ECONOMIC CAUSES OF ADULT ILL HEALTH

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This study will investigate the economic determinants of adult ill-health and mortality in Malaysia and Indonesia, using an extremely rich set of data, the first and second Malaysia Family Life Surveys (MFLS) and the Indonesia Family Life Survey (IFLS). While substantial progress has been made in examining economic correlates of child health and mortality, rather little work has been done on adult correlates. This is due in part to the absence of data sets which have detailed health and socio-economic data at the individual, household and community levels. The two MFLS's and the IFLS meet these stringent criteria. We will investigate reduced form determinants of adult ill-health and mortality. Special attention will be paid to aged adults, using two health indicators; measures of functional difficulties with activities of daily living (ADL's) and a self-reported measure of general health status. We will investigate the effects of the elderly's living arrangements on their health, explicitly taking into account that living arrangements are chosen (endogenous). In particular, we are interested in investigating the hypothesis that the health status of frail older individuals is better if they live with their children than if they live alone. For both prime-age and elderly adults we will investigate the effects of individual and household level covariates such as the education of all family members and household income. A novel feature of the analysis will be its focus on intergenerational effects. Specifically, characteristics of all children will be determinants of the health of elderly adults, and similarly the characteristics of the parents will be determinants of the health of prime age adults. In addition to individual and household level covariates, we will examine the effects of community infrastructure and prices on health status. We are specifically interested in the effects of the availability and price of different types of health care providers and programs. We will also examine the impact of variables that influence the community illness environment such as quality of housing, and water and sewerage infrastructure. We will test for interactions between the availability of community infrastructure and household characteristics. This will help us understand the conditions under which household and community investments have their greatest payoffs. For example, to what extent are the effects of education or household income reduced (or strengthened) in areas where toilet sanitation is poor and sources of clean water unavailable? Finally, using the MFLS-1 and -2 we will investigate the importance of potential bases caused mortality selection.