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Health, Aging and Socio-Economic Status in Mexico

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Title: Transition from good to poor health among the elderly in Mexico Author: Administrator Last modified by: Administrator Created Date: 4/15/2007 11:11:14 PM – PowerPoint PPT presentation

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Title: Health, Aging and Socio-Economic Status in Mexico


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

Total fertility rate Total fertility rate Total fertility rate Life expectancy Life expectancy Life expectancy
Years 55-60 75-80 95-00 55-60 75-80 95-00
Mexico 6.80 5.25 2.67 55.2 65.0 73.7
Centr Am 6.31 4.90 2.90 54.5 64.1 71.9
South Am 5.74 4.27 2.65 55.1 62.9 70.3
North Am 3.72 1.78 1.95 69.7 73.4 76.7
Gap w NA 3.08 3.47 0.72 14.5 8.4 3.0
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
Adulthood
Childhood
Golden Years
Education
Health
Income
Health
CSES
Health
8
Directions of causality
Adulthood
Childhood
Golden Years
Education
Health
Income
Health
CSES
Health
9
Directions of causality
Adulthood
Childhood
Golden Years
Education
Health
Parental SES
Income
Health
CSES
Shocks
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
  • Moms and dads education
  • Dads occupation

12
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13
Determinants of (Unconditional) Good Health
14
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15
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16
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17
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, dads occupation (agriculture,
    construction, services, business, office, etc)

18
Results
19
Is fertility playing a role?
Adulthood
Childhood
Golden Years
Education
Health
Income
Health
CSES
Health
20
Is fertility playing a role?
Adulthood
Childhood
Golden Years
Education
Health
Income
Health
CSES
Health
Fertility
21
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 (gtprimary) 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

22
Robustness checks
  • Education endogenous?
  • CSES endogenous?
  • Number of children ever born endogenous?
  • Use parental background as IV
  • Results

23
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?

24
Validity of Subjective Health Measure
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