Economy and health: essays on early-life conditions, health, and health insurance

Viluma, L., 2019, [Groningen]: University of Groningen, SOM research school. 123 p.

Research output: ThesisThesis fully internal (DIV)

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  • Title and contents

    Final publisher's version, 739 KB, PDF document

  • Chapter 1

    Final publisher's version, 461 KB, PDF document

  • Chapter 2

    Final publisher's version, 1.02 MB, PDF document

  • Chapter 3

    Final publisher's version, 831 KB, PDF document

  • Chapter 4

    Final publisher's version, 983 KB, PDF document

  • Chapter 5

    Final publisher's version, 1.18 MB, PDF document

  • Acknowledgments

    Final publisher's version, 295 KB, PDF document

  • Bibliography

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  • Samenvatting

    Final publisher's version, 433 KB, PDF document

  • Complete thesis

    Final publisher's version, 1.67 MB, PDF document

  • Propositions

    Final publisher's version, 352 KB, PDF document

This thesis focuses on two aspects of the interactions between economy and health. First, based on the fetal programming hypothesis that suggests a relationship between the economic circumstances before birth and health later in life, I analyze the impact of macroeconomic conditions around birth on infant health and on adult cardiovascular disease risk. The results in chapters 2 and 3 show that high provincial unemployment rates decrease fertility, improve the socio-economic cohort composition of mothers and lead to a lower birthweight in boys. Moreover, girls exposed to unfavorable business-cycle conditions at birth are at an increased risk for fatal CVD events in adult life. Chapter 4 focuses on one of the potential mechanisms linking the economic conditions and health – ambient stress. There, I show that stress caused by high unemployment levels can increase the probability of Cesarean delivery for male babies.
The second part of this thesis takes a different look at the interactions of economy and health by investigating incentives for moral hazard and selection in health insurance. Chapter 5 investigates whether the voluntary deductible in the Dutch health insurance system reduces excessive use of healthcare services or acts only as a cost reduction tool for low-risk individuals. The results show that even though healthier people are more likely to opt for a higher deductible, overall, the voluntary deductible reduces moral hazard in healthcare utilization in the Netherlands.
Original languageEnglish
QualificationDoctor of Philosophy
Awarding Institution
Award date8-Apr-2019
Place of Publication[Groningen]
Print ISBNs978-94-034-1435-5
Electronic ISBNs978-94-034-1434-8
Publication statusPublished - 2019

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