Economics And Human Biology[JOURNAL]
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200 papers
Inequality in provider and patient-initiated healthcare cancellations during Covid-19.
Jacob N, Arabadzhyan A, Kasteridis P … +2 more , Mason A, Rice N
Econ Hum Biol · 2025 Dec · PMID 41260053 · Full text
The Covid-19 pandemic adversely affected access to healthcare raising concerns about worsening health, unmet need and subsequent 'displaced' demand. Yet little is known about how this displaced demand was distributed or...
The Covid-19 pandemic adversely affected access to healthcare raising concerns about worsening health, unmet need and subsequent 'displaced' demand. Yet little is known about how this displaced demand was distributed or whether it reflected patient's decisions to cancel versus provider's decisions to ration care. Using survey data for England from the UK Household Longitudinal Study, we examine whether planned care continued (or alternative provided), was cancelled by the provider or cancelled by the patient and how these outcomes vary across socio-demographic, clinical, regional and treatment-type characteristics. We estimate weighted multinomial logit models for April-July 2020 (pooled and wave specific), including region and month effects and a region-month Covid-mortality proxy for local NHS strain. Cancellations were overwhelmingly provider-initiated (87% vs 13% patient-initiated). A clear age gradient emerges: provider-initiated cancellations rise with age while patient-initiated cancellations fall; the provider-to-patient cancellation ratio is much higher for those aged 65+ than for younger adults, consistent with providers 'moving first' for older adults under capacity constraints. Several groups experienced 'double jeopardy' with elevated risks of both provider and patient cancellation: ethnic minority respondents, people in smaller households, urban residents, and those in the North East and Yorkshire and the Humber regions. Because provider cancellations predominated, providers largely determined which treatments continued. Without safeguards, such rationing risks amplified existing inequalities, particularly for double-jeopardy groups. Backlog recovery should protect elective capacity, especially for procedures, and prioritise proactive outreach and flexible scheduling for these groups, whilst reducing patient-side barriers.
Pollution avoidance: Within and across category substitution.
Courty P, Liu D
Econ Hum Biol · 2025 Dec · PMID 41242033 · Publisher ↗
Theater attendance responses to air pollution vary by theater type. Multiplex theaters benefit from increased attendance during periods of high pollution, often at the expense of smaller theaters. However, these effects...
Theater attendance responses to air pollution vary by theater type. Multiplex theaters benefit from increased attendance during periods of high pollution, often at the expense of smaller theaters. However, these effects do not balance out at the chain level-some theater chains see attendance gains, while others experience losses. Furthermore, the average absolute attendance response at the individual theater level is significantly larger than the overall average, indicating that prior studies that focus solely on aggregate demand vastly underestimate pollution avoidance.
Impact of health insurance expansion on patients' financial burden and family well-being in South Korea.
Bae G, Ko H, Lee HM … +1 more , Park S
Econ Hum Biol · 2025 Dec · PMID 41240762 · Publisher ↗
South Korea achieved universal health coverage through a mandatory national health insurance system, but has historically lacked comprehensive benefits coverage, leading to a high proportion of out-of-pocket spending. In...
South Korea achieved universal health coverage through a mandatory national health insurance system, but has historically lacked comprehensive benefits coverage, leading to a high proportion of out-of-pocket spending. In 2013, the government expanded benefits coverage for high-cost disease groups, including cancer, cardiac diseases, cerebrovascular diseases, and rare diseases. While prior studies show that this health insurance expansion reduced out-of-pocket spending at the individual level, its broader implications for family well-being remain unclear. To assess the effects of the 2013 health insurance expansion on patients' financial burden and family well-being, we conducted difference-in-differences analyses with entropy balancing using longitudinal data from the 2010-2017 Korea Health Panel Survey. Our analysis confirms that the benefits coverage expansion reduced patients' out-of-pocket spending by 30 %, though, effects on overall family well-being were insignificant. However, our subgroup analyses suggest that family members with higher educational attainment experienced improvements in mental health when a household member was affected by the policy. Our finding indicates that while health insurance expansion provides direct financial benefits across the entire study population, its indirect effects on family well-being vary by educational level. This highlights the critical role of education in maximizing the broader benefits of health insurance expansion.
Early life exposure to climate shocks and the protective role of cash transfers.
Munyanyi ME, Damoah KA, Tirivayi N
Econ Hum Biol · 2025 Dec · PMID 41205309 · Publisher ↗
This study investigates how early-life drought exposure affects child undernutrition-stunting, underweight, and wasting-and evaluates whether cash transfers can mitigate these impacts. Using rainfall, household, and chil...
This study investigates how early-life drought exposure affects child undernutrition-stunting, underweight, and wasting-and evaluates whether cash transfers can mitigate these impacts. Using rainfall, household, and child-level data from Ghana and Burkina Faso, we find that birth-year droughts increase stunting and underweight in Ghana but reduce wasting, while in Burkina Faso, pre-birth droughts raise the risk of wasting and underweight. Gender differences emerge: in Ghana, drought exposure increases stunting among boys, while girls are more affected in birth-year droughts. In Burkina Faso, boys are more vulnerable to wasting from birth-year droughts, while girls face greater risks of wasting and underweight from pre-birth droughts. Across both countries, children in female-headed households appear less vulnerable to drought shocks compared to those in male-headed households. The negative effects of drought are most pronounced in early childhood and decline with age. Cash transfers play a protective role, reducing underweight associated with birth-year drought and mitigating stunting and underweight linked to pre-birth droughts in Ghana. In Burkina Faso, they alleviate the effects of birth-year drought on stunting, underweight, and wasting, and underweight and wasting linked to pre-birth drought exposure.
(A)symmetries in beauty-status exchange: Spousal relative income and partners' BMI (at) during marriage.
Syrda J
Econ Hum Biol · 2025 Dec · PMID 41192366 · Publisher ↗
Beauty-status exchange, while extensively researched as a static concept at match formation, received very little to no attention as a dynamic phenomenon that can occur during marriage. Prior research typically relied on...
Beauty-status exchange, while extensively researched as a static concept at match formation, received very little to no attention as a dynamic phenomenon that can occur during marriage. Prior research typically relied on absolute income measures, whereas relative ones are theoretically better at capturing exchange. This study addresses these gaps by examining the existence, extent and nature of the dynamic "beauty-status exchange" as compared to the static one. Using PSID data (1999-2019; 3744 couples) this is the first study to analyse changes in physical attractiveness (approximated by BMI) in response to relative income shifts. The results reveal asymmetrical, gendered exchange patterns at marriage selection, however, during marriage, the effects are symmetrical: increase in one spouse's relative income is associated with a lower BMI in the other, as well as a reduced log odds of being overweight or obese. This income shift is linked to greater physical activity in the other spouse, suggesting purposeful behavioural adjustments. Finally, heterogeneity analyses show the beauty - status exchange is concentrated among highly educated women: the positive association between women's BMI and obesity likelihood, and her relative income is significantly steeper for college educated women. Conversely, the negative association between wives' relative income and husbands' log-odds of obesity is attenuated or reversed among college-educated men, suggesting that in dual-career, high-skill men, rising spousal income may increase work incentives and shift investments away from appearance.
Birth weight and school performance.
Pedersen IK, Reme BA, Mølland E … +1 more , Kinge JM
Econ Hum Biol · 2025 Dec · PMID 41187389 · Publisher ↗
This study investigates the long-term association between birth weight and school performance in Norway, with a focus on how this relationship has evolved alongside demographic changes. We contribute to the literature by...
This study investigates the long-term association between birth weight and school performance in Norway, with a focus on how this relationship has evolved alongside demographic changes. We contribute to the literature by examining this link in a contemporary context using nearly two decades of administrative data. Our findings indicate that higher birth weight is consistently associated with better school performance, particularly in mathematics. This association remains robust across multiple model specifications, including those that account for unobserved family heterogeneity. We also find a slightly stronger association among girls, though the gender interaction is small and not robust in the twin design. Overall, the results underscore birth weight as a stable predictor of academic achievement and highlight its relevance for understanding early-life determinants of human capital development.
The impact of health shocks on worker performance: Evidence from Major League Baseball.
Chikish Y, Humphreys BR
Econ Hum Biol · 2025 Dec · PMID 41151476 · Publisher ↗
A small, recent, growing literature examines the impact of health shocks in the form of illness or disease, and interventions aimed at mitigating the impact of these health shocks, on labor market outcomes. These papers...
A small, recent, growing literature examines the impact of health shocks in the form of illness or disease, and interventions aimed at mitigating the impact of these health shocks, on labor market outcomes. These papers report evidence that labor market outcomes improve significantly following health shocks and interventions. We extend this analysis to a novel setting where a workplace injury represents the health shock and s surgical procedure to repair this injury represents the intervention. We employ matching methods to construct a counterfactual comparison group of uninjured Major League Baseball (MLB) pitchers and compare labor market outcome in this group to treated MLB pitchers who experienced ulnar collateral ligament (UCL) injuries and underwent a reconstructive ligament repair procedure. Surgical repair of UCL injuries extends post-injury MLB pitcher careers by roughly 1.3 seasons relative to matched uninjured pitchers, a 14.5% increase that generates substantial economic benefits for players and teams. Post-injury and treatment pitcher performance, in terms of batting success of hitters faced by treated pitchers, improves by roughly 8%.
Social homogeneity and spread of pandemic: Evidence from India.
Das U, Rathore U, Sarkhel P
Econ Hum Biol · 2025 Dec · PMID 41138686 · Publisher ↗
Compliance with the public health guidelines during pandemics requires coordinated community actions which might be undermined in socially diverse areas. In this paper, we assess the relationship between caste-group homo...
Compliance with the public health guidelines during pandemics requires coordinated community actions which might be undermined in socially diverse areas. In this paper, we assess the relationship between caste-group homogeneity and spread of COVID-19 infection during the nationwide lockdown and unlocking period in India. Estimates using daily data show that caste-homogeneous districts experienced slower growth in infection for about 2.5 months since the beginning of the lockdown. The findings further indicate that caste-homogeneous districts took more days to cross the concentration thresholds of 50-500 cases. In terms of mechanisms, we find suggestive evidence of lower mobility in caste-homogeneous localities during the lockdown period, which would have slowed infection spread. We also find a significantly higher engagement of frontline health workers in these districts after the outbreak. Our findings reveal how caste-group homogeneity can be used to identify potential hotspots and emphasize the importance of health workers, and decentralized policy response.
Spouses as home health workers, childcare workers and cooks: Insights for applied research.
Grossbard S
Econ Hum Biol · 2025 Dec · PMID 41138685 · Publisher ↗
This paper presents a model of decision-making in households that produce META-goods such as their children's human capital, health care of elderly relatives, and good nutrition. The model takes into account two kinds of...
This paper presents a model of decision-making in households that produce META-goods such as their children's human capital, health care of elderly relatives, and good nutrition. The model takes into account two kinds of substitution in production: (1) between producing META-goods at home e.g. by preparing a meal and purchasing goods produced commercially e.g. by eating out and (2) between goods produced at home by oneself and goods produced at home by a spouse or partner. New insights are offered that can help interpret empirical analyses of observed gaps in the following behaviors of individuals living in couple: consumption, labor supply, time spent caring for young children, time spent caring for older relatives, and time spent cooking and cleaning. Existing research has reported gaps in such behaviors, including gender, age, weight, income and education gaps. The model's emphasis on the importance of household production and the role that spouses and non-marital partners may play in such production leads to the identification of new variables related to marriage markets that could help explain consumption, labor supply, own caregiving or caregiving by partners or spouses. These explanatory variables include sex ratios (and exogenous parameters that influence sex ratios), changes in marriage and divorce laws, and combinations of personal characteristics associated with likelihood of marriage or cohabitation.
Invisible killer under the blue sky：Ozone pollution and infant mortality in China.
Chen H, Wu H, Xu J
Econ Hum Biol · 2025 Dec · PMID 41101158 · Publisher ↗
There is growing empirical evidence that air pollution will increase infant mortality in developed countries. Less understood is invisible pollution under the blue sky-causal effects of ozone pollution on infant mortalit...
There is growing empirical evidence that air pollution will increase infant mortality in developed countries. Less understood is invisible pollution under the blue sky-causal effects of ozone pollution on infant mortality in developing countries, especially China. In this paper, we manually collect Chinese mortality data of 160 cities and adopt a mixed two-stage least squares (M2SLS) method to estimate the causal effects of ozone pollution on infant mortality and under-5-child mortality during 2015-2018. We find that 10 μg/m3 rise from ozone pollution causes 60 additional infant deaths per 100,000 (16 %), and 100 additional children under 5 years old deaths per 100,000 (20 %). During the sample period, the rising ozone pollution would kill about 90,000 children under 5 years old and incur economic losses of more than 670 billion yuan. This paper contributes to our knowledge of detrimental health effects of ozone pollution in developing countries.
Maternal mortality, tuberculosis and social deprivation in Madrid during the second and third decades of the 20th century.
González-Esteban AT, Mazzoni S, Oris M … +1 more , Ramiro-Fariñas D
Econ Hum Biol · 2025 Dec · PMID 41043215 · Publisher ↗
In this paper we jointly study maternal mortality and tuberculosis during the second and third decades of the 20th century in Madrid. Nicknamed the "city of death", the Spanish capital was marked by a high mortality wher...
In this paper we jointly study maternal mortality and tuberculosis during the second and third decades of the 20th century in Madrid. Nicknamed the "city of death", the Spanish capital was marked by a high mortality where tuberculosis accounted for approximately 26/28 % of all deaths of women of reproductive age. Using a large longitudinal individual-level database including causes of death, we discuss the definitions of maternal mortality, then highlight its high level in the Spanish capital. However, the risk of dying was significantly lower for migrant women than for native. In the context studied, an evident example of the "healthy migrant" paradox with selection at origin is outlined. At the same time, there are clear links between tuberculosis as a cause of death during the 60 days following a delivery and the socio-spatial inequalities characteristic of a city that saw wealthy areas side by side with disadvantaged areas, characterized by low standards of living conditions and insufficient hygiene. The results of the statistical models analyzed are controlled for geographic, social and biological variables in addition to individual demographic characteristics. The robustness of the results is ensured by the size of the sample used, which allowed us to study an event - a death following delivery - that, even at the time of this study, was rare.
Expanded prescription coverage and opioid use disorders: Evidence from Medicare Part D.
Ang RB
Econ Hum Biol · 2025 Dec · PMID 40997713 · Publisher ↗
Medicare Part D, implemented on January 2006, expanded subsidized outpatient prescription-drug coverage, including medication-assisted treatment (MAT) drugs, for adults aged 65 and older. Using 6.2 million discharge reco...
Medicare Part D, implemented on January 2006, expanded subsidized outpatient prescription-drug coverage, including medication-assisted treatment (MAT) drugs, for adults aged 65 and older. Using 6.2 million discharge records from the 2001 to 2011 Healthcare Cost and Utilization Project National Inpatient Sample, I study how this policy influenced serious opioid use disorder (OUD) events. The analysis uses a difference-in-differences framework that compares OUD-related hospitalizations among 65- to 69-year-olds with those of 60- to 64-year-olds, and an event study confirms parallel trends before implementation. Part D lowered OUD-related hospital admissions by 158.3 per 100,000 discharges, a 53% decline from the pre-policy mean. The reduction is concentrated in admissions that include diagnoses of opioid abuse or dependence, whereas admissions related to opioid poisoning show little change. Larger proportional declines among Black and Hispanic adults and among men indicate that changes in drug coverage were accompanied by differences in outcomes across demographic groups. Estimates are robust across alternative specifications. By reducing out-of-pocket costs for MAT drugs covered by Part D, comprehensive prescription benefits can substantially cut avoidable hospital stays even when individual treatment uptake is not observed. These findings inform current debates on drug-benefit design for aging populations confronting opioid-related harm and illustrate how insurance coverage shapes health production later in life.
The impact of biomedical innovation on cancer mortality in 37 countries, 2003-2017.
Lichtenberg FR
Econ Hum Biol · 2025 Dec · PMID 40992227 · Publisher ↗
Previous studies have shown that biomedical innovation, as measured by the long-run change in the vintage of MeSH descriptors of PubMed articles, has been the principal cause of declining cancer mortality in the U.S. The...
Previous studies have shown that biomedical innovation, as measured by the long-run change in the vintage of MeSH descriptors of PubMed articles, has been the principal cause of declining cancer mortality in the U.S. The effect of biomedical innovation on cancer mortality outside of the U.S. may be different from its effect in the U.S. This study uses similar methods to investigate econometrically the impact that biomedical innovation had on cancer mortality in 37 countries during the period 2003-2017. Estimates based on pooled data by cancer site, country, and year indicate that the age-adjusted cancer mortality rate is significantly inversely related to the vintage of descriptors of PubMed articles about that cancer site 9-20 years (but not 0-8 years) earlier, controlling for the age-adjusted cancer incidence rate. The mortality rate is most strongly inversely related to the vintage of descriptors 16 years earlier. This finding is consistent with evidence from other studies that there is a substantial lag from biomedical innovation to population health. Excluding the U.S. (which accounts for 26 % of the cancer deaths in the 37 countries) from the sample does not have a substantial effect on the estimates. 85 % of the 2003-2017 decline in the cancer mortality rate is estimated to be attributable to the 1987-2001 increase in mean vintage. Only 6 % of the 2003-2017 decline in the cancer mortality rate is estimated to be attributable to the contemporaneous decline in the cancer incidence rate. In addition to estimating models using pooled data for many countries, we estimate models of the cancer mortality rate separately for each country. The estimate of the coefficient of vintage 16 years earlier is negative and significant for 24 of the 37 countries, and negative and marginally significant for 2 other countries; it is not positive and significant for any country. The population-weighted mean of the 37 estimates is very similar to the estimate from the model based on pooled data from many countries.
Effects of the 2021 expanded Child Tax Credit on parents' well-being and time use.
Lebihan L
Econ Hum Biol · 2025 Dec · PMID 40975920 · Publisher ↗
The American Rescue Plan Act of 2021 temporarily provided unconditional monthly cash benefits to most households with children to reduce child poverty during the COVID-19 pandemic. Using the American Time Use Survey and...
The American Rescue Plan Act of 2021 temporarily provided unconditional monthly cash benefits to most households with children to reduce child poverty during the COVID-19 pandemic. Using the American Time Use Survey and Well-Being Supplement, we examine the effects of the 2021 Child Tax Credit (CTC) expansion on well-being and time-use activities of households with children. We find that the CTC expansion was associated with improved parental well-being and health. The analysis also shows a significant increase in the time the parent spends with the child. The results are robust to several robustness checks and consistent with existing evidence.
Hot and cold, safe and unsafe: Evaluating the impact of extreme temperatures on work-related accidents in China.
Yao Z, Cao X
Econ Hum Biol · 2025 Dec · PMID 40972417 · Publisher ↗
We investigate how extreme temperatures impact work-related accidents across 411 cities in China from 2015 to 2019. Using a linear probability model, we find a significant causal link between rising temperatures and work...
We investigate how extreme temperatures impact work-related accidents across 411 cities in China from 2015 to 2019. Using a linear probability model, we find a significant causal link between rising temperatures and workplace accidents, with a 10°C increase leading to a 0.09 % rise in accident probability. Our analysis shows that temperatures over 24-26°C markedly increase accident risk, particularly in outdoor-intensive industries like construction and public facility management, with southern regions facing higher hazards due to prolonged heat exposure. Robustness checks, including lagged and lead temperature effects, confirm the consistency of our findings, reinforcing the direct link between environmental conditions and accident occurrence. This research contributes a comprehensive, causal view of temperature's effect on workplace safety in a developing context, emphasizing the urgent need for temperature-sensitive safety protocols. For developing countries such as China, climate-resilient labor policies, including adaptive work schedules, cooling breaks, and shaded workspaces, are critical to protect workers and sustain productivity as global temperatures rise. Our findings lay a foundation for policy actions aimed at bolstering occupational safety standards to address escalating climate risks.
The (birthweight) gains from trade: Chinese imports and infant health in Sub-Saharan Africa.
Aguero JM, Ukil P
Econ Hum Biol · 2025 Dec · PMID 40946627 · Publisher ↗
A growing literature has documented broad negative impacts of Chinese imports to advanced economies, mainly due to the competition of these imports with local production. However, for countries with a smaller manufacturi...
A growing literature has documented broad negative impacts of Chinese imports to advanced economies, mainly due to the competition of these imports with local production. However, for countries with a smaller manufacturing sector and which have not experienced a structural transformation away from agriculture, Chinese imports could have positive effects. We find evidence supporting this claim using a sample of over 350,000 births from 25 countries in Sub-Sahara Africa. Our identification compares the birthweight of biological siblings born at different levels of Chinese imports to their country. We find that an increase in Chinese imports of $100 (constant USD) is associated with an increase in birthweight by almost 14 g. Gains are larger for female children, children born to lesser-educated mothers and from imports of health- and food-related goods.
The impact of Long-term Care Insurance on household income inequality: Evidence from China.
Chi Y, Zhang Q
Econ Hum Biol · 2025 Dec · PMID 40939218 · Publisher ↗
The stable performance of the national economy constitutes a vital component in achieving common prosperity. As a crucial element of the social security system, evaluating the actual effectiveness of Long-Term Care Insur...
The stable performance of the national economy constitutes a vital component in achieving common prosperity. As a crucial element of the social security system, evaluating the actual effectiveness of Long-Term Care Insurance (LTCI) in providing a safety net for families has emerged as a core issue in current policy implementation. This paper explores the impact and mechanisms of LTCI policies on household income inequality, based on three waves of data from the China Health and Retirement Longitudinal Study (CHARLS) in 2013, 2015, 2018, and 2020, along with macro-level data from various provincial-level administrative regions. The study finds that the introduction of the LTCI policy has significantly mitigated the level of household income inequality in pilot areas. This mitigating effect exhibits significant heterogeneity concerning medical payment risk and across urban and rural regions. Furthermore, the findings demonstrate that LTCI contributes positively to reducing household income inequality primarily through two mechanisms: the social job creation effect and the reduction in family caregiving burden. Based on these findings, the research provides valuable insights for bridging income inequality and achieving common prosperity.
The impact of obesity on human capital accumulation: Exploring the driving factors.
Carrasco R, González-González D
Econ Hum Biol · 2025 Dec · PMID 40930011 · Publisher ↗
This paper examines the impact of childhood obesity on Spanish high school students' academic achievement and human capital accumulation. To address potential endogeneity concerns, we exploit exogenous variation in obesi...
This paper examines the impact of childhood obesity on Spanish high school students' academic achievement and human capital accumulation. To address potential endogeneity concerns, we exploit exogenous variation in obesity within peer groups, using data from friendship networks. Specifically, we instrument individual obesity with the average body mass index of intransitive friendship triads. Our results indicate that obesity has a negative effect on academic outcomes, particularly on overall grades for girls and on cognitive abilities for both boys and girls. We also find a negative impact of obesity on girls' mathematics scores, whereas boys experience a positive effect. We identify several key drivers underlying these relationships, including class fixed-effects, which potentially reflect teacher bias, psychological well-being, and expectations related to labor market discrimination.
Responses in child health to concerted reconstruction efforts in the aftermath of the 2016 earthquake in Ecuador.
Pacheco-Miranda J, Wagner N, Ponce J
Econ Hum Biol · 2025 Dec · PMID 40907345 · Publisher ↗
The paper explores the short-term impact of recovery in the aftermath of a natural disaster on a set of child health outcomes. We analyze the impacts of a major earthquake with a magnitude of 7.8 that occurred on the coa...
The paper explores the short-term impact of recovery in the aftermath of a natural disaster on a set of child health outcomes. We analyze the impacts of a major earthquake with a magnitude of 7.8 that occurred on the coast of Ecuador on April 16, 2016. As damage was geographically concentrated, affected infrastructure and individuals could be readily identified. We implement a quasi-experimental difference-in-difference (DiD) strategy with geo-referenced data to compare affected and non-affected children, which is complemented by the event study approach, inverse probability weighting, placebo tests, and a synthetic DiD, which together provide a robust empirical framework identifying that the quick and large response of the government compensated for the earthquake-induced destruction. Affected children aged 0-5 years show similar levels of nutrition (weight-, height-, and BMI-for-age) and anemia as non-affected children. There is even some indication from the heterogeneity analyses (birth cohorts) that weight-for-age might have improved after the disaster and in response to the concerted reconstruction. We present exploratory evidence suggesting that the reconstruction activities led to infrastructure improvements, that nutritional programs continued their operations, and mothers in affected areas engaged more in breastfeeding. All three channels are likely to contribute to the stable child health environment in earthquake-affected areas relative to the non-affected areas, suggesting that mitigation of negative health consequences for the weakest members of society, i.e., the children, is possible in the aftermath of a natural disaster if appropriate activities and policies are put in place.
Women's age at marriage and obesity in Pakistan.
Tafesse W, Hussain A, Suhrcke M
Econ Hum Biol · 2025 Dec · PMID 40896984 · Full text
Obesity is a growing public health concern, particularly in low- and middle-income countries, where women face a disproportionate burden. In Pakistan, over half of adult women are overweight or obese. While socio-economi...
Obesity is a growing public health concern, particularly in low- and middle-income countries, where women face a disproportionate burden. In Pakistan, over half of adult women are overweight or obese. While socio-economic and demographic factors associated with obesity have been widely studied, less is known about the role of age at marriage as a potential determinant of women's obesity. This study examines the relationship between marital age and obesity risk among Pakistani women using data from the 2012-13 and 2017-18 Pakistan Demographic and Health Surveys. Baseline OLS models show that later marriage is significantly associated with a lower risk of obesity, with stronger effects observed among younger cohorts. Instrumental-variable estimates, exploiting community norms around marital age, confirm the OLS results for urban women, indicating that each additional year of delayed marriage reduces obesity risk by 0.7 percentage points. Analysis of mechanisms highlights fertility patterns, schooling, literacy, labour-force participation, health knowledge, and a reduced spousal age gap as key pathways linking early marriage to higher obesity risk among urban women.
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