Paul Nystedt

Investments in social capital--implications of social interactions for the production of health

This paper develops a theoretical model of the family as producer of health- and social capital. There are both direct and indirect returns on the production and accumulation of health- and social capital. Direct returns (the consumption motives) result since health and social capital both enhance individual welfare per se. Indirect returns (the investment motives) result since health capital increases the amount of productive time, and social capital improves the efficiency of the production technology used for producing health capital. The main prediction of the theoretical model is that the amount of social capital is positively related to the level of health; individuals with high levels of social capital are healthier than individuals with lower levels of social capital, ceteris paribus. An empirical model is estimated, using a set of individual panel data from three different time periods in Sweden. We find that social capital is positively related to the level of health capital, which supports the theoretical model. Further, we find that the level of social capital (1) declines with age, (2) is lower for those married or cohabiting, and (3) is lower for men than for women.

Height and Earnings: The Role of Cognitive and Noncognitive Skills

We use large-scale register data on 450,000 Swedish males who underwent mandatory military enlistment at age 18, and a subsample of 150,000 siblings, to examine why tall people earn more. We show the importance of both cognitive and noncognitive skills, as well as family background and muscular strength for the height-earnings relationship. In addition, we show that a substantial height premium remains after these factors have been accounted for, which originates from very short people having low earnings. This is mostly explained by the sorting of short people into low-paid occupations, which may indicate discrimination by stature.

Health care for the elderly: two cases of technology diffusion

Diffusion of medical technology and the growing proportion of elderly people in the population are generally regarded as major contributors to the increasing health care expenditure in the industrialised world. This study explores the importance of one specific factor in this process, the change in the use of technology among elderly patients. In some instances, a new technology is first used among younger patients and then gradually extended to the elderly. Two such cases are studied, both representing costly procedures: coronary bypass surgery (treatment of coronary heart disease) and dialysis (treatment of uraemia). In both cases, we demonstrate significant diffusion to older age groups. It is also tentatively concluded that the diffusion of technology could have an important effect on per capita health care expenditure among the oldest of the old.

Getting ready for the marriage market? The association between divorce risks and investments in attractive body mass among married europeans

This article explores to what extent married middle-aged individuals in Europe are governed by the risk of experiencing divorce, when shaping their physical appearance. The main result is that divorce risks, proxied by national divorce rates, are negatively connected to body mass index (BMI) among married individuals but unrelated to BMI among singles. Hence, it seems that married people in societies where divorce risks are high are more inclined to invest in their outer appearance. One interpretation is that high divorce rates make married people prepare for a potential divorce and future return to the marriage market.

A cost-effectiveness analysis of a health education programme for elderly persons with age-related macular degeneration: a longitudinal study.

Purpose: To analyse the cost-effectiveness of the activity-based Health Education Programme ‘Discovering New Ways’ versus a standard Individual Programme. Method: Two-hundred and twenty-nine persons were randomized to either the Health Education Programme or an Individual Programme. The present study is based on 131 persons who participated in the 28-month follow-up. Costs for the low vision clinic were documented prospectively along with external costs. A cost-effectiveness analysis was done using cases with an improved level of perceived security in daily activities as the effectiveness measure. Results: The Health Education Programme led to significantly more cases with an improved level of perceived security (45 vs. 10%, CI 95%: 21 – 49, p value < 0.001) and the total social cost per treatment was lower (28 004 vs. 36 341 SEK). Taken separately the low vision clinic costs were slightly higher due to a higher prescription of assistive devices, but external costs were lower for the Health Education Programme compared to the Individual Programme, though neither of these differences was statistically significant. Conclusion: The results suggest that replacing the standard Individual Programme with the Health Education Programme ‘Discovering New Ways’ is cost-effective as more persons experience increased security to a lesser total cost.

Body Size, Skills, and Income: Evidence From 150,000 Teenage Siblings

We provide new evidence on the long-run labor market penalty of teenage overweight and obesity using unique and large-scale data on 150,000 male siblings from the Swedish military enlistment. Our empirical analysis provides four important results. First, we provide the first evidence of a large adult male labor market penalty for being overweight or obese as a teenager. Second, we replicate this result using data from the United States and the United Kingdom. Third, we note a strikingly strong within-family relationship between body size and cognitive skills/noncognitive skills. Fourth, a large part of the estimated body-size penalty reflects lower skill acquisition among overweight and obese teenagers. Taken together, these results reinforce the importance of policy combating early-life obesity in order to reduce healthcare expenditures as well as poverty and inequalities later in life.

Is there an Intermarriage Premium for Male Immigrants? Exogamy and Earnings in Sweden 1990-2009

This paper analyzes the impact of intermarriage on the economic integration of immigrants in Sweden, measured by annual earnings. We use longitudinal register data for the period 1990–2009 for the total population of immigrant men born 1960–1974. The results reveal large intermarriage premiums, but overall this seems to be a result of selection effects as most of the premium is visible already at the time of marriage. For the most economically marginalized immigrants, however, an intermarriage premium arises within marriage implying that forming a union with a native triggers a more rapid earnings growth among them.

Widowhood-related mortality in Scania, Sweden during the 19th century

In this article, mortality risks are empirically examined in connection with spousal bereavement in four parishes in Scania, southern Sweden, during the 19th century using duration analysis. The data are longitudinal and the inhabitants have been followed literally from the cradle to the grave. To simultaneously catch transitory (shock) and persistent (long-term) effects of widowhood on mortality of the surviving spouse, the Cox semiparametric proportional hazards model has been applied with time spent in widowhood as a time-dependent multiple factor. Widowers in general were found to face higher relative mortality risks than widows and the effect of bereavement decreased through time. The estimated relative risks for males were dependent on socioeconomic status and widowers classified as landless faced high relative risks. Quantitatively, the magnitude of our estimates was large in comparison with similar studies made on contemporary data.

Widowhood strategies in preindustrial society

In preindustrial society, the loss of a spouse usually impelled the surviving party to adapt quickly by choosing between certain strategies: to remain the head of the household, to remarry, to enter a household headed by a child or the spouse of child, to dissolve the household and enter into an unrelated persons household, or to migrate out of the parish. The use of competing-risk hazard models and longitudinal microlevel data shows that demographic, socioeconomic, and gender-related factors interacted in determining the choice of strategy in a rural area of southern Sweden during the nineteenth century.

Changes in alcohol consumption : An analysis of self-reported use of alcohol in a Swedish national sample 1988-89 and 1996-97

Aim: To analyse factors associated with alcohol consumption, and how these changed over the period 1988—97, a period during which Sweden entered the European Union. Methods: Data were used from two waves (1988—89 and 1996—97) of the representative longitudinal micro-level ULF survey in Sweden to estimate a two-part model of consumption. Results: Experiencing financial stress, monthly salary, and not being married were all correlated with alcohol consumption, especially for males in 1988—89. In 1996—97 these correlations were much weaker, revealing a levelling-out trend towards conformity. The pattern was less clear for females. Further, the youngest age group (16—29 years) increased its consumption significantly more than the older age groups. Conclusion: There were significant changes in alcohol behaviour, especially for males, coinciding with Sweden joining the EU and preceding the very substantial general increase in consumption levels since 1998. This underlying process should be kept in mind when analysing the more recent trends. The results support the contention that alcohol policy should be a combination of measures targeting the whole population (e.g. via public health campaigns) with specific measures directed towards more vulnerable groups (e.g. young people).