Health, Health Seeking Behavior, and Health Care

Abstract

Health status and socioeconomic status are important determinants of individuals’ wellbeing. Information on income alone, or on health alone, provides a less complete picture. Better health can lead to higher income, and higher income can lead to better health, so that we cannot fully understand the dynamics of either process without understanding both. Much of the research on international health and income has focused on the cross-country relationships between population health and national income. Starting from Preston (1975, 1980), these relationships have been used to investigate the causes of mortality decline, particularly the relative roles of income and of medical knowledge. And data on adult height have been used to investigate the causes of the historical decline in mortality, see in particular Fogel (1997, 2004), Floud, Wachter, and Gregory (1990), and Steckel (1995). The Commission for Macroeconomics and Health (2001) used the same data to argue that it is health care, through its effect on health status, that is an important engine of economic growth. Another strand of research, particula rly associated with Sen (see for example Sen 1999), and embodied in UNDPs Human Development Index, argues that comparisons of wellbeing must look at health (and education) together with income. Until relatively recently, surveys that collected information on income rarely collected comprehensive information on health, while most standardized health surveys, the Demographic and Health Surveys (DHS) being the most notable examples, contained at best rudimentary and unsatisfactory information on economic status. The National Income Dynamics Study would be an ideal vehicle to understand the joint determination of economic status and health status in South Africa.