Biased Risk Perceptions of Longevity and Disability in Old Age

Rational learning theories postulate that information channels and cognitive biases such as individual optimism may influence an individuals assessment of the risk of undesired events, especially with regard to those that have a cumulative nature. This is the case with disability in old age, which may take place upon survival to an advanced age, and such factors have been regarded as responsible for certain individual behaviours (for example, the limited incidence of insurance purchase). This paper examines the determinants of individual perceptions with regard to disability in old age and longevity. The cumulative nature of such perceptions of risk is tested, and potential biases are identified, including optimism and a set of information determinants. Empirical evidence from a representative survey of Catalonia is presented to illustrate these effects. The findings from this research suggest a significant overestimation of disability in old age, yet this is not the case with longevity. Furthermore, individual perceptions with regard to disability in old age, unlike those with regard to longevity, exhibit on aggregate an optimistic bias and, are perceived as cumulative risks. Gender influences the perceived risk of disability in old age at a population level but not at the individual level, and the opposite holds true for age. Finally, self-reported health status is the main variable behind risk perceptions at both the individual and population level.longevity, disability in old age, risk perceptions, optimism, cumulative risks

Unveiling vertical state downscaling: identity and/or the economy?

State rescaling may take a variety of shapes although scant research has been carried out into the mechanisms and economic incentives that underpin rescaling processes. Recent literature in economics, economic sociology and political economy has identified at least two broad rescaling mechanisms, namely the development of regional identity - operating at the cultural level and proxing preference heterogeneity-, and the heterogeneity in levels of economic development, which influence the extent of regional redistribution. This paper empirically examines the mechanisms of vertical state rescaling by drawing upon empirical evidence from Catalonia and the Basque Country, to explore the evolution of sub-state identity and the rise of inter-territorial fiscal grievances - weakening intraregional economic solidarity. Findings corroborate the idea that the combination of widening sub-national identity raises the costs of managing heterogeneous spatial identities and strengthens support for vertical state downscaling. Similarly, ending regional fiscal solidarity it is found to increase the average income of Catalonia by 37% and even 17% in the Basque Country. However, the effect of regional identity exceeds that of regional redistribution in explaining state rescaling support in the magnitude of one to seven. These findings speak to the debate on the formation of Europe, in that they reveal limits to regional redistribution and highlight the importance of a common spatial identity

Socio-Economic Inequalities in Reported Depression in Spain : A Decomposition Approach

Recent evidence questions some conventional view on the existence of income-related inequalities in depression suggesting in turn that other determinants might be in place, such as activity status and educational attainment. Evidence of socio-economic inequalities is especially relevant in countries such as Spain that have a limited coverage of mental health care and are regionally heterogeneous. This paper aims at measuring and explaining the degree of socio-economic inequality in reported depression in Spain. We employ linear probability models to estimate the concentration index and its decomposition drawing from 2003 edition of the Spanish National Health Survey, the most recent representative health survey in Spain. Our findings point towards the existence of avoidable inequalities in the prevalence of reported depression. However, besides pure income effects explaining 37% of inequality, economic activity status (28%), education (15%) and demographics (15%) play also a key encompassing role. Although high income implies higher resources to invest and cure (mental) illness, environmental factors influencing in peoples perceived social status act as indirect path as explaining the prevalence of depression. Finally, we find evidence of a gender effect, gender social-economic inequality in income is mainly avoidable.occupational status, education, socio-economic inequities in health, depression

Generational Effects on Adult Height in Contemporary Spain: Exploring Gender and Individual Heterogeneity

As adult height is a well-established retrospective measure of health and standard of living, it is important to understand the factors that determine it. Among them, the influence of socio-environmental factors has been subjected to empirical scrutiny. This paper explores the influence of generational (or environmental) effects and individual and gender-specific heterogeneity on adult height. Our data set is from contemporary Spain, a country governed by an authoritarian regime between 1939 and 1977. First, we use normal position and quantile regression analysis to identify the determinants of self-reported adult height and to measure the influence of individual heterogeneity. Second, we use a Blinder-Oaxaca decomposition approach to explain the gender height gap and its distribution, so as to measure the influence on this gap of individual heterogeneity. Our findings suggest a significant increase in adult height in the generations that benefited from the countrys economic liberalization in the 1950s, and especially those brought up after the transition to democracy in the 1970s. In contrast, distributional effects on height suggest that only in recent generations has height increased more among the tallest. Although the mean gender height gap is 11 cm, generational effects and other controls such as individual capabilities explain on average roughly 5% of this difference, a figure that rises to 10% in the lowest 10% quantile.blinder-oaxaca decomposition, quantile regression, generational effects, adult height, gender gap, individual heterogeneity

The hedonic placebo effect of traditional medicines

To date, the scientific evidence on traditional medicines is scant and under-developed, yet, paradoxically individuals continue to use it and claim high satisfaction levels. What can explain this effect? Using self-collected data from Ghana we argue that variations in satisfaction across individuals can be attributed to the hedonic placebo effect gained from using traditional medicines, in which processes involved with its consumption are as important, if not more important, than measures of self-reported health outcome. Findings suggest that individuals’ health seeking behaviour should be evaluated using procedural, as well as outcome, utility

Decomposing Cross-Country Gaps in Obesity and Overweight: Does the Social Environment Matter?

[cat] Una qüestió clau sobre la producció de salut relativament poc explorada es refereix a la influència dels factors socioeconòmics i mediambientals sobre el pes i l’obesitat. Aquesta problemàtica adquireix particular rellevància quan es comparen dos països Mediterranis com Itàlia i Espanya. És interessant adonar-se que l’obesitat a Espanya és 5 punts percentual més elevada al 2003 mentre que a l’any 1990 era aproximadament la mateixa en ambdós països. Aquesta article presenta una descomposició no lineal dels gaps o diferencials en taxes de sobrepès (índex de massa corporal – IMC- entre 25 i 29.9 9 kg/m2), obesitat classe 1 (IMC≥30 kg/m2) i classe 2 (IMC≥35 kg/m2) entre Espanya i Itàlia per gènere i grups d’edat. En explicar aquests gaps entre països aïllem les influències dels estils de vida, els efectes socioeconòmics i els mediambientals. Els nostres resultats indiquen que quan no es controla pels efectes mediambientals (efectes de grup o ‘peer effects’) els hàbits alimentaris i el nivell educatiu són els principals predictors del gaps totals entre països (36-52%), si bé aquests dos factors exerceixen un impacte diferenciat segons gènere i edat. Un tant paradoxalment, quan controlem pels efectes de grup aquests predictors perden la seva capacitat explicativa i els efectes de grup passen a explicar entre el 46-76% dels gaps en sobrepès i obesitat i mostren un patró creixent amb l’edat.[eng] A key question underpinning health production, and one that remains relatively unexplored, is the influence of socio-economic and environmental factors on weight gain and obesity. Such issues acquire particular relevance when data from two Mediterranean countries (Italy and Spain) are compared. Interestingly, the obesity rate was 5 percentage points higher in Spain in 2003 while in 1990 it had been roughly the same in the two countries. This paper reports a non-linear decomposition of gaps in overweight (body mass index – BMI - between 25 and 29.9 kg/m2), class 1 (BMI≥30 kg/m2) and class 2 obesity (BMI≥35 kg/m2) between Spain and Italy by both gender and age. We isolate the influence of lifestyles, socioeconomic and environmental effects in explaining cross-country gaps in the prevalence of obesity. Our findings suggest that when the social environment (peer effects) is not controlled for, eating habits and education are the main predictors of total cross-country gaps (36-52%), albeit that these two factors have a different impact depending on gender and age. Somewhat paradoxically, however, when we controlled for the social environment, these previous predictors lost their explanatory power and peer effects were found to explain between 46 and 76% of gaps and to exhibit an increasing age pattern

Medicines in parallel trade in the European Union: a gravity specification

While recent research has explored the phenomenon of drug parallel trade in regulated environments such as the European Union (EU), or the European Economic Area, little is known about the mechanisms that explain its origin or the role of the distribution chain in exporting and importing countries in determining its extent. By building on theoretical literature explaining the role of the distribution chain, this paper draws on an empirical specification of a gravity model to examine the determinants of inter-country flows of parallel-traded drugs. In this context, the paper deals with the effect of differences in the regulation of and competition in the distribution chain in the countries of origin and destination. The paper draws on proprietary data from the Intercontinental Medical Statistics database (for the Netherlands and other EU countries that export to the Netherlands) which identify the country of origin of parallel-imported medicines from 1997-2002 for a therapeutic group (statins) for which there is no generic competition. The study reveals that although parallel trade is a specific form of arbitrage, it is primarily a regulation-induced phenomenon. As a result, although the driving force for parallel trade is price differences across countries, the propagation mechanism lies in (a) the way drug prices are regulated across countries and (b) fragmentation and the underlying incentive structure in the wholesale distribution chain in countries where drug prices are regulated. The implications that flow from our study are that a more flexible and competitive and less fragmented (along national borders) distribution chain, particularly at wholesale level, might reduce the extent of and potential for parallel trade

New articipatory policymaking processes: a single concept, different realities

No podemos entender quiénes somos sin entender de dónde venimos. Ocurre con las personas pero también con las políticas locales de participación ciudadana. Por ello, el objetivo de esta breve reflexión será doble. En primer lugar, argumentaremos que las nuevas políticas de participación desarrolladas por los ayuntamientos españoles elegidos en las elecciones municipales de 2015 se han movido por sendas considerablemente diversas. En segundo lugar, sugeriremos que estos caminos diferentes tienen que ver con las coaliciones socio-políticas dominantes en cada uno de los casos y en la interpretación que cada uno de los socios de las mismas realiza sobre cuáles fueron los aciertos y los errores de prácticas participativas previas (Navarro, 2001)

La abstención en las grandes ciudades, Madrid y Barcelona

El artículo analiza la evolución de la participación electoral en las áreas metropolitanas de Madrid y Barcelona. Tras la descripción de los cambios y la distribución local de la abstención se intenta apuntar algunas hipótesis explicativas a partir de técnicas de regresión múltiple. Se utilizan diversas variables agregadas (nivel de estudios, clase social, etc...) Entre las que el efecto desmovilizador del paro y de la inmigración reciente y el incremento de la participación allí donde hay mas asociaciones aparecen como las conclusiones más significativas

Obesity and the Incidence of Chronic Diseases: a Seemingly Unrelated Probit Approach

Western societies can reduce avoidable mortality and morbidity by better understanding the relationship between obesity and chronic disease. This paper examines the joint determinants of obesity and of heart disease, diabetes, hypertension, and elevated cholesterol. It analyzes a broadly representative Spanish dataset, the 1999 Survey on Disabilities, Impairments and Health Status, using a health production theoretical framework together with a seemingly unrelated probit model approach that controls for unobserved heterogeneity and endogeneity. Its findings provide suggestive evidence of a positive and significant, although specification-dependent, association between obesity and the prevalence of chronic illness.hypertension, cardiovascular disease, high cholesterol, chronic illness, health production, body mass index, obesity, diabetes