-1177, September.
    6. Uri Gneezy & Stephan Meier & Pedro Rey-Biel, 2011. "When and Why Incentives (Don't) Work to Modify Behavior," Journal of Economic Perspectives, American Economic Association, vol. 25(4), pages 191-210, Fall.
    7. Rosemary Avery & Donald Kenkel & Dean R. Lillard & Alan Mathios, 2007. "Private Profits and Public Health: Does Advertising of Smoking Cessation Products Encourage Smokers to Quit?," Journal of Political Economy, University of Chicago Press, vol. 115, pages 447-481.
    8. Charles Courtemanche & James Marton & Benjamin Ukert & Aaron Yelowitz & Daniela Zapata, 2018. "Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self‐Assessed Health," Southern Economic Journal, John Wiley & Sons, vol. 84(3), pages 660-691, January.
    9. repec:hrv:faseco:34737827 is not listed on IDEAS
    10. Emily Oster, 2016. "Does Disease Cause Vaccination? Disease Outbreaks and Vaccination Response," NBER Working Papers 22464, National Bureau of Economic Research, Inc.
    11. David R. Just & Joseph Price, 2013. "Using Incentives to Encourage Healthy Eating in Children," Journal of Human Resources, University of Wisconsin Press, vol. 48(4), pages 855-872.
    12. Marianne P. Bitler & Christopher S. Carpenter, 2016. "Health Insurance Mandates, Mammography, and Breast Cancer Diagnoses," American Economic Journal: Economic Policy, American Economic Association, vol. 8(3), pages 39-68, August.
    13. Michael Darden, 2017. "Smoking, Expectations, and Health: A Dynamic Stochastic Model of Lifetime Smoking Behavior," Journal of Political Economy, University of Chicago Press, vol. 125(5), pages 1465-1522.
    14. Xavier Giné & Dean Karlan & Jonathan Zinman, 2010. "Put Your Money Where Your Butt Is: A Commitment Contract for Smoking Cessation," American Economic Journal: Applied Economics, American Economic Association, vol. 2(4), pages 213-235, October.
    15. Amy Finkelstein & Matthew Gentzkow & Heidi Williams, 2016. "Sources of Geographic Variation in Health Care: Evidence From PatientMigration," The Quarterly Journal of Economics, Oxford University Press, vol. 131(4), pages 1681-1726.
    16. Kate Ho & Ariel Pakes, 2014. "Hospital Choices, Hospital Prices, and Financial Incentives to Physicians," American Economic Review, American Economic Association, vol. 104(12), pages 3841-3884, December.
    17. Julie S. Downs & George Loewenstein & Jessica Wisdom, 2009. "Strategies for Promoting Healthier Food Choices," American Economic Review, American Economic Association, vol. 99(2), pages 159-164, May.
    18. Mariana Carrera & Heather Royer & Mark Stehr & Justin Sydnor, 2020. "The Structure of Health Incentives: Evidence from a Field Experiment," Management Science, INFORMS, vol. 66(5), pages 1890-1908, May.
    19. Bryan Bollinger & Phillip Leslie & Alan Sorensen, 2011. "Calorie Posting in Chain Restaurants," American Economic Journal: Economic Policy, American Economic Association, vol. 3(1), pages 91-128, February.
    20. Jessica Wisdom & Julie S. Downs & George Loewenstein, 2010. "Promoting Healthy Choices: Information versus Convenience," American Economic Journal: Applied Economics, American Economic Association, vol. 2(2), pages 164-178, April.
    21. Kosali Simon & Aparna Soni & John Cawley, 2017. "The Impact of Health Insurance on Preventive Care and Health Behaviors: Evidence from the First Two Years of the ACA Medicaid Expansions," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 36(2), pages 390-417, March.
    22. Cawley, John & Price, Joshua A., 2013. "A case study of a workplace wellness program that offers financial incentives for weight loss," Journal of Health Economics, Elsevier, vol. 32(5), pages 794-803.
    23. Matthew C. Farrelly & William N. Evans & Edward Montgomery, 1999. "Do Workplace Smoking Bans Reduce Smoking?," American Economic Review, American Economic Association, vol. 89(4), pages 728-747, September.
    24. Jacob Goldin & Tatiana Homonoff, 2013. "Smoke Gets in Your Eyes: Cigarette Tax Salience and Regressivity," American Economic Journal: Economic Policy, American Economic Association, vol. 5(1), pages 302-336, February.
    25. Emily Oster, 2015. "Diabetes and Diet: Behavioral Response and the Value of Health," NBER Working Papers 21600, National Bureau of Economic Research, Inc.
    26. Kosali Simon & Aparna Soni & John Cawley, 2016. "The Impact of Health Insurance on Preventive Care and Health Behaviors: Evidence from the 2014 ACA Medicaid Expansions," NBER Working Papers 22265, National Bureau of Economic Research, Inc.
    27. Dan Acland & Matthew R. Levy, 2015. "Naiveté, Projection Bias, and Habit Formation in Gym Attendance," Management Science, INFORMS, vol. 61(1), pages 146-160, January.
    28. Acland, Dan & Levy, Matthew R., 2015. "Naiveté, projection bias, and habit formation in gym attendance," LSE Research Online Documents on Economics 66147, London School of Economics and Political Science, LSE Library.
    29. Gary Charness & Uri Gneezy, 2009. "Incentives to Exercise," Econometrica, Econometric Society, vol. 77(3), pages 909-931, May.
    30. Anca M. Grecu & Dhaval M. Dave & Henry Saffer, 2019. "Mandatory Access Prescription Drug Monitoring Programs and Prescription Drug Abuse," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 38(1), pages 181-209, January.
    31. Philip Babcock & Kelly Bedard & Gary Charness & John Hartman & Heather Royer, 2015. "Letting Down The Team? Social Effects Of Team Incentives," Journal of the European Economic Association, European Economic Association, vol. 13(5), pages 841-870, October.
    32. Donald S. Kenkel & Sida Peng & Michael F. Pesko & Hua Wang, 2020. "Mostly harmless regulation? Electronic cigarettes, public policy, and consumer welfare," Health Economics, John Wiley & Sons, Ltd., vol. 29(11), pages 1364-1377, November.
    33. Milkman, Katherine L. & Beshears, John & Choi, James J. & Laibson, David I. & Madrian, Brigitte, 2011. "Using Implementation Intentions Prompts to Enhance Influenza Vaccination Rates," Scholarly Articles 8057976, Harvard Kennedy School of Government.
    34. Jay Bhattacharya & Alan M. Garber & Jeremy D. Goldhaber-Fiebert, 2015. "Nudges in Exercise Commitment Contracts: A Randomized Trial," NBER Working Papers 21406, National Bureau of Economic Research, Inc.
    35. Loewenstein, George & Price, Joseph & Volpp, Kevin, 2016. "Habit formation in children: Evidence from incentives for healthy eating," Journal of Health Economics, Elsevier, vol. 45(C), pages 47-54.
    36. Johanna Catherine Maclean & Michael F. Pesko & Steven C. Hill, 2017. "The Effect of Insurance Expansions on Smoking Cessation Medication Prescriptions: Evidence from ACA Medicaid Expansions," NBER Working Papers 23450, National Bureau of Economic Research, Inc.
    37. Jérôme Adda & Francesca Cornaglia, 2006. "Taxes, Cigarette Consumption, and Smoking Intensity," American Economic Review, American Economic Association, vol. 96(4), pages 1013-1028, September.
    38. Downs, J.S. & Wisdom, J. & Wansink, B. & Loewenstein, G., 2013. "Supplementing menu labeling with calorie recommendations to test for facilitation effects," American Journal of Public Health, American Public Health Association, vol. 103(9), pages 1604-1609.
    39. Andrew S. Hanks & David R. Just & Brian Wansink, 2012. "Healthy Convenience: Nudging Students Toward Healthier Choices in Lunchroom," Working Papers 03, Cornell Center for Behavioral Economics in Child Nutrition Programs.
    40. Stefano DellaVigna & Ulrike Malmendier, 2006. "Paying Not to Go to the Gym," American Economic Review, American Economic Association, vol. 96(3), pages 694-719, June.
    41. repec:dys:benwps:2012-03 is not listed on IDEAS
    42. Daniel Mochon & Janet Schwartz & Josiase Maroba & Deepak Patel & Dan Ariely, 2017. "Gain Without Pain: The Extended Effects of a Behavioral Health Intervention," Management Science, INFORMS, vol. 63(1), pages 58-72, January.
    43. Jérôme Adda, 2007. "Behavior towards health risks: An empirical study using the “Mad Cow” crisis as an experiment," Journal of Risk and Uncertainty, Springer, vol. 35(3), pages 285-305, December.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Mariana Carrera & Heather Royer & Mark Stehr & Justin Sydnor, 2020. "The Structure of Health Incentives: Evidence from a Field Experiment," Management Science, INFORMS, vol. 66(5), pages 1890-1908, May.
    2. Condliffe, Simon & Işgın, Ebru & Fitzgerald, Brynne, 2017. "Get thee to the gym! A field experiment on improving exercise habits," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 70(C), pages 23-32.
    3. Belot, Michèle & James, Jonathan & Nolen, Patrick, 2016. "Incentives and children's dietary choices: A field experiment in primary schools," Journal of Health Economics, Elsevier, vol. 50(C), pages 213-229.
    4. Allais, Olivier & Bazoche, Pascale & Teyssier, Sabrina, 2017. "Getting more people on the stairs: The impact of point-of-decision prompts," Social Science & Medicine, Elsevier, vol. 192(C), pages 18-27.
    5. Carrera, Mariana & Royer, Heather & Stehr, Mark & Sydnor, Justin & Taubinsky, Dmitry, 2018. "The limits of simple implementation intentions: Evidence from a field experiment on making plans to exercise," Journal of Health Economics, Elsevier, vol. 62(C), pages 95-104.
    6. Manuela Angelucci & Silvia Prina & Heather Royer & Anya Samek, 2015. "When Incentives Backfire: Spillover Effects in Food Choice," NBER Working Papers 21481, National Bureau of Economic Research, Inc.
    7. Carrera, Mariana & Royer, Heather & Stehr, Mark & Sydnor, Justin, 2018. "Can financial incentives help people trying to establish new habits? Experimental evidence with new gym members," Journal of Health Economics, Elsevier, vol. 58(C), pages 202-214.
    8. Christina Gravert & Linus Olsson Collentine, 2019. "When nudges aren't enough: Incentives and habit formation in public transport usage," CEBI working paper series 19-10, University of Copenhagen. Department of Economics. The Center for Economic Behavior and Inequality (CEBI).
    9. Cappelen, Alexander W & Charness, Gary & Ekström, Mathias & Gneezy, Uri & Tungodden, Bertil, 2017. "Exercise Improves Academic Performance," Working Paper Series 1180, Research Institute of Industrial Economics.
    10. Harris, Matthew C. & Kessler, Lawrence M., 2019. "Habit formation and activity persistence: Evidence from gym equipment," Journal of Economic Behavior & Organization, Elsevier, vol. 166(C), pages 688-708.
    11. Gravert, Christina & Olsson Collentine, Linus, 2021. "When nudges aren’t enough: Norms, incentives and habit formation in public transport usage," Journal of Economic Behavior & Organization, Elsevier, vol. 190(C), pages 1-14.
    12. Ozturk, Orgul D. & Frongillo, Edward A. & Blake, Christine E. & McInnes, Melayne M. & Turner-McGrievy, Gabrielle, 2020. "Before the lunch line: Effectiveness of behavioral economic interventions for pre-commitment on elementary school children's food choices," Journal of Economic Behavior & Organization, Elsevier, vol. 176(C), pages 597-618.
    13. Daniel Mochon & Janet Schwartz & Josiase Maroba & Deepak Patel & Dan Ariely, 2017. "Gain Without Pain: The Extended Effects of a Behavioral Health Intervention," Management Science, INFORMS, vol. 63(1), pages 58-72, January.
    14. Augurzky, Boris & Bauer, Thomas K. & Reichert, Arndt R. & Schmidt, Christoph M. & Tauchmann, Harald, 2018. "Habit formation, obesity, and cash rewards," FAU Discussion Papers in Economics 06/2018, Friedrich-Alexander University Erlangen-Nuremberg, Institute for Economics.
    15. Kirgios, Erika L. & Mandel, Graelin H. & Park, Yeji & Milkman, Katherine L. & Gromet, Dena M. & Kay, Joseph S. & Duckworth, Angela L., 2020. "Teaching temptation bundling to boost exercise: A field experiment," Organizational Behavior and Human Decision Processes, Elsevier, vol. 161(S), pages 20-35.
    16. Nan Yang & Yong Long Lim, 2018. "Temporary Incentives Change Daily Routines: Evidence from a Field Experiment on Singapore’s Subways," Management Science, INFORMS, vol. 64(7), pages 3365-3379, July.
    17. Mortimer, Duncan & Harris, Anthony & Wijnands, Jasper S. & Stevenson, Mark, 2021. "Persistence or reversal? The micro-effects of time-varying financial penalties," Journal of Economic Behavior & Organization, Elsevier, vol. 188(C), pages 72-86.
    18. Jan Marcus & Thomas Siedler & Nicolas R. Ziebarth, 2022. "The Long-Run Effects of Sports Club Vouchers for Primary School Children," American Economic Journal: Economic Policy, American Economic Association, vol. 14(3), pages 128-165, August.
    19. Erev, Ido & Hiller, Maximilian & Klößner, Stefan & Lifshitz, Gal & Mertins, Vanessa & Roth, Yefim, 2022. "Promoting healthy behavior through repeated deposit contracts: An intervention study," Journal of Economic Psychology, Elsevier, vol. 92(C).
    20. Stecher, Chad & Mukasa, Barbara & Linnemayr, Sebastian, 2021. "Uncovering a behavioral strategy for establishing new habits: Evidence from incentives for medication adherence in Uganda," Journal of Health Economics, Elsevier, vol. 77(C).

    More about this item

    Keywords

    Health Behaviors; Health Shocks; Spillovers; Family; Coworkers;
    All these keywords.

    JEL classification:

    • D10 - Microeconomics - - Household Behavior - - - General
    • D83 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Search; Learning; Information and Knowledge; Communication; Belief; Unawareness
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:kud:epruwp:17-05. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: . General contact details of provider: https://edirc.repec.org/data/epcbsdk.html .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Thomas Hoffmann (email available below). General contact details of provider: https://edirc.repec.org/data/epcbsdk.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.