Life Expectancy for Low Education Groups in the US is Worsening

It is well known that there are significant socioeconomic gradients in mortality and morbidity, and there is a substantial literature on this subject. Nevertheless, there are many people who do not seem to find these trends concerning. Or at least, not concerning enough for society to act upon. Whatever about increasing relative differences, it is quite a different matter to see increases in actual mortality rates. Especially in a country like the US, and especially given the recent substantial increases in (average) life expectancy. This deserves more coverage and should be seen in the context of the similar pattern in real wages for certain groups.

The following NYT Article discusses the issue. The abstract for the article being cited is below.   

http://www.nytimes.com/2012/09/21/us/life-expectancy-for-less-educated-whites-in-us-is-shrinking.html?hp

Differences In Life Expectancy Due To Race And Educational Differences Are Widening, And Many May Not Catch Up

Health Affairs, August 2012, vol. 31 no. 8, 1803-1813

http://content.healthaffairs.org/content/31/8/1803.abstract

    S. Jay Olshansky, Toni Antonucci, Lisa Berkman, Robert H. Binstock, Axel Boersch-Supan, John T. Cacioppo, Bruce A. Carnes, Laura L. Carstensen, Linda P. Fried, Dana P. Goldman, James Jackson, Martin Kohli, John Rother, Yuhui Zheng, John Rowe

Abstract

It has long been known that despite well-documented improvements in longevity for most Americans, alarming disparities persist among racial groups and between the well-educated and those with less education. In this article we update estimates of the impact of race and education on past and present life expectancy, examine trends in disparities from 1990 through 2008, and place observed disparities in the context of a rapidly aging society that is emerging at a time of optimism about the next revolution in longevity. We found that in 2008 US adult men and women with fewer than twelve years of education had life expectancies not much better than those of all adults in the 1950s and 1960s. When race and education are combined, the disparity is even more striking. In 2008 white US men and women with 16 years or more of schooling had life expectancies far greater than black Americans with fewer than 12 years of education—14.2 years more for white men than black men, and 10.3 years more for white women than black women. These gaps have widened over time and have led to at least two “Americas,” if not multiple others, in terms of life expectancy, demarcated by level of education and racial-group membership. The message for policy makers is clear: implement educational enhancements at young, middle, and older ages for people of all races, to reduce the large gap in health and longevity that persists today.

Early-Life Health and Adult Circumstance in Developing Countries

Early-Life Health and Adult Circumstance in Developing Countries

Janet Currie, Tom Vogl

NBER Working Paper No. 18371
Issued in September 2012
NBER Program(s):   AG   CH   HC   HE   LS

A growing literature documents the links between long-term outcomes and health in the fetal period, infancy, and early childhood. Much of this literature focuses on rich countries, but researchers are increasingly taking advantage of new sources of data and identification to study the long reach of childhood health in developing countries. Health in early life may be a more significant determinant of adult outcomes in these countries because health insults are more frequent, the capacity to remediate is more limited, and multiple shocks may interact. However, the underlying relationships may also be more difficult to measure, given significant mortality selection. We survey recent evidence on the adult correlates of early-life health and the long-term effects of shocks due to disease, famine, malnutrition, pollution, and war.

http://www.princeton.edu/~tvogl/currie_vogl_AR.pdf

Population Association of America – Call for Papers

Dear PAA Colleagues,

Reminder – The deadline for submissions for the PAA 2013 Annual Meeting is September 21, 2012. The PAA Annual Meeting will be held April 11-13, in New Orleans, Louisiana. The Call for Papers (PDF) is posted on the 2013 Annual Meeting Program Website. Submissions are made online.

Information is also posted for:

Travel Awards
Member-Initiated Meetings
Advertisements, Book displays and Exhibits

The PAA Board of Directors wishes to encourage broad participation in the Annual Meeting. If you would like to serve as a session Chair or Discussant at the 2013 Annual Meeting, please indicate your interest by sending an email to stephanie@popassoc.org.
In order to appear on the program, presenters must register for the meeting. Registration fees are posted on the PAA website.  Registration will open in January 2013.

Check the PAA website throughout the year for updated meeting information.

Thank you,
PAA 2013 Annual Meeting Services

Session Topics:
Fertility, Family Planning, Sexual Behavior, and Reproductive Health
Marriage, Family, Households, and Unions
Children and Youth
Health and Mortality
Race, Ethnicity, and Gender
Migration and Population Distribution
Economy, Labor Force, Education, and Inequality
Population, Development, and Environment
Population and Aging
Data and Methods
Applied Demography

Details:
http://paa2013.princeton.edu/

Robustness in health research: Do differences in health measures, techniques, and time frame matter?

Robustness in health research: Do differences in health measures, techniques, and time frame matter?
Paul Frijters, Aydogan Ulker
Journal of Health Economics
Volume 27, Issue 6, December 2008, Pages 1626–1644

Abstract
Survey-based health research is in a boom phase following an increased amount of health spending in OECD countries and the interest in ageing. A general characteristic of survey-based health research is its diversity. Different studies are based on different health questions in different datasets; they use different statistical techniques; they differ in whether they approach health from an ordinal or cardinal perspective; and they differ in whether they measure short-term or long-term effects. The question in this paper is simple: do these differences matter for the findings? We investigate the effects of life-style choices (drinking, smoking, exercise) and income on six measures of health in the US Health and Retirement Study (HRS) between 1992 and 2002: (1) self-assessed general health status, (2) problems with undertaking daily tasks and chores, (3) mental health indicators, (4) BMI, (5) the presence of serious long-term health conditions, and (6) mortality. We compare ordinal models with cardinal models; we compare models with fixed effects to models without fixed-effects; and we compare short-term effects to long-term effects. We find considerable variation in the impact of different determinants on our chosen health outcome measures; we find that it matters whether ordinality or cardinality is assumed; we find substantial differences between estimates that account for fixed effects versus those that do not; and we find that short-run and long-run effects differ greatly. All this implies that health is an even more complicated notion than hitherto thought, defying generalizations from one measure to the others or one methodology to another.

JEL classification C23; C25; I31; Z1
Keywords Morbidity; Mortality; Lifestyle; Income

Ungated Version

New ESRI Working Paper: The Long Term Health Effects of Education

The Long Term Health Effects of Education

Vincent O Sullivan*

Abstract: Using data from The Irish Longitudinal Study on Ageing, I find that exogenous changes in the schooling of men born into lower social class families in Ireland during the late 1940s and 1950s had a statistically significant positive effect on their self-reported health in later life. I also find that the increased level of schooling had a statistically significant positive effect on physical exercise in later life as well as reducing the probability of an individual experiencing certain non-cardiovascular chronic conditions. However no statistically significant effect was found in relation to cardiovascular disease, self-rated mental health, smoking behaviour or self-reported and objectively measured memory although there is a high degree of imprecision in these estimates.

Corresponding Author: Vincent.o-sullivan@tcd.ie
Keywords: Causal Effects of Education, Self-Reported Health, Older People

CIISN Health in Crisis Conference

Sarah Gibney and Marcella McGovern will present at the Critical Issues in Irish Society Network (CIISN) Health in Crisis Conference in UCD on April 19th. Further details below.

Dear colleague,

We are pleased to announce that registration is now open for the CIISN Health in Crisis Conference on Thursday 19th April 2012, Seminar Room, Humanities Institute, University College Dublin. Please see attached poster for the conference outline.

This conference will bring together PhD students, researchers and prominent international academics, as well as health campaigners in the public eye to discuss issues critical to health and well-being in our society. It will offer researchers the opportunity to network, as well as a chance to reach new audiences within and beyond the academic sphere.

Speakers include:

Professor Eamon O'Shea (Irish Center for Social Gerontology,NUI Galway)
Dr Noel Richardson (Director of Center for Men's Health,CIT)
Orla Tinsley (Cystic Fibrosis Campaigner)

Health in Crisis Conference

The Critical Issues in Irish Society Network wishes to announce a call for abstracts for a one-day conference, Health in Crisis?

Following on from the success of last year’s seminar series, the CIISN present the one-day conference ‘Health in Crisis?’. This conference will bring together PhD students, researchers and prominent international academics, as well as health campaigners from the public eye to discuss issues critical to health and well being in our society. It will offer researchers the opportunity to network, as well as a chance to reach new audiences beyond the academic sphere.

Presentations and presentation posters will be structured around streams that include:

1. Experiences of Health and Illness

2. Chronic conditions

3. Patient organisation and support groups

4. Health policy, service delivery and organisation

5. Health technologies and genetics

6. Inequalities

7. Gender& Ethnicity

8. Life-course: reproductive health, ageing, death and dying

9. Ethics

10. Individual, collective and global risk

11. Preventive Health

12. Theory

13. Methods

The abstract submission is now open. Closing deadline is Friday 24th February2012.

The conference will be held in University College Dublin April 2012.

Upcoming details will be available on http://ciisn.wordpress.com/

New IZA Working Paper: The Effects of World War II on Economic and Health Outcomes across Europe

IZA DP No. 6296

Iris Kesternich, Bettina Siflinger, James P. Smith, Joachim K. Winter:

The Effects of World War II on Economic and Health Outcomes across Europe

Abstract:
In this paper, we investigate the long-run effects of World War II on socio-economic status (SES) and health of older individuals in Europe. Physical and psychological childhood events are important predictors for labor market and health outcomes in adult life, but studies that quantify these effects in large samples that cover entire diverse populations are still rare. We will analyze data from SHARELIFE, a retrospective survey conducted as part of the Survey on Health, Aging, and Retirement in Europe (SHARE) in 2009. This survey provides detailed data on events in childhood including those during the war as well as several measures of exposure to war shocks such as experience of dispossession, persecution, combat in local areas, and hunger periods for over 20,000 individuals in 13 European countries. We find that exposure to the war itself, and even more importantly to individual-level shocks caused by the war such as hunger periods, significantly predict old-age outcomes at older ages.

http://ftp.iza.org/dp6296.pdf

Seminar on Maternal and Child Health with David Barker

For a summary of Barker's work see http://www.thebarkertheory.org/. Geary's Orla Doyle and Colm Harmon are also speaking at this event.

The First One Thousand Days: Policy Implications for Maternal and Child Health

The School of Public Health, Physiotherapy and Population Science is hosting a workshop on Thursday 1^st December 1pm-5pm, with a keynote lecture by Professor David Barker of the University of Southampton. Professor David Barker is a world-renowned authority on early life influences on later health and wellbeing and his developmental plasticity hypothesis has influenced a large body of research over the last two decades.

Please find attached flyer with details of the event.

Please RSVP to beth.kilkenny@ucd.ie by Friday 18^th November if you would like to attend.

www.ucd.ie/phps

www.ucd.ie/cshw

VOX Article on long-run determinants of health

Here is a VOX article about my joint work with James Smith and Mark McGovern on long-run determinants of health in Ireland. Working on this and similar papers over the last few years, it has been a constant focus as to how the decisions made in one era affect the outcomes in later ones, particularly when they impact on children. Similarly, working on these topics gives a dramatic sense of how select a sample the current Irish population are, namely the ones that both survived and stayed in or returned to Ireland and a related research agenda looks at migration from Ireland, the first paper (linked here) looking at migration to England in the 20th century, with health selection being very different across the decades. 

At Ireland's current stage of economic development, the obvious targets such as preventable infant mortality due to basic sanitation are no longer a policy focus. The work of my co-author on childhood mental health effects on later adult outcomes (see his IDEAS page here and UCD Ulysses lecture here) is one important direction in thinking about long-run effects of current policies.  In general, the interaction between economic performance, policy and mental health is a key area (I give a brief summary on the post below). 

CReAM Working Paper on Effects of Migration on Blood Pressure and Hypertension

Interesting working paper, following on from a recent JHE paper that looked at the effect on mental health.

CReAM Discussion Paper No 24/10

Natural Experiment Evidence on the Effect of Migration on Blood Pressure and Hypertension

John Gibson*, Steven Stillman**, David McKenzie† and Halahingano Rohorua‡

* University of Waikato and Motu Economic and Public Policy Research ** Motu, University of Waikato, IZA and CreAM † Development Research Group, World Bank, IZA and CreAM ‡ University of Waikato

Non-Technical Abstract

Over 200 million people live outside their country of birth and experience large gains in material well-being by moving to where wages are higher. But the effect of this migration on health is less clear and existing evidence is ambiguous because of the potential for self- selection bias. In this paper, we use a natural experiment, comparing successful and unsuccessful applicants to a migration lottery to experimentally estimate the impact of migration on measured blood pressure and hypertension. Hypertension is a leading global health problem, as well as being an important health measure that responds quickly to migration. We use various econometric estimators to form bounds on the treatment effects since there appears to be selective non-compliance in the natural experiment. Even with these bounds the results suggest significant and persistent increases in blood pressure and hypertension, which have implications for future health budgets given the recent worldwide increases in immigration.

Keywords: Bloodpressure,Hypertension,Lottery,Migration,Naturalexperiment. JEL Classification: C21, I12, J61.

The negative effect of height on well-being: a tall story?

Height and well-being amongst older Europeans
Kevin Denny

This paper uses a cross-country representative sample of Europeans over the age of 50 to analyse whether individuals’ height is associated with higher or lower levels of well-being. Two outcomes are used: a measure of depression symptoms reported by individuals and a categorical measure of life satisfaction. It is shown that there is a concave relationship between height and symptoms of depression. These results are sensitive to the inclusion of several sets of controls reflecting demographics, human capital and health status. While parsimonious models suggest that height is protective against depression, the addition of controls, particularly related to health, suggests the reverse effect: tall people are predicted to have slightly more symptoms of depression. Height has no significant association with life satisfaction in models with controls for health and human capital.

Here also

Quality of Death International Rankings

A new report by the Economist Intelligence Unit has ranked countries according to quality of end of life care. Ranking is based on an index comprising various indicators such as health care spending, life expectancy, access to medication, public awareness and policy environment. The UK comes out on top, Ireland also does relatively well and is ranked 4^th. Some of the key findings:

- Drug availability is the most important practical issue
-State funding of end-of-life care is limited and often prioritises conventional treatment
-More palliative care may mean less health spending

More details here.

IZA - Disease Prevalence, Disease Incidence, and Mortality in the United States and in England

New IZA Working Paper. 

Disease Prevalence, Disease Incidence, and Mortality in the United States and in England

Banks, James (j.banks@ifs.org.uk) (Institute for Fiscal Studies, London)
Muriel, Alastair (ali_m@ifs.org.uk) (Institute for Fiscal Studies, London)
Smith, James P. (smith@rand.org) (RAND)

We find disease incidence and prevalence are both higher among Americans in age groups 55-64 and 70-80 indicating that Americans suffer from higher past cumulative disease risk and experience higher immediate risk of new disease onset compared to the English. In contrast, age specific mortality rates are similar in the two countries with an even higher risk among the English after age 65. Our second aim explains large financial gradients in mortality in the two countries. Among 55-64 year olds, we estimate similar health gradients in income and wealth in both countries, but for 70-80 year old, we find no income gradient in UK. Standard behavioral risk factors (work, marriage, obesity, exercise, and smoking) almost fully explain income gradients among 55-64 years old in both countries and a significant part among Americans 70-80 years old. The most likely explanation of no English income gradient relates to their income benefit system. Below the median, retirement benefits are largely flat and independent of past income and hence past health during the working years. Finally, we report evidence using a long panel of American respondents that their subsequent mortality is not related to large changes in wealth experienced during the prior ten year period.

Social Status and Health

This is a tricky area due to various concerns about endogeneity etc, but there are some papers which provide experimental evidence for the relationship between social status and susceptibility to illness. In each of the following participants were exposed to the cold virus and tracked to examine which individuals developed symptoms. The first, Sociability and Susceptibility to the Common Cold (Cohen et al 2003), found that sociability was negatively associated with the probability of developing a cold following infection. The second, Objective and Subjective Socioeconomic Status and Susceptibility to the Common Cold (Cohen et al 2008), found that subjective SES was negatively associated with the development of symptoms. Particularly interesting was the fact that this was independent of objective SES. There was some evidence that the relationship was mediated by sleeping patterns. You still have to wonder exactly what “sociability” and socioeconomic status are measuring, but interesting all the same.

A Healthy Recovery

IT article today indicates that an additional 10,000 full medical (GMS) cards are being issued per month. I would estimate that the number of people with voluntary PHI is currently falling at a third of this rate, i.e., ~ 3,000 per month. It's worth taking stock of these numbers and the effect they will be having on service demand and quality.

All public sectors are facing considerable funding cuts next month but I would urge caution in what is done in the public health sector. It's vital to recognise that this current trend in GMS coverage when budgets and labour remain fixed means a heavier work-load for each individual public health worker. When labour is fixed and funding is falling, as is widely expected in the near future, the situation is exacerbated. We need to think carefully about what broad brush-stokes will really mean. In other public sectors we might expect an increase in demand - more people might choose to finish school, there might be an increase in theft and property crime. But public education and justice are fundamentally different; their services are both less labour-intensive and less sensitive to demand (there aren't an additional 10,000 criminals being reprimanded or school-aged kids showing up each month!). Forthcoming policy needs to consider these facts and design an appropriate response that will ensure quality of service to the patient and fair conditions for staff.

Along with considered measures it now makes increasing sense to seriously revisit the issue of average length of in-patient stay. According to the ESRI's most recent 2007 national report, GMS medical card holders were discharged after an average of 7 days; about 3 days longer than non-GMS discharges. Of course there are a number of reasons why this is the case but to date we have no evidence on the matter.

ESRI Report on Future HealthCare Needs

The ESRI released a volume of papers on the future of healthcare in Ireland.

link here