Efficiency of Health Investment: Education or Intelligence?

Health Econ. 2016 Sep;25(9):1056-72. doi: 10.1002/hec.3356. Epub 2016 May 3.

Abstract

In this paper, we hypothesize that education is associated with a higher efficiency of health investment, yet that this efficiency advantage is solely driven by intelligence. We operationalize efficiency of health investment as the probability of dying conditional on a certain hospital diagnosis and estimate a multistate structural equation model with three states: (i) healthy, (ii) hospitalized, and (iii) death. We use data from a Dutch cohort born around 1940 that links intelligence tests at age 12 years to later-life hospitalization and mortality records. The results indicate that intelligent individuals have a clear survival advantage for most hospital diagnoses, while the remaining disparities across education groups are small and not statistically significant. © 2016 The Authors. Health Economics Published by John Wiley & Sons Ltd.

Keywords: education; health; intelligence; multistate duration model.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Choice Behavior
  • Cohort Studies
  • Educational Status*
  • Female
  • Health Status*
  • Hospitalization / statistics & numerical data*
  • Humans
  • Intelligence*
  • Male
  • Models, Statistical
  • Mortality
  • Netherlands
  • Neuropsychological Tests / statistics & numerical data*