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Erschienen in: Social Indicators Research 3/2017

03.10.2016

Ethnic Diversity and Health Outcomes

verfasst von: Sefa Awaworyi Churchill, Janet Exornam Ocloo, Diana Siawor-Robertson

Erschienen in: Social Indicators Research | Ausgabe 3/2017

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Abstract

This study hypothesizes a relationship between ethnic diversity and health outcomes. We explore the effects of ethnic and linguistic heterogeneity (measured by indices of ethnic and linguistic fractionalization) on various health outcomes in a cross-section of 91 countries. We explore outcomes relating to four major categories of health: (1) immunization rates, (2) prevalence of diseases, (3) life expectancy and mortality rates, and (4) health related infrastructure and staff. Across all dimensions examined, evidence suggests that higher heterogeneity is bad for health outcomes. We explore several potential mechanisms which could explain the observed negative effects of ethnic and linguistic diversity on health.

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1
Detailed discussion on instrument and its composition can be found in Ahlerup and Olsson (2012). We further supplement the conventional 2SLS regressions with the Lewbel 2SLS which uses internally generated instruments, and propensity score matching (PSM). Given space constraints, we present details of the Lewbel (2SLS) and PSM methodologies in the online appendix.
 
2
Results for robustness exercises are also reported in the online appendix.
 
3
The inclusion of trust, social network and discrimination in our cross-section regression significantly reduces the number of observation thus making it difficult to make meaningful inferences. We therefore use the mixed effect panel regressions to test the effects of these variables on health outcomes. Also, the social networks variable is dropped from this regression due to a high correlation with trust. For brevity, we report results for regressions with ethnic fractionalization only. Note that the effects of potential channels remain the same in both specification given that only the index of fractionalization changes in each regression.
 
Literatur
Zurück zum Zitat Ahlerup, P. (2009). The causal effects of ethnic diversity: An instrumental variables approach. Gothenburg University Economics Working Paper 386. Ahlerup, P. (2009). The causal effects of ethnic diversity: An instrumental variables approach. Gothenburg University Economics Working Paper 386.
Zurück zum Zitat Ahlerup, P., & Olsson, O. (2012). The roots of ethnic diversity. Journal of Economic Growth, 17(2), 71–102.CrossRef Ahlerup, P., & Olsson, O. (2012). The roots of ethnic diversity. Journal of Economic Growth, 17(2), 71–102.CrossRef
Zurück zum Zitat Alesina, A., Devleeschauwer, A., Easterly, W., Kurlat, S., & Wacziarg, R. (2003). Fractionalization. Journal of Economic Growth, 8(2), 155–194.CrossRef Alesina, A., Devleeschauwer, A., Easterly, W., Kurlat, S., & Wacziarg, R. (2003). Fractionalization. Journal of Economic Growth, 8(2), 155–194.CrossRef
Zurück zum Zitat Alesina, A., & Ferrara, E. L. (2000). Participation in heterogeneous communities. The Quarterly Journal of Economics, 115(3), 847–904. doi:10.2307/2586898.CrossRef Alesina, A., & Ferrara, E. L. (2000). Participation in heterogeneous communities. The Quarterly Journal of Economics, 115(3), 847–904. doi:10.​2307/​2586898.CrossRef
Zurück zum Zitat Alesina, A., & La Ferrara, E. (2002). Who trusts others? Journal of Public Economics, 85(2), 207–234.CrossRef Alesina, A., & La Ferrara, E. (2002). Who trusts others? Journal of Public Economics, 85(2), 207–234.CrossRef
Zurück zum Zitat Awaworyi Churchill, S., Okai, D., & Posso, A. (2015). Internet use and ethnic heterogeneity in a cross-section of countries. Economic Papers: A Journal of Applied Economics and Policy, 35(1), 59–72. doi:10.1111/1759-3441.12125.CrossRef Awaworyi Churchill, S., Okai, D., & Posso, A. (2015). Internet use and ethnic heterogeneity in a cross-section of countries. Economic Papers: A Journal of Applied Economics and Policy, 35(1), 59–72. doi:10.​1111/​1759-3441.​12125.CrossRef
Zurück zum Zitat Bandiera, O., Barankay, I., & Rasul, I. (2005). Cooperation in collective action. Economics of Transition, 13(3), 473–498.CrossRef Bandiera, O., Barankay, I., & Rasul, I. (2005). Cooperation in collective action. Economics of Transition, 13(3), 473–498.CrossRef
Zurück zum Zitat Banerjee, A., Iyer, L., & Somanathan, R. (2005). History, social divisions, and public goods in rural India. Journal of the European Economic Association, 3(2–3), 639–647.CrossRef Banerjee, A., Iyer, L., & Somanathan, R. (2005). History, social divisions, and public goods in rural India. Journal of the European Economic Association, 3(2–3), 639–647.CrossRef
Zurück zum Zitat Becker, G. S. (1957). The economics of discrimination. Chicago: University of Chicago Press. Becker, G. S. (1957). The economics of discrimination. Chicago: University of Chicago Press.
Zurück zum Zitat Berman, M., & Fenaughty, A. (2005). Technology and managed care: Patient benefits of telemedicine in a rural health care network. Health Economics, 14(6), 559–573. doi:10.1002/hec.952.CrossRef Berman, M., & Fenaughty, A. (2005). Technology and managed care: Patient benefits of telemedicine in a rural health care network. Health Economics, 14(6), 559–573. doi:10.​1002/​hec.​952.CrossRef
Zurück zum Zitat Blackwell, D., & Girshick, M. (1954). Theory of games and statistical decisions. New York: Wiley. Blackwell, D., & Girshick, M. (1954). Theory of games and statistical decisions. New York: Wiley.
Zurück zum Zitat Blau, F. D., Ferber, M. A., Winkler, A. E., & Winkler, A. E. (1986). The economics of women, men, and work. Englewood Cliffs, NJ: Prentice-Hall. Blau, F. D., Ferber, M. A., Winkler, A. E., & Winkler, A. E. (1986). The economics of women, men, and work. Englewood Cliffs, NJ: Prentice-Hall.
Zurück zum Zitat Blimes, R. J. (2006). The indirect effect of ethnic heterogeneity on the likelihood of civil war onset. Journal of Conflict Resolution, 50(4), 536–547.CrossRef Blimes, R. J. (2006). The indirect effect of ethnic heterogeneity on the likelihood of civil war onset. Journal of Conflict Resolution, 50(4), 536–547.CrossRef
Zurück zum Zitat Boyd, R., & Richerson, P. J. (1988). Culture and the evolutionary process. Chicago: University of Chicago Press. Boyd, R., & Richerson, P. J. (1988). Culture and the evolutionary process. Chicago: University of Chicago Press.
Zurück zum Zitat Chen, L., Yip, W., Chang, M.-C., Lin, H.-S., Lee, S.-D., Chiu, Y.-L., et al. (2007). The effects of Taiwan’s National Health Insurance on access and health status of the elderly. Health Economics, 16(3), 223–242. doi:10.1002/hec.1160.CrossRef Chen, L., Yip, W., Chang, M.-C., Lin, H.-S., Lee, S.-D., Chiu, Y.-L., et al. (2007). The effects of Taiwan’s National Health Insurance on access and health status of the elderly. Health Economics, 16(3), 223–242. doi:10.​1002/​hec.​1160.CrossRef
Zurück zum Zitat Cook, K. S., & Cooper, R. M. (2003). Experimental studies of cooperation, trust, and social exchange. Trust and reciprocity, interdisciplinary lesson from experimental research (pp. 209–244). New York: Russell Sage Foundation. Cook, K. S., & Cooper, R. M. (2003). Experimental studies of cooperation, trust, and social exchange. Trust and reciprocity, interdisciplinary lesson from experimental research (pp. 209–244). New York: Russell Sage Foundation.
Zurück zum Zitat Crémieux, P.-Y., Meilleur, M.-C., Ouellette, P., Petit, P., Zelder, M., & Potvin, K. (2005). Public and private pharmaceutical spending as determinants of health outcomes in Canada. Health Economics, 14(2), 107–116. doi:10.1002/hec.922.CrossRef Crémieux, P.-Y., Meilleur, M.-C., Ouellette, P., Petit, P., Zelder, M., & Potvin, K. (2005). Public and private pharmaceutical spending as determinants of health outcomes in Canada. Health Economics, 14(2), 107–116. doi:10.​1002/​hec.​922.CrossRef
Zurück zum Zitat Cruickshank, J. K., & Beevers, D. G. (2013). Ethnic factors in health and disease. Oxford, UK: Butterworth-Heinemann. Cruickshank, J. K., & Beevers, D. G. (2013). Ethnic factors in health and disease. Oxford, UK: Butterworth-Heinemann.
Zurück zum Zitat Daponte, B. O., Sanders, S., & Taylor, L. (1999). Why do low-income households not use food stamps? Evidence from an Experiment. The Journal of Human Resources, 34(3), 612–628. doi:10.2307/146382.CrossRef Daponte, B. O., Sanders, S., & Taylor, L. (1999). Why do low-income households not use food stamps? Evidence from an Experiment. The Journal of Human Resources, 34(3), 612–628. doi:10.​2307/​146382.CrossRef
Zurück zum Zitat Easterly, W. (2007). Inequality does cause underdevelopment: Insights from a new instrument. Journal of Development Economics, 84(2), 755–776.CrossRef Easterly, W. (2007). Inequality does cause underdevelopment: Insights from a new instrument. Journal of Development Economics, 84(2), 755–776.CrossRef
Zurück zum Zitat Easterly, W., & Levine, R. (1997). Africa’s growth tragedy: Policies and ethnic divisions. The Quarterly Journal of Economics, 112(4), 1203–1250.CrossRef Easterly, W., & Levine, R. (1997). Africa’s growth tragedy: Policies and ethnic divisions. The Quarterly Journal of Economics, 112(4), 1203–1250.CrossRef
Zurück zum Zitat Esteban, J., & Ray, D. (1999). Conflict and distribution. Journal of Economic Theory, 87(2), 379–415.CrossRef Esteban, J., & Ray, D. (1999). Conflict and distribution. Journal of Economic Theory, 87(2), 379–415.CrossRef
Zurück zum Zitat Fafchamps, M. (2000). Ethnicity and credit in African manufacturing. Journal of Development Economics, 61(1), 205–235.CrossRef Fafchamps, M. (2000). Ethnicity and credit in African manufacturing. Journal of Development Economics, 61(1), 205–235.CrossRef
Zurück zum Zitat Green, E. D. (2005). On the endogeneity of ethnic secessionist groups. PhD diss., London School of Economics. Green, E. D. (2005). On the endogeneity of ethnic secessionist groups. PhD diss., London School of Economics.
Zurück zum Zitat Günther, I., & Schipper, Y. (2013). Pumps, germs and storage: The impact of improved water containers on water quality and health. Health Economics, 22(7), 757–774. doi:10.1002/hec.2852.CrossRef Günther, I., & Schipper, Y. (2013). Pumps, germs and storage: The impact of improved water containers on water quality and health. Health Economics, 22(7), 757–774. doi:10.​1002/​hec.​2852.CrossRef
Zurück zum Zitat Häkkinen, U., Järvelin, M.-R., Rosenqvist, G., & Laitinen, J. (2006). Health, schooling and lifestyle among young adults in Finland. Health Economics, 15(11), 1201–1216. doi:10.1002/hec.1123.CrossRef Häkkinen, U., Järvelin, M.-R., Rosenqvist, G., & Laitinen, J. (2006). Health, schooling and lifestyle among young adults in Finland. Health Economics, 15(11), 1201–1216. doi:10.​1002/​hec.​1123.CrossRef
Zurück zum Zitat Henderson, E. A. (1997). Culture or contiguity ethnic conflict, the similarity of states, and the onset of war, 1820–1989. Journal of Conflict Resolution, 41(5), 649–668.CrossRef Henderson, E. A. (1997). Culture or contiguity ethnic conflict, the similarity of states, and the onset of war, 1820–1989. Journal of Conflict Resolution, 41(5), 649–668.CrossRef
Zurück zum Zitat Humphreys, B. R., McLeod, L., & Ruseski, J. E. (2014). Physical activity and health outcomes: Evidence from Canada. Health Economics, 23(1), 33–54. doi:10.1002/hec.2900.CrossRef Humphreys, B. R., McLeod, L., & Ruseski, J. E. (2014). Physical activity and health outcomes: Evidence from Canada. Health Economics, 23(1), 33–54. doi:10.​1002/​hec.​2900.CrossRef
Zurück zum Zitat Hwang, J., & Christensen, C. M. (2008). Disruptive innovation in health care delivery: A framework for business-model innovation. Health Affairs, 27(5), 1329–1335.CrossRef Hwang, J., & Christensen, C. M. (2008). Disruptive innovation in health care delivery: A framework for business-model innovation. Health Affairs, 27(5), 1329–1335.CrossRef
Zurück zum Zitat Khwaja, A. I. (2001). Can good projects succeed in bad communities? Collective action in the Himalayas. In Collective action in the Himalayas (March 2001). John F. Kennedy School of Government Faculty Research Working Papers Series RWP01-043. Khwaja, A. I. (2001). Can good projects succeed in bad communities? Collective action in the Himalayas. In Collective action in the Himalayas (March 2001). John F. Kennedy School of Government Faculty Research Working Papers Series RWP01-043.
Zurück zum Zitat Korsch, B. M., Gozzi, E. K., & Francis, V. (1968). Gaps in doctor-patient communication I. Doctor–patient interaction and patient satisfaction. Pediatrics, 42(5), 855–871. Korsch, B. M., Gozzi, E. K., & Francis, V. (1968). Gaps in doctor-patient communication I. Doctor–patient interaction and patient satisfaction. Pediatrics, 42(5), 855–871.
Zurück zum Zitat Krieger, N., & Berkman, L. (2000). Discrimination and health: Social epidemiology. New York: Oxford University Press. Krieger, N., & Berkman, L. (2000). Discrimination and health: Social epidemiology. New York: Oxford University Press.
Zurück zum Zitat Kumar, S., & Vollmer, S. (2013). Does access to improved sanitation reduce childhood diarrhea in rural India? Health Economics, 22(4), 410–427. doi:10.1002/hec.2809.CrossRef Kumar, S., & Vollmer, S. (2013). Does access to improved sanitation reduce childhood diarrhea in rural India? Health Economics, 22(4), 410–427. doi:10.​1002/​hec.​2809.CrossRef
Zurück zum Zitat La Porta, R., Lopez-de-Silanes, F., Shleifer, A., & Vishny, R. (1999). The quality of government. Journal of Law Economics and Organization, 15(1), 222–279.CrossRef La Porta, R., Lopez-de-Silanes, F., Shleifer, A., & Vishny, R. (1999). The quality of government. Journal of Law Economics and Organization, 15(1), 222–279.CrossRef
Zurück zum Zitat Lake, D. A., & Baum, M. A. (2001). The invisible hand of democracy political control and the provision of public services. Comparative Political Studies, 34(6), 587–621.CrossRef Lake, D. A., & Baum, M. A. (2001). The invisible hand of democracy political control and the provision of public services. Comparative Political Studies, 34(6), 587–621.CrossRef
Zurück zum Zitat Lee, N. (2014). Migrant and ethnic diversity, cities and innovation: Firm effects or city effects? Journal of Economic Geography,. doi:10.1093/jeg/lbu032. Lee, N. (2014). Migrant and ethnic diversity, cities and innovation: Firm effects or city effects? Journal of Economic Geography,. doi:10.​1093/​jeg/​lbu032.
Zurück zum Zitat Lewbel, A. (2012). Using heteroscedasticity to identify and estimate mismeasured and endogenous regressor models. Journal of Business & Economic Statistics, 30(1), 67–80.CrossRef Lewbel, A. (2012). Using heteroscedasticity to identify and estimate mismeasured and endogenous regressor models. Journal of Business & Economic Statistics, 30(1), 67–80.CrossRef
Zurück zum Zitat Mauro, P. (1995). Corruption and growth. The Quarterly Journal of Economics, 110(3), 681–712.CrossRef Mauro, P. (1995). Corruption and growth. The Quarterly Journal of Economics, 110(3), 681–712.CrossRef
Zurück zum Zitat Michalopoulos, S. (2012). The origins of ethnolinguistic diversity. The American Economic Review, 102(4), 1508.CrossRef Michalopoulos, S. (2012). The origins of ethnolinguistic diversity. The American Economic Review, 102(4), 1508.CrossRef
Zurück zum Zitat Nathan, M. (2014). Same difference? Minority ethnic inventors, diversity and innovation in the UK. Journal of Economic Geography,. doi:10.1093/jeg/lbu006. Nathan, M. (2014). Same difference? Minority ethnic inventors, diversity and innovation in the UK. Journal of Economic Geography,. doi:10.​1093/​jeg/​lbu006.
Zurück zum Zitat Nobles, J., & Frankenberg, E. (2009). Mothers’ community participation and child health. Journal of Health and Social Behavior, 50(1), 16–30.CrossRef Nobles, J., & Frankenberg, E. (2009). Mothers’ community participation and child health. Journal of Health and Social Behavior, 50(1), 16–30.CrossRef
Zurück zum Zitat Pascoe, E. A., & Smart Richman, L. (2009). Perceived discrimination and health: A meta-analytic review. Psychological Bulletin, 135(4), 531.CrossRef Pascoe, E. A., & Smart Richman, L. (2009). Perceived discrimination and health: A meta-analytic review. Psychological Bulletin, 135(4), 531.CrossRef
Zurück zum Zitat Paulus, R. A., Davis, K., & Steele, G. D. (2008). Continuous innovation in health care: Implications of the Geisinger experience. Health Affairs, 27(5), 1235–1245.CrossRef Paulus, R. A., Davis, K., & Steele, G. D. (2008). Continuous innovation in health care: Implications of the Geisinger experience. Health Affairs, 27(5), 1235–1245.CrossRef
Zurück zum Zitat Remler, D. K., & Glied, S. A. (2003). What other programs can teach us: Increasing participation in health insurance programs. American Journal of Public Health, 93(1), 67–74.CrossRef Remler, D. K., & Glied, S. A. (2003). What other programs can teach us: Increasing participation in health insurance programs. American Journal of Public Health, 93(1), 67–74.CrossRef
Zurück zum Zitat Reynal-Querol, M., & Montalvo, J. G. (2005). Ethnic polarization, potential conflict and civil war. American Economic Review, 95(3), 796–816.CrossRef Reynal-Querol, M., & Montalvo, J. G. (2005). Ethnic polarization, potential conflict and civil war. American Economic Review, 95(3), 796–816.CrossRef
Zurück zum Zitat Stuber, J. P. (2000). Beyond stigma: What barriers actually affect the decisions of low-income families to enroll in Medicaid. Center for Health Services Research and Policy, George Washington University. Stuber, J. P. (2000). Beyond stigma: What barriers actually affect the decisions of low-income families to enroll in Medicaid. Center for Health Services Research and Policy, George Washington University.
Zurück zum Zitat Wang, C., & Steiner, B. (2015). Can ethno-linguistic diversity explain cross-country differences in social capital?: A global perspective. Economic Record, 91(294), 338–366. doi:10.1111/1475-4932.12195.CrossRef Wang, C., & Steiner, B. (2015). Can ethno-linguistic diversity explain cross-country differences in social capital?: A global perspective. Economic Record, 91(294), 338–366. doi:10.​1111/​1475-4932.​12195.CrossRef
Zurück zum Zitat Williams, D. R., Neighbors, H. W., & Jackson, J. S. (2003). Racial/ethnic discrimination and health: Findings from community studies. American Journal of Public Health, 93(2), 200–208. doi:10.2105/AJPH.93.2.200.CrossRef Williams, D. R., Neighbors, H. W., & Jackson, J. S. (2003). Racial/ethnic discrimination and health: Findings from community studies. American Journal of Public Health, 93(2), 200–208. doi:10.​2105/​AJPH.​93.​2.​200.CrossRef
Zurück zum Zitat Witherington, E., Pirzada, O., & Avery, A. (2008). Communication gaps and readmissions to hospital for patients aged 75 years and older: Observational study. Quality and Safety in Health Care, 17(1), 71–75.CrossRef Witherington, E., Pirzada, O., & Avery, A. (2008). Communication gaps and readmissions to hospital for patients aged 75 years and older: Observational study. Quality and Safety in Health Care, 17(1), 71–75.CrossRef
Metadaten
Titel
Ethnic Diversity and Health Outcomes
verfasst von
Sefa Awaworyi Churchill
Janet Exornam Ocloo
Diana Siawor-Robertson
Publikationsdatum
03.10.2016
Verlag
Springer Netherlands
Erschienen in
Social Indicators Research / Ausgabe 3/2017
Print ISSN: 0303-8300
Elektronische ISSN: 1573-0921
DOI
https://doi.org/10.1007/s11205-016-1454-7

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