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Social Inequalities in Health Insurance Coverage and Health: Lessening Selection Bias with Fixed Effects Regression |
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Abstract:
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This paper will determine the extent to which health insurance has an impact on health, net of adult socioeconomic status, using data from the 1979 National Longitudinal Survey of Youth. A satisfactory answer to this question requires estimates of the effects of health insurance on health that are less affected by selection biases. This will be achieved by framing this question within the counterfactual account of causality and using fixed effects models with sibling clusters to corroborate – or refute – the results of a conventional OLS regression. Fixed effects models postulate that, by using one sibling virtually as a “control” for another one, it is possible to estimate the effects of current factors net of common family background and genetic predispositions (Guo and VanWey 1999). Results show that public insurance has in the conventional regression a strong negative association with health. However, as hypothesized, this negative relationship declines in magnitude and becomes non significant in the fixed effects regression with sibling clusters. Conversely, the effects of years uninsured, which were non significant in the OLS regression, increase in magnitude and become highly significant in the fixed effects regression. Private insurance had no significant effect on health beyond that of adult SES in either model. These results suggest that being uninsured has a strong negative impact on health, while public and private insurance may have no impact beyond that of adult SES. However, this relationship can only be observed with methods that specifically address the selection bias in health insurance allocation. |
Most Common Document Word Stems:
health (255), insur (178), effect (102), model (70), measur (64), sibl (58), year (53), ses (49), studi (45), public (44), coverag (44), respond (43), variabl (39), result (35), regress (35), use (34), 2 (33), fix (33), 2000 (32), status (31), general (31), |
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health insurance, health, socioeconomic status, selection bias, fixed effect models, sibling models |
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Association:
Name: American Sociological Association
URL: http://www.asanet.org
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Citation:
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MLA Citation:
| Quesnel Vallee, Amelie. "Social Inequalities in Health Insurance Coverage and Health: Lessening Selection Bias with Fixed Effects Regression" Paper presented at the annual meeting of the American Sociological Association, Atlanta Hilton Hotel, Atlanta, GA, Aug 16, 2003 <Not Available>. 2009-05-26 <http://www.allacademic.com/meta/p106976_index.html> |
APA Citation:
| Quesnel Vallee, A. , 2003-08-16 "Social Inequalities in Health Insurance Coverage and Health: Lessening Selection Bias with Fixed Effects Regression" Paper presented at the annual meeting of the American Sociological Association, Atlanta Hilton Hotel, Atlanta, GA Online <.PDF>. 2009-05-26 from http://www.allacademic.com/meta/p106976_index.html |
Publication Type: Conference Paper/Unpublished Manuscript
Review Method: Peer Reviewed
Abstract: This paper will determine the extent to which health insurance has an impact on health, net of adult socioeconomic status, using data from the 1979 National Longitudinal Survey of Youth. A satisfactory answer to this question requires estimates of the effects of health insurance on health that are less affected by selection biases. This will be achieved by framing this question within the counterfactual account of causality and using fixed effects models with sibling clusters to corroborate – or refute – the results of a conventional OLS regression. Fixed effects models postulate that, by using one sibling virtually as a “control” for another one, it is possible to estimate the effects of current factors net of common family background and genetic predispositions (Guo and VanWey 1999). Results show that public insurance has in the conventional regression a strong negative association with health. However, as hypothesized, this negative relationship declines in magnitude and becomes non significant in the fixed effects regression with sibling clusters. Conversely, the effects of years uninsured, which were non significant in the OLS regression, increase in magnitude and become highly significant in the fixed effects regression. Private insurance had no significant effect on health beyond that of adult SES in either model. These results suggest that being uninsured has a strong negative impact on health, while public and private insurance may have no impact beyond that of adult SES. However, this relationship can only be observed with methods that specifically address the selection bias in health insurance allocation. |
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| Document Type: |
.PDF |
| Page count: |
16 |
| Word count: |
9129 |
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| Draft – Please do not cite without permission Social Inequalities in Health Insurance Coverage and Health in the U.S.: Addressing the Selection Bias in Health and SES with Fixed Effects Regression Amélie Quesnel-Vallée M.Sc. M.A.* Department of Sociology Duke University Abstract This paper will determine the extent to which health insurance has an impact on health net of that of more conventional measures of socioeconomic status (SES) namely education and income using data from the 1979 National Longitudinal Survey |
| and outliers and no significant problems were found (i.e. no clear patterns were apparent in the residuals and the results did not change when the outlier values were excluded from the analyses). Moreover there was no indication of multicollinearity according to the variance inflation factors. The consistency in results found in these analyses suggests that the results exposed here are replicable and not simply an artifact of the sample or the measures used. 19 However note that as mentioned |
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