Sven E. Wilson

The health capital of families: an investigation of the inter-spousal correlation in health status

This study documents and analyzes the inter-spousal correlation in health status (ISCIHS) among married couples in later life. A simple economic theory is developed that integrates standard theories of marriage markets and health capital formation. This theory implies that several causal factors will lead to a positive correlation in the health status of spouses. These include assortative matching in the marriage market along dimensions related to health (such as education); a tendency to share common life-style behaviors such as diet, smoking and exercise; shared environmental risk factors for disease; and a potential for direct effects of the health of one spouse on the health of the other. Empirical estimates using the 1992 Health and Retirement study in the USA demonstrate that ISCIHS is large in magnitude, highly statistically significant, and robust to alternative measures of health status. ISCIHS exists even after controlling for age, education, income, and other socioeconomic and demographic determinants of health status, including behavioral risk factors. These covariates reduce the overall correlation coefficient by 33% to 57%, depending on the health measure, which suggests both that marriage formation and decision making processes systematically affect health in later life and that heretofore unidentified risk factors for disease and disability exist at the household level.

Marital status and colon cancer outcomes in US Surveillance, Epidemiology and End Results registries: Does marriage affect cancer survival by gender and stage?

BACKGROUND Marital status has been associated with outcomes in several cancer sites including breast cancer in the literature, but little is known about colon cancer, the fourth most common cancer in the US. METHODS A total of 127,753 patients with colon cancer were identified who were diagnosed between 1992 and 2006 in the US Surveillance, Epidemiology and End Results (SEER) Program. Marital status consisted of married, single, separated/divorced and widowed. Chi-square tests were used to examine the association between marital status and other variables. The Kaplan-Meier method was used to estimate survival curves. Cox proportional hazards models were fit to estimate the effect of marital status on survival. RESULTS Married patients were more likely to be diagnosed at an earlier stage (and for men also at an older age) compared with single and separated/divorced patients, and more likely to receive surgical treatment than all other marital groups (all p<0.0001). The five-year survival rate for the single was six percentage points lower than the married for both men and women. After controlling for age, race, cancer stage and surgery receipt, married patients had a significantly lower risk of death from cancer (for men, HR: 0.86, CI: 0.82-0.90; for women, HR: 0.87, CI: 0.83-0.91) compared with the single. Within the same cancer stage, the survival differences between the single and the married were strongest for localized and regional stages, which had overall middle-range survival rates compared to in situ or distant stage so that support from marriage could make a big difference. CONCLUSIONS Marriage was associated with better outcomes of colon cancer for both men and women, and being single was associated with lower survival rate from colon cancer.

New estimates of the direct costs of traumatic spinal cord injuries: results of a nationwide survey

New estimates of the direct costs of traumatic spinal cord injuries (SCI) are obtained from a comprehensive survey of the US SCI population. These direct costs, defined as the value (in 1988 dollars) of resources used specifically to treat or to adapt to the SCI condition, represent the average experience of the US SCI population. Responses to a detailed questionnaire administered to a sample of traumatic SCI persons in the United States provide the primary source of data for this study. Analysis of this survey data indicates that more recently injured SCI persons (ie those injured since 1970) spent an average of 171 days in a hospital over the first 2 years post injury. Initial hospital expenses will average

Warfare and Welfare: Military Service, Combat, and Marital Dissolution:

95,203. Home modification costs in excess of

PREJUDICE & POLICY Racial Discrimination in the Union Army Disability Pension System, 1865-1906

8,000 can also be expected. After recovery and rehabilitation, a SCI person will pay, on average,

UNION ARMY VETERANS, ALL GROWN UP

2,958 per year in hospital expenses and

Persistent social networks: Civil war veterans who fought together co-locate in later life

4,908 per year for other medical services, supplies and adaptive equipment. Personal assistance costs and costs of institutional care will average

A Lot More to Do: The Sensitivity of Time-Series Cross-Section Analyses to Simple Alternative Specifications

6,269 per year. These cost estimates represent the incremental costs of SCI, ie they exclude any costs that would have been incurred in the absence of SCI.

More Dollars than Sense: Refining Our Knowledge of Development Finance Using AidData

This article investigates the impact of military service on the duration of a veterans first marriage, a topic in the literature with both scant and highly contradictory conclusions. Our sample consisted of 3,800 males from the National Survey of Families and Households (1987-1994). Using hazard rate analysis, we estimate the impact of both combat and noncombat assignments on marital duration. Our statistical results imply: (1) self-reported participation in combat increases the hazard rate for marital dissolution by over 60 percent; (2) time of marriage (whether before, during, or after the war) does not affect dissolution, except for wartime marriages during WWII, where the effect is strong; and (3) the effects of war differ significantly across the major U.S. wars; surprisingly, the strongest negative impact on duration occurs with the neglected Korean War veterans.

Chasing Success: Health Sector Aid and Mortality

The Union Army disability pension was an early experiment in colorblind social policy. However, it shortchanged Blacks in 2 ways. First, the law was unable to account for the challenges Blacks faced in proving their eligibility because of the legacy of slavery and discrimination against Black troops during the Civil War. Second, the increasing leniency accorded White soldiers by the Pension Bureau was not extended in the same measure to Blacks. Active discrimination against Blacks resulted in part from local discretion, evidenced by the significantly lower approval rates for both White and Black veterans in the South. Furthermore, when Whites and Blacks claimed disabilities that were easily verifiable, outcomes were similar, but when verification required a degree of trust, Blacks fared considerably worse than Whites.