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The health knowledge mechanism: evidence on the link between education and health lifestyle in the Philippines

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  • Roman Hoffmann

    (Austrian Academy of Sciences)

  • Sebastian Uljas Lutz

    (Vienna University of Economics and Business)

Abstract

Studies have found substantial differences in health-related behavior and health care usage between educational groups, which may explain part of the well-documented educational gradient in health. The allocative efficiency hypothesis offers a behavioral explanation for these reported differences. According to this theory, the educated possess more health knowledge and information, allowing them to make better health choices. We perform a mediation analysis to study this mechanism using original survey data from the Philippines, a lower-middle-income country. As an extension of previous empirical research, we construct a comprehensive index that captures different dimensions of health knowledge. Using generalized propensity scores, we find strong support for the allocative efficiency argument. Schooling is significantly associated with health knowledge levels, which explain up to 69% of the education effect on health lifestyle. This corresponds to twice the mediation strength of economic resources, suggesting an important role of this factor in explaining education effects on health decisions.

Suggested Citation

  • Roman Hoffmann & Sebastian Uljas Lutz, 2019. "The health knowledge mechanism: evidence on the link between education and health lifestyle in the Philippines," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(1), pages 27-43, February.
    • Handle: RePEc:spr:eujhec:v:20:y:2019:i:1:d:10.1007_s10198-017-0950-2
    DOI: 10.1007/s10198-017-0950-2
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    as
    1. Michael Kremer & Edward Miguel, 2007. "The Illusion of Sustainability," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 122(3), pages 1007-1065.
    2. Victor R. Fuchs, 1982. "Economic Aspects of Health," NBER Books, National Bureau of Economic Research, Inc, number fuch82-1, June.
    3. Oster, Emily, 2012. "HIV and sexual behavior change: Why not Africa?," Journal of Health Economics, Elsevier, vol. 31(1), pages 35-49.
    4. Ettner, Susan L., 1996. "New evidence on the relationship between income and health," Journal of Health Economics, Elsevier, vol. 15(1), pages 67-85, February.
    5. Grossman, Michael, 2006. "Education and Nonmarket Outcomes," Handbook of the Economics of Education, in: Erik Hanushek & F. Welch (ed.), Handbook of the Economics of Education, edition 1, volume 1, chapter 10, pages 577-633, Elsevier.
    6. Marjon van der Pol, 2011. "Health, education and time preference," Health Economics, John Wiley & Sons, Ltd., vol. 20(8), pages 917-929, August.
    7. Johnston, David W. & Lordan, Grace & Shields, Michael A. & Suziedelyte, Agne, 2015. "Education and health knowledge: Evidence from UK compulsory schooling reform," Social Science & Medicine, Elsevier, vol. 127(C), pages 92-100.
    8. Govert e. Bijwaard & Hans Van Kippersluis, 2016. "Efficiency of Health Investment: Education or Intelligence?," Health Economics, John Wiley & Sons, Ltd., vol. 25(9), pages 1056-1072, September.
    9. Gabriel Picone & Frank Sloan & Donald Taylor, 2004. "Effects of Risk and Time Preference and Expected Longevity on Demand for Medical Tests," Journal of Risk and Uncertainty, Springer, vol. 28(1), pages 39-53, January.
    10. Erik Hanushek & F. Welch (ed.), 2006. "Handbook of the Economics of Education," Handbook of the Economics of Education, Elsevier, edition 1, volume 1, number 1, June.
    11. Park, Cheolsung & Kang, Changhui, 2008. "Does education induce healthy lifestyle?," Journal of Health Economics, Elsevier, vol. 27(6), pages 1516-1531, December.
    12. Aboud, Frances E. & Singla, Daisy R., 2012. "Challenges to changing health behaviours in developing countries: A critical overview," Social Science & Medicine, Elsevier, vol. 75(4), pages 589-594.
    13. Victor R. Fuchs, 1982. "Time Preference and Health: An Exploratory Study," NBER Chapters, in: Economic Aspects of Health, pages 93-120, National Bureau of Economic Research, Inc.
    14. Pascaline Dupas, 2011. "Do Teenagers Respond to HIV Risk Information? Evidence from a Field Experiment in Kenya," American Economic Journal: Applied Economics, American Economic Association, vol. 3(1), pages 1-34, January.
    15. de Walque, Damien, 2007. "How does the impact of an HIV/AIDS information campaign vary with educational attainment? Evidence from rural Uganda," Journal of Development Economics, Elsevier, vol. 84(2), pages 686-714, November.
    16. Ulrich Kohler & Kristian Bernt Karlson & Anders Holm, 2011. "Comparing coefficients of nested nonlinear probability models," Stata Journal, StataCorp LP, vol. 11(3), pages 420-438, September.
    17. Halliday, Timothy J. & He, Hui & Ning, Lei & Zhang, Hao, 2019. "Health Investment Over The Life-Cycle," Macroeconomic Dynamics, Cambridge University Press, vol. 23(1), pages 178-215, January.
    18. Pascaline Dupas, 2009. "What Matters (and What Does Not) in Households' Decision to Invest in Malaria Prevention?," American Economic Review, American Economic Association, vol. 99(2), pages 224-230, May.
    19. Eide, Eric R. & Showalter, Mark H., 2011. "Estimating the relation between health and education: What do we know and what do we need to know?," Economics of Education Review, Elsevier, vol. 30(5), pages 778-791, October.
    20. Kluve, Jochen & Schneider, Hilmar & Uhlendorff, Arne & Zhao, Zhong, 2007. "Evaluating Continuous Training Programs Using the Generalized Propensity Score," Ruhr Economic Papers 35, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    21. Anna Aizer & Laura Stroud, 2010. "Education, Knowledge and the Evolution of Disparities in Health," NBER Working Papers 15840, National Bureau of Economic Research, Inc.
    22. Lange, Fabian, 2011. "The role of education in complex health decisions: Evidence from cancer screening," Journal of Health Economics, Elsevier, vol. 30(1), pages 43-54, January.
    23. Rosenzweig, Mark R & Schultz, T Paul, 1989. "Schooling, Information and Nonmarket Productivity: Contraceptive Use and Its Effectiveness," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 30(2), pages 457-477, May.
    24. Arendt, Jacob Nielsen, 2008. "In sickness and in health--Till education do us part: Education effects on hospitalization," Economics of Education Review, Elsevier, vol. 27(2), pages 161-172, April.
    25. Erik Hanushek & F. Welch (ed.), 2006. "Handbook of the Economics of Education," Handbook of the Economics of Education, Elsevier, edition 1, volume 2, number 2, June.
    26. Cutler, David M. & Lleras-Muney, Adriana, 2010. "Understanding differences in health behaviors by education," Journal of Health Economics, Elsevier, vol. 29(1), pages 1-28, January.
    27. M. Christopher Auld & Nirmal Sidhu, 2005. "Schooling, cognitive ability and health," Health Economics, John Wiley & Sons, Ltd., vol. 14(10), pages 1019-1034, October.
    28. Jochen Kluve & Hilmar Schneider & Arne Uhlendorff & Zhong Zhao, 2012. "Evaluating continuous training programmes by using the generalized propensity score," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 175(2), pages 587-617, April.
    29. Altindag, Duha & Cannonier, Colin & Mocan, Naci, 2011. "The impact of education on health knowledge," Economics of Education Review, Elsevier, vol. 30(5), pages 792-812, October.
    30. Kemptner, Daniel & Jürges, Hendrik & Reinhold, Steffen, 2011. "Changes in compulsory schooling and the causal effect of education on health: Evidence from Germany," Journal of Health Economics, Elsevier, vol. 30(2), pages 340-354, March.
    31. Tenn, Steven & Herman, Douglas A. & Wendling, Brett, 2010. "The role of education in the production of health: An empirical analysis of smoking behavior," Journal of Health Economics, Elsevier, vol. 29(3), pages 404-417, May.
    32. Jessica Cohen & Pascaline Dupas & Simone Schaner, 2015. "Price Subsidies, Diagnostic Tests, and Targeting of Malaria Treatment: Evidence from a Randomized Controlled Trial," American Economic Review, American Economic Association, vol. 105(2), pages 609-645, February.
    33. Cairncross, Sandy & Shordt, Kathleen & Zacharia, Suma & Govindan, Beena Kumari, 2005. "What causes sustainable changes in hygiene behaviour? A cross-sectional study from Kerala, India," Social Science & Medicine, Elsevier, vol. 61(10), pages 2212-2220, November.
    34. Hoffmann, Roman & Muttarak, Raya, 2017. "Learn from the Past, Prepare for the Future: Impacts of Education and Experience on Disaster Preparedness in the Philippines and Thailand," World Development, Elsevier, vol. 96(C), pages 32-51.
    35. Ellen Meara, 2001. "Why is Health Related to Socioeconomic Status?," NBER Working Papers 8231, National Bureau of Economic Research, Inc.
    36. Gary S. Becker, 1962. "Investment in Human Capital: A Theoretical Analysis," NBER Chapters, in: Investment in Human Beings, pages 9-49, National Bureau of Economic Research, Inc.
    37. Jensen, Robert & Lleras-Muney, Adriana, 2012. "Does staying in school (and not working) prevent teen smoking and drinking?," Journal of Health Economics, Elsevier, vol. 31(4), pages 644-657.
    38. Jacobson, Lena, 2000. "The family as producer of health -- an extended grossman model," Journal of Health Economics, Elsevier, vol. 19(5), pages 611-637, September.
    39. Kenkel, Donald S, 1991. "Health Behavior, Health Knowledge, and Schooling," Journal of Political Economy, University of Chicago Press, vol. 99(2), pages 287-305, April.
    40. Jürges, Hendrik & Reinhold, Steffen & Salm, Martin, 2011. "Does schooling affect health behavior? Evidence from the educational expansion in Western Germany," Economics of Education Review, Elsevier, vol. 30(5), pages 862-872, October.
    41. Böckerman, Petri & Maczulskij, Terhi, 2016. "The Education-health Nexus: Fact and fiction," Social Science & Medicine, Elsevier, vol. 150(C), pages 112-116.
    42. Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-255, March-Apr.
    43. Grossman, Michael, 2000. "The human capital model," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 7, pages 347-408, Elsevier.
    44. Muurinen, Jaana-Marja, 1982. "Demand for health: A generalised Grossman model," Journal of Health Economics, Elsevier, vol. 1(1), pages 5-28, May.
    45. Ashraf, Nava & Jack, B. Kelsey & Kamenica, Emir, 2013. "Information and subsidies: Complements or substitutes?," Journal of Economic Behavior & Organization, Elsevier, vol. 88(C), pages 133-139.
    46. Ulrich Kohler, 2011. "Comparing coefficients between nested nonlinear probability models," German Stata Users' Group Meetings 2011 08, Stata Users Group.
    47. Robyn, Paul Jacob & Fink, Günther & Sié, Ali & Sauerborn, Rainer, 2012. "Health insurance and health-seeking behavior: Evidence from a randomized community-based insurance rollout in rural Burkina Faso," Social Science & Medicine, Elsevier, vol. 75(4), pages 595-603.
    48. Schultz, Theodore W, 1975. "The Value of the Ability to Deal with Disequilibria," Journal of Economic Literature, American Economic Association, vol. 13(3), pages 827-846, September.
    49. Pascaline Dupas, 2011. "Health Behavior in Developing Countries," Annual Review of Economics, Annual Reviews, vol. 3(1), pages 425-449, September.
    50. Yoram Ben-Porath, 1967. "The Production of Human Capital and the Life Cycle of Earnings," Journal of Political Economy, University of Chicago Press, vol. 75(4), pages 352-352.
    51. Fuchs, Victor R. (ed.), 1982. "Economic Aspects of Health," National Bureau of Economic Research Books, University of Chicago Press, number 9780226267852, July.
    52. de Walque, Damien, 2007. "Does education affect smoking behaviors?: Evidence using the Vietnam draft as an instrument for college education," Journal of Health Economics, Elsevier, vol. 26(5), pages 877-895, September.
    53. Jochen Kluve & Hilmar Schneider & Arne Uhlendorff & Zhong Zhao, 2012. "Evaluating continuous training programmes by using the generalized propensity score," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 175(2), pages 587-617, April.
    54. A. J. Culyer & J. P. Newhouse (ed.), 2000. "Handbook of Health Economics," Handbook of Health Economics, Elsevier, edition 1, volume 1, number 1.
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    More about this item

    Keywords

    Education; Health knowledge; Health lifestyle; Allocative efficiency; Developing country; Philippines;
    All these keywords.

    JEL classification:

    • D83 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Search; Learning; Information and Knowledge; Communication; Belief; Unawareness
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • I26 - Health, Education, and Welfare - - Education - - - Returns to Education
    • O2 - Economic Development, Innovation, Technological Change, and Growth - - Development Planning and Policy

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