Sam Watson’s journal round-up for 9th May 2016

Every Monday our authors provide a round-up of some of the most recently published peer reviewed articles from the field. We don’t cover everything, or even what’s most important – just a few papers that have interested the author. Visit our Resources page for links to more journals or follow the HealthEconBot. If you’d like to write one of our weekly journal round-ups, get in touch.

The association between income and life expectancy in the United States, 2001-2014. JAMA [PubMedPublished 26th April 2016

The relationship between wealth, income, and health has been examined in many hundreds of studies. The relationship is complex and still not well understood. Individual material circumstances affect patterns of consumption and health behaviours; relative socioeconomic position modifies these effects through psychosocial stressors and social patterns of behaviour; environmental and other neighbourhood factors also have further influences. So, what sets this study apart? It uses data from 1.4 billion tax records from citizens of the United States (p-values are still reported however!). Adults aged 40-76 from 1999 to 2014 are included. The authors find a gap in life expectancy of 15 years for men and 10 years for women between the top and bottom 1% of the income distribution. This gap increased over time with gains to life expectancy in the top quintile of the income distribution larger than those in the bottom between 2001-2014. There were also significant differences within income quintiles between high and low income areas, which were also correlated with health behaviors. This study provides a fascinating and comprehensive overview of income and health in the US. However, it does not really further our understanding of how these various relationships work, despite some bold claims.

The effects of exposure to better neighborhoods on children: new evidence from the Moving to Opportunity experiment. American Economic Review [RePEcPublished April 2016

The previous study in this round-up showed that there was a wide variation in changes to life expectancy over time for individuals in the bottom income quintile by geographic area. Between 2001 and 2014 changes to life expectancy varied between an increase of four years to a decrease of two years. But, these correlations don’t really provide enough information to formulate policy; is it the individuals in the neighbourhood or the neighbourhood itself? One way of investigating this would be to randomly provide the opportunity to move from a high poverty to a low poverty area and investigate the outcomes. In the 1990s the Moving to Opportunity (MtO) experiment provided vouchers to families to move to better neighbourhoods. Previous investigations of the effects of these vouchers found that families who moved had better physical and mental health, subjective well being, and safety but did not find evidence of improvements to employment or earnings. This present study examines the outcomes for those who were children at the time of the MtO program. Circumstances in early life, even as early as birth, are hypothesised to be important to later life outcomes. People who were part of families who were assigned vouchers and who were aged under 13 at the time of the program had greater earnings in their 20s and were more likely to attend college. These effects were not replicated in those aged 13-18 at the time of the MtO program.

Responding to risk: circumcision, information, and HIV prevention. The Review of Economics and Statistics Published May 2016

Understanding how people respond to new information on risk is important to formulate effective health policy. If individuals perceive their risk of an adverse health outcome to be low they may engage in riskier behaviours and conversely for those with perceived high risk. The net effect of greater health education is therefore ambiguous. This study investigates the effect of the perception of the risk of contracting HIV on the practice of safe sex among males in Malawi. Male circumcision can reduce the risk of transmission of HIV by up to 60%, thus circumcised males are at lower risk than their uncircumcised counterparts. The study included both circumcised and uncircumcised males and provided information about HIV transmission and circumcision to a random set of the participants in the study. The study found that the low risk (circumcised) males did not engage in more risky sexual behaviour while the higher risk (uncircumcised) males both reduced the frequency of sex and increased their use of condoms. Extrapolating from these results, this study may suggest that an increase in information has an overall positive effect by reducing risk.

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