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We investigate how career disruptions in terms of job loss may impact morbidity for individuals diagnosed with type 2 diabetes (T2D). Combining unique, high-quality longitudinal data from the Swedish National Diabetes Register (NDR) with matched employer–employee data, we focus on individuals diagnosed with T2D, who are established on the labor market and who lose their job in a mass layoff. Using a conditional difference-in-differences evaluation approach, our results give limited support for job loss having an impact on health behavior, diabetes progression, and cardiovascular risk factors.

Health information drives crucial consumer health decisions and plays a central role in healthcare markets. Consumers who are better-informed about smoking, diet, and physical activity make healthier choices outside the healthcare sector (Kenkel, 1991; Ippolito & Mathios, 1990, 1995; Meara, 2001). Better-informed consumers also interact differently with physicians and other healthcare providers (e.g., Cutler, Landrum, & Stewart, 2006). In addition to the immediate consequences for individual consumers, health economists have long recognized that information also has broader implications for principal–agent relationships and the functioning of healthcare markets.¹ More recent lines of research in health economics and medical sociology emphasize the potential role of consumer information in explaining health disparities associated with socioeconomic status (Deaton, 2002; Goldman & Lakdawalla, 2001; Glied & Lleras-Muney, 2003; Link & Phelan, 1995). Both health economists and medical sociologists stress that because of disparities in consumer information, rapid medical progress tends to be accompanied by increased disparities in medical treatment and health outcomes.

To evaluate the extent to which a person’s educational attainment moderates the relationship between his or her objective markers of health and self-rated health (SRH).

I use 10 years’ worth of data from the National Health and Nutrition Examination Survey (NHANES 1999–2009; N = 30,823) to examine how diagnosed medical conditions, health behaviors, and biomarkers are differentially associated with SRH by educational attainment. I use regression analysis to evaluate these relationships.

Results show that while medical conditions are negatively associated with SRH equally across education levels, behaviors and biomarkers have stronger association with SRH among individuals with greater education. Those with more education are more likely to have had their blood pressure and cholesterol checked in recent months. They are also more likely to correctly identify themselves as overweight when their body mass index exceeds 25.

The chapter’s findings indicate that education may play a role in how people interpret and evaluate their own health. Real differences in how people evaluate their health can impact the conclusions that researchers can draw when comparing SRH between education groups. In addition these results can motivate further research in the causes of health disparities. Self-evaluation of health can potentially influence how people monitor and manage their health. Differences in self-evaluation between levels of educational attainment could contribute to disparities in health and mortality.

This chapter examines the relationship between self-rated health, objective markers of health, and education in a novel framework.

Recently, the institutional performance model has been used to explain the increased distrust of health care system by arguing that distrust is a function of individuals’ perceptions on the quality of life in neighborhood and social institutions. We examined (1) whether individuals assess two dimensions of distrust consistently, (2) if the multilevel institutional performance model explains the variation of distrust across neighborhoods, and (3) how distrust patterns affect preventive health care behaviors.

Using data from 9,497 respondents in 914 census tracts (neighborhoods) in Philadelphia, we examined the patterns of how individuals evaluate the competence and values distrust using the Multilevel Latent Class Analysis (MLCA), and then investigated how neighborhood environment factors are associated with distrust patterns. Finally, we used regression to examine the relationships between distrust patterns and preventive health care.

The MLCA identified four distrust patterns: Believers, Doubters, Competence Skeptics, and Values Skeptics. We found that 55 percent of the individuals evaluated competence and values distrust coherently, with Believers reporting low levels and Doubters having high levels of distrust. Competence and Values Skeptics assessed distrust inconsistently. Believers were the least likely to reside in socioeconomically disadvantaged and racially segregated neighborhoods among these patterns. In contrast to Doubters, Believers were more likely to use preventive health care, even after controlling for other socioeconomic factors including insurance coverage.

Our findings suggest that distrust patterns are a function of neighborhood conditions and distrust patterns are associated with preventive health care. This study provides important policy implications for health care and future interventions.

Several high-profile prescription drugs have been withdrawn from the U.S. market in the last decade, yet there is no direct evidence of how a prescription drug withdrawal affects consumers’ use of remaining drugs within the same therapeutic class. In theory, remaining drugs in the therapeutic class could enjoy competitive benefits or suffer negative spillovers from the withdrawal of a competing drug. Using the Medical Expenditure Panel Survey, we test for spillovers following prescription drug withdrawals in six therapeutic classes between 1997 and 2001. Results vary, but we find stronger evidence of negative spillovers than competitive benefits. We conclude with a discussion of the characteristics of drugs and classes that may influence how remaining drugs are affected by a withdrawal in the class.

In this chapter, we draw on health lifestyle, human capital, and health commodity theories to examine the effects of educational attainment on a wide range of individual dietary behaviors and dietary lifestyles.

Using data from the 2005-2006 iteration of the National Health and Nutrition Examination Survey (n = 2,135), we employ negative binomial regression and binary logistic regression to model three dietary lifestyle indices and thirteen healthy dietary behaviors.

We find that having a college degree or higher is associated with seven of the thirteen healthy dietary behaviors, including greater attention to nutrition information (general nutrition, serving size, calories, and total fat) and consumption of vegetables, protein, and dairy products. For the most part, education is unrelated to the inspection of cholesterol and sodium information and consumption of fruits/grains/sweets, and daily caloric intake. We observe that having a college degree is associated with healthier dietary lifestyles, the contemporaneous practice of multiple healthy dietary behaviors (label checking and eating behaviors). Remarkably, household income and the poverty-to-income ratio are unrelated to dietary lifestyles and have virtually no impact on the magnitude of the association between education and dietary lifestyles.

Our findings are consistent with predictions derived from health lifestyle and human capital theories. We find no support for health commodity theory, the idea that people who are advantaged in terms of education live healthier lifestyles because they tend to have the financial resources to purchase the elements of a healthy lifestyle.

This study examined use of preventive health care services, for working-age adults with mobility limitations (uses mobility aids, has difficulty walking, difficulty standing for extended periods of time, or difficulty climbing steps) and for working-age adults reporting no mobility limitation, in order to identify similarities and disparities between the two populations. We analyzed data from the 1994 National Health Interview Survey Disability Supplement and NHIS Year 2000 file with cross-tabulation and logistic regression procedures to examine the relationship between mobility limitation and use of health screenings, immunizations, and health behavior counseling. Results were mixed, but disparities in preventive service use were identified.

The purpose of this chapter is to review and synthesise the available evidence for the health benefits of walking. It follows a non-systematic evidence review and finds that the evidence base for the health benefits of walking is growing. Increasingly we are finding strong evidence for the beneficial effects of walking for both individuals and populations. More evidence is required on how to better understand the health outcomes associated with walking and how to promote long term increases in walking behaviour. Systematic reviews of specific health benefits remain rare. Walking should be promoted in all population groups regardless of age or sex. There are currently few existing integrative syntheses of the physical and mental health outcomes associated with walking and this chapter aims to help fill that gap.

Diet therapy or nutritional therapy has become a real challenge in the fight against the increasing number of modern illnesses such as obesity, diabetes, cardiovascular diseases and cancers. The scientific community has recognized the importance of studies that will support or rebut the association of certain nutrition/energy inputs with the prevention and/or improvement of certain diseases. Patient counseling is offered by medical doctors, nutritionists and dieticians, but patients often seek additional sources of information from popular media that may not be adequately scientifically supported. Whose responsibility is it when the Diet Therapy is not an effective treatment and where does the consequent ethical and moral responsibility lie?

This chapter argues for the importance of a nutritionally educated scientist evaluating the diets that are seen to be related with the health improvement also excluding diets that are mostly related to the patients’ well-being as the Mediterranean, DASH (Dietary Approaches to Stop Hypertension), Ketogenic and Vegetarian diet. Diet guidelines are often explained with linguistic variables (as “reduce the input of” etc.) which can be differently perceived by the end user. The interpretation if a linguistic variable is presented using the body mass index categories using a bell-shaped curve. The preferable area fits to the linguistic variable “acceptable BMI.” But also are indicated those areas which are less preferable. Those examples of information interpretations show the necessity of knowledge transfer. The quantity of information presented in diet guidelines can be experienced as a great muddle for patients; leaving them not knowing where and how to start. So, remains the ethical and moral responsibility of all links in the chain of nutritional and diet research and recommendations. Only objective and open-minded recommendations based on the latest scientific facts can gain confidence of the social, economical, and political subjects which must put the well-being of the population uppermost in their mind.

The purpose of this paper is to explore consumer thinking about nutrition decisions and how firms can use consumers’ awareness of the links between nutrients and health generated by public health messages to market products, including ones, which have little nutritional value. We approach this issue by tracking the development of public health messages based on scientific research, dissemination of those messages in the popular press, and use of nutrition claims in food advertisements to assess whether firms are timing the use of nutrition claims to take advantage of heuristic-based decision-making. Our findings suggest that the timing of the development of nutrition information, its dissemination in the press, and use in advertising accords well with a heuristic processing model in which firms take advantage of associations between nutrient information and health in their advertisements. However, the demonstrated relationships may not be causal. Further research will be needed to provide stronger and more comprehensive evidence regarding the proposed message hijacking process. If the message hijacking framework is borne out: (1) simple overall health rating scales could significantly improve consumer decision-making, (2) the impact of misleading advertisements could be mitigated by encouraging a multidimensional view of nutrition, and (3) more intensive regulation of product labeling could limit the impact of hijacked messages.

Overall, this paper considers a novel hypothesis about the impact of public health messages on nutrition and health.