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Screening Tests, Information, and the Health-Education Gradient

Abstract

The association between health outcomes and education – the health-education gradient - is widely documented but little is known about its source. Using microeconomic data on a sample of individuals aged 50+ in eight European countries, we find that education and cognitive skills (such as verbal fluency) are associated with a greater propensity for standard screening tests (mammography and colonoscopy). In order to study the role of information on the decision to screen, we test whether the health-education gradient varies with the quality of the information provided by the health care system, as proxied by the quality of the General Practitioner. Using an Instrumental Variable approach to control for the potential endogeneity of the GP quality score, we find evidence of a strong and significant complementarity between education and quality of primary care. We interpret this result as evidence that health-education gradient can be explained, at least in part, by the fact that better educated individuals are more able to process and internalize health related information as provided by GPs.

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Paper provided by Centre for Studies in Economics and Finance (CSEF), University of Naples, Italy in its series CSEF Working Papers with number 187.

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Date of creation: 01 Jan 2008
Date of revision: 28 Apr 2008
Publication status: Published in Journal of Population Ageing, 2011, 4(4), pp. 251-269
Handle: RePEc:sef:csefwp:187
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Keywords: Health; education; information; general practitioners;

Find related papers by JEL classification:

  • I0 - Health, Education, and Welfare - - General
  • I1 - Health, Education, and Welfare - - Health
  • I2 - Health, Education, and Welfare - - Education

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  10. Agar Brugiavini & Tullio Jappelli & Guglielmo Weber, 2002. "The Survey on Health, Aging and Wealth," CSEF Working Papers 86, Centre for Studies in Economics and Finance (CSEF), University of Naples, Italy.
  11. de Walque, Damien, 2007. "How does the impact of an HIV/AIDS information campaign vary with educational attainment? Evidence from rural Uganda," Journal of Development Economics, Elsevier, vol. 84(2), pages 686-714, November.
  12. Sherry Glied & Adriana Lleras-Muney, 2003. "Health Inequality, Education and Medical Innovation," NBER Working Papers 9738, National Bureau of Economic Research, Inc.
  13. John Mullahy, 1999. "It'll only hurt a second? Microeconomic determinants of who gets flu shots," Health Economics, John Wiley & Sons, Ltd., vol. 8(1), pages 9-24.
  14. Martin Marshall & Sheila Leatherman & Soeren Mattke, 2004. "Selecting Indicators for the Quality of Health Promotion, Prevention and Primary Care at the Health Systems Level in OECD Countries," OECD Health Technical Papers 16, OECD Publishing.
  15. Scott, Anthony, 2000. "Economics of general practice," Handbook of Health Economics,in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 22, pages 1175-1200 Elsevier.
  16. Devillanova, Carlo, 2008. "Social networks, information and health care utilization: Evidence from undocumented immigrants in Milan," Journal of Health Economics, Elsevier, vol. 27(2), pages 265-286, March.
  17. Donald S. Kenkel, 1991. "What you don't know really won't hurt you," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 10(2), pages 304-309.
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Cited by:

  1. Binswanger, J. & Carman, K.G., 2011. "The Role of Desicion Making Processes in the Correlation between Wealth and Health," Discussion Paper 2011-005, Tilburg University, Center for Economic Research.
  2. Majo, M.C., 2010. "A microeconometric analysis of health care utilization in Europe," Other publications TiSEM 1cf5fd2f-8146-4ef8-8eb5-e, Tilburg University, School of Economics and Management.
  3. Wübker, Ansgar, 2011. "Who gets a mammogram amongst European women aged 50-69 years and why are there such large differences across European countries?," Discussion Papers 15/2011, Witten/Herdecke University, Faculty of Management and Economics.
  4. Carbone, Jared C. & Kverndokk, Snorre, 2014. "Individual investments in education and health," HERO On line Working Paper Series 2014:1, Oslo University, Health Economics Research Programme.

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