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Efficiency of health investment: education or intelligence?

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  • Bijwaard, G.
  • van Kippersluis, H.

Abstract

In this paper we hypothesize that education is associated with a higher efficiency of health investment, yet that this efficiency advantage is solely driven by intelligence. We operationalize efficiency of health investment as the probability of dying conditional on a certain hospital diagnosis, and estimate a multistate structural equation model with three states: (i) healthy, (ii) hospitalized, and (iii) death. We use data from a Dutch cohort born around 1940 that links intelligence tests at age 12 to later-life hospitalization and mortality records. The results suggest that higher intelligence induces the higher educated to be more efficient users of health investment - intelligent individuals have a clear survival advantage for most hospital diagnoses - yet for unanticipated health shocks and diseases that require complex treatments such as COPD, education still plays a role.

Suggested Citation

  • Bijwaard, G. & van Kippersluis, H., 2015. "Efficiency of health investment: education or intelligence?," Health, Econometrics and Data Group (HEDG) Working Papers 15/12, HEDG, c/o Department of Economics, University of York.
  • Handle: RePEc:yor:hectdg:15/12
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    1. Heckman, James J. & Humphries, John Eric & Veramendi, Gregory & Urzua, Sergio, 2014. "Education, Health and Wages," IZA Discussion Papers 8027, Institute of Labor Economics (IZA).
    2. Donald S. Kenkel, 1995. "Should you eat breakfast? Estimates from health production functions," Health Economics, John Wiley & Sons, Ltd., vol. 4(1), pages 15-29, January.
    3. repec:adr:anecst:y:2005:i:79-80:p:25 is not listed on IDEAS
    4. Hans van Kippersluis, & Owen O’Donnell & Eddy van Doorslaer, 2011. "Long-Run Returns to Education: Does Schooling Lead to an Extended Old Age?," Journal of Human Resources, University of Wisconsin Press, vol. 46(4), pages 695-721.
    5. Robert Kaestner & Kevin Callison, 2011. "Adolescent Cognitive and Noncognitive Correlates of Adult Health," Journal of Human Capital, University of Chicago Press, vol. 5(1), pages 29-69.
    6. Damon Clark & Heather Royer, 2013. "The Effect of Education on Adult Mortality and Health: Evidence from Britain," American Economic Review, American Economic Association, vol. 103(6), pages 2087-2120, October.
    7. Erik Hanushek & F. Welch (ed.), 2006. "Handbook of the Economics of Education," Handbook of the Economics of Education, Elsevier, edition 1, volume 1, number 1, June.
    8. Sherry Glied & Adriana Lleras-Muney, 2008. "Technological innovation and inequality in health," Demography, Springer;Population Association of America (PAA), vol. 45(3), pages 741-761, August.
    9. Adriana Lleras-Muney, 2005. "The Relationship Between Education and Adult Mortality in the United States," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 72(1), pages 189-221.
    10. Albouy, Valerie & Lequien, Laurent, 2009. "Does compulsory education lower mortality?," Journal of Health Economics, Elsevier, vol. 28(1), pages 155-168, January.
    11. Costas Meghir & Mårten Palme & Emilia Simeonova, 2013. "Education, Cognition and Health: Evidence from a Social Experiment," NBER Working Papers 19002, National Bureau of Economic Research, Inc.
    12. Adriana Lleras-Muney & Frank R. Lichtenberg, 2010. "Are the More Educated More Likely to Use New Drugs?," NBER Chapters, in: Contributions in Memory of Zvi Griliches, pages 671-696, National Bureau of Economic Research, Inc.
    13. Michael Grossman, 2015. "The Relationship between Health and Schooling: What’s New?," NBER Working Papers 21609, National Bureau of Economic Research, Inc.
    14. James J. Heckman, 2012. "The developmental origins of health," Health Economics, John Wiley & Sons, Ltd., vol. 21(1), pages 24-29, January.
    15. Lange, Fabian, 2011. "The role of education in complex health decisions: Evidence from cancer screening," Journal of Health Economics, Elsevier, vol. 30(1), pages 43-54, January.
    16. Gabriella Conti & James J. Heckman & Sergio Urzua, 2010. "Early endowments, education, and health," Working Papers 2011-001, Human Capital and Economic Opportunity Working Group.
    17. Bijwaard, Govert E. & van Kippersluis, Hans & Veenman, Justus, 2015. "Education and health: The role of cognitive ability," Journal of Health Economics, Elsevier, vol. 42(C), pages 29-43.
    18. Erik Hanushek & F. Welch (ed.), 2006. "Handbook of the Economics of Education," Handbook of the Economics of Education, Elsevier, edition 1, volume 2, number 2, June.
    19. M. Christopher Auld & Nirmal Sidhu, 2005. "Schooling, cognitive ability and health," Health Economics, John Wiley & Sons, Ltd., vol. 14(10), pages 1019-1034, October.
    20. Pilar García-Gómez & Hans van Kippersluis & Owen O’Donnell & Eddy van Doorslaer, 2013. "Long-Term and Spillover Effects of Health Shocks on Employment and Income," Journal of Human Resources, University of Wisconsin Press, vol. 48(4), pages 873-909.
    21. 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.
    22. 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.
    23. Gilleskie, Donna B. & Harrison, Amy L., 1998. "The effect of endogenous health inputs on the relationship between health and education," Economics of Education Review, Elsevier, vol. 17(3), pages 279-295, June.
    24. Gabriella Conti & James Heckman & Sergio Urzua, 2010. "The Education-Health Gradient," American Economic Review, American Economic Association, vol. 100(2), pages 234-238, May.
    25. 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.
    26. Goldman Dana P & Lakdawalla Darius N., 2005. "A Theory of Health Disparities and Medical Technology," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 4(1), pages 1-32, September.
    27. Muurinen, Jaana-Marja, 1982. "Demand for health: A generalised Grossman model," Journal of Health Economics, Elsevier, vol. 1(1), pages 5-28, May.
    28. Ngina Chiteji, 2010. "Time Preference, Noncognitive Skills and Well Being across the Life Course: Do Noncognitive Skills Encourage Healthy Behavior?," American Economic Review, American Economic Association, vol. 100(2), pages 200-204, May.
    29. Griliches, Zvi, 1977. "Estimating the Returns to Schooling: Some Econometric Problems," Econometrica, Econometric Society, vol. 45(1), pages 1-22, January.
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    Cited by:

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    3. Ahsan, Md Nazmul & Maharaj, Riddhi, 2018. "Parental human capital and child health at birth in India," Economics & Human Biology, Elsevier, vol. 30(C), pages 130-149.
    4. Bijwaard, G.E.; & Tynelius, P.;, 2018. "The impact of mental problems on mortality and how it is moderated by education," Health, Econometrics and Data Group (HEDG) Working Papers 18/16, HEDG, c/o Department of Economics, University of York.
    5. Nikolov, Plamen & Pape, Andreas & Tonguc, Ozlem & Williams, Charlotte, 2020. "Predictors of Social Distancing and Mask-Wearing Behavior: Panel Survey in Seven U.S. States," IZA Discussion Papers 13745, Institute of Labor Economics (IZA).
    6. Jichun Zhao & Hongbiao Wang & Jianxin Guo, 2021. "Smog Avoidance Investment While Improving Air Quality: Health Demand or Risk Aversion? Evidence from Cities in China," IJERPH, MDPI, vol. 18(15), pages 1-21, July.
    7. Bijwaard, Govert E., 2022. "Educational differences in mortality and hospitalisation for cardiovascular diseases," Journal of Health Economics, Elsevier, vol. 81(C).
    8. Oikawa, M., 2020. "The effect of education on health policy reform: Evidence from Japan," Health, Econometrics and Data Group (HEDG) Working Papers 20/08, HEDG, c/o Department of Economics, University of York.
    9. Roman Hoffmann & Sebastian Uljas Lutz, 2019. "The health knowledge mechanism: evidence on the link between education and health lifestyle in the Philippines," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(1), pages 27-43, February.
    10. Masato Oikawa, 2024. "The role of education in health policy reform outcomes: evidence from Japan," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 25(1), pages 49-76, February.

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    More about this item

    Keywords

    education; intelligence; health; multistate duration model;
    All these keywords.

    JEL classification:

    • C41 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods: Special Topics - - - Duration Analysis; Optimal Timing Strategies
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I24 - Health, Education, and Welfare - - Education - - - Education and Inequality

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