Essays on Human Capital Investments: Pharmaceuticals and Education

University dissertation from Department of Economics, Lund Universtiy

Abstract: This thesis consists of four essays on individual health behaviour and investment in higher education. Three of them consider different aspects of pharmaceutical utilization and aim at explaining some of the observed individual variation in access and adherence to treatment regimens. The fourth explores the potential link from health in young adulthood to subsequent university education.

The first essay develops a dynamic model of the individual's pharmaceutical drug treatment decisions, making the distinction between instantaneous utility effects and dynamic long-term health investment effects. The model provides an economic tool for understanding individual pharmaceutical-treatment decisions.

The second essay uses this model and examines whether people with higher treatment benefits are more adherent to long-term treatments for cardiovascular diseases and mental illness than people with lower benefits. The empirical results show a positive relationship between feasible treatment benefit and adherence to cardiovascular treatments and antidepressants. This finding is consistent with the model suggesting that adherence is an informed and rational decision reflecting treatment benefits and costs.

The third essay relates to inequalities in health care access by identifying disparities in pharmaceutical utilization between natives and immigrants in Sweden. Using the national pharmacy register and survey information on socioeconomic characteristics and individual health, we find differences in the pattern of pharmaceutical utilization between immigrants and natives. As immigrants are less likely than natives to access standard preventive pharmaceuticals for cardiovascular diseases, this may relate to and reinforce the observed health differences between the groups.

The fourth essay follows individuals, who were diagnosed with type 1 diabetes onset at age 17 to 20, in order to ascertain whether the onset affects their chances of a university education. The most important result is that type 1 diabetes onset among women in young adulthood exerts negative influences on both university education and motherhood. Comparisons of women with university education show that type 1 diabetes is negatively associated with having children, suggesting that type 1 diabetes increases the trade-off between these life goals.