Topics in the economics of health and aging

The following three essays contain examinations of several topics in the economics of health and aging. While the subject matter of each essay is quite distinct, all three share a strong empirical focus, and attempt to shed light on issues at the intersection of family, society, economics and health. The first essay examines the effects of women's labor force participation on health, primarily the health of their employed spouses. A wide array of data sources is used do demonstrate that among married couples, men whose spouses work suffer from a range of adverse health outcomes, compared to men whose spouses are homemakers. The results strongly suggest that dual-earning households are subjected to high levels of chronic stress, leading to poorer health outcomes. Statistical identification constrains the analysis to the health of men alone. The second essay shares some of the data sources used in the first, though shifts the focus to a much broader question. I conduct a cross-country comparison of health outcomes across five developed nations, to examine their performance on a range of chronic conditions. Importantly, this comparison overcomes many challenges in the existing literature by relying primarily on objectively measured health, rather than self-reported data. The comparison yields a surprising result: though considerably more obese, Americans display remarkably low levels of hypertension and total cholesterol. Treatment patterns can account for much of the difference, suggesting that the American healthcare system might be better at screening and treating these conditions, contrary to common belief. Finally, in the third essay I address a topic more closely associated with aging than health per se. In it, I examine whether a strategic bequest motive can account for apparent sub-optimal tax planning of older households with respect to estate taxes. I develop a theoretical model incorporating both strategic exchange and tax considerations among altruistic parents, leading to an outcome consistent with the literature on suboptimal estate tax behavior. I then turn to test the model's predictions using data from the Health and Retirement Study, and find evidence consistent with a strategic bequest motive among households more likely to face the estate tax.

Public health

20090