The socioeconomic gradient in health: The role of intra-household resource allocation

THE SOCIOECONOMIC GRADIENT IN HEALTH: THE ROLE OF INTRA-HOUSEHOLD RESOURCE ALLOCATION AND DECISION-MAKER’S GENDER Elena Bárcena (Universidad de Málaga) Maite Blázquez (Universidad Autónoma de Madrid) Ana Isabel Moro (Universidad de Granada) 25th IAFFE Annual Conference Motivation The family context is likely to play a role in the relationship between socioeconomic status and health: a. The economic situation of other family members plays a role in determining individual levels of health (Burgess, 1945; Gardner and Oswald, 2004; Cai and Kalb, 2006) b. The decision-making process in a family has an important bearing on the intra-household dynamics and welfare of the household (Sundari, 2013) Thus…. Family arrangements in terms of resource allocation and decision-making are likely to affect individual levels of health. Motivation Objective: To contribute to the literature on the fields of health and household economics by analysing the impact of different household financial regimes on the health status of males and females in a number of European countries. Motivation This investigation is interesting for a number of reasons: 1. Understanding the different pathways between individual socioeconomic status and health becomes of special relevance in choosing the most appropriate public policies aimed at improving the well-being of a society. Motivation This investigation is interesting for a number of reasons: 2. The prevalence and duration of health problems place a considerable burden on health and social care systems. The cost of depression in the European Economic Area has been estimated at €136.3 billion, of which around one third falls on the health care system (McDaid et al., 2008). Motivation This investigation is interesting for a number of reasons: 3. The nature of intra-household arrangements is of relevance for the design of focalized social programmes that aim at raising people’s well-being, allowing one to assess whether policy will be effective. Motivation This investigation is interesting for a number of reasons: 4. It is important to pay special attention to the gender dimension: a. women today are still at higher risks of financial strain due to their position in the labour force, family role, and lower earnings. b. there is evidence of higher prevalence of mental health problems, such as depression, among women compared to men (Mirowsky and Ross, 1989). Motivation The main results can be summarized as follows: There is evidence of the collective model assumption, suggesting that the income-pooling hypothesis (unitary approach) is not always supported and that significant inequalities might exist within the same family. Specifically, each member of the couple is worse off if his/her partner has most decision-making responsibilities. Motivation The main results can be summarized as follows: The presence of children in the household plays a role in the effect that household financial regimens exert on individual self-assessed health, especially among females. Literature review Pahl (1989) classification of financial regimens: 3. shared management or pooling system: both partners put their income into a common pool, which both have access to. It is also characterized by equal decisionmaking power and equal responsibility by both partners. 4. independent management system:both partners have income, but they have separate bank accounts and they do not have access to each other’s income. There is no common budget and each partner has a separate sphere of responsibility in terms of financial management. Data set and variables Data set The 2010 module on intra-household sharing of resources of the EUSILC. Sample: heterosexual couples, with or without children, for 21 countries (Austria, Germany, Belgium, France, Luxembourg, the United Kingdom, Italy, Greece, Spain, Portugal, Cyprus, Malt, Poland, Hungary, Estonia, Latvia, Bulgaria, Czech Republic, Lithuania, Romania, Slovak Republic). We eliminate couples with inconsistent responses on the decision-making variables. Separate estimations for males and females Data set and variables Variables SAH: “How is your health in general?”. Five-point response scale ranging from very bad to very good. Household income and material deprivation Income: household equivalent income. Material deprivation: multidimensional index using 9 items proposed by Eurostat: paying rent, mortgage or utility bills; keeping the home adequately warm; facing unexpected expenses; eating meat or proteins regularly; going on holiday; a television; a washing machine; a car; and a telephone. Data set and variables Variables Money management and decision-making Household Information HA010 (Regime of household finances) How are the incomes you receive in your household dealt with? (All incomes as common resources; Some incomes as common resources and the rest as private resources; All incomes as private resources of the person receiving them; No income in the household) Personal Information: Decision-making (More me, balanced, more my partner) PA030: (shopping) Who in your couple is generally more likely to make decisions on everyday shopping? PA040: (children’s expenses) Who in your couple is generally more likely to make decisions on important expenses to make for the child(ren)? PA050: (furniture etc.) Who in your couple is generally more likely to make decisions on expensive purchases of consumer durables and furniture? PA060: (borrowing) Who in your couple is generally more likely to make decisions on borrowing money? PA070: (savings) Who in your household is generally more likely to make decisions on saving money? Data set and variables Variables Money management and decision-making Type of Financial Regimen Income pooling Decisionmaking(a) WholeWage_female all income pooling HA010=1 Mainly female WholeWage_male all income pooling HA010=1 Mainly male Allowance_female not all income pooling HA010==2|3 Mainly female Allowance_male not all income pooling HA010==2|3 Mainly male Pooling all income pooling HA010=1 Shared Independent not all income pooling HA010==2|3 Shared (a) Decisions about shopping, child, durables, borrowing and savings are variables PA030-PA070 Econometric model and research strategy Probit-adapted ordinary least squares (POLS) (Van Praag and Ferrer-i-Carbonell (2008: 29-34)) SAH i  yi  Di  FRi  Xi  Ci  i Equivalent net household income material household deprivation household financial regimen individual and household characteristics dummies to control for clustering Results FEMALE MALE Income 0.036* 0.053** Deprivation -0.879*** -0.882*** Financial regimen WholeWage_female 0.028*** -0.022** WholeWage_male -0.101*** -0.019 Allowance_female 0.003 -0.083*** Allowance_male -0.115*** -0.051* Independent 0.009 0.007 Pooling (ref. category) Income_separately 0.040*** 0.050*** Consensual Union 0.069** 0.038 Children 0.077*** 0.040*** Age -1.733*** -3.434*** Age2 -0.320 1.597** Educational Level Secondary 0.063*** 0.076*** Tertiary 0.145*** 0.193*** Primary (ref. category) Labour Market Status Part-time employee -0.039* -0.116*** Unemployed -0.141*** -0.101** Inactive -0.147*** -0.424*** Full-time employee (ref. category) FEMALE MALE Partner’s Educational Level Secondary 0.067** 0.029 Tertiary 0.138*** 0.083*** Primary (ref. category) Partner’s Labour Market Status Part-time employee -0.001 0.002 Unemployed -0.039 -0.002 Inactive -0.071* 0.059*** Full-time employee (ref. category) Country dummies Yes Yes Cons 1.096*** 1.501*** N75385 75385 Results FEMALE MALE Income 0.036* 0.053** Deprivation -0.879*** -0.882*** Financial regimen WholeWage_female 0.028*** -0.022** WholeWage_male -0.101*** -0.019 Allowance_female 0.003 -0.083*** Allowance_male -0.115*** -0.051* Independent 0.009 0.007 Pooling (ref. category) Income_separately 0.040*** 0.050*** Consensual Union 0.069** 0.038 Children 0.077*** 0.040*** Age -1.733*** -3.434*** Age2 -0.320 1.597** Educational Level Secondary 0.063*** 0.076*** Tertiary 0.145*** 0.193*** Primary (ref. category) Labour Market Status Part-time employee -0.039* -0.116*** Unemployed -0.141*** -0.101** Inactive -0.147*** -0.424*** Full-time employee (ref. category) FEMALE MALE Partner’s Educational Level Secondary 0.067** 0.029 Tertiary 0.138*** 0.083*** Primary (ref. category) Partner’s Labour Market Status Part-time employee -0.001 0.002 Unemployed -0.039 -0.002 Inactive -0.071* 0.059*** Full-time employee (ref. category) Country dummies Yes Yes Cons 1.096*** 1.501*** N75385 75385 Results FEMALE MALE Income 0.036* 0.053** Deprivation -0.879*** -0.882*** Financial regimen WholeWage_female 0.028*** -0.022** WholeWage_male -0.101*** -0.019 Allowance_female 0.003 -0.083*** Allowance_male -0.115*** -0.051* Independent 0.009 0.007 Pooling (ref. category) Income_separately 0.040*** 0.050*** Consensual Union 0.069** 0.038 Children 0.077*** 0.040*** Age -1.733*** -3.434*** Age2 -0.320 1.597** Educational Level Secondary 0.063*** 0.076*** Tertiary 0.145*** 0.193*** Primary (ref. category) Labour Market Status Part-time employee -0.039* -0.116*** Unemployed -0.141*** -0.101** Inactive -0.147*** -0.424*** Full-time employee (ref. category) FEMALE MALE Partner’s Educational Level Secondary 0.067** 0.029 Tertiary 0.138*** 0.083*** Primary (ref. category) Partner’s Labour Market Status Part-time employee -0.001 0.002 Unemployed -0.039 -0.002 Inactive -0.071* 0.059*** Full-time employee (ref. category) Country dummies Yes Yes Cons 1.096*** 1.501*** N75385 75385 Results FEMALE MALE Income 0.036* 0.053** Deprivation -0.879*** -0.882*** Financial regimen WholeWage_female 0.028*** -0.022** WholeWage_male -0.101*** -0.019 Allowance_female 0.003 -0.083*** Allowance_male -0.115*** -0.051* Independent 0.009 0.007 Pooling (ref. category) Income_separately 0.040*** 0.050*** Consensual Union 0.069** 0.038 Children 0.077*** 0.040*** Age -1.733*** -3.434*** Age2 -0.320 1.597** Educational Level Secondary 0.063*** 0.076*** Tertiary 0.145*** 0.193*** Primary (ref. category) Labour Market Status Part-time employee -0.039* -0.116*** Unemployed -0.141*** -0.101** Inactive -0.147*** -0.424*** Full-time employee (ref. category) FEMALE MALE Partner’s Educational Level Secondary 0.067** 0.029 Tertiary 0.138*** 0.083*** Primary (ref. category) Partner’s Labour Market Status Part-time employee -0.001 0.002 Unemployed -0.039 -0.002 Inactive -0.071* 0.059*** Full-time employee (ref. category) Country dummies Yes Yes Cons 1.096*** 1.501*** N75385 75385 THE SOCIOECONOMIC GRADIENT IN HEALTH: THE ROLE OF INTRA-HOUSEHOLD RESOURCE ALLOCATION AND DECISION-MAKER’S GENDER Elena Bárcena (Universidad de Málaga) Maite Blázquez (Universidad Autónoma de Madrid) Ana Isabel Moro (Universidad de Granada) 25th IAFFE Annual Conference