This paper examines the impact of universal, free, and easily accessible primary healthcare on population health as measured by age-specific mortality rates, focusing on a nationwide socialized medicine program implemented in Turkey. The Family Medicine Program (FMP), launched in 2005, assigns each Turkish citizen to a specific state-employed family physician who o↵ers a wide range of primary healthcare services that are free-of-charge. Furthermore, these services are provided at family health centers, which operate on a walk-in basis and are located within the neighborhoods in close proximity to the patients. To identify the causal impact of the FMP, we exploit the variation in its introduction across provinces and over time. Our estimates indicate that the FMP caused the mortality rate to decrease by 25.6% among infants, 7.7% among the elderly, and 22.9% among children ages 1-4. These estimates translate into 2.6, 1.29, and 0.13 fewer deaths among infants, the elderly, and children ages 1-4, respectively. Furthermore, the e↵ects appear to strengthen over time. We also show evidence to suggest that the FMP has contributed to an equalization of mortality across provinces. Finally, our calculations indicate that each family physician saves about 0.15, 0.46, and 0.005 lives among infants, the elderly, and children ages 1-4 per province every year.
We examine the impact of widespread adoption of natural gas as a source of fuel on infant mortality in Turkey, using variation across provinces and over time in the intensity of natural gas utilisation. Our estimates indicate that the expansion of natural gas infrastructure has resulted in a significant decrease in the rate of infant mortality.Specifically, a one-percentage point increase in natural gas intensity -measured by the rate of subscriptions to natural gas services -would cause the infant mortality rate to decrease by 4%, which would translate into approximately 348 infant lives saved in 2011 alone.
Wealth, Portfolio allocation, Elderly, Marital history,
One of the consequences of rapid economic growth and industrialization in the developing world has been deterioration in environmental conditions and air quality. While air pollution is a serious threat to health in most developing countries, environmental regulations are rare and the determination to address the problem is weak due to ongoing pressures to sustain robust economic growth. Under these constraints, natural gas, as a clean, abundant, and highly-efficient source of energy, has emerged as an increasingly attractive source of fuel, which could address some of the environmental and health challenges faced by these countries without undermining their economies. In this paper, we examine the impact of air pollution on infant mortality in Turkey using variation across provinces and over time in the adoption of natural gas as a cleaner fuel. Our results indicate that the expansion of natural gas infrastructure has caused a significant decrease in the rate of infant mortality in Turkey. In particular, a onepercentage point increase in the rate of subscriptions to natural gas services would cause the infant mortality rate to decline by about 4 percent, which could result in 383 infant lives saved in 2011 alone. These results are robust to a large number of specifications. Finally, we use supplemental data on total particulate matter and sulfur dioxide to produce direct estimates of the effects of these pollutants on infant mortality using natural gas expansion as an instrument. Our elasticity estimates from the instrumental variable analysis are 1.39 for particulate matter and 0.68 for sulfur dioxide.
We use the first five waves of the Household, Income and Labour Dynamics in Australia survey to examine what determines the maternity leave taken by pre‐birth employed mothers of newborn children in Australia. We find that the difficulties faced by mothers in finding appropriate child care in terms of both cost and quality hinder them from returning to the labour market following childbirth. Maternity leave entitlements lead to an earlier return to the labour market following the birth of a child, relative to those who have no leave rights at all. Mothers with higher wages in their pre‐birth employment and mothers with higher education levels tend to return to the labour market earlier than their lower wage and less educated counterparts. More flexible pre‐birth jobs are associated with an increase in the likelihood of mothers returning to the workforce earlier than the average. Household wealth, however, seems to play a facilitating role in mothers taking a longer period of maternity leave to look after the newborn child. That is, mothers who have higher wealth levels can ‘afford’ to stay on maternity leave longer, to look after their children better during their primary developmental months. We believe that this article provides useful insights into the employment transitions of Australian mothers after having a baby.
This article focuses on the relationship between private insurance status and dental service utilisation in Australia using data between 1995 and 2001. This article employs joint maximum likelihood to estimate models of time since last dental visit treating private ancillary health insurance (PAHI) as endogenous. The sensitivity of results to the choice between two different but related types of instrumental variables is examined. We find robust evidence in both 1995 and 2001 that individuals with a PAHI policy make significantly more frequent dental consultations relative to those without such coverage. A comparison of the 1995 and 2001 results, however, suggests that there has been an increasing role of PAHI in terms of the frequency of dental consultations over time. This seems intuitive given the trends in the price of unsubsidised private dental consultations. In terms of policy, our results suggest that while government measures to increase private health insurance coverage in Australia have been successful to a significant degree, that success may have come at some cost in terms of socio‐economic inequality as the privately insured are provided much better access to care and financial protection.
Survey-based health research is in a boom phase following an increased amount of health spending in OECD countries and the interest in ageing. A general characteristic of survey-based health research is its diversity. Different studies are based on different health questions in different datasets; they use different statistical techniques; they differ in whether they approach health from an ordinal or cardinal perspective; and they differ in whether they measure short-term or long-term effects. The question in this paper is simple: do these differences matter for the findings? We investigate the effects of life-style choices (drinking, smoking, exercise) and income on six measures of health in the US Health and Retirement Study (HRS) between 1992 and 2002: (1) self-assessed general health status, (2) problems with undertaking daily tasks and chores, (3) mental health indicators, (4) BMI, (5) the presence of serious long-term health conditions, and (6) mortality. We compare ordinal models with cardinal models; we compare models with fixed effects to models without fixed-effects; and we compare short-term effects to long-term effects. We find considerable variation in the impact of different determinants on our chosen health outcome measures; we find that it matters whether ordinality or cardinality is assumed; we find substantial differences between estimates that account for fixed effects versus those that do not; and we find that short-run and long-run effects differ greatly. All this implies that health is an even more complicated notion than hitherto thought, defying generalizations from one measure to the others or one methodology to another.
Elderly, Consumption, Household structure, D12, E21, I31,
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