Health in cities: neighborhood effects and scioeconomic determinants in the Spanish case

Abstract

The impact of place on individual outcomes, like health, presents many causal challenges that have disputed treatments in the literature. A 2011 study by Bilger Carrieri addresses them via instrumentation, to surprising results that equate neighborhood impact with that of economic deprivation and even education. The aim of this paper is to use this strategy as a guide to address the questions for Spain with more recent data: What links exist between income, neighborhood problems, and health? Can we proceed in a way to certainly avoid bias and endogeneity? How much does neighborhood impact health outcomes? These are answered by assessing the microdata from the 2018 Spanish Survey on Living Conditions, for three different health outcomes given the use of a neighborhood problems aggregate (tested for the independence of these indicators). Testing neighborhood effects on health with the assumption of no endogeneity and performing endogeneity tests, correcting for the identification problem by testing instruments for neighborhood effect and income. Finally, an ordered probit model is fitted to evaluate the incremental effects of neighborhood problems, income and education on health outcomes.