title: Essays on Inequalities in Health
Creators: name: Balasooriya Mudiyanselage, Namal N
Publisher: name: Griffith University
Year: 2022

description: This thesis comprises four empirical essays on the different aspects of health inequality. These four chapters are written in the form of self-contained articles. Chapter 3 explores the effects of inherited socioeconomic characteristics on markers of unhealthy body weight. Taking Australian microdata from 2007 to 2013, we show that approximately 4% of the variation in outcomes is determined by factors beyond an individual’s control, such as their race, gender and social class. Paternal socioeconomic status is the primary explanatory factor, with those born to more affluent fathers slightly less likely to be overweight in adulthood. Decompositions reveal that only 20%–25% of this effect is attributable to advantaged families exhibiting better health behaviours, implying that unobserved factors also play an important role. Since diseases associated with unhealthy weight significantly strain public healthcare systems, our results have implications for the provision of treatment when resources are constrained. Chapter 4 specifies a multigeneration inequality-of-opportunity (IOP) model to study multigenerational health transmission mechanisms in Australian panel data. By applying IOP models, we demonstrate that grandparental socioeconomic status (SES) is an important determinant of personal health, even after controlling for health and SES at the parental level. Our findings hold over a range of mental and physical health outcomes and appear to be especially sensitive to educational outcomes on the father’s side. Since ingrained socioeconomic (dis)advantages that persist over multiple generations may be indicative of “social class,” our results suggest that subtle attitudinal and behavioural characteristics associated with this variable may be a key driver of health disparities. Chapter 5 examines the effects of knowledge of HIV/AIDS (human immunodeficiency virus/ acquired immune deficiency syndrome) on HIV prevalence, instrumenting individuals’ knowledge of HIV using the level of maternal education. We use pooled Demographic and Health Surveys data from 21 countries in sub-Saharan Africa to show that knowledge about HIV transmission effectively reduces infection rates. Our results persist across a variety of indicators and are plausibly causal. Since educational attainment is passed across generations, the empirical findings of this chapter suggest that individuals born to educated mothers are safer from HIV than those born to less educated mothers. Chapter 6 presents new evidence of the causal effect of air pollution on Australian health outcomes, using the Black Saturday bushfires in 2009 as a natural experiment. This event was one of the largest bushfires in Australian history and emitted approximately four million tonnes of carbon dioxide into the atmosphere. We use data from the Household, Income and Labour Dynamics in Australia panel and compare the health status of individuals living in affected and unaffected regions before and after the event. Using a triple differences procedure, we further examine whether there is a difference in vulnerability to bushfire smoke by comparing people living in urban and regional areas. The findings of this chapter demonstrate that ambient air pollution had significant negative effects on health and that the magnitudes were higher for individuals residing in urban areas.