Master of Science in Economics Laurea Magistrale in Scienze Economiche. Diet, income and chronic degenerative diseases

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1 UNIVERSITÀ DI PISA Master of Science in Economics Laurea Magistrale in Scienze Economiche Diet, income and chronic degenerative diseases Supervisors: Prof. Tommaso Luzzati Dr. Giovanni Bernardo Candidate: Andrea Lari Academic Year

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3 Abstract This M.Sc. dissertation focuses on the relationship between lifestyles, socio- economic position and the onset of noncommunicable diseases. In the first chapter, after defining the chronic degenerative diseases from a medical point of view, I focus on cardiovascular diseases, diabetes and obesity. I report the risk factors behind this type of pathologies and I put forward a possible interpretation for their persistence in time. In the second chapter I highlight the relationship between economic welfare and healthy diet. With this respect, as well known, two polar cases exist, slow vs. fast food. Diet, for instance, explains childhood obesity, resulting from bad eating habits, diffused in low-income neighbourhoods. This bring me to a short survey of the existing literature in the health economics field, where I present some interesting paper on the relationships between eating behaviour and the occurrence of pathologies (such as diabetes and cardiovascular disease or infarction). Since most of the analyses are based on US data, in chapter three, I try to replicate some of the results with Italian micro-data, Aspetti della vita quotidiana, ISTAT. After this step, I try to verify the direct relationship existing between socio-economic position of households and the quality of the food they consume. The analysis ends with discussing, on the basis of existing literature, the policies to reduce junk-food consumption and improve consumers health. Key words: Cardiovascular diseases, Obesity, Chronic degenerative diseases, Health economics, Econometric analysis, Public health policies. i

4 Introduction Chapter I: Chronic degenerative diseases I.a. Medical definition I.b. Cardiovascular diseases, diabetes and chronic respiratory diseases I.c. Examining risk factors I.d. Obesity and nutrition Chapter II: Eating habits and income levels II.a. Socio-economic differences in food habits II.b. Slow vs. fast food II.c. Childhood obesity II.d. Technological change and reduced consumption of calories II.e. A survey of the literature Chapter III: Empirical evidence for Italy III.a. Causes of death in Italy: an overview III.b. Material and methods III.c. Estimates for Italy III.d. Public health policies III.e. Price elasticity and consumption habits Conclusions ii

5 Introduction In the past, demographic changes were ruled by war, famine and severe epidemics. Nowadays lifestyles determine the fate of population, which is, in the rich countries, mainly affected by non communicable diseases. This work will focus on the relationship between lifestyles, socioeconomic position and the onset of noncommunicable diseases. I will report the literature on the link between habits (such as smoking, excessive consumption of alcohol and sugary drinks, but also energy dense diet) and the increase in the likelihood of triggering terrible diseases involving personal and monetary costs such as health costs imposed on households and on state budgets and years of life lost due to illness. After reporting the definition of WHO's noncommunicable diseases, I will focus on the risk factors and in particular on the social plague of obesity. Obesity is the result of an unhealthy diet that causes damage not only to the body but also to the mind. Then I will test whether our sample shows a direct relationship between the quality of food consumed by families and a proxy of disposable income, as highlighted for instance by Drewnowski (2004). With the available data I will also test the role of education and income level in preventing inappropriate lifestyles. Therefore it will be possible to define how health policies could reduce these huge social costs. To this purpose, I will give a glance to the literature that explores at the micro level, the price elasticity of demand for food and beverage that harm health. 3

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