Health and Economic Growth: Reconciling the Micro and Macro Evidence.

Economists use micro-based and macro-based approaches to assess the macroeconomic return to population health. The macro-based approach tends to yield estimates that are either negative and close to zero or positive and an order of magnitude larger than the range of estimates derived from the micro-based approach. This presents a micro-macro puzzle regarding the macroeconomic return to health. We reconcile the two approaches by controlling for the indirect effects of health on income per capita, which macro-based approaches usually include but micro-based approaches deliberately omit when isolating the direct income effects of health. Our results show that the macroeconomic return to health lies in the range of plausible microeconomic estimates, demonstrating that both approaches are in fact consistent with one another.

Health dynamics shape life-cycle incomes.

This paper empirically investigates the long-run effects of major health improvements on income growth in the United States. To isolate exogenous changes in health, the econometric model uses quasi-experimental variation in cardiovascular disease mortality across states over time. Based on data for the white population, the results show that there is a causal link between health and income per person, and they provide novel evidence that health dynamics shape life-cycle incomes. Life-cycle income profiles slope more strongly at the beginning and at the end of work life in 2000 than in 1960, indicating that age becomes a more prominent determinant of income dynamics over this period. The channels for this transformation include better health, higher educational attainment, and changing labor supply.

The demographic dividend is more than an education dividend.

The demographic dividend has long been viewed as an important factor for economic development and provided a rationale for policies aiming at a more balanced age structure through birth control and family planning. Assessing the relative importance of age structure and increases in human capital, recent work has argued that the demographic dividend is related to education and has suggested a dominance of improving education over age structure. Here we reconsider the empirical relevance of shifts in the age distribution for development for a panel of 159 countries over the period 1950 to 2015. Based on a flexible model of age-structured human capital endowments, the results document important interactions between age structure and human capital endowments, suggesting that arguments of clear dominance of education over age structure are unwarranted and lead to potentially misleading policy conclusions. An increase in the working-age population share has a strong and significant positive effect on growth, even conditional on human capital, in line with the conventional notion of a demographic dividend. An increase in human capital only has positive growth effects if combined with a suitable age structure. An increasing share of the most productive age groups has an additional positive effect on economic performance. Finally, the results show considerable heterogeneity in the effect of age structure and human capital for different levels of development. Successful policies for sustainable development should take this heterogeneity into account to avoid detrimental implications of a unidimensional focus on human capital without accounting for demography.