School of Public Health, University of California, Berkeley, CA 94720-7360, USA.
Econ Hum Biol. 2014 Mar;13:34-45. doi: 10.1016/j.ehb.2013.10.001. Epub 2013 Oct 24.
This study estimates the causal impact of variation in the expenditures of California county departments of public health on all-cause mortality rates and the associated value of lives saved. Since the activities of county departments of public health are likely to affect mortality rates with a lag, Koyck distributed lag models are estimated using the Lewbel instrumental variables estimator. The findings show that an additional $10 per capita of public health expenditures reduces all-cause mortality by 9.1 deaths per 100,000. At current funding levels, the long-run annual number of lives saved by the presence of county departments of public health in California is estimated to be approximately 27,000 (26,937 lives, 95% confidence interval: [11,963, 41,911]). The annual value of these lives is estimated to be worth $212.8 billion using inflation-adjusted standard U.S. government estimates of the value of a statistical life ($7.9 million).
本研究估计了加利福尼亚州各县级公共卫生部门支出变化对全因死亡率的因果影响，以及由此带来的生命价值。由于县级公共卫生部门的活动可能会产生滞后影响死亡率，因此使用 Lewbel 工具变量估计器对 Koyck 分布滞后模型进行了估计。研究结果表明，每增加 10 美元的人均公共卫生支出可使每 10 万人的全因死亡率降低 9.1 人。按照目前的资金水平，加利福尼亚州县级公共卫生部门的存在每年估计可挽救约 27000 人的生命（26937 条生命，95%置信区间：[11，963，41，911]）。根据通胀调整后的美国政府对统计生命价值的标准估计（790 万美元），这些生命的年价值估计为 2128 亿美元。
