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New Findings in Health and Health Care Across and Within Countries

Paper Session

Saturday, Jan. 3, 2026 10:15 AM - 12:15 PM (EST)

Philadelphia Convention Center, 201-B
Hosted By: American Economic Association
  • Chair: Jon Skinner, Dartmouth College

Reexamining Geographic Variation in Health and Health Care

Amy Finkelstein
,
Massachusetts Institute of Technology

Abstract

A large literature has documented widespread variation in health care spending per capita across areas of the United States without correspondingly better health outcomes. Recent work has used mover designs to estimate the causal impact of place on both health care spending and mortality. In this paper, we investigate whether places that increase health care spending also tend to be places that increase health, and find that they do not.

International Comparison of Physician Earnings

Josh Gottlieb
,
University of Chicago
Jeffrey Hicks
,
University of Toronto
Lisa Laun
,
Institute for Evaluation of Labour Market and Education Policy
Mårten Palme
,
Stockholm University
Maria Polyakova
,
Stanford University
Victoria Udalova
,
U.S. Census Bureau
Maria Ventura
,
University of Edinburgh
Aidan Buehler
,
University of Chicago

Abstract

We compare physician earnings using tax data from the U.S., Canada, Sweden, and the Netherlands. Physicians are concentrated in the top few percentiles of the income distribution in all four countries, especially in the U.S. and especially in certain specialties. U.S. physicians' absolute earnings far exceed the other countries. These absolute differences primarily reflect countries’ overall income distributions, rather than physicians' locations in those distributions. This suggests that broader labor markets in each country, and thus physicians’ outside options, drive absolute earnings. Policy changes that shift U.S. physicians’ incomes to match physicians’ relative positions in other high-income countries’ distributions would have a minimal impact on healthcare spending.

Exploring the Atomistic Versus Ecological Fallacies in SES-Health Gradients

Johannes Spinnewijn
,
London School of Economics
William Parker
,
London School of Economics

Abstract

A substantial body of research has explored the relationship between socioeconomic status (SES) and health, often relying on various levels of spatial aggregation. Using rich Dutch data we investigate how the specification of these observational units impacts the observed SES-health gradient. First, we find that individual-level and area-level gradients measure conceptually distinct, yet complementary, relationships, which happen to have similar magnitudes in the Dutch context. Hybrid aggregation levels, where health is measured individually but SES is aggregated, conflate these two distinct relationships. Second, our analysis reveals that area-level analyses obscure significant non-linearity in the health-SES relationship due to compressed SES variation at the aggregate level. Finally, low-income households are considerably more susceptible to the influence of their neighbourhood on health, with the bottom decile of household income experiencing 4-8 times greater exposure than the top decile, depending on the geographic unit. These insights underscore the trade-offs in data aggregation choices when studying socioeconomic health disparities

Discussant(s)
Jon Skinner
,
Dartmouth College
Atul Gupta
,
University of Pennsylvania
Michael Stepner
,
University of Toronto
JEL Classifications
  • I1 - Health