Project Details
Description
PROJECT SUMMARY
A significant body of research shows that having money is highly correlated with better health. But determining
how much of the association is causal is challenging. The gold standard for determining causality is prospective
random assignment of treatment, but practical and ethical considerations often make it hard to award money or
equivalent resources in a truly random way. Thus, researchers have used longitudinal studies of parents’ income
and children’s health or exogenous changes in social and fiscal policy to show that additional money lowers
mortality. But studies with true randomization—lottery winners and people randomly given different levels of
health insurance—show more modest influences of money on mortality. This study produces the first ever
estimates of how randomly awarded wealth affects mortality over a lifetime of follow-up in two generations, for
both men and women, and constructs a policy relevant metric of the incremental wealth required for an additional
year of life expectancy. The project analyzes the long-term implications of a major land redistribution policy in
New Zealand in which low interest loans for farms were awarded by lottery. Program terms ensured applicants
were of similar economic status, and the policy operated like a true random experiment. Loan terms were similar
to modern mortgages: low annual payments over a long term. Documents show randomization was adhered to
for over 20 years. New Zealand’s universal, centralized death registration facilitates construction of a matched
intergenerational sample of lottery winners and losers and their children. Ninety percent of applicants can be
linked to death records, which is a significantly higher linkage rate than can be obtained in the US. These
estimates will be a lower bound on how much money matters for health because New Zealand had low inequality,
high life expectancy, and the subjects were born in an era when infectious disease was an important cause of
death. This R21 project has four aims: 1) estimate the causal effects of winning land on lottery participants’
mortality, 2) estimate the causal effects of winning land on the mortality of children of lottery participants, 3)
estimate gender differences in the effects of wealth on mortality, and 4) identify potential mechanisms that
contributed to life expectancy differences. The study design combines the inferential strengths of true random
assignment in a block design with additional contrasts between children born before and after their parents
participated in the lottery to identify effects of wealth on mortality in two generations. Contrasts in effect sizes by
sex, birth order, and generation are used to identify potential causal mechanisms. Causal mediation analysis of
early adult health measures, mid-life occupational status, urban or rural residence, and lifetime wealth
accumulation illuminate potential pathways between wealth and reduced mortality. The proposed research, with
a credible causal identification strategy and lifetime follow-up, will contribute significantly to knowledge of how
money and social status affect health, aging, and mortality.
Status | Active |
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Effective start/end date | 2/15/23 → 1/31/25 |
Funding
- National Institute on Aging: $244,071.00
- National Institute on Aging: $182,223.00
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