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Screening Tests, Information, and the Health-Education Gradient

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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.

Suggested Citation

  • Ciro Avitabile & Tullio Jappelli & Mario Padula, 2008. "Screening Tests, Information, and the Health-Education Gradient," CSEF Working Papers 187, Centre for Studies in Economics and Finance (CSEF), University of Naples, Italy, revised 28 Apr 2008.
  • Handle: RePEc:sef:csefwp:187
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    1. repec:aph:ajpbhl:1994:84:1:50-55_3 is not listed on IDEAS
    2. Steven Simoens & Jeremy Hurst, 2006. "The Supply of Physician Services in OECD Countries," OECD Health Working Papers 21, OECD Publishing.
    3. Kenkel, Donald S, 1991. "Health Behavior, Health Knowledge, and Schooling," Journal of Political Economy, University of Chicago Press, vol. 99(2), pages 287-305, April.
    4. James Banks & Michael Marmot & Zoe Oldfield & James P. Smith, 2009. "The SES Health Gradient on Both Sides of the Atlantic," NBER Chapters,in: Developments in the Economics of Aging, pages 359-406 National Bureau of Economic Research, Inc.
    5. Deri, Catherine, 2005. "Social networks and health service utilization," Journal of Health Economics, Elsevier, vol. 24(6), pages 1076-1107, November.
    6. Kenkel, D., 1988. "The Demand For Preventive Medical Care," Papers 3-88-4, Pennsylvania State - Department of Economics.
    7. Gabriel Picone & Frank Sloan & Donald Taylor, 2004. "Effects of Risk and Time Preference and Expected Longevity on Demand for Medical Tests," Journal of Risk and Uncertainty, Springer, vol. 28(1), pages 39-53, January.
    8. 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.
    9. Christelis, Dimitris & Jappelli, Tullio & Padula, Mario, 2010. "Cognitive abilities and portfolio choice," European Economic Review, Elsevier, vol. 54(1), pages 18-38, January.
    10. David M. Cutler & Adriana Lleras-Muney, 2006. "Education and Health: Evaluating Theories and Evidence," NBER Working Papers 12352, National Bureau of Economic Research, Inc.
    11. 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.
    12. 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.
    13. Sherry Glied & Adriana Lleras-Muney, 2003. "Health Inequality, Education and Medical Innovation," NBER Working Papers 9738, National Bureau of Economic Research, Inc.
    14. 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.
    15. 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.
    16. 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.
    17. 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.
    18. 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?," Wittener Diskussionspapiere zu alten und neuen Fragen der Wirtschaftswissenschaft 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.

    More about this item

    Keywords

    Health; education; information; general practitioners;

    JEL classification:

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

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