健康状况不佳的终身成本
The Lifetime Costs of Bad Health
Review of Economic Studies · 2024 · [{"name": "Mariacristina De Nardi", "affiliation": ["University of Minnesota", "Federal Reserve Bank of Minneapolis"]}, {"name": "Svetlana Pashchenko", "affiliation": ["University of Georgia"]}, {"name": "Ponpoje Porapakkarm", "affiliation": ["National Graduate Institute for Policy Studies"]}]
中文摘要
摘要 是什么造成了按健康状况划分的经济结果差异？不健康的代价有多大？我们表明，即使控制个人过去的健康史，健康动态在很大程度上仍是由事前固定的异质性——即健康类型——所驱动的。事实上，健康类型是长期健康状况不佳的关键驱动因素。我们将这些丰富的健康动态纳入一个估计的结构模型，并表明健康类型及其与其他固定特征的相关性，对于解释按健康状况划分的经济结果中观察到的差距十分重要。生命周期中因健康状况不佳导致的货币损失和福利损失巨大、高度集中，且在很大程度上源于生命早期已预先决定的因素。相关货币成本中很大一部分来自收入损失，尤其是对处于工作年龄的人群而言；而福利损失中相当大一部分则源于健康状况影响了预期寿命。
Abstract
Abstract What generates the observed differences in economic outcomes by health? How costly it is to be unhealthy? We show that health dynamics are largely driven by ex-ante fixed heterogeneity, or health types, even when controlling for one’s past health history. In fact, health types are the key driver of long spells of bad health. We incorporate these rich health dynamics in an estimated structural model and show that health types and their correlation with other fixed characteristics are important to account for the observed gap in economic outcomes by health. Monetary and welfare losses due to bad health over the life-cycle are large, concentrated, and to a large extent due to factors pre-determined earlier in life. A large portion of the related monetary costs is due to income losses, especially for people of working age, while a substantial portion of the welfare losses arises because health affects life expectancy.