Health affairs
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The period from the 1980s to the present has witnessed a lively and unsettled debate concerning the legalization of marijuana, cocaine, heroin, and other illicit substances in the United States. Proponents of legalization argue that the demand for these harmful and potentially addictive substances is not responsive to price. Opponents argue that prices will fall tremendously in a regime characterized by legalization and that the option of legalization and taxation is not feasible. In this paper we summarize theoretical and empirical evidence suggesting that none of these propositions is correct.
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Socioeconomic status (SES) underlies three major determinants of health: health care, environmental exposure, and health behavior. In addition, chronic stress associated with lower SES may also increase morbidity and mortality. ⋯ Lessons for U. S. policy approaches are taken from the Acheson Commission in England, which was charged with reducing health disparities in that country.
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Men in the United States with family incomes in the top 5 percent of the distribution in 1980 had about 25 percent longer to live than did those in the bottom 5 percent. Proportional increases in income are associated with equal proportional decreases in mortality throughout the income distribution. I discuss possible reasons for this gradient and ask whether it calls for the redistribution of income in the interest of public health. I argue that the existence of the gradient strengthens the case for income redistribution in favor of the poor but that targeting health inequalities would not be sound policy.
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This paper describes the most recent ten-year projections of national health spending. projections, produced annually, are based on econometric and actuarial models of the health sector. Our current outlook includes a sharper near-term increase in the health sector's share of gross domestic product (GDP), which reaches 16.8 percent by 2010, compared with the 15.9 percent projected last year. This difference largely reflects legislation-driven increases in public spending growth combined with a weaker economic outlook. Recent acceleration in private-sector health spending is projected to peak in 2002.
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This paper compares the effects of obesity, overweight, smoking, and problem drinking on health care use and health status based on national survey data. Obesity has roughly the same association with chronic health conditions as does twenty years' aging; this greatly exceeds the associations of smoking or problem drinking. ⋯ Obesity is associated with a 36 percent increase in inpatient and outpatient spending and a 77 percent increase in medications, compared with a 21 percent increase in inpatient and outpatient spending and a 28 percent increase in medications for current smokers and smaller effects for problem drinkers. Nevertheless, the latter two groups have received more consistent attention in recent decades in clinical practice and public health policy.