Family Health Behaviors

We study how health behaviors are shaped through family spillovers. We leverage administrative data to identify the effects of health shocks on family members' consumption of preventive care and health-related behaviors, constructing counterfactuals for affected households using households that experience the same shock but a few years in the future. Spouses and adult children immediately improve their health behaviors and their responses are both significant and persistent. These spillovers are far-reaching as they cascade even to coworkers. While some responses are consistent with learning information about one's own health, the evidence points to salience as a major operative explanation. (JEL D15, D83, I12, J12) Health behaviors, broadly defined as any action, investment, or consumption choice that can affect health and mortality risk, are a key input in the production of individuals' health (McGinnis and Foege 1993; Mokdad et al. 2004; Cutler, Glaeser, and Rosen 2009). These behaviors take a variety of forms including both adverse habits, such as smoking and drinking, and positive actions, such as the consumption of risk-reducing preventive care. The importance of identifying what determines health-related behaviors, which are notorious for being hard to change, has led to an active literature on a range of potential factors, with some particular focus on financial incentives and health education. 1 Still, we lack a clear understanding of the channels through which health behaviors and habits evolve over the life cycle. A long tradition of economic research has underscored the importance of family interactions in determining individual behavior, particularly in the context of consumption and labor supply choices (Becker 1991; Browning, Chiappori, and Weiss 1 Cutler (2004) and Cawley and Ruhm (2011) offer reviews for developed economies, and Kremer and Glennerster (2011) review evidence from randomized evaluations in developing countries.