IDEAS home Printed from https://ideas.repec.org/p/wbk/wbrwps/3324.html
   My bibliography  Save this paper

Health care decisions as a family matter - intra-household education externalities and the utilization of health services

Author

Listed:
  • Lindelow, Magnus

Abstract

The author is concerned with the role of education as a determinant of health care choices. His central premise is that utilization of health services is determined not solely by an individual's own education, but rather by a notion of effective education, which incorporates the educational attainment of other household members. The author sets out a general framework for representing intra-household education externalities, and proposes a number of specific hypotheses concerning the way in which the education of different household members affects health care choices. He tests these hypotheses on data from Mozambique, focusing on maternity services and child immunizations. The author draws five major conclusions from the analysis. First, while maternal education seems to be the education variable of primary importance for the health care choices under consideration, the education of other household members has a significant and sometimes large effect. Second, his analysis suggests that while the education of the person (non-spouse) in the household with the highest-level education is important,the level of education of additional household members does not have an impact on health care choices. Third, the data provide no evidence of a gender difference in education externalities. Fourth, the author examines the merits of two alternative representations of the education externality, but is unable to conclude unambiguously in favor of one specification over the other. Finally, although the analysis highlights the importance of both education and a number of other explanatory variables in understanding health care choices, spatial fixed effects remain highly significant.

Suggested Citation

  • Lindelow, Magnus, 2004. "Health care decisions as a family matter - intra-household education externalities and the utilization of health services," Policy Research Working Paper Series 3324, The World Bank.
    • Handle: RePEc:wbk:wbrwps:3324
    as

    Download full text from publisher

    File URL: http://www-wds.worldbank.org/external/default/WDSContentServer/WDSP/IB/2004/08/04/000012009_20040804140329/Rendered/PDF/WPS3324.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. John Strauss & Duncan Thomas, 1998. "Health, Nutrition, and Economic Development," Journal of Economic Literature, American Economic Association, vol. 36(2), pages 766-817, June.
    2. Hossain, Shaikh I., 1989. "Effect of public programs on family size, child education and health," Journal of Development Economics, Elsevier, vol. 30(1), pages 145-158, January.
    3. Kim Streatfield & Masri Singarimbun & Ian Diamond, 1990. "Maternal Education and Child Immunization," Demography, Springer;Population Association of America (PAA), vol. 27(3), pages 447-455, August.
    4. Margaret Grosh & Paul Glewwe, 2000. "Designing Household Survey Questionnaires for Developing Countries," World Bank Publications - Books, The World Bank Group, number 25338.
    5. Panis, Constantijn W. A. & Lillard, Lee A., 1994. "Health inputs and child mortality: Malaysia," Journal of Health Economics, Elsevier, vol. 13(4), pages 455-489.
    6. Anastasia Gage & A. Sommerfelt & Andrea Piani, 1997. "Household structure and childhood immunization in Niger and Nigeria," Demography, Springer;Population Association of America (PAA), vol. 34(2), pages 295-309, May.
    7. Foster, Andrew D & Rosenzweig, Mark R, 1996. "Technical Change and Human-Capital Returns and Investments: Evidence from the Green Revolution," American Economic Review, American Economic Association, vol. 86(4), pages 931-953, September.
    8. Davidson, Russell & MacKinnon, James G., 1993. "Estimation and Inference in Econometrics," OUP Catalogue, Oxford University Press, number 9780195060119.
    9. Guilkey, David K. & Riphahn, Regina T., 1998. "The determinants of child mortality in the Philippines: estimation of a structural model," Journal of Development Economics, Elsevier, vol. 56(2), pages 281-305, August.
    10. Barrera, Albino, 1990. "The role of maternal schooling and its interaction with public health programs in child health production," Journal of Development Economics, Elsevier, vol. 32(1), pages 69-91, January.
    11. Mwabu, Germano M., 1986. "Health care decisions at the household level: Results of a rural health survey in Kenya," Social Science & Medicine, Elsevier, vol. 22(3), pages 315-319, January.
    12. Gibson, John, 2001. "Literacy and Intrahousehold Externalities," World Development, Elsevier, vol. 29(1), pages 155-166, January.
    13. Lavy, Victor & Strauss, John & Thomas, Duncan & de Vreyer, Philippe, 1996. "Quality of health care, survival and health outcomes in Ghana," Journal of Health Economics, Elsevier, vol. 15(3), pages 333-357, June.
    14. Akin, John S & Griffin, Charles C & Guilkey, David K & Popkin, Barry M, 1986. "The Demand for Primary Health Care Services in the Bicol Region of the Philippines," Economic Development and Cultural Change, University of Chicago Press, vol. 34(4), pages 755-782, July.
    15. Basu, Kaushik & Narayan, Ambar & Ravallion, Martin, 2001. "Is literacy shared within households? Theory and evidence for Bangladesh," Labour Economics, Elsevier, vol. 8(6), pages 649-665, December.
    16. Basu, Kaushik & Narayan, Ambar & Ravallion, Martin, 1999. "Is knowledge shared within households?," Policy Research Working Paper Series 2261, The World Bank.
    17. Hollis Chenery† & T.N. Srinivasan (ed.), 1988. "Handbook of Development Economics," Handbook of Development Economics, Elsevier, edition 1, volume 1, number 1.
    18. Behrman, Jere R. & Deolalikar, Anil B., 1988. "Health and nutrition," Handbook of Development Economics, in: Hollis Chenery & T.N. Srinivasan (ed.), Handbook of Development Economics, edition 1, volume 1, chapter 14, pages 631-711, Elsevier.
    19. Gertler, Paul & Rahman, Omar & Feifer, Chris & Ashley, Deanna, 1993. "Determinants of pregnancy outcomes and targeting of maternal health services in Jamaica," Social Science & Medicine, Elsevier, vol. 37(2), pages 199-211, July.
    20. Schwartz, J Brad & Akin, John S & Popkin, Barry M, 1988. "Price and Income Elasticities of Demand for Modern Health Care: The Case of Infant Delivery in the Philippines," The World Bank Economic Review, World Bank, vol. 2(1), pages 49-76, January.
    21. Wolfe, Barbara L & Behrman, Jere R, 1984. "Determinants of Women's Health Status and Health-Care Utilization in a Developing Country: A Latent Variable Approach," The Review of Economics and Statistics, MIT Press, vol. 66(4), pages 696-703, November.
    22. Wong, Emelita L. & Popkin, Barry M. & Guilkey, David K. & Akin, John S., 1987. "Accessibility, quality of care and prenatal care use in the Philippines," Social Science & Medicine, Elsevier, vol. 24(11), pages 927-944, January.
    23. Wolfe, Barbara L. & Behrman, Jere R., 1982. "Determinants of child mortality, health, and nutrition in a developing country," Journal of Development Economics, Elsevier, vol. 11(2), pages 163-193, October.
    24. Gertler, Paul & Locay, Luis & Sanderson, Warren, 1987. "Are user fees regressive? : The welfare implications of health care financing proposals in Peru," Journal of Econometrics, Elsevier, vol. 36(1-2), pages 67-88.
    25. Basu, Kaushik & Foster, James E, 1998. "On Measuring Literacy," Economic Journal, Royal Economic Society, vol. 108(451), pages 1733-1749, November.
    26. T. Paul Schultz, 1999. "Health and Schooling Investments in Africa," Journal of Economic Perspectives, American Economic Association, vol. 13(3), pages 67-88, Summer.
    27. 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.
    28. Behrman, Jere R. & Wolfe, Barbara L., 1987. "How does mother's schooling affect family health, nutrition, medical care usage, and household sanitation?," Journal of Econometrics, Elsevier, vol. 36(1-2), pages 185-204.
    29. Michael Grossman, 1972. "The Demand for Health: A Theoretical and Empirical Investigation," NBER Books, National Bureau of Economic Research, Inc, number gros72-1.
    30. Sonalde Desai & Soumya Alva, 1998. "Maternal education and child health: Is there a strong causal relationship?," Demography, Springer;Population Association of America (PAA), vol. 35(1), pages 71-81, February.
    31. Benefo, Kofi & Schultz, T Paul, 1996. "Fertility and Child Mortality in Cote d'Ivoire and Ghana," The World Bank Economic Review, World Bank, vol. 10(1), pages 123-158, January.
    32. Strauss, John & Thomas, Duncan, 1995. "Human resources: Empirical modeling of household and family decisions," Handbook of Development Economics, in: Hollis Chenery & T.N. Srinivasan (ed.), Handbook of Development Economics, edition 1, volume 3, chapter 34, pages 1883-2023, Elsevier.
    33. Anne Pebley & Noreen Goldman & Germán Rodríguez, 1996. "Prenatal and delivery care and childhood immunization in guatemala: Do family and community matter?," Demography, Springer;Population Association of America (PAA), vol. 33(2), pages 231-247, May.
    34. Fiona Steele & Ian Diamond & Sajeda Amin, 1996. "Immunization Uptake in Rural Bangladesh: A Multilevel Analysis," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 159(2), pages 289-299, March.
    35. Bicego, George T. & Ties Boerma, J., 1993. "Maternal education and child survival: A comparative study of survey data from 17 countries," Social Science & Medicine, Elsevier, vol. 36(9), pages 1207-1227, May.
    36. Ryan, Gery W., 1998. "What do sequential behavioral patterns suggest about the medical decision-making process?: Modeling home case management of acute illnesses in a rural Cameroonian village," Social Science & Medicine, Elsevier, vol. 46(2), pages 209-225, January.
    37. Thomas, Duncan & Strauss, John & Henriques, Maria-Helena, 1990. "Child survival, height for age and household characteristics in Brazil," Journal of Development Economics, Elsevier, vol. 33(2), pages 197-234, October.
    38. Strauss, J. & Thomas, D., 1995. "Empirical Modeling of Household and Family Decisions," Papers 95-12, RAND - Reprint Series.
    39. Paul Glewwe, 1999. "Why Does Mother's Schooling Raise Child Health in Developing Countries? Evidence from Morocco," Journal of Human Resources, University of Wisconsin Press, vol. 34(1), pages 124-159.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Yared Seid, 2021. "Do illiterate mothers learn from their literate kids? Evidence from maternal nutritional knowledge," Review of Development Economics, Wiley Blackwell, vol. 25(2), pages 677-693, May.
    2. Philip H. Brown & Caroline Theoharides, 2009. "Health‐seeking behavior and hospital choice in China's New Cooperative Medical System," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 47-64, July.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Somanathan, Aparnaa, 2008. "Use of modern medical care for pregnancy and childbirth care : does female schooling matter ?," Policy Research Working Paper Series 4625, The World Bank.
    2. Gustav Ranis & Frances Stewart, 2000. "Strategies for Success in Human Development," Journal of Human Development and Capabilities, Taylor & Francis Journals, vol. 1(1), pages 49-69.
    3. Francesco Burchi, 2012. "Whose education affects a child’s nutritional status? From parents' to household's education," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 27(23), pages 681-704.
    4. Gustav Ranis, 2000. "Strategies for Success in Human Development," Working Papers 808, Economic Growth Center, Yale University.
    5. Alejandro Ramirez & Gustav Ranis, 1997. "Economic Growth and Human Development," Working Papers 787, Economic Growth Center, Yale University.
    6. Ahsan, Md Nazmul & Maharaj, Riddhi, 2018. "Parental human capital and child health at birth in India," Economics & Human Biology, Elsevier, vol. 30(C), pages 130-149.
    7. Aslam, Monazza & Kingdon, Geeta Gandhi, 2012. "Parental Education and Child Health—Understanding the Pathways of Impact in Pakistan," World Development, Elsevier, vol. 40(10), pages 2014-2032.
    8. Vikram, Kriti & Vanneman, Reeve & Desai, Sonalde, 2012. "Linkages between maternal education and childhood immunization in India," Social Science & Medicine, Elsevier, vol. 75(2), pages 331-339.
    9. Regina Fuchs & Elsie Pamuk & Wolfgang Lutz, 2010. "Education or wealth: which matters more for reducing child mortality in developing countries?," Vienna Yearbook of Population Research, Vienna Institute of Demography (VID) of the Austrian Academy of Sciences in Vienna, vol. 8(1), pages 175-199.
    10. Rubalcava, Luis N. & Teruel, Graciela M., 2004. "The role of maternal cognitive ability on child health," Economics & Human Biology, Elsevier, vol. 2(3), pages 439-455, December.
    11. Marini, Alessandra & Gragnolati, Michele, 2003. "Malnutrition and poverty in Guatemala," Policy Research Working Paper Series 2967, The World Bank.
    12. Subha Mani, 2012. "Is there Complete, Partial, or No Recovery from Childhood Malnutrition? – Empirical Evidence from Indonesia," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 74(5), pages 691-715, October.
    13. Steven Block, 2002. "Nutrition Knowledge Versus Schooling in the Demand for Child Micronutrient Status," Working Papers in Food Policy and Nutrition 10, Friedman School of Nutrition Science and Policy.
    14. Ranis, Gustav & Stewart, Frances & Ramirez, Alejandro, 2000. "Economic Growth and Human Development," World Development, Elsevier, vol. 28(2), pages 197-219, February.
    15. Magnus Lindelow, 2004. "The Utilization of Curative Health Care in Mozambique: Does Income Matter?," Development and Comp Systems 0409057, University Library of Munich, Germany.
    16. Chen, Yuyu & Li, Hongbin, 2009. "Mother's education and child health: Is there a nurturing effect?," Journal of Health Economics, Elsevier, vol. 28(2), pages 413-426, March.
    17. Sadique, M. Z. & Asadullah, M. N., 2006. "Identifying the effect of public health program on child immunisation in rural Bangladesh," Working Papers 06/06, Department of Economics, City University London.
    18. Karki Nepal, Apsara, 2018. "What matters more for child health: A father’s education or mother’s education?," World Development Perspectives, Elsevier, vol. 10, pages 24-33.
    19. Edgar Villa & Patricia Medrano & Catherine Rodríguez, 2004. "Does mother’s education matter in child’s health? Evidence from South Africa," Econometric Society 2004 Latin American Meetings 229, Econometric Society.
    20. Steven Block, 2003. "Nutrition Knowledge, Household Coping, and the Demand for Micronutrient-Rich Foods," Working Papers in Food Policy and Nutrition 20, Friedman School of Nutrition Science and Policy.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wbk:wbrwps:3324. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Roula I. Yazigi (email available below). General contact details of provider: https://edirc.repec.org/data/dvewbus.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.