UCL Department of Economics


IFS-STICERD seminar - Jonathan Kolstad (Berkeley Haas)

19 April 2023, 12:30 pm–1:45 pm

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What Drives Health Inequality? Social Determinants of Health and Health Care Access

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Carole Reginer

Abstract: Using rich administrative data from the Netherlands we study the relationship between income and health outcomes. Prior work has documented an important negative relationship between income and mortality (e.g. Chetty, et al., 2016). Little is known, however, about the drivers of this relationship. Is access to health care a key driver of these differences? Alternatively, do social factors (often referred to as "social determinants of health") lead to mortality differences by income? The importance of these different factors is of intrinsic interest to economists but also has important policy implications: should resources be focused on health care systems and access or on social factors outside of the traditional health care system? We study the contributing factors determining mortality by income using rich administrative data for the population of the Netherlands. Using these data we study gradients in i) access to health care and ii) mortality. We find no evidence for differential access to care but substantial remaining differences in mortality. We then document that a large share of mortality differences can be explained by the relative rates of chronic disease (e.g. diabetes, hypertension). Chronic disease rates deviate by income group early in life, suggesting that mortality differences in later life are driven by the stock of disease due to factors outside of the health care system. Furthermore, these differences cannot be "undone" by providing equal access to health care later in life.

Location: IFS Conference Basement Room or Zoom | Meeting ID: 876 1049 1533 |Passcode: seminar

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