Rationing by waiting is having its greatest effect on those at the bottom of the income ladder. As I wrote at the Health Affairs blog:“Think metaphorically of waiting in line for care. The lowest-income families are at the end of that line. The longer the line, the longer they will have to wait. If you do something to shorten the line, you will be mainly benefiting higher-income people who are at the front.”There is another study gated with abstract that suggests that even low-income patients are more deterred by non-price barriers than by money prices.
Public health insurance programs comprise a large share of federal and state government expenditure, and these programs are due to be expanded as part of the 2010 Affordable Care Act. Despite a large literature on the effects of these programs on health care utilization and health outcomes, little prior work has examined the long-term effects of these programs and resultant health improvements on important outcomes, such as educational attainment. We contribute to filling this gap in the literature by examining the effects of the public insurance expansions among children in the 1980s and 1990s on their future educational attainment. Our findings indicate that expanding health insurance coverage for low-income children has large effects on high school completion, college attendance and college completion. These estimates are robust to only using federal Medicaid expansions, and they are mostly due to expansions that occur when the children are older i.e., not newborns. We present suggestive evidence that better health is one of the mechanisms driving our results by showing that Medicaid eligibility when young translated into better teen health. Overall, our results indicate that the long-run benefits of public health insurance are substantial.
Now, the World Bank’s David Evans and Anna Popova are out with a new paper reviewing what evidence is out there about aid to the global poor and alcohol/tobacco consumption. They found 19 studies which attempted to measure the effect of cash transfers — both no strings attached ones and ones families receive if they fulfill certain conditions, like school attendance — on the purchase and consumption of “temptation goods”; the studies contained a total of 44 estimates of cash’s effect in various contexts. 82 percent of those estimates showed that the transfers reduced consumption of or spending on alcohol and tobacco. The vast majority of those weren’t statistically significant, so the best conclusion is that there’s no evidence transfers affect drinking or smoking behavior.
We know health insurance influences health — but can it change educational outcomes, too? A new study says yes.The paper, recently published by the National Bureau of Economic Research, examined expansions of Medicaid in the 1980s and 1990s. The authors found that the expansions resulted in consistent improvements in high school and college attainment.A 10 percentage point increase in childhood Medicaid eligibility reduced the rate of high school dropouts by 5 percent and increased completion of a bachelor’s degree by 3.3 to 3.7 percent.
A paper written in 2003 by David Kindig and Greg Stoddard in the American Journal of Public Health took a stab at it. They write –Although the term “population health” has been much more commonly used in Canada than in the United States, a precise definition has not been agreed upon even in Canada, where the concept it denotes has gained some prominence.They proceeded to define it as “the health outcomes of a group of individuals, including the distribution of such outcomes within the group.” They go on to explain –We support the idea that a hallmark of the field of population health is significant attention to the multiple determinants of such health outcomes, however measured. These determinants include medical care, public health interventions, aspects of the social environment income, education, employment, social support, culture and of the physical environment urban design, clean air and water, genetics, and individual behavior.In other words: Everything under the sun.Such an all-inclusive definition is not very helpful, so people keep trying. Ten years later Michael Stoto gave it a shot in a paper published by Academy Health, “Population Health in the Affordable Care Act Era.” This paper spends half its space explaining some of the different definitions currently in use. The balance of the paper is suggesting to researchers how they can tailor their projects to take advantage of funding opportunities presented by ObamaCare.
The doubling of human life expectancy is one of the most remarkable achievements of the past century. Consider, Lomborg writes, that “the twentieth century saw life expectancy rise by about 3 months for every calendar year.” The average child in 1900 could expect to live to just 32 years old; now that same child should make it to 70. This increase came during a century when worldwide economic output, driven by the spread of capitalism and freedom, grew by more than 4,000 percent. These gains occurred in developed and developing countries alike; among men and women; and even in a sense among children, as child mortality plummeted.
Why are we living so much longer? Massive improvements in public health certainly played an important role. The World Health Organization’s global vaccination efforts essentially eradicated smallpox. But this would have been impossible without the innovative methods of vaccine preservation developed in the private sector by British scientist Leslie Collier. Oral rehydration therapies and antibiotics have also been instrumental in reducing child mortality. Simply put, technological progress is the key to these gains—and market economies have liberated, and rewarded, technological innovation.
A subject long ignored by policymakers, and one that unemployment counselors are too sheepish to raise with job seekers, the link between bulging waistlines and joblessness is now of intense interest to researchers studying the long-term effects of the country’s economic malaise.
Recent studies and surveys have shown a distinct relationship between unemployment and obesity, particularly for lower-skilled workers who struggle to find work — a search made more challenging by their weight.