IDEAS home Printed from https://ideas.repec.org/p/nbr/nberwo/25618.html
   My bibliography  Save this paper

The Roots of Health Inequality and The Value of Intra-Family Expertise

Author

Listed:
  • Yiqun Chen
  • Petra Persson
  • Maria Polyakova

Abstract

Do differences in health literacy contribute to the widely documented health-income gradient? In the context of Sweden, we document a strong relationship between exposure to health-related expertise – captured by the presence of a health professional in the family – and health. Exposure to expertise raises preventive health investments throughout the lifecycle, improves physical health, and prolongs life. Two quasi-experimental research designs – admissions lotteries into medical school and variation in the timing of medical degrees – support a causal interpretation of these effects. We estimate that unequal exposure to health-related expertise may account for up to 18 percent of the population-wide health-income gradient.

Suggested Citation

  • Yiqun Chen & Petra Persson & Maria Polyakova, 2019. "The Roots of Health Inequality and The Value of Intra-Family Expertise," NBER Working Papers 25618, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:25618
    Note: AG CH EH PE
    as

    Download full text from publisher

    File URL: http://www.nber.org/papers/w25618.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Heather Royer, 2009. "Separated at Girth: US Twin Estimates of the Effects of Birth Weight," American Economic Journal: Applied Economics, American Economic Association, vol. 1(1), pages 49-85, January.
    2. Bart J. Bronnenberg & Jean-Pierre Dubé & Matthew Gentzkow & Jesse M. Shapiro, 2015. "Do Pharmacists Buy Bayer? Informed Shoppers and the Brand Premium," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 130(4), pages 1669-1726.
    3. repec:pri:cheawb:case_paxson_economic_status_paper is not listed on IDEAS
    4. Itzik Fadlon & Torben Heien Nielsen, 2019. "Family Health Behaviors," American Economic Review, American Economic Association, vol. 109(9), pages 3162-3191, September.
    5. Chorniy, Anna & Currie, Janet & Sonchak, Lyudmyla, 2018. "Exploding asthma and ADHD caseloads: The role of medicaid managed care," Journal of Health Economics, Elsevier, vol. 60(C), pages 1-15.
    6. 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.
    7. Lundborg, Petter & Majlesi, Kaveh, 2018. "Intergenerational transmission of human capital: Is it a one-way street?," Journal of Health Economics, Elsevier, vol. 57(C), pages 206-220.
    8. Case, Anne & Lee, Diana & Paxson, Christina, 2008. "The income gradient in children's health: A comment on Currie, Shields and Wheatley Price," Journal of Health Economics, Elsevier, vol. 27(3), pages 801-807, May.
    9. Erin M. Johnson & M. Marit Rehavi, 2016. "Physicians Treating Physicians: Information and Incentives in Childbirth," American Economic Journal: Economic Policy, American Economic Association, vol. 8(1), pages 115-141, February.
    10. Martha J. Bailey & Andrew Goodman-Bacon, 2015. "The War on Poverty's Experiment in Public Medicine: Community Health Centers and the Mortality of Older Americans," American Economic Review, American Economic Association, vol. 105(3), pages 1067-1104, March.
    11. Nadine Ketel & Edwin Leuven & Hessel Oosterbeek & Bas van der Klaauw, 2016. "The Returns to Medical School: Evidence from Admission Lotteries," American Economic Journal: Applied Economics, American Economic Association, vol. 8(2), pages 225-254, April.
    12. 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.
    13. Marcella Alsan & Owen Garrick & Grant Graziani, 2019. "Does Diversity Matter for Health? Experimental Evidence from Oakland," American Economic Review, American Economic Association, vol. 109(12), pages 4071-4111, December.
    14. Kunz-Ebrecht, Sabine R. & Kirschbaum, Clemens & Steptoe, Andrew, 2004. "Work stress, socioeconomic status and neuroendocrine activation over the working day," Social Science & Medicine, Elsevier, vol. 58(8), pages 1523-1530, April.
    15. Björkegren, Evelina, 2018. "Neighborhoods and youth health: Everybody needs good neighbors?," Working Paper Series 2018:10, IFAU - Institute for Evaluation of Labour Market and Education Policy.
    16. Adam Isen & Maya Rossin-Slater & W. Reed Walker, 2017. "Every Breath You Take—Every Dollar You’ll Make: The Long-Term Consequences of the Clean Air Act of 1970," Journal of Political Economy, University of Chicago Press, vol. 125(3), pages 848-902.
    17. Petra Persson & Maya Rossin-Slater, 2018. "Family Ruptures, Stress, and the Mental Health of the Next Generation," American Economic Review, American Economic Association, vol. 108(4-5), pages 1214-1252, April.
    18. Costas Meghir & Mårten Palme & Emilia Simeonova, 2018. "Education and Mortality: Evidence from a Social Experiment," American Economic Journal: Applied Economics, American Economic Association, vol. 10(2), pages 234-256, April.
    19. 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.
    20. Stefan Hut & Emily Oster, 2018. "Changes in Household Diet: Determinants and Predictability," NBER Working Papers 24892, National Bureau of Economic Research, Inc.
    21. Hvide, Hans K. & Oyer, Paul, 2017. "Dinner Table Human Capital and Entrepreneurship," Research Papers repec:ecl:stabus:3658, Stanford University, Graduate School of Business.
    22. Mark R Cullen & Clint Cummins & Victor R Fuchs, 2012. "Geographic and Racial Variation in Premature Mortality in the U.S.: Analyzing the Disparities," PLOS ONE, Public Library of Science, vol. 7(4), pages 1-13, April.
    23. Douglas Almond & Bhashkar Mazumder, 2011. "Health Capital and the Prenatal Environment: The Effect of Ramadan Observance during Pregnancy," American Economic Journal: Applied Economics, American Economic Association, vol. 3(4), pages 56-85, October.
    24. Prashant Bharadwaj & Petter Lundborg & Dan-Olof Rooth, 2018. "Birth Weight in the Long Run," Journal of Human Resources, University of Wisconsin Press, vol. 53(1), pages 189-231.
    25. Justin McCrary & Heather Royer, 2011. "The Effect of Female Education on Fertility and Infant Health: Evidence from School Entry Policies Using Exact Date of Birth," American Economic Review, American Economic Association, vol. 101(1), pages 158-195, February.
    26. Rebecca Diamond & Petra Persson, 2016. "The Long-term Consequences of Teacher Discretion in Grading of High-stakes Tests," NBER Working Papers 22207, National Bureau of Economic Research, Inc.
    27. Alex Bell & Raj Chetty & Xavier Jaravel & Neviana Petkova & John Van Reenen, 2019. "Who Becomes an Inventor in America? The Importance of Exposure to Innovation," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 134(2), pages 647-713.
    28. repec:pri:cheawb:case_paxson_economic_status_paper.pdf is not listed on IDEAS
    29. Samuel Lee & Petra Persson, 2016. "Financing from Family and Friends," The Review of Financial Studies, Society for Financial Studies, vol. 29(9), pages 2341-2386.
    30. Fiva, Jon H. & Hægeland, Torbjørn & Rønning, Marte & Syse, Astri, 2014. "Access to treatment and educational inequalities in cancer survival," Journal of Health Economics, Elsevier, vol. 36(C), pages 98-111.
    31. Jonas Hjort & Mikkel Sølvsten & Miriam Wüst, 2017. "Universal Investment in Infants and Long-Run Health: Evidence from Denmark's 1937 Home Visiting Program," American Economic Journal: Applied Economics, American Economic Association, vol. 9(4), pages 78-104, October.
    32. 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.
    33. Wüst, Miriam, 2012. "Early interventions and infant health: Evidence from the Danish home visiting program," Labour Economics, Elsevier, vol. 19(4), pages 484-495.
    34. Adriana Lleras-Muney, 2018. "Mind the Gap: A Review of The Health Gap: The Challenge of an Unequal World by Sir Michael Marmot," Journal of Economic Literature, American Economic Association, vol. 56(3), pages 1080-1101, September.
    35. repec:ucn:wpaper:10197/317 is not listed on IDEAS
    36. Ilyana Kuziemko, 2014. "Human Capital Spillovers in Families: Do Parents Learn from or Lean on Their Children?," Journal of Labor Economics, University of Chicago Press, vol. 32(4), pages 755-786.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Persson, Petra & Qiu, Xinyao & Rossin-Slater, Maya, 2021. "Family Spillover Effects of Marginal Diagnoses: The Case of ADHD," IZA Discussion Papers 14020, Institute of Labor Economics (IZA).
    2. Persson, Petra & Qiu, Xinyao & Rossin-Slater, Maya, 2021. "Family Spillover Effects of Marginal Diagnoses: The Case of ADHD," CEPR Discussion Papers 15660, C.E.P.R. Discussion Papers.
    3. Amy Finkelstein & Petra Persson & Maria Polyakova & Jesse M. Shapiro, 2022. "A Taste of Their Own Medicine: Guideline Adherence and Access to Expertise," American Economic Review: Insights, American Economic Association, vol. 4(4), pages 507-526, December.
    4. Frakes, Michael & Gruber, Jonathan & Jena, Anupam, 2021. "Is great information good enough? Evidence from physicians as patients," Journal of Health Economics, Elsevier, vol. 75(C).
    5. Werbeck, Anna & Wübker, Ansgar & Ziebarth, Nicolas R., 2021. "Cream skimming by health care providers and inequality in health care access: Evidence from a randomized field experiment," Journal of Economic Behavior & Organization, Elsevier, vol. 188(C), pages 1325-1350.
    6. Bautista, María Angélica & González, Felipe & Martinez, Luis R. & Muñoz, Pablo & Prem, Mounu, 2020. "Does Higher Education Reduce Mortality? Evidence from a Natural Experiment in Chile," SocArXiv 5s2px, Center for Open Science.
    7. Humlum, Maria Knoth & Morthorst, Marius Opstrup & Thingholm, Peter Rønø, 2022. "Sibling Spillovers and the Choice to Get Vaccinated: Evidence from a Regression Discontinuity Design," IZA Discussion Papers 15109, Institute of Labor Economics (IZA).
    8. Abu-Qarn, Aamer & Lichtman-Sadot, Shirlee, 2021. "Older Adult Health Following Greater Access to Secondary Health Care: Evidence from Bus Service Introductions to Arab Towns in Israel," IZA Discussion Papers 14490, Institute of Labor Economics (IZA).
    9. Elisabeth Artmann & Hessel Oosterbeek & Bas van der Klaauw, 2022. "Do Doctors Improve the Health Care of Their Parents? Evidence from Admission Lotteries," American Economic Journal: Applied Economics, American Economic Association, vol. 14(3), pages 164-184, July.
    10. Everding, Jakob, 2019. "Heterogeneous spillover effects of children's education on parental mental health," hche Research Papers 18, University of Hamburg, Hamburg Center for Health Economics (hche).
    11. Persson, Petra & Rossin-Slater, Maya, 2019. "When Dad Can Stay Home: Fathers' Workplace Flexibility and Maternal Health," IZA Discussion Papers 12386, Institute of Labor Economics (IZA).

    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. Gabriella Conti, 2013. "The Developmental Origins of Health Inequality," Research on Economic Inequality, in: Health and Inequality, volume 21, pages 285-309, Emerald Group Publishing Limited.
    2. Hilary Hoynes & Diane Whitmore Schanzenbach & Douglas Almond, 2016. "Long-Run Impacts of Childhood Access to the Safety Net," American Economic Review, American Economic Association, vol. 106(4), pages 903-934, April.
    3. Møllegaard, Stine, 2020. "The effect of birth weight on behavioral problems in early adolescence: New evidence from monozygotic twins," Economics & Human Biology, Elsevier, vol. 36(C).
    4. Verónica Amarante & Marco Manacorda & Edward Miguel & Andrea Vigorito, 2016. "Do Cash Transfers Improve Birth Outcomes? Evidence from Matched Vital Statistics, Program, and Social Security Data," American Economic Journal: Economic Policy, American Economic Association, vol. 8(2), pages 1-43, May.
    5. Chloe N. East & Sarah Miller & Marianne Page & Laura R. Wherry, 2023. "Multigenerational Impacts of Childhood Access to the Safety Net: Early Life Exposure to Medicaid and the Next Generation's Health," American Economic Review, American Economic Association, vol. 113(1), pages 98-135, January.
    6. Amarante, Veronica & Manacorda, Marco & Miguel, Edward & Vigorito, Andrea, 2011. "Do Cash Transfers Improve Birth Outcomes? Evidence from Matched Vital Statistics, Social Security and Program Data," IZA Discussion Papers 6231, Institute of Labor Economics (IZA).
    7. Daniel Auer & Johannes S. Kunz, 2021. "Communication Barriers and Infant Health: Intergenerational Effects of Randomly Allocating Refugees Across Language Regions," SoDa Laboratories Working Paper Series 2021-07, Monash University, SoDa Laboratories.
    8. Jacqz, Irene, 2022. "Toxic test scores: The impact of chemical releases on standardized test performance within U.S. schools," Journal of Environmental Economics and Management, Elsevier, vol. 115(C).
    9. Douglas Almond & Janet Currie & Valentina Duque, 2018. "Childhood Circumstances and Adult Outcomes: Act II," Journal of Economic Literature, American Economic Association, vol. 56(4), pages 1360-1446, December.
    10. Kreiner, Claus Thustrup & Sievertsen, Hans Henrik, 2020. "Neonatal health of parents and cognitive development of children," Journal of Health Economics, Elsevier, vol. 69(C).
    11. Francisco J. Cabrera-Hernández & Pedro P. Orraca-Romano, 2023. "Inequality in the Household: How Parental Income Matters for the Long-Term Treatment of Healthy and Unhealthy Siblings," Journal of Family and Economic Issues, Springer, vol. 44(3), pages 674-692, September.
    12. Settele, Sonja & Ewijk, Reyn van, 2018. "Can cigarette taxes during pregnancy mitigate the intergenerational transmission of socioeconomic status?," Labour Economics, Elsevier, vol. 55(C), pages 130-148.
    13. Noghanibehambari, Hamid, 2022. "Intergenerational health effects of Medicaid," Economics & Human Biology, Elsevier, vol. 45(C).
    14. Dora L. Costa, 2015. "Health and the Economy in the United States from 1750 to the Present," Journal of Economic Literature, American Economic Association, vol. 53(3), pages 503-570, September.
    15. Petra Persson & Maya Rossin-Slater, 2018. "Family Ruptures, Stress, and the Mental Health of the Next Generation," American Economic Review, American Economic Association, vol. 108(4-5), pages 1214-1252, April.
    16. Mark E. Mcgovern, 2013. "Still Unequal at Birth: Birth Weight,Socio-economic Status and Outcomes at Age 9," The Economic and Social Review, Economic and Social Studies, vol. 44(1), pages 53-84.
    17. Gabriella Conti & Mark Hanson & Hazel Inskip & Sarah Crozier & Cyrus Cooper & Keith Godfrey, 2018. "Beyond Birth Weight: The Origins of Human Capital," Working Papers 2018-089, Human Capital and Economic Opportunity Working Group.
    18. Owen O'Donnell & Eddy Van Doorslaer & Tom Van Ourti, 2013. "Health and Inequality," Tinbergen Institute Discussion Papers 13-170/V, Tinbergen Institute.
    19. Yuda, Michio, 2020. "Childhood health and future outcomes: Evidence from panel surveys for the Japanese population," Japan and the World Economy, Elsevier, vol. 54(C).
    20. Janet Currie, 2011. "Ungleichheiten bei der Geburt: Einige Ursachen und Folgen," Perspektiven der Wirtschaftspolitik, Verein für Socialpolitik, vol. 12(s1), pages 42-65, May.

    More about this item

    JEL classification:

    • D12 - Microeconomics - - Household Behavior - - - Consumer Economics: Empirical Analysis
    • D83 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Search; Learning; Information and Knowledge; Communication; Belief; Unawareness
    • G22 - Financial Economics - - Financial Institutions and Services - - - Insurance; Insurance Companies; Actuarial Studies
    • H1 - Public Economics - - Structure and Scope of Government
    • H4 - Public Economics - - Publicly Provided Goods
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality

    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:nbr:nberwo:25618. See general information about how to correct material in RePEc.

    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: the person in charge (email available below). General contact details of provider: https://edirc.repec.org/data/nberrus.html .

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

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.