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Health, Aging and Socio-Economic Status in Mexico

Health, Aging and Socio-Economic Status in Mexico. Sonia Laszlo (McGill) Franque Grimard (McGill) Wilfredo Lim (Columbia). Motivation – Research questions. What are the long-term health effects of socio-economic status (SES) during childhood?

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Health, Aging and Socio-Economic Status in Mexico

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  1. Health, Aging and Socio-Economic Status in Mexico Sonia Laszlo (McGill) Franque Grimard (McGill) Wilfredo Lim (Columbia)

  2. Motivation – Research questions • What are the long-term health effects of socio-economic status (SES) during childhood? • How much persists beyond its effect on human capital investment and earnings capacity? • Long term effects of education?

  3. Motivation - Literature • Income gradient: health outcomes positively affected by income or SES • Via child health: Case et al. AER ’02; Currie & Stabile AER ’03 • Child health  education (Glewwe & Miguel, HDE ’08) • Child health & education  income (large literature) • But: income and health jointly determined • Recently: in utero or childhood SES • Maccini & Yang (AER forthcoming), Almond (JPE ’06): long term health effects of conditions prevailing in utero • Akresh & Verwimp (’07): conditions prevailing in early childhood have long run health outcomes • Review: Strauss and Thomas (HDE ’08)

  4. Motivation – Aging population • We focus on the aging population (50+) in Mexico • Developing countries: • Changing burden of disease • Pressures on medical resources and financing • Yet little literature in economics on these countries • Contribution: • Build on Case et al. (JHE ’05) and Buckley et al. (JHE ’04) • Long-term effects of childhood SES on health of the elderly

  5. Why aging in a developing country? • Epidemiological transition : • Demographic transition  shift in disease burden from infectious to non-communicable diseases. • Demographic transition: Source: UN, ESA

  6. What We Do • Examine Determinants of: • Good health for individuals aged 50+ in Mexico in 2001 and 2003 • Conditional on good or bad health in 2001 transition (à la Buckley et al., JHE ’04) • Does education matter? • Does childhood SES matter?

  7. Directions of ‘causality’ Childhood Adulthood ‘Golden Years’ Education Health Income Health CSES Health

  8. Directions of ‘causality’ Childhood Adulthood ‘Golden Years’ Education Health Income Health CSES Health

  9. Directions of ‘causality’ Childhood Adulthood ‘Golden Years’ Education Parental SES Health Income Health Shocks CSES Health

  10. Mexican Health and Aging Study (MHAS) • Modeled after the U.S. Health and Retirement Study. • We use the two-year panel data set (2001 and 2003)on Mexicans born prior to 1951 • No geographic location codes – limitation • Self-reported health: “Would you say your health is…” • Excellent 1 • Very good 2 • Good 3 • Fair 4 • Poor 5 • We know self reported health measures are measured with error (Baker et al., JHR ’04) • We check for robustness to some sensitivity analysis in our measure Good Health = 1 Good Health = 0

  11. MHAS - We use: • Childhood SES  “Before age 10…” : • Did your residence have a toilet? • Did you regularly go to bed hungry? • Did anyone sleep in the same room where you cooked? • Did you regularly wear shoes? • Current SES • Education, age, gender, marital status • Per capita household assets, ‘income’ • Parental background • Mom’s and dad’s education • Dad’s occupation

  12. Determinants of (Unconditional) Good Health

  13. Transition from health status in 2001 to good health in 2003 • Follow Buckley et al. (’04) • Condition on good / bad health in 2001: • Conditioning to some extent controls for endogeneity of education/SES • Control for remaining endogeneity in education using parental characteristics • Parental residence primarily urban, parental education, dad’s occupation (agriculture, construction, services, business, office, etc…)

  14. Results

  15. Is fertility playing a role? Childhood Adulthood ‘Golden Years’ Education Health Income Health CSES Health

  16. Is fertility playing a role? Childhood Adulthood ‘Golden Years’ Education Health Income Health CSES Health Fertility

  17. Is fertility playing a role? • Cannot answer question directly – lack of data on reproductive health in MHAS • Yet: • Gender differences in LR determinants of health during ‘golden years’ • Stronger (>primary) education gradient for women • Weak (but negative) effects of number of children ever born on ‘golden years’ health and transition from bad health • And: • CSES strongly significant effect on number of children ever born

  18. Robustness checks • Education endogenous? • CSES endogenous? • Number of children ever born endogenous? • Use parental background as IV • Results

  19. Conclusions • Childhood SES  Education  adult health • Poverty during childhood matters above and beyond its effects on education (and income) • Effect pronounced for transition from good to good health • Find differential gender effects • Policy?

  20. Validity of Subjective Health Measure

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