Health Care Decisions as a Family Matter: Intrahousehold Education Externalities and the Utilization of Health Services
The author is concerned with the role of education as a determinant of health care choices. His central premise is that utilization of health services is determined not solely by an individual's own education, but rather by a notion of effecti...
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| Format: | Policy Research Working Paper |
| Language: | English en_US |
| Published: |
World Bank, Washington, D.C.
2013
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| Online Access: | http://documents.worldbank.org/curated/en/2004/06/4999222/health-care-decisions-family-matter-intra-household-education-externalities-utilization-health-services http://hdl.handle.net/10986/14175 |
| Summary: | The author is concerned with the role of
education as a determinant of health care choices. His
central premise is that utilization of health services is
determined not solely by an individual's own education,
but rather by a notion of effective education, which
incorporates the educational attainment of other household
members. The author sets out a general framework for
representing intra-household education externalities, and
proposes a number of specific hypotheses concerning the way
in which the education of different household members
affects health care choices. He tests these hypotheses on
data from Mozambique, focusing on maternity services and
child immunizations. The author draws five major conclusions
from the analysis. First, while maternal education seems to
be the education variable of primary importance for the
health care choices under consideration, the education of
other household members has a significant and sometimes
large effect. Second, his analysis suggests that while the
education of the person (non-spouse) in the household with
the highest-level education is important, the level of
education of additional household members does not have an
impact on health care choices. Third, the data provide no
evidence of a gender difference in education externalities.
Fourth, the author examines the merits of two alternative
representations of the education externality, but is unable
to conclude unambiguously in favor of one specification over
the other. Finally, although the analysis highlights the
importance of both education and a number of other
explanatory variables in understanding health care choices,
spatial fixed effects remain highly significant. |
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