Essays in Health Economics: Empirical Studies on the Determinants of Health

Kenneth Lee

Advisor: Dr. Robin Hanson

Committee Members: Dr. David Levy, Dr. Jack Hadley, College of Health and Human Services

Carow Hall, Conference Room
April 26, 2011, 08:30 AM to 09:30 AM


This dissertation describes results of empirical studies addressing important issues in the field of health economics, one of the fastest-growing fields within economics.  The investigated problems include two major topic areas: aggregate health determinant effects on health and individual health determinants effects on health.  For the aggregate study, this dissertation extends current research by including detailed health expenditure data from the Centers for Medicare & Medicaid Services (CMS) at the Department of Health and Human Services; using instrumental variables techniques to reduce the likelihood of cross correlation between expenditure and health outcome variables; and defining a set of state-level factor variables that provide an incisive look into differing state characteristics.  The empirical results indicate a consistent negative impact of aggregate health expenditure on life expectancy, infant mortality, and all-cause mortality.  Income elasticity results indicate that health is not a luxury goodThe focus of the individual study involves relationships between geography and health, occupation and health, and the interaction effects between geography and occupation on health.   This study uses data defined within the survey of choice, the National Longitudinal Mortality Study (NLMS), for location of birth and standard occupations; and uses occupation variables and state-level characteristic variables, which were both defined through factor analyses.   In particular, the race data show consistently worse health for black men and women relative to whites.  Being female is always more healthy than being male. Living in rural areas (and suburban areas) is better for health than living in urban areas.  Health improves as the amount of education and income rise.In addition, this study considers the impact of occupation category groupings on health and uses the results of an occupation factor analysis to define job characteristics.  Traits related to “job IQ,” for example, creativity and cognitive ability, show consistent, significant, and positive impacts on health even with a variety of confounding variables, suggesting that job IQ is fundamental to explaining the impact of occupations on health.