Bénédicte H. Apouey

Winning Big But Feeling No Better? The Effect of Lottery Prizes on Physical and Mental Health

We use British panel data to determine the exogenous impact of income on a number of individual health outcomes: general health status, mental health, physical health problems, and health behaviours (drinking and smoking). Lottery winnings allow us to make causal statements regarding the effect of income on health, as the amount won by winners is largely exogenous. Positive income shocks have no significant effect on self-assessed overall health, but a significant positive effect on mental health. This result seems paradoxical on two levels. First, there is a well-known gradient in health status in cross-sectional data, and second, general health should partly reflect mental health, so that we may expect both variables to move in the same direction. We propose a solution to the first apparent paradox by underlining the endogeneity of income. For the second, we show that lottery winnings are also associated with more smoking and social drinking. General health will reflect both mental health and the effect of these behaviours and so may not improve following a positive income shock.

Family income and child health in the UK

Recent studies examining the relationship between family income and child health in the UK have produced mixed findings. We re-examine the income gradient in child general health and its evolution with child age in this country, using a very large sample of British children. We find that there is no correlation between income and child general health at ages 0-1, that the gradient emerges around age 2 and is constant from age 2 to age 17. In addition, we show that the gradient remains large and significant when we reduce the endogeneity of income. Furthermore, our results indicate that the gradient in general health reflects a greater prevalence of chronic conditions among low-income children and a greater severity of these conditions. Taken together, these findings suggest that income does matter for child health in the UK and may play a role in the intergenerational transmission of socioeconomic status.

On Measuring and Explaining Socioeconomic Polarization in Health with an Application to French Data

This paper proposes two original measures of socioeconomic polarization, in order to quantify phenomena that are not always taken into account by social inequality measures. Our approach is inspired by the literature on bivariate inequality (the concentration index) and univariate polarization. Like the concentration index, our social polarization measures can be easily computed thanks to a “convenient” regression and decomposed into their determinants. Moreover changes in polarization can also be decomposed into their causes. The paper also provides an empirical illustration of our methods for the probability of reporting excellent or very good health, using cross-sectional data on French women. The findings suggest that after 65 years of age, social polarization in this probability decreases whereas social inequality remains stable. Consequently social polarization conveys additional information to that contained in the concentration index.

Inequality and Bi-Polarization in Socioeconomic Status and Health: Ordinal Approaches

Traditional indices of bi-dimensional inequality and polarization were developed for cardinal variables and cannot be used to quantify dispersion in ordinal measures of socioeconomic status and health. This paper develops two approaches to the measurement of inequality and bi-polarization using only ordinal information. An empirical illustration is given for 24 European Union countries in 2004-2006 and 2011. Results suggest that inequalities and bi-polarization in income and health are especially large in Estonia and Portugal, and that inequalities have significantly increased in recent years in Austria, Belgium, Finland, Germany, and the Netherlands, whereas bi-polarization significantly decreased in France, Portugal, and the UK.

Health policies and the relationships between socioeconomic status, access to health care, and health

Health policies tend to focus on improving the access to health care of persons of low-socioeconomic status to improve their health. This commentary argues that health policies directly directed at health and socioeconomic status (and other components of individual welfare) will also be effective if one wants to improve the well-being of the poor.

Racial and Ethnic Disparities in Awareness of Cancer Genetic Testing Among Online Users: Internet Use, Health Knowledge, and Socio-Demographic Correlates

The increased availability of genetic information online has led to growing concerns regarding health disparities among racial and ethnic groups and the need to examine the role of race/ethnicity in genetic testing awareness. Online users from a national representative sample were analyzed to explain the racial/ethnic differences in genetic testing awareness. The analysis indicated that health-related knowledge, online information-seeking behaviors, and information trust of the Internet were correlated with the prediction for awareness of online genetic testing information in different ethnic groups. The study also highlights these differences and identifies the priority ranking of the factors that reflect racial gaps. These findings suggest that the diversities in amount of trust of online information sources, education initiatives of health services, and knowledge of the existence of clinical trials and Centers for Disease Control and Prevention need to be considered more closely for racial/ethnic subgroups.

Malaria Prevalence, Indoor Residual Spraying, and Insecticide-Treated Net Usage in Sub-Saharan Africa

This paper analyzes the effect of malaria prevalence and indoor residual spraying on the probability of sleeping under an insecticide-treated bed net in nine Sub-Saharan countries. Specifically, it examines whether bed net usage is elastic with respect to malaria prevalence and whether indoor residual spraying, which is a public intervention, crowds out bed net usage, which is a private behavior. Using data on individual bed net usage and household indoor residual spraying combined with local malaria prevalence, we show that malaria prevalence has a positive effect on bed net usage, but that bed net usage is inelastic with respect to malaria prevalence, with elasticity ranging from 0.42 for adult women to 0.59 for older children, in our preferred model. We also find that indoor residual spraying does not crowd out bed net usage. Instead, individuals who live in houses that were recently sprayed are more likely to use a bed net.

Social Interactions and Malaria Preventive Behaviors in Sub-Saharan Africa

This paper examines the existence of social interactions in malaria preventive behaviors in Sub-Saharan Africa, that is, whether an individuals social environment has an influence on the individuals preventive behaviors. We focus on the two population groups which are the most vulnerable to malaria (children under 5 years and pregnant women) and on two preventive behaviors (sleeping under a bednet and taking intermittent preventive treatment during pregnancy). We define the social environment of the individual as people living in the same region. To detect social interactions, we calculate the size of the social multiplier by comparing the effects of an exogenous variable at individual and regional levels. Our data come from 92 surveys for 29 Sub-Saharan countries between 1999 and 2012, and they cover approximately 660,000 children and 95,000 women. Our results indicate that there are social interactions in malaria preventive behaviors in the form of social multipliers effects of womens education and household wealth. The long-run effects of these characteristics on preventive behaviors at the regional level are larger than those apparent at the individual level.

Child Health and Use of Health Care Services in France: Evidence on the Role of Family Income

Our paper investigates the relationship between family income and child health in France. We first examine whether there is a significant correlation between family income and child general health, and the evolution of this relationship across childhood years. We then study the role of specific health problems, the use of health care services, and supplemental health insurance coverage, in the income gradient in general health. We also quantify the role of income in child anthropometric measurements. Whenever possible, we compare our results for France with those obtained for other developed countries.

Preparation for Old Age in France: The Roles of Preferences and Expectations

This article assesses the roles of preferences and expectations on preparation for old age, employing unique data on French individuals aged 50+. The data do not only contain information on the general feeling to prepare for old age and on specific preparation activities in various domains, but also on risk and time attitudes, family and social altruism, and expected disability and longevity. Half of the sample reports preparing for old age. Future orientation emerges as an important predictor of preparation. While risk attitudes and altruism also matter for preparation, their effect may be less systematic across outcomes than that of general future orientation. Individuals who expect to become disabled or to live longer are more likely to prepare for old age. Policies promoting healthy aging should include messages targeting present-oriented individuals and try to make people more future-oriented.