How Much Might Universal Health Insurance Reduce Socioeconomic Disparities in Health? A Comparison of the Us and Canada

36 Pages Posted: 16 Sep 2004 Last revised: 13 Oct 2022

See all articles by Sandra L. Decker

Sandra L. Decker

International Longevity Center; National Bureau of Economic Research (NBER)

Dahlia Remler

City University of New York - Baruch College - Marxe School of Public and International Affairs; National Bureau of Economic Research (NBER); CUNY The Graduate Center - Department of Economics

Date Written: August 2004

Abstract

A strong association between lower socioeconomic status (SES) and worse health-- the SES-health gradient-- has been documented in many countries, but little work has compared the size of the gradient across countries. We compare the size of the income gradient in self-reported health in the US and Canada. We find that being below median income raises the likelihood that a middle aged person is in poor or fair health by about 15 percentage points in the U.S., compared to less than 8 percentage points in Canada. We also find that the 7 percentage point gradient difference between the two countries is reduced by about 4 percentage points after age 65, the age at which the virtually all U.S. citizens receive basic health insurance through Medicare. Income disparities in the probability that an individual lacks a usual source of care are also significantly larger in the US than in Canada before the age of 65, but about the same after 65. Our results are therefore consistent with the availability of universal health insurance in the U.S, or at least some other difference that occurs around the age of 65 in one country but not the other, narrowing SES differences in health between the US and Canada.

Suggested Citation

Decker, Sandra L. and Remler, Dahlia, How Much Might Universal Health Insurance Reduce Socioeconomic Disparities in Health? A Comparison of the Us and Canada (August 2004). NBER Working Paper No. w10715, Available at SSRN: https://ssrn.com/abstract=583428

Sandra L. Decker (Contact Author)

International Longevity Center ( email )

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National Bureau of Economic Research (NBER)

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Dahlia Remler

City University of New York - Baruch College - Marxe School of Public and International Affairs ( email )

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National Bureau of Economic Research (NBER) ( email )

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CUNY The Graduate Center - Department of Economics ( email )

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