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

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Event Type: 
Seminar Series
Date and Time: 
Monday, September 24, 2018
2:00 pm – 3:30 pm

Mounting evidence points to a stark correlation between income and health, yet the causal mechanisms behind this gradient are poorly understood. This paper asks whether persistent exposure to information about scalable health behaviors can improve health and whether differential exposure to such information contributes to the health-income gradient. Our empirical setting, Sweden, allows us to shut down differences in formal access to health care, and to leverage population-wide tax data linked to birth and medical records. First, we document strong socioeconomic gradients in mortality and health that exist despite the equalized access to formal healthcare.  Second, we measure the effect of information on a set of health behaviors and changes in health that are attributable to informational treatment, by utilizing natural experiments in the intra-family exposure to a healthcare professional. We exploit “admission lotteries” into medical schools for short-run outcomes and event study designs for long-run outcomes. We find that medical expertise in the extended family reduces mortality of older adults, by reducing the likelihood of severe cardiovascular conditions and increasing adherence to medication. Younger generations exposed to expertise in the family are in turn more likely to engage in preventive behaviors, and newborns experience safer births. Third, we show that the poor respond the most to having expertise in the family, but also face the greatest information scarcity. The interaction between poverty and access to information about health and health care may play a significant role in sustaining health inequality.