CHAPTER 4 SOCIOECONOMIC DISPARITIES IN HEALTH
CHAPTER 4 SOCIOECONOMIC DISPARITIES IN HEALTH
Intro Previously... Grossman model Individuals make choices about their health based on time constraints,budget constraints,and utility Optimal amount of health (H*)changes based on decisions about tradeoffs How does socioeconomic status(SES)affect health and choices about health? Does health determine SES?Or does SES determine health? Use empirical evidence to explore these questions Bhattacharya,Hyde and Tu-HealthEconomics
Bhattacharya, Hyde and Tu – Health Economics Intro Previously… Grossman model Individuals make choices about their health based on time constraints, budget constraints, and utility Optimal amount of health (H*) changes based on decisions about tradeoffs How does socioeconomic status (SES) affect health and choices about health? Does health determine SES? Or does SES determine health? Use empirical evidence to explore these questions
The pervasiveness of health disparities
The pervasiveness of health disparities
Health disparities are everywhere Health Disparity:(def)differences in health- incidence,prevalence,mortality,and burden of disease--between specific populations ex:death rates for all cancer types for both men and women are highest among African Americans1 Ubiquitous worldwide across races, educational attainments,employment grades, and incomes Broadly across all socioeconomic statuses(SES) Bhattacharya,Hyde and Tu-HealthEconomics
Bhattacharya, Hyde and Tu – Health Economics Health disparities are everywhere Health Disparity: (def) differences in health -- incidence, prevalence, mortality, and burden of disease -- between specific populations ex: death rates for all cancer types for both men and women are highest among African Americans1 Ubiquitous worldwide across races, educational attainments, employment grades, and incomes Broadly across all socioeconomic statuses (SES)
Health disparities are everywhere By education: College graduates are 25%more likely to survive to age 68 than high school dropouts By race: Hispanics report better health status than black individuals White individuals report better health then both Hispanic and black individuals Health deteriorates with age across all races,but disparities persist Bhattacharya,Hyde and Tu-HealthEconomics
Bhattacharya, Hyde and Tu – Health Economics Health disparities are everywhere By education: College graduates are 25% more likely to survive to age 68 than high school dropouts By race: Hispanics report better health status than black individuals White individuals report better health then both Hispanic and black individuals Health deteriorates with age across all races, but disparities persist
Health disparities across income Generally:high-income individuals self-report a higher health status than those of lower incomes For most conditions,the poor exhibit more incidences of disease Some exceptions like Bronchitis--no difference Hay fever--the rich appear to be diagnosed with hay fever more often May be explainable if richer children visit the doctor more often and hence,are more likely to be diagnosed Bhattacharya,Hyde and Tu-HealthEconomics
Bhattacharya, Hyde and Tu – Health Economics Health disparities across income Generally: high-income individuals self-report a higher health status than those of lower incomes For most conditions, the poor exhibit more incidences of disease Some exceptions like Bronchitis -- no difference Hay fever -- the rich appear to be diagnosed with hay fever more often May be explainable if richer children visit the doctor more often and hence, are more likely to be diagnosed
Disparities even with universal insurance Even in countries with universal health insurance, health disparities persist Canada: Self-reported health status for children at high SES better than children of low SES(Currie and Stabile 2003) England: We discuss the Whitehall studies later Bhattacharya,Hyde and Tu-HealthEconomics
Bhattacharya, Hyde and Tu – Health Economics Disparities even with universal insurance Even in countries with universal health insurance, health disparities persist Canada: Self-reported health status for children at high SES better than children of low SES (Currie and Stabile 2003) England: We discuss the Whitehall studies later
Theories to explain health disparities
Theories to explain health disparities
Why do health disparities exist? Reasons/theories Early life events Income levels Stress of being poor Work capacity ▣Impatience Adherence to medical advice Policy importance of understanding causes of disparities before addressing them Bhattacharya,Hyde and Tu-HealthEconomics
Bhattacharya, Hyde and Tu – Health Economics Why do health disparities exist? Reasons/theories Early life events Income levels Stress of being poor Work capacity Impatience Adherence to medical advice Policy importance of understanding causes of disparities before addressing them
What causes what? Does bad health cause low SES? Does low SES cause bad health? Are there other factors? Health SES Other variables Bhattacharya,Hyde and Tu-HealthEconomics
Bhattacharya, Hyde and Tu – Health Economics What causes what? Does bad health cause low SES? Does low SES cause bad health? Are there other factors?