Volume 28, Number 4 (Fall) 1993
Strauss, John, Paul Gertler, Omar Rahman, and Kristin Fox. 1993. "Gender and Life-Cycle Differentials in the Patterns and Determinants of Adult Health." Journal of Human Resources 28(4):791-837.
This study investigates the socioeconomic determinants of adult ill-health in developing countries. We use as measures of health, self-reported general health plus a variety of measures of problems in physical functioning. We begin by comparing measures of adult ill-health in four countries: Bangladesh, Jamaica, Malaysia, and the United States, finding that women report more problems and at earlier ages than do men; this despite the greater longevity of women. We examine the sensitivity of these gender differentials to mortality selection and find that while accounting for this does cut down the differentials, they remain. We discuss potential reasons for these findings and then examine the Jamaican data in more detail. We formulate and estimate a reduced form economic model, focusing on the effects of education. We find strong positive effects of own education on health, mirroring results commonly found in the child health literature. At older ages, however, the education differential disappears. Per capita household expenditure, treated as endogenous, is added to the model to attempt to control for long-run income. It is not found to affect adult female health, but limited evidence is found for an effect on males. Strong residential effects exist, although the factors behind them remain to be investigated. Our most robust finding is that even controlling for socioeconomic covariates, strong life-cycle effects exist and are different for men and women. Controlling for these factors, women still report more health problems at earlier ages than do men.
John Strauss is a professor of economics at Michigan State University, Paul J Gertler and Omar Rahman are researchers at the RAND Corporation, and Kristin Fox is a researcher in the Jamaican Ministry of Health. This research was partly funded by the U.S. Bureau of Census contract number 50-YABC-1-66007, U.S. National Institutes of Child Health and Human Development grant number P01-HD28372-01 and the Safe Motherhood Initiative of the World Bank. The authors are grateful to Barbara Torrey and Kevin Kinsella for initial encouragement; to Mark Rosenzweig and T. Paul Schultz for detailed comments on an earlier draft; to Michael Grossman, Mark McClellan, Henry Mosely, Guilherme Sedlacek, James P. Smith, Duncan Thomas, and participants of the Rockefeller Foundation Conference on Women's Human Capital and Development for helpful suggestions; to the Planning Institute of Jamaica for making the data available; and to Carol Edwards, Adnan Rahman, My Vuong, and Nga Vuong for excellent programming assistance. The data used in this article can be obtained from June 1994 through June 1997 from the authors at the following address: Professor John Strauss, Department of Economics, Michigan State University, Marshall Hall, East Lansing, MI 48824.
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