Health Economic Development and Policy () - Lecture Notes
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Course
Economic Health Development and Policy
Institution
Erasmus Universiteit Rotterdam (EUR)
LECTURE NOTES and Q&A
The two main aims of the course are to illustrate the link between health and economic development and to assess the rationale and effectiveness of public health expenditure, both, in the context of developing countries.
Specifically the aims are:
• To introduce particip...
• Economic Development and Policy •
2018-2019
Lecture 1
Look at child health: nutritional status.
These components were the basis of the program they developed.
The program was ruled out in some areas and then in other areas, a bit later (randomly chosen).
Height under 5years of age: predictor of future indicators.
Why economists are interested in studying health issues?
Health and illness are a major concern in social equity and justice.
• health is the basis of economic productivity
• health interacts with other inputs
• the healthier the better!
Why study health and development?
Health tends to be poor in developing countries
Diseases are widespread
— Geoclimatic
— Institutions, colonial legacy, war
Children and young adults most affected
— Shaky basis for development
Vicious circle of underdevelopment and bad health
Work is more physical in low income countries —> good health and nutrition is even more important
Health as investment in better future
Health in Development Economics: common questions in the field
· health production and determinants
· macro and micro effects of health and income
· micro and macro consequences of bad health on income
· how can we boost health efficiently?
Health and Economics:
Health is multifaceted and complex — important for worker productivity
Variables of interest:
— Nutrition (quality and quantity)
— Morbidity and mortality (statistics from hospitals…)
— Sickness spell
— Disease environment
— Health infrastructures
Health capital accumulation (i.e. height)
Health inputs and flows (nutrition)
Health shocks (diarrhea)
Lifecycle approach
Example of what Stunting leads to:
· small adult stature
· lower wages
· worse cognition skills
· chronic diseases
,Aggregate Health Measures:
— LE
— Mortality (infant and maternal) // data quality is a problem too, if you want to study this long term
— Morbidity
— Data quality
— Between cross-country vs. within country changes
All Cause of Mortality under 5
,Nutritional patterns are changing very rapidly, incomes change and junk food coming from other countries. Nutrition
value goes down.
Some survey measures:
• biomarkers
• anthropometric indicators
• nutrition inputs
• health expenditures
• self-reported health
• medical history
• maternal mortality (to expand sample size: ask about dead siblings during labour/pregnancy)
Morbidity measures:
WHO growth standards:
— Height for age (stunting)
— Weight for age
— Weight for height (wasting)
, Z-scores: standardization of anthropometric indicators (formula for measure x for a child with age in months a) take
the median to avoid the extremes
-2 and -3 is ok, anything above: severe stunting.
Child nutrition: genetic and behavioural (favour male first child)
22% under 5yo were stunted (too short for their age)
Normal distribution: polygamy and monogamy mothers — centred around -2 points
Height and weight across age groups:
After 20 months the score drops
Macro Evidence – Micro foundations (Jack and Lewis, 2009)
• how did we get so healthy?
Nutrition
Public health
Education
Vaccination
Spread of health and medical knowledge (WHO)
Lifestyle changes matter more than healthcare?
Health care spending
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