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A discrete latent factor model for smoking, cancer and mortality

This paper investigates the relationships between social circumstances, individual behaviours, and ill-health later in life, with a particular focus on the development of cancer. A discrete latent factor model incorporating individuals' smoking and health outcomes (lifespan and time-to-cancer) is jointly estimated, using the 1984/5 British Health and Lifestyle Survey (HALS) dataset and its July 2009 follow-up, allowing for unobservable factors to affect decisions regarding smoking behaviours as well as health outcomes. Results from this discrete latent factor model are found to be substantially different to those derived from single-equation modelling, suggesting the presence of unobserved heterogeneity. Contrary to previous work on the relationship between circumstances and the development of cancer, a social gradient in time-to-cancer is observed, with individuals in the lowest two social classes developing cancer significantly sooner than individuals in the highest social class. The reduction in estimated median time-to-cancer between individuals in the highest social class, and those in the lowest social class, is found to be between 4 and 4.5 years; approximately twice as many individuals in the lowest social classes as in the highest social class are predicted to develop cancer by an observed age of 75. Those in lower social classes are found to be more likely to smoke, smoke earlier in life, and smoke more cigarettes before quitting.

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Paper provided by HEDG, c/o Department of Economics, University of York in its series Health, Econometrics and Data Group (HEDG) Working Papers with number 13/14.

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Date of creation: Jun 2013
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Handle: RePEc:yor:hectdg:13/14
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HEDG/HERC, Department of Economics and Related Studies, University of York, York, YO10 5DD, United Kingdom

Phone: (0)1904 323776
Web page: http://www.york.ac.uk/economics/postgrad/herc/hedg/
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  1. S. Balia & AM. Jones, 2004. "Mortality, Lifestyle and Socio-Economic Status," Working Paper CRENoS 200416, Centre for North South Economic Research, University of Cagliari and Sassari, Sardinia.
  2. Heckman, James & Singer, Burton, 1984. "A Method for Minimizing the Impact of Distributional Assumptions in Econometric Models for Duration Data," Econometrica, Econometric Society, vol. 52(2), pages 271-320, March.
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  8. Mroz, Thomas A., 1999. "Discrete factor approximations in simultaneous equation models: Estimating the impact of a dummy endogenous variable on a continuous outcome," Journal of Econometrics, Elsevier, vol. 92(2), pages 233-274, October.
  9. Pedro Rosa Dias, 2009. "Inequality of opportunity in health: evidence from a UK cohort study," Health Economics, John Wiley & Sons, Ltd., vol. 18(9), pages 1057-1074.
  10. Kaprio, Jaakko & Koskenvuo, Markku, 1989. "Twins, smoking and mortality: A 12-year prospective study of smoking-discordant twin pairs," Social Science & Medicine, Elsevier, vol. 29(9), pages 1083-1089, January.
  11. Balia S & Jones A.M, 2009. "Catching the habit: a study of inequality of opportunity in smoking-related mortality," Health, Econometrics and Data Group (HEDG) Working Papers 09/08, HEDG, c/o Department of Economics, University of York.
  12. Jérôme Adda & Valérie Lechene, 2013. "Health Selection and the Effect of Smoking on Mortality," Scandinavian Journal of Economics, Wiley Blackwell, vol. 115(3), pages 902-931, 07.
  13. Bo E. Honoré & Adriana Lleras-Muney, 2006. "Bounds in Competing Risks Models and the War on Cancer," Econometrica, Econometric Society, vol. 74(6), pages 1675-1698, November.
  14. David M. Cutler, 2008. "Are We Finally Winning the War on Cancer?," Journal of Economic Perspectives, American Economic Association, vol. 22(4), pages 3-26, Fall.
  15. Heather Brown & Marjon Pol, 2014. "The Role Of Time Preferences In The Intergenerational Transfer Of Smoking," Health Economics, John Wiley & Sons, Ltd., vol. 23(12), pages 1493-1501, December.
  16. Roberto G. Gutierrez, 2002. "Parametric frailty and shared frailty survival models," Stata Journal, StataCorp LP, vol. 2(1), pages 22-44, February.
  17. Douglas, Stratford & Hariharan, Govind, 1994. "The hazard of starting smoking: Estimates from a split population duration model," Journal of Health Economics, Elsevier, vol. 13(2), pages 213-230, July.
  18. Pedro Rosa Dias & Andrew M. Jones, 2007. "Giving equality of opportunity a fair innings," Health Economics, John Wiley & Sons, Ltd., vol. 16(2), pages 109-112, 02.
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