How Much Might Universal Health Insurance Reduce Socioeconomic Disparities in Health? A Comparison of the US and Canada
A strong association between lower socioeconomic status (SES) and worse health-- the SES-health gradient-- has been documented in many countries, but little work has compared the size of the gradient across countries. We compare the size of the income gradient in self-reported health in the US and Canada. We find that being below median income raises the likelihood that a middle aged person is in poor or fair health by about 15 percentage points in the U.S., compared to less than 8 percentage points in Canada. We also find that the 7 percentage point gradient difference between the two countries is reduced by about 4 percentage points after age 65, the age at which the virtually all U.S. citizens receive basic health insurance through Medicare. Income disparities in the probability that an individual lacks a usual source of care are also significantly larger in the US than in Canada before the age of 65, but about the same after 65. Our results are therefore consistent with the availability of universal health insurance in the U.S, or at least some other difference that occurs around the age of 65 in one country but not the other, narrowing SES differences in health between the US and Canada.
|Date of creation:||Aug 2004|
|Publication status:||published as Decker, Sandra L. and Dahlia K. Remler. “How Much Does Universal Health Insurance Reduce Socioeconomic Disparities in Health? A Comparison of the US and Canada.” Applied Health Economics and Health Policy 3, 4 (2005): 205-216.|
|Contact details of provider:|| Postal: National Bureau of Economic Research, 1050 Massachusetts Avenue Cambridge, MA 02138, U.S.A.|
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- Theodore Joyce & Robert Kaestner, 1996. "The effect of expansions in medicaid income eligibility on abortion," Demography, Springer;Population Association of America (PAA), vol. 33(2), pages 181-192, May.
- Deaton, Angus S & Paxson, Christina H, 1998.
"Aging and Inequality in Income and Health,"
American Economic Review,
American Economic Association, vol. 88(2), pages 248-253, May.
- Deaton, A., 1998. "Aging and Inequality in Income and Health," Papers 181, Princeton, Woodrow Wilson School - Development Studies.
- Ettner, Susan L., 1996. "New evidence on the relationship between income and health," Journal of Health Economics, Elsevier, vol. 15(1), pages 67-85, February.
- 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.
- Adriana Lleras-Muney, 2002. "The Relationship Between Education and Adult Mortality in the United States," NBER Working Papers 8986, National Bureau of Economic Research, Inc.
- Meer, Jonathan & Miller, Douglas L. & Rosen, Harvey S., 2003. "Exploring the health-wealth nexus," Journal of Health Economics, Elsevier, vol. 22(5), pages 713-730, September.
- Jonathan Meer & Douglas L. Miller & Harvey S. Rosen, 2003. "Exploring the Health-Wealth Nexus," NBER Working Papers 9554, National Bureau of Economic Research, Inc.
- Dwyer, Debra Sabatini & Mitchell, Olivia S., 1999. "Health problems as determinants of retirement: Are self-rated measures endogenous?," Journal of Health Economics, Elsevier, vol. 18(2), pages 173-193, April.
- Debra S. Dwyer & Olivia S. Mitchell, "undated". "Health Problems as Determinants of Retirement: Are Self-Rated Measures Endogenous?," Pension Research Council Working Papers 98-7, Wharton School Pension Research Council, University of Pennsylvania.
- Debra Sabatini Dwyer & Olivia S. Mitchell, 1998. "Health Problems as Determinants of Retirement: Are Self-Rated Measures Endogenous?," NBER Working Papers 6503, National Bureau of Economic Research, Inc.
- Jonathan Gruber & David A. Wise, 2004. "Social Security Programs and Retirement around the World: Micro-Estimation," NBER Books, National Bureau of Economic Research, Inc, number grub04-1, October.
- Jonathan Gruber & David A. Wise, 2002. "Social Security Programs and Retirement Around the World: Micro Estimation," NBER Working Papers 9407, National Bureau of Economic Research, Inc.
- James P. Smith, 1999. "Healthy Bodies and Thick Wallets: The Dual Relation between Health and Economic Status," Journal of Economic Perspectives, American Economic Association, vol. 13(2), pages 145-166, Spring.
- R. Kaestner, 2000. "A note on the effect of minimum drinking age laws on youth alcohol consumption," Contemporary Economic Policy, Western Economic Association International, vol. 18(3), pages 315-325, 07.
- Steven G. Prus, 2001. "The Relationship between Age, Socio-Economic Status, and Health among Adult Canadians," Social and Economic Dimensions of an Aging Population Research Papers 57, McMaster University.
- Michael Baker & Jonathan Gruber & Kevin Milligan, 2004. "Income Security Programs and Retirement in Canada," NBER Chapters,in: Social Security Programs and Retirement around the World: Micro-Estimation, pages 99-152 National Bureau of Economic Research, Inc.
- Gruber, Jonathan, 1994. "The Incidence of Mandated Maternity Benefits," American Economic Review, American Economic Association, vol. 84(3), pages 622-641, June.
- van Doorslaer, Eddy & Wagstaff, Adam & van der Burg, Hattem & Christiansen, Terkel & De Graeve, Diana & Duchesne, Inge & Gerdtham, Ulf-G & Gerfin, Michael & Geurts, Jose & Gross, Lorna, 2000. "Equity in the delivery of health care in Europe and the US," Journal of Health Economics, Elsevier, vol. 19(5), pages 553-583, September.
- John Bound, 1991. "Self-Reported Versus Objective Measures of Health in Retirement Models," Journal of Human Resources, University of Wisconsin Press, vol. 26(1), pages 106-138.
- Joyce, Theodore & Kaestner, Robert, 1996. "State reproductive policies and adolescent pregnancy resolution: The case of parental involvement laws," Journal of Health Economics, Elsevier, vol. 15(5), pages 579-607, October.
- Theodore Joyce & Robert Kaestner, 1995. "State Reproductive Policies and Adolescent Pregnancy Resolution: The Case of Parental Involvement Laws," NBER Working Papers 5354, National Bureau of Economic Research, Inc.