The Roots of Health Inequality and The Value of Intra-Family Expertise

66 Pages Posted: 8 Mar 2019

See all articles by Yiqun Chen

Yiqun Chen

Duke University

Petra Persson

Stanford University; Research Institute of Industrial Economics (IFN)

Maria Polyakova

Stanford University - Department of Health Research and Policy; National Bureau of Economic Research (NBER)

Multiple version iconThere are 3 versions of this paper

Date Written: March 5, 2019

Abstract

Mounting evidence documents a stark correlation between income and health, yet the causal mechanisms behind this gradient are poorly understood. This paper examines the impact of access to expertise on health, and whether unequal access to expertise contributes to the health-income gradient. Our empirical setting, Sweden, allows us to shut down inequality in formal access to health care; we first document that strong socioeconomic gradients nonetheless persist. Second, we study the effect of access to health-related expertise – captured by the presence of a health professional in the extended family – on health. Exploiting “admissions lotteries” into medical schools and variation in the timing of degrees, we show that access to intra-family medical expertise has far-reaching health consequences, at all ages: It raises longevity, improves drug adherence and reduces the occurrence of lifestyle-related disease in adulthood, raises vaccination rates in adolescence, and reduces tobacco exposure in utero. Third, we show that the effects of expertise are larger at the lower end of the income distribution – precisely where access to expertise is scarcer. Unequal access to health-related expertise can account for as much as 18% of the health-SES gradient, and may thus play a significant role in sustaining health inequality.

Keywords: social insurance, family, expert, information, health decision-making, inequality

JEL Classification: D12, D83, G22, H1, H4, H5, I13, I14

Suggested Citation

Chen, Yiqun and Persson, Petra and Polyakova, Maria, The Roots of Health Inequality and The Value of Intra-Family Expertise (March 5, 2019). University of Chicago, Becker Friedman Institute for Economics Working Paper No. 2019-45. Available at SSRN: https://ssrn.com/abstract=3348709 or http://dx.doi.org/10.2139/ssrn.3348709

Yiqun Chen (Contact Author)

Duke University ( email )

100 Fuqua Drive
Durham, NC 27708-0204
United States

Petra Persson

Stanford University ( email )

Stanford, CA 94305
United States

Research Institute of Industrial Economics (IFN) ( email )

Box 55665
Grevgatan 34, 2nd floor
Stockholm, SE-102 15
Sweden

Maria Polyakova

Stanford University - Department of Health Research and Policy ( email )

Redwood Building, T111
150 Governor's Lane
Stanford, CA 94305
United States

HOME PAGE: http://web.stanford.edu/~mpolyak/

National Bureau of Economic Research (NBER) ( email )

1050 Massachusetts Avenue
Cambridge, MA 02138
United States

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