ECONOMICS OF HEALTH INEQUALITY

Transcription

1 TINBERGEN INSTITUTE SUMMER SCHOOL ECONOMICS OF HEALTH INEQUALITY ERASMUS UNIVERSITY ROTTERDAM JUNE 2018 This course will arm you with tools to measure health inequality. In addition to gaining competence in the computation of health inequality indices, you will be forced to consider the normative implications of the measures. You will also become familiar with both economic models that aim to explain socioeconomic disparities in health and empirical methods used to estimate socioeconomic determinants of health and health behavior. Finally, you will evaluate the argument that socioeconomic disparities in health reflect, at least in part, the impact of ill- health on economic outcomes. MONDAY, JUNE 25 Lecture 1: Socioeconomic- related health inequality Examples of socioeconomic gradient in health Trends in health inequality Socioeconomic gradient in health over the life cycle Absolute and relative inequality Outline of the course Lecture 2: Rank- dependent health inequality measures (Generalised) Concentration curve (CC) and index (CI) Analogous measures used in epidemiology Practical 1: Inference for concentration curves Testing dominance of concentration curve against line of equality Testing dominance between independent & dependent concentration curves Practical 2: Estimation and inference for the concentration index Convenient covariance and regression Standard errors of CI estimates Lecture 3: Corrected concentration indices Taking account of measurement properties of health outcomes CIs for non- ratio- scaled & bounded health outcomes Absolute versus relative: inequality planes Practical 3: Computation of corrected concentration indices Assignment 1: Testing CC dominance and computation of CIs using conindex

2 TUESDAY, JUNE 26 Practical 4: Solutions to Assignment 1 Lecture 4: Normative foundations of health inequality measures Axiomatic foundation of the CI Seminar 1: Do you prefer a smaller concentration index? Discussion based on responses to survey experiment Lecture 5: Alternative attitudes to health inequality Aversion to inequality, poverty and extremes Trading off health inequality and mean health Computation of extended and symmetric CIs using condindex Lecture 6: Decomposition of health inequality Decomposition of the concentration index Critique of CI decomposition Decomposition based on the recentred influence function Short introduction into longitudinal decompositions Practical 5: Decomposition of the concentration index

3 WEDNESDAY, JUNE 27 Lecture 7: Unfair health inequality Concepts of fairness Compensation and reward Direct unfairness and the fairness gap Comparison with CI approach Direct and indirect standardisation Lecture 8: Inequality of opportunity for health Effort and circumstances Where to draw the responsibility cut? Vertical equity How to deal with luck? And risk? Broader concepts of welfare Practical 6: Empirical testing of equality of opportunity for health Application based on Garcia- Gomez et al Introduction to assignment Lecture 9: Positive economics of health inequality: theory Grossman model of health capital Extending Grossman to explain socioeconomic determination of health Testable predictions Lecture 10: Origins of the gradient Empirics: o In utero stressors à adult health / SES o Parental SES à infant/child health o Child health à human capital à adult SES Theory: an economic model of human development? Seminar 2: Does the Grossman model explain health inequality? How well does the Grossman model perform in explaining health inequality? How could it be improved in this respect? How can we use theory to guide empirical work? What are the limitations of economic theory in understanding health behaviour? What crucial determinants of health are absent from the model? Evening Social Event and Dinner

4 THURSDAY, JUNE 28 Lecture 11: Socioeconomic determinants of health: Causality I Identification strategies that exploit rich data o Control for confounders observable in rich data o Difference out unobservable confounders (fixed effects) Testing absence of a causal effect Lecture 12: Socioeconomic determinants of health: Causality II Identification strategies using instruments from natural experiments Education à health using schooling reforms Wealth, income à health using lotteries & stock market gains Seminar 3: What do we know socioeconomic determinants of health? Structural vs reduced form estimates of SES à health External validity of evidence from natural experiments Evidence base for causal effects of SES on health Practical 7: Estimation of health models using natural experiments

5 FRIDAY, JUNE 29 Lecture 13: Health determined economic inequality Reverse causality and health selection hypothesis Health à work & wages Disability insurance Health à (medical expenses à ) wealth Seminar 4: Policy response to health inequality What do we learn from measures of SES- related health inequality? What role should they play in health and social policy formation? Can health disparities be addressed by income redistribution policy? Is health an important determinant of economic inequality? Can health disparities be addressed by social insurance? Student presentations and evaluation