Causal effects of wealth on health: Evidence from lifetime follow-up of randomized land redistribution

财富对健康的因果影响：随机土地再分配的终生随访证据

• 批准号: 10592575
• 负责人: Evan W Roberts
• 金额: $ 24.41万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-02-15 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10592575
• 关键词: Address; Adult; Affect; Age; Aging; Award; Binding; Birth; Birth Order; Cause of Death; Cessation of life; Child; Child Health; Child Mortality; Childhood; Communicable Diseases; Data; Data Set; Death Records; Economics; Elderly; Employment; Ensure; Ethics; Etiology; Family; Farm; Gender; Generations; Health; Health Insurance; Health Policy; Health Status; Housing; Income; Inequality; International; Knowledge; Life; Life Cycle Stages; Life Expectancy; Link; Longevity; Longitudinal Studies; Measures; Mediation; Modernization; New Zealand; Occupational Status; Outcome; Parents; Participant; Pathway interactions; Pattern; Persons; Pilot Projects; Policies; Population Process; Privatization; Process; Property; Public Policy; Randomized; Records; Research; Research Design; Research Personnel; Resources; Risk Factors; Role; Sampling; Savings; Siblings; Social Policies; Social Processes; Social status; Societies; Socioeconomic Status; Spouses; Subgroup; System; Testing; Time; Woman; cohort; comparative; design; experimental study; farmer; follow-up; gender difference; health disparity; improved; infancy; interest; intergenerational; men; middle age; mortality; novel; offspring; payment; programs; prospective; residence; rural residence; sex; social; urban residence

PROJECT SUMMARY A significant body of research shows that having money is highly correlated with better health. But determining how much of the association is causal is challenging. The gold standard for determining causality is prospective random assignment of treatment, but practical and ethical considerations often make it hard to award money or equivalent resources in a truly random way. Thus, researchers have used longitudinal studies of parents’ income and children’s health or exogenous changes in social and fiscal policy to show that additional money lowers mortality. But studies with true randomization—lottery winners and people randomly given different levels of health insurance—show more modest influences of money on mortality. This study produces the first ever estimates of how randomly awarded wealth affects mortality over a lifetime of follow-up in two generations, for both men and women, and constructs a policy relevant metric of the incremental wealth required for an additional year of life expectancy. The project analyzes the long-term implications of a major land redistribution policy in New Zealand in which low interest loans for farms were awarded by lottery. Program terms ensured applicants were of similar economic status, and the policy operated like a true random experiment. Loan terms were similar to modern mortgages: low annual payments over a long term. Documents show randomization was adhered to for over 20 years. New Zealand’s universal, centralized death registration facilitates construction of a matched intergenerational sample of lottery winners and losers and their children. Ninety percent of applicants can be linked to death records, which is a significantly higher linkage rate than can be obtained in the US. These estimates will be a lower bound on how much money matters for health because New Zealand had low inequality, high life expectancy, and the subjects were born in an era when infectious disease was an important cause of death. This R21 project has four aims: 1) estimate the causal effects of winning land on lottery participants’ mortality, 2) estimate the causal effects of winning land on the mortality of children of lottery participants, 3) estimate gender differences in the effects of wealth on mortality, and 4) identify potential mechanisms that contributed to life expectancy differences. The study design combines the inferential strengths of true random assignment in a block design with additional contrasts between children born before and after their parents participated in the lottery to identify effects of wealth on mortality in two generations. Contrasts in effect sizes by sex, birth order, and generation are used to identify potential causal mechanisms. Causal mediation analysis of early adult health measures, mid-life occupational status, urban or rural residence, and lifetime wealth accumulation illuminate potential pathways between wealth and reduced mortality. The proposed research, with a credible causal identification strategy and lifetime follow-up, will contribute significantly to knowledge of how money and social status affect health, aging, and mortality.

项目摘要 一项重要的研究表明，有钱与更好的健康密切相关。但确定 这种关联在多大程度上是因果关系是一个挑战。确定因果关系的金标准是前瞻性的 随机分配的治疗，但实际和道德的考虑往往很难奖钱或 以一种真正随机的方式获得同等的资源。因此，研究人员对父母的收入进行了纵向研究， 以及儿童健康或社会和财政政策的外部变化，以表明额外的资金会降低 mortality.但是真正随机化的研究--彩票中奖者和随机给予不同水平的 健康保险--显示金钱对死亡率的影响较小。这项研究首次产生了 估计随机获得的财富如何影响两代人一生中的死亡率， 男性和女性，并构建了一个政策相关的指标，增加财富所需的额外 年的预期寿命。该项目分析了2002年一项重大土地再分配政策的长期影响， 在新西兰，农场低息贷款是通过抽签方式发放的。计划条款确保申请人 他们的经济状况相似，政策的运作就像一个真正的随机实验。贷款条件相似 到现代抵押贷款：长期低年付款。文件显示遵守了随机化 20多年了新西兰的统一、集中的死亡登记有助于建立一个匹配的 彩票中奖者和中奖者及其子女的代际样本。百分之九十的申请人可以 与死亡记录相关，这比在美国获得的关联率要高得多。这些 由于新西兰的不平等程度较低， 高预期寿命，受试者出生在一个传染病是导致死亡的重要原因的时代。 死亡这个R21项目有四个目标：1）估计赢得土地对彩票参与者的因果影响， 死亡率，2）估计赢得土地对彩票参与者子女死亡率的因果影响，3） 估计财富对死亡率影响的性别差异，以及4）确定潜在的机制， 导致了预期寿命的差异。研究设计结合了真随机的推理优势 分配在区组设计中，在父母之前和之后出生的孩子之间增加对比 参加彩票活动，以确定财富对两代人死亡率的影响。效应量对比 性别、出生顺序和世代被用来确定潜在的因果机制。因果中介分析 早期成人健康指标、中年职业状况、城市或农村居住地和终身财富 财富积累揭示了财富和降低死亡率之间的潜在途径。研究建议，与 一个可靠的因果识别策略和终身随访，将大大有助于了解如何 金钱和社会地位影响健康、衰老和死亡率。