CAS EC 387 Introduction to Health Economics

L3: Demand for Health and Health Care I

Department of Economics

Spring 2020

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Decline in Mortality over Time I

Major causes of declining mortality

The last two centuries have seen a dramatic and unprecedented
population growth due to a major decline in mortality

The following explanations are commonly cited:

Improved nutrition
Public health measures
Medical progress

Improved nutrition
economic/technological progress =) higher caloric intake =) higher
resistance to disease

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Decline in Mortality over Time II

steady rise in ’living standards’and the associated rise in average

nutritional intake
municipal sanitation and hygiene improvements positive but secondary
factors, (only assumed importance during the last third of the 19th
century)
GDP and mortality - the Preston curve

Public health measures and germ theory

sanitation, sewage systems, pasteurization
reduction in airborne diseases largest contribution to reduced mortality
(TB, bronchitis, pneumonia, in‡uenza)
also decline in waterborne diseases (cholera, dysentery) but 95% of
decline in waterborne diseases occured before therapies

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Decline in Mortality over Time III

Medical progress
most important mortality reducer after 1950 (cardiovascular, neo-natal
care)
improved quality of life, longer life expectancy from various conditions

Individual behavior most important determinant of health?

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Decline in Mortality the Past Fifty Years

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Lifestyle and Health I

Lifestyle and mortality rates

Classic study: mortality in Nevada and Utah (Fuchs, 1974)

States are similar in many ways:

geography
average income levels
average education
health care spending

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Lifestyle and Health II

Di¤erent in behavioral aspects:

smoking
drinking
gambling
divorce rates
geographical instability

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Lifestyle and Health III

Large and signi…cant di¤erences in mortality rates for all age groups:

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Life Expectancy and Income
The Preston curve

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Life Expectancy and Income Inequality Developed
Countries

Source: Wilkinson and Pickett, The Spirit Level, The Equality Trust

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Infant Mortality and Inequality I

Source: Wilkinson and Pickett, The Spirit Level, The Equality Trust

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Health and Income Inequality I

Source: Wilkinson and Pickett, The Spirit Level, The Equality Trust

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Health and Income Inequality US States

Source: Wilkinson and Pickett, The Spirit Level, The Equality Trust

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Health and Average Income

Source: Wilkinson and Pickett, The Spirit Level, The Equality Trust

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Child Well-being and Income Inequailty

Source: Wilkinson and Pickett, The Spirit Level, The Equality Trust

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Adult Obesity and Income Inequailty

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Mental Illness and Income Inequality I

Source: Wilkinson and Pickett, The Spirit Level, The Equality Trust

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Drug Use and Income Inequality I

Source: Wilkinson and Pickett, The Spirit Level, The Equality Trust

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