Health status convergence at the local level: empirical evidence from Austria

Abstract

IntroductionHealth is an important dimension of welfare comparisons across individuals, regions and states. Particularly from a long-term perspective, within-country convergence of the health status has rarely been investigated by applying methods well established in other scientific fields. In the following paper we study the relation between initial levels of the health status and its improvement at the local community level in Austria in the time period 1969-2004.MethodsWe use age standardized mortality rates from 2381 Austrian communities as an indicator for the health status and analyze the convergence/divergence of overall mortality for (i) the whole population, (ii) females, (iii) males and (iv) the gender mortality gap. Convergence/Divergence is studied by applying different concepts of cross-regional inequality (weighted standard deviation, coefficient of variation, Theil-Coefficient of inequality). Various econometric techniques (weighted OLS, Quantile Regression, Kendall's Rank Concordance) are used to test for absolute and conditional beta-convergence in mortality.ResultsRegarding sigma-convergence, we find rather mixed results. While the weighted standard deviation indicates an increase in equality for all four variables, the picture appears less clear when correcting for the decreasing mean in the distribution. However, we find highly significant coefficients for absolute and conditional beta-convergence between the periods. While these results are confirmed by several robustness tests, we also find evidence for the existence of convergence clubs.ConclusionsThe highly significant beta-convergence across communities might be caused by (i) the efforts to harmonize and centralize the health policy at the federal level in Austria since the 1970s, (ii) the diminishing returns of the input factors in the health production function, which might lead to convergence, as the general conditions (e.g. income, education etc.) improve over time, and (iii) the mobility of people across regions, as people tend to move to regions/communities which exhibit more favorable living conditions.JEL classification: I10, I12, I18

Sigma and beta convergence in regional mortality: A case study of the Netherlands

“…Both within the United Kingdom (Boyle, Exeter, and Flowerdew 2004;Leyland 2004;Dorling 1997;Leyland 2004;Shaw et al 1999;, between provinces in Canada (Mustard, Derksen, and Black 1999;Manuel and Hockin 2000), and for the 2,068 counties in the United States (Ezzati et al 2008), a tendency from convergence in the past to divergence in the more recent past follows from the various studies; in New Zealand, recent divergence has been observed as well (Pearce and Dorling 2006). On the other hand, Gächter and Theurl (2011) observed continuing convergence in Austria. In addition, Valkonen (2001) observed clear differences between several European countries in the trend in regional differences.…”

“…Valkonen (2001) also stressed the need for systematic studies on the trends in differential mortality, including mortality by region. Convergence of health due to diminishing returns of increases in health expenditures, improvement of education, and economic development is to be expected (Gächter and Theurl 2011). By contrast, divergence may occur due to the 'Matthew effect': regions with high life expectancy may experience even faster improvements.…”

“…In economic literature, however, a clear distinction is being made between sigma convergence and beta convergence following the work by Barro (e.g., Sala-i-Martin 1990, 1992) and with recent applications to the study of health convergence (Nixon 2000;MonteroGranados, de Dios Jiménez, and Martín 2007;Gächter and Theurl 2011). Where sigma convergence concerns the formal study of trends over time in cross-sectional dispersion measures, beta convergence formally explores regression towards the mean of the different values over time (Barro and Sala-i-Martin 1992;Nixon 2000;MonteroGranados, de Dios Jiménez, and Martín 2007;Gächter and Theurl 2011).…”

Demographic Convergence and its Linkage with Health Inequalities in India

“…Few studies also suggested such resurgence led to a recent setback in convergence of life expectancy at birth across the countries worldwide. This is also mainly attributable to unequal progress of public health outcomes across the world countries McMichael et al, 2004;Becker et al, 2005;Moser et al, 2005;Bloom and Canning, 2007;Dorius, 2008Dorius, , 2010Clark, 2011;Gächter and Engelbert, 2011). However, there are no studies across the world or in India, which focused on transition in maternal and child health care and outcome indicators.…”

“…Few studies also suggested recent setbacks in convergence of life expectancy at birth across the countries worldwide McMichael et al, 2004;Becker et al, 2005;Moser et al 2005;Bloom and Canning, 2009, Dorius, 2008Clark, 2011;Gächter and Engelbert, 2011). The expectation that emerged in the 1960s and 1970s of the world gains in LEB does not guarantee convergence in population health status by a general deterministic process (McMichael et al, 2004).…”