title: Efficiency of Health Investment: Education or Intelligence?
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.
authors.affiliation: Netherlands Interdisciplinary Demographic Institute (NIDI-KNAW/University of Groningen), Groningen, The Netherlands.|IZA, Bonn, Germany.
authors.forename: Govert E
authors.identifier: 0000-0002-6458-1647
authors.initials: GE
authors.lastname: Bijwaard
authors.affiliation: Erasmus School of Economics, Erasmus University Rotterdam, Rotterdam, The Netherlands.|Department of Economics, Chinese University of Hong Kong, Hong Kong, China.|Tinbergen Institute, Amsterdam, The Netherlands.
authors.forename: Hans
authors.initials: H
authors.lastname: Van Kippersluis
mesh_terms: D000368:Aged; D002755:Choice Behavior; D015331:Cohort Studies; D004522:Educational Status; D005260:Female; D006304:Health Status; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007360:Intelligence; D008297:Male; D015233:Models, Statistical; D009026:Mortality; D009426:Netherlands; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*
keywords: education; health; intelligence; multistate duration model