Exercise or Extra Fries? How Behaviors Impact Health Over the Life Cycle

87 Pages Posted: 27 Feb 2024 Last revised: 7 Apr 2024

See all articles by Neha Bairoliya

Neha Bairoliya

Marshall School of Business - University of Southern California

Ray Miller

Colorado State University

Vegard M. Nygaard

University of Houston

Date Written: February 18, 2024


Leveraging a unique thirty-year panel of U.S. registered nurses, we explore why individuals who appear ex-ante homogeneous in their health when entering adulthood experience divergent health outcomes as they age. We find that among those entering adulthood in good health, individuals in the top diet quality or exercise deciles at age 30 are roughly 50% more likely to maintain a healthy weight and have no chronic diseases three decades later, compared to those in the bottom deciles. Behaviors exhibit strong persistence, though exercise exhibits more long-term persistence than diet. While individuals might enter adulthood with healthy weight and no diseases, they vary in their health types due to factors like birth conditions, adolescent weight, and family disease history, which we find significantly affects weight and disease progression over time. To disentangle the role of initial conditions from behaviors in determining health trajectories, we propose a novel structural framework of endogenous health evolution. The model accounts for two sources of fixed heterogeneity—health types derived from data and unobserved exercise types inferred from long-term exercise patterns— in addition to differences in diet habits, weight, and diseases. We find that initial conditions account for one-third of the variance in weight at older ages. While course correction through behaviors can only partially make up for poor initial conditions at the onset of adulthood, promoting healthy behaviors can reduce total healthcare expenses by at least 8%, or $100 billion annually.

Funding Information: This project did not receive any funding. The data used in this project is supported by the National Institute of Health under award number U01CA176726.

Declaration of Interests: None of the co-authors involved in the project have received any funding or have any competing interest to declare.

Keywords: obesity, diet, exercise, frailty, BMI, medical spending, health production function

JEL Classification: I12, I14, H51, D15

Suggested Citation

Bairoliya, Neha and Miller, Ray and Nygaard, Vegard M., Exercise or Extra Fries? How Behaviors Impact Health Over the Life Cycle (February 18, 2024). Available at SSRN: https://ssrn.com/abstract=4730783 or http://dx.doi.org/10.2139/ssrn.4730783

Neha Bairoliya (Contact Author)

Marshall School of Business - University of Southern California ( email )

701 Exposition Blvd
Los Angeles, CA 90089
United States

Ray Miller

Colorado State University ( email )

Fort Collins, CO 80523
United States

Vegard M. Nygaard

University of Houston ( email )

Houston, TX 77204-5882
United States

HOME PAGE: http://https://sites.google.com/site/vegardmokleivnygaard/

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