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

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  • Persson, Petra
  • Chen, Yiqun
  • Polyakova, Maria
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.

Suggested Citation

  • Persson, Petra & Chen, Yiqun & Polyakova, Maria, 2019. "The Roots of Health Inequality and the Value of Intra-Family Expertise," CEPR Discussion Papers 13583, C.E.P.R. Discussion Papers.
  • Handle: RePEc:cpr:ceprdp:13583
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    Cited by:

    1. Persson, Petra & Qiu, Xinyao & Rossin-Slater, Maya, 2021. "Family Spillover Effects of Marginal Diagnoses: The Case of ADHD," IZA Discussion Papers 14020, Institute of Labor Economics (IZA).
    2. Persson, Petra & Qiu, Xinyao & Rossin-Slater, Maya, 2021. "Family Spillover Effects of Marginal Diagnoses: The Case of ADHD," CEPR Discussion Papers 15660, C.E.P.R. Discussion Papers.
    3. Everding, Jakob, 2019. "Heterogeneous spillover effects of children's education on parental mental health," hche Research Papers 18, University of Hamburg, Hamburg Center for Health Economics (hche).
    4. Amy Finkelstein & Petra Persson & Maria Polyakova & Jesse M. Shapiro, 2022. "A Taste of Their Own Medicine: Guideline Adherence and Access to Expertise," American Economic Review: Insights, American Economic Association, vol. 4(4), pages 507-526, December.
    5. Werbeck, Anna & Wübker, Ansgar & Ziebarth, Nicolas R., 2021. "Cream skimming by health care providers and inequality in health care access: Evidence from a randomized field experiment," Journal of Economic Behavior & Organization, Elsevier, vol. 188(C), pages 1325-1350.
    6. Frakes, Michael & Gruber, Jonathan & Jena, Anupam, 2021. "Is great information good enough? Evidence from physicians as patients," Journal of Health Economics, Elsevier, vol. 75(C).
    7. Bautista, María Angélica & González, Felipe & Martinez, Luis R. & Muñoz, Pablo & Prem, Mounu, 2020. "Does Higher Education Reduce Mortality? Evidence from a Natural Experiment in Chile," SocArXiv 5s2px, Center for Open Science.
    8. Persson, Petra & Rossin-Slater, Maya, 2019. "When Dad Can Stay Home: Fathers' Workplace Flexibility and Maternal Health," IZA Discussion Papers 12386, Institute of Labor Economics (IZA).
    9. Humlum, Maria Knoth & Morthorst, Marius Opstrup & Thingholm, Peter Rønø, 2024. "Sibling spillovers and the choice to get vaccinated: Evidence from a regression discontinuity design," Journal of Health Economics, Elsevier, vol. 94(C).
    10. Abu-Qarn, Aamer & Lichtman-Sadot, Shirlee, 2021. "Older Adult Health Following Greater Access to Secondary Health Care: Evidence from Bus Service Introductions to Arab Towns in Israel," IZA Discussion Papers 14490, Institute of Labor Economics (IZA).
    11. Bautista, María Angélica & González, Felipe & Martinez, Luis R. & Muñoz, Pablo & Prem, Mounu, 2020. "Does Higher Education Reduce Mortality? Evidence from a Natural Experiment in Chile," SocArXiv 5s2px, Center for Open Science.
    12. Elisabeth Artmann & Hessel Oosterbeek & Bas van der Klaauw, 2022. "Do Doctors Improve the Health Care of Their Parents? Evidence from Admission Lotteries," American Economic Journal: Applied Economics, American Economic Association, vol. 14(3), pages 164-184, July.

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    More about this item

    JEL classification:

    • D12 - Microeconomics - - Household Behavior - - - Consumer Economics: Empirical Analysis
    • D83 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Search; Learning; Information and Knowledge; Communication; Belief; Unawareness
    • G22 - Financial Economics - - Financial Institutions and Services - - - Insurance; Insurance Companies; Actuarial Studies
    • H1 - Public Economics - - Structure and Scope of Government
    • H4 - Public Economics - - Publicly Provided Goods
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality

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