ORCID Profile
0000-0002-6396-7054
Current Organisation
Monash University
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Panel Data Analysis | Health Economics | Applied Economics |
Human Capital Issues | Health Inequalities | Behaviour and Health | Health Policy Evaluation
Publisher: Springer Science and Business Media LLC
Date: 17-09-2022
Publisher: Wiley
Date: 27-10-2022
DOI: 10.1002/HEC.4449
Abstract: Prior research shows that economic downturns are associated with increases in mental illness. However, we know little about whose mental health is most negatively affected. Is it the young or old, men or women, employed or non‐employed, rich or poor? Using an 18‐year panel dataset of Australians, we contribute to this understanding by estimating the impact of changes in unemployment on mental health, separately by population subgroups. Our mental health measure captures psychological distress and emotional difficulties, which are often missed by infrequent event indicators such as suicides. We find that young women suffer most during economic downturns. Men and women of older ages are not significantly affected. The effects for young women are driven by those in insecure employment, and those from low socioeconomic backgrounds. Our results suggest that public health programs should emphasize the mental health of young women during economic downturns.
Publisher: Elsevier BV
Date: 11-2014
DOI: 10.1016/J.SOCSCIMED.2014.10.007
Abstract: Self-assessed general health (SAH) is one of the most frequently employed health measures in social science research. Its generic nature means it captures elements of health that more guided measures cannot, and its brevity makes it possible for health information to be included in crowded multifaceted surveys. However, a shortcoming of SAH is that it provides little guidance to researchers as to what in iduals are thinking of when they assess their health - when a survey respondent reports that their health is "poor", is it because they are in pain, tired, depressed, unable to climb stairs, or something else entirely? This limits the possible inference from empirical research. It also means that important determinants and consequences of health can be missed if they are only weakly reflected in SAH. Given the continued use of SAH, it is important to better understand its structure. In this paper we use household panel data from Australia to answer two related questions: (i) what components of health does SAH most strongly represent? and (ii) does the use of SAH conceal important health effects? To answer the first question, we use a detailed health instrument and take a rigorous econometric approach to identify the health dimensions most strongly reflected in SAH. To answer the second question, we estimate the causal effects of income on SAH and on disaggregated health measures using instrumental-variables models. We find that some health dimensions - especially vitality - are consistently important to an in idual when they assess their health, while other dimensions are inconsequential. We demonstrate that this fact provides insight in to why some studies find weak income gradients in SAH. Instrumental-variable regression results show that shocks to household income have no effect on SAH, but strongly improve several dimensions of health that are less commonly measured.
Publisher: Elsevier BV
Date: 10-2017
DOI: 10.1016/J.SOCSCIMED.2017.08.033
Abstract: Systematic differences in the ways that people use and interpret response categories (differential item functioning, DIF) can introduce bias when using self-assessments to compare health or quality of life across heterogeneous groups. This paper reports on an exploratory analysis involving the use of anchoring vignettes to identify DIF in a commonly used measure for assessing health-related quality of life - namely the EQ-5D. Using data from a bespoke (i.e. custom) survey that recruited a representative s le of 4300 respondents from the general Australian population in 2014 and 2015, we find that the assumptions of response consistency (RC) and vignette equivalence (VE) hold in a sub-s le of respondents aged 55-65 years (n = 914), which demonstrates that vignettes can appropriately identify DIF in EQ-5D reporting for this age group. We find that the EQ-5D is indeed subject to DIF, and that failure to account for DIF can lead to conclusions that are misleading when using the instrument to compare health or quality of life across heterogeneous groups. We also provide several important insights in terms of the identifying assumptions of RC and VE. We conclude that the implications of DIF could be of considerable importance, not only for outcomes research, but for funding decisions in healthcare more broadly given the strong reliance on patient-reported outcome measures in economic evaluations for health technology assessment.
Publisher: Wiley
Date: 10-10-2017
DOI: 10.1002/HEC.3433
Publisher: Wiley
Date: 12-01-2017
DOI: 10.1002/HEC.3313
Abstract: This paper discusses two types of response-scale heterogeneity, which may impact upon the EQ-5D. Response-scale heterogeneity in reporting occurs when in iduals systematically differ in their use of response scales when responding to self-assessments. This type of heterogeneity is widely observed in relation to other self-assessed measures but is often overlooked with regard to the EQ-5D. Analogous to this, preference elicitation involving the EQ-5D could be subject to a similar type of heterogeneity, where variations across respondents may occur in the interpretations of the levels (response categories) being valued. This response-scale heterogeneity in preference elicitation may differ from variations in preferences for health states, which have been observed in the literature. This paper explores what these forms of response-scale heterogeneity may mean for the EQ-5D and the potential implications for researchers who rely on the instrument as a measure of health and quality of life. We identify situations where they are likely to be problematic and present potential avenues for overcoming these issues. Copyright © 2016 John Wiley & Sons, Ltd.
Publisher: Wiley
Date: 30-06-2015
DOI: 10.1002/HEC.3211
Abstract: Obese children tend to perform worse academically than normal-weight children. If poor cognitive achievement is truly a consequence of childhood obesity, this relationship has significant policy implications. Therefore, an important question is to what extent can this correlation be explained by other factors that jointly determine obesity and cognitive achievement in childhood? To answer this question, we exploit a rich longitudinal dataset of Australian children, which is linked to national assessments in math and literacy. Using a range of estimators, we find that obesity and body mass index are negatively related to cognitive achievement for boys but not girls. This effect cannot be explained by sociodemographic factors, past cognitive achievement or unobserved time-invariant characteristics and is robust to different measures of adiposity. Given the enormous importance of early human capital development for future well-being and prosperity, this negative effect for boys is concerning and warrants further investigation.
Publisher: Wiley
Date: 30-03-2023
DOI: 10.1002/HEC.4683
Abstract: Non‐communicable diseases (NCDs) disproportionately affect people in low‐ and middle‐income countries (LMICs), yet context‐specific evidence on policies that impact NCD risk factors is lacking. We estimate the impact of a massive Indonesian primary school expansion program in the 1970s on NCD risk factors in later life using data from two surveys with very large s le sizes. We find that in non‐Java regions of Indonesia, the program led to significant increases in the likelihood of overweight and high waist circumference among women, but not among men. The increase for women can be partly explained by increased consumption of high‐calorie packaged and take‐away meals. We find no meaningful impacts on high blood pressure for either sex. Despite the increase in body weight, the program had a negligible impact on diabetes and cardiovascular disease diagnosis. It led to an improvement in women's self‐reported health outcomes in their early‐40s, but these benefits largely disappeared once they reached their mid‐40s.
Publisher: Wiley
Date: 23-09-2012
Publisher: Wiley
Date: 13-07-2020
DOI: 10.1111/OBES.12370
Publisher: University of Chicago Press
Date: 06-2017
DOI: 10.1086/692016
Publisher: Informa UK Limited
Date: 06-2013
Publisher: Wiley
Date: 08-05-2020
DOI: 10.1111/ADD.15090
Publisher: Elsevier BV
Date: 05-2011
DOI: 10.1016/J.YPMED.2011.03.006
Abstract: To investigate the influence of employment patterns on weight gain and weight loss in young adult women. Study s le is 5164 participants in the Australian Longitudinal Study on Women's Health who completed surveys in 2003 and 2006. Logistic regression was used to estimate odds ratios of weight change. The adjusted odds of gaining weight, compared with women in stable full-time work (49.7%), were lower for women in stable part-time work (47.3%, OR = 0.74, CI: 0.58-0.94), or who transitioned from not in the labour force (NILF) to part-time (42.8%, OR = 0.68, CI: 0.47-0.99) or full-time (37.5%, OR = 0.54, CI: 0.34-0.85) work. Heavy weight gain (>10 kg) was less likely among women in stable part-time work (6.4%, OR=0.59, CI: 0.37-0.93) compared with those in stable full-time work (8.1%). The likelihood of weight loss compared with women in stable full-time employment (22.4%) was higher among stable part-time workers (28.4% OR = 1.34, CI: 1.02-1.75) and those who transitioned from full-time to part-time work (24.8%, OR = 1.30, CI: 1.01-1.67). The lower likelihood of heavy weight gain associated with fewer work hours suggests more time spent at work may contribute to weight gain. Young women in full-time employment may benefit from workplace interventions supporting healthier lifestyles.
Publisher: Springer Science and Business Media LLC
Date: 03-01-2014
DOI: 10.1007/S11136-013-0615-2
Abstract: Self-rated health (SRH) is widely used to measure and compare the health status of different groups of in iduals. However, SRH can suffer from heterogeneity in reporting styles, making health comparisons problematic. Anchoring vignettes is a promising technique for improving inter-group comparisons of SRH. A key identifying assumption of the approach is response consistency-that respondents rate themselves using the same underlying response scale that they rate the vignettes. Despite growing research into response consistency, it remains unclear how respondents rate vignettes and why respondents may not assess vignettes and themselves consistently. Vignettes for the EQ-5D-5L were developed and included in an online survey. In-depth interviews were conducted with participants following survey completion. Response consistency was examined through qualitative analysis of the interview responses and quantitative coding of participants' thought processes. Our analysis showed that anchoring vignettes for the EQ-5D-5L is feasible, but that response consistency may not hold for some participants. Respondents are more likely to rate their own health and vignettes in the same way if presented with overall health state vignettes than single health dimension vignettes, and if they imagined themselves in the health state of the hypothetical in idual. This research highlights opportunities to improve the design of anchoring vignettes in order to enhance response consistency. It additionally provides new evidence on the feasibility of employing anchoring vignettes for the EQ-5D-5L, which is promising for future work to address reporting heterogeneity in the EQ-5D-5L.
Publisher: Elsevier BV
Date: 09-2018
DOI: 10.1016/J.EHB.2018.07.003
Abstract: The effect of childhood obesity on medical costs incurred by the Australian Government is estimated using five waves of panel data from the Longitudinal Study of Australian Children, which is linked to public health insurance administrative records from Medicare Australia. Instrumental variables estimators are used to address concerns about measurement error and selection bias. The additional annual medical costs due to overweight and obesity among 6 to 13 year olds is about $43 million (in 2015 AUD). This is driven by a higher utilisation of general practitioner and specialist doctors. The results suggest that the economic consequences of childhood obesity are much larger than previously estimated.
Publisher: Wiley
Date: 29-10-2021
DOI: 10.1002/HEC.4451
Abstract: The obesity epidemic is a significant public policy issue facing the international community, resulting in substantial costs to in iduals and society. Various policies have been suggested to reduce and prevent obesity, including those informed by standard economics (a key feature of which is the assumption that in iduals are rational) and behavioral economics (which identifies and harness deviations from rationality). It is not known which policy interventions taxpayers find acceptable and would prefer to fund via taxation. We provide evidence from a discrete choice experiment on an Australian s le of 996 in iduals to investigate social acceptability of eight policies: mass media c aign traffic light nutritional labeling taxing sugar sweetened beverages prepaid cards to purchase healthy food financial incentives to exercise improved built environment for physical activity bans on advertising unhealthy food and drink to children and improved nutritional quality of food sold in public institutions. Latent class analysis revealed three classes differing in preferences and key respondent characteristics including capacity to benefit. Social acceptability of the eight policies at realistic levels of tax increases was explored using post‐estimation analysis. Overall, 78% of the s le were predicted to choose a new policy, varying from 99% in those most likely to benefit from obesity interventions to 19% of those least likely to benefit. A policy informed by standard economics, traffic light labeling was the most popular policy, followed by policies involving regulation: bans on junk food advertising to children and improvement of food quality in public institutions. The least popular policies were behaviorally informed: prepaid cards for the purchase of only healthy foods, and financial incentives to exercise.
Publisher: Wiley
Date: 03-02-2014
DOI: 10.1111/DPR.12054
Publisher: Wiley
Date: 07-08-2015
DOI: 10.1002/HEC.3094
Abstract: Obesity, like many health conditions, is more prevalent among the socioeconomically disadvantaged. In our data, very poor women are three times more likely to be obese and five times more likely to be severely obese than rich women. Despite this strong correlation, it remains unclear whether higher wealth causes lower obesity. In this paper, we use nationally representative panel data and exogenous wealth shocks (primarily inheritances and lottery wins) to shed light on this issue. Our estimates show that wealth improvements increase weight for women, but not men. This effect differs by initial wealth and weight-an average-sized wealth shock received by initially poor and obese women is estimated to increase weight by almost 10 lb. Importantly, for some females, the effects appear permanent. We also find that a change in diet is the most likely explanation for the weight gain. Overall, the results suggest that additional wealth may exacerbate rather than alleviate weight problems.
Publisher: Elsevier BV
Date: 2019
DOI: 10.1016/J.SOCSCIMED.2018.10.025
Abstract: This paper focuses on the long-term impacts of attending a high school with inadequate sports facilities. We use prospective data from the British National Child Development Study, a continuing panel of a cohort of 17,634 children born in Great Britain during a single week of March 1958. Our empirical approach exploits the educational system they were exposed to: children were sorted by educational ability at age 11, but conditional on educational ability, attended their closest school. This produces quasi-random variation in the quality of the school sports facilities across respondents. We use this variation between cohort members residing within the same local authority area, and focus on outcome measures of physical activity, health, health-related lifestyle activities, and socioeconomic status, collected at ages between 33 and 50 years. We control for any potential links between the inadequacy of sports facilities and inadequacy of other facility types, and test that allocation to school type is random with respect to pre-high school observables. We find that attending a school with inadequate sports facilities led to a statistically significant, modest decrease in the likelihood of physical activity participation during adulthood. In contrast, we find no evidence that inadequate sports facilities worsened adulthood measures of physical and mental health, lifestyle or socioeconomic status.
Publisher: Elsevier BV
Date: 06-2018
DOI: 10.1016/J.YPMED.2018.02.034
Abstract: Adolescent obesity not only has serious long-term health implications, but also the potential to lead to a socioeconomic trajectory of lower earnings and household income. However, the magnitude and mechanisms of such outcomes across the life course are poorly understood. Using birth cohort data from the British National Child Development Study (1958 to 2008), we examined the relationship between adolescent obesity (at age 16) and future household income, employment, wages, marriage and spousal earnings when in iduals were in their 30s, 40s and 50s. We additionally investigated the role of obesity persistence from childhood (age 11) through to adulthood (age 33). After adjusting for a rich set of childhood characteristics, compared to normal weight, obesity at age 16 was associated with significantly lower levels of future household income for women (by approximately 14%), but not men. This household income penalty was greater for women with obesity in both childhood and adulthood. The household income penalty for women appeared to be driven by a lower likelihood of marriage and lower spousal earnings for those who were married, and not by their own wage penalty in the labour market. The spousal earnings penalty occurred even when obesity did not persist into adulthood.
Publisher: Elsevier BV
Date: 11-2021
Publisher: Elsevier BV
Date: 10-2017
DOI: 10.1016/J.SOCSCIMED.2017.08.032
Abstract: Self-assessed health (SAH) measures are widely used in models of health and health inequalities. Such models assume that SAH is a reliable measure of health status. We utilise a unique feature of a national longitudinal survey to examine the consistency of responses to a standard SAH question that is asked twice to the same in idual in close temporal proximity in up to three waves (2001, 2009, and 2013). In particular, we analyse whether the consistency of responses varies with personal characteristics. The main analysis s le includes 18,834 in idual-year observations. We find that 57% of respondents provide inconsistent reports at least once. Characteristics that are associated with significantly higher inconsistencies are age, education, cognitive ability, and time between responses. The results suggest that there are systematic differences in the ability of in iduals' to self-evaluate and summarise their own health. Consequently, failure to account for such error may lead to large estimation biases in models of health outcomes, particularly with respect to the relationship between education, cognitive ability, and health.
Publisher: Elsevier BV
Date: 07-2017
DOI: 10.1016/J.JHEALECO.2017.05.001
Abstract: The relationship between health and work is frequently investigated using self-assessments of disability from social surveys. The complication is that respondents may overstate their level of disability to justify non-employment and welfare receipt. This study provides new evidence on the existence and magnitude of justification bias by exploiting a novel feature of a large longitudinal survey: each wave respondents are asked identical disability questions twice near the beginning and end of the face-to-face interview. Prior to answering the second disability question, respondents are asked a series of questions that increase the salience of their employment and welfare circumstances. Justification bias is identified by comparing the variation between the two measures within-in iduals over time, with the variation in employment status over time. Results indicate substantial and statistically significant justification bias especially for men and women who receive disability pensions.
Publisher: Springer Science and Business Media LLC
Date: 19-06-2012
DOI: 10.1038/IJO.2012.92
Abstract: To investigate the influence of employment and work hours on weight gain and weight loss among middle-aged women. Quantile regression techniques were used to estimate the influence of employment and hours worked on percentage weight change over 2 years across the entire distribution of weight change in a cohort of middle-aged women. A range of controls was included in the models to isolate the effect of work status. A total of 9276 women aged 45-50 years at baseline who were present in both the 1996 and 1998 surveys of the Australian Longitudinal Study of Women's Health. The women were a representative s le of the Australian population. Being out of the labour force or unemployed was associated with lower weight gain and higher weight loss than being employed. The association was stronger at low to moderate levels of weight gain. Among employed women, working regular (35-40), long (41-48) or very long (49+) hours was associated with increasingly higher levels of weight gain compared with working part-time hours. The association was stronger for women with greater weight gain overall. The association between unemployment and weight change became insignificant when health status was controlled for. Employment was associated with more weight gain and less weight loss. Among the employed, working longer hours was associated with more weight gain, especially at the higher levels of weight gain where the health consequences are more serious. These findings suggest that as women work longer hours they are more likely to make lifestyle choices that are associated with weight gain.
Start Date: 09-2018
End Date: 12-2023
Amount: $402,996.00
Funder: Australian Research Council
View Funded ActivityStart Date: 03-2021
End Date: 12-2024
Amount: $513,835.00
Funder: Australian Research Council
View Funded Activity