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The Effect of Education on Health Behaviors and Obesity in Turkey: Instrumental Variable Estimates from a Developing Country

  • Aysıt Tansel
  • Deniz KaraoğlanEmail author
Original Article

Abstract

This study investigates the causal effect of education on health behaviors and obesity in Turkey, which is a middle-income developing country. Health Surveys of the Turkish Statistical Institute for the years 2008, 2010 and 2012 are used. The health behaviors considered are smoking, alcohol consumption, fruit and vegetable consumption, and exercise, and one health outcome, namely, obesity. We examine the causal effect of education on these health behaviors and on obesity. An instrumental variable approach is used in order to address the endogeneity of education to health behaviors. Educational expansion of the early 1960s is used as the source of exogenous variation in the years of schooling. Our main findings are as follows. Education does not significantly affect the probability of smoking or exercise. As the education level increases, the probability of alcohol consumption and the probability of fruit and vegetable consumption also increase. Nevertheless, some of the initial results change when we perform robustness checks. In order to check the robustness of our results, we narrow the time period around the policy years, since the impact of political and socio-economic developments may change the preferences of the individuals and hence invalidate our results. The evidence from the samples used for robustness checks suggests that there is a negative significant relationship between the probability of smoking and the years of schooling. Therefore, we can state that education can be a relevant policy instrument to fight smoking in Turkey. However, it is not a sufficient policy instrument to combat obesity, unlike in developed countries. This study provides a baseline for further research on the various aspects of health behaviors in Turkey.

Keywords

Health behaviors Education Instrumental variable estimation Turkey 

Résumé

Cette étude examine le lien de cause à effet entre l’instruction et les comportements liés à la santé ainsi que l’obésité en Turquie, pays en développement à revenu intermédiaire. Nous utilisons les enquêtes sur la santé de l’Institut statistique turc pour les années 2008, 2010 et 2012. Les comportements liés à la santé qui sont considérés sont le tabagisme, la consommation d’alcool, la consommation de fruits et légumes, l’exercice physique et l’un des résultats en terme de santé, à savoir l’obésité. Nous examinons l’effet causal de l’instruction sur ces comportements de santé et l’obésité. L’approche de la variable instrumentale est utilisée pour traiter l’endogénéité du niveau d’instruction par rapport aux comportements de santé. L’expansion de l’instruction du début des années 1960 est utilisée comme source de variation exogène au cours de la scolarité. Nos principales conclusions sont les suivantes. Le niveau d’instruction n’a pas d’incidence significative sur la probabilité de fumer ou de faire de l’exercice. À mesure que le niveau d’instruction augmente, la probabilité de consommation d’alcool et celle de fruits et légumes augmente également. Néanmoins, certains des résultats initiaux changent lorsque nous effectuons des contrôles de robustesse. Afin de vérifier la robustesse de nos résultats, nous réduisons la période aux années directement avant et après des décisions politiques clés car l’impact des développements politiques et socio-économiques peut modifier les préférences des individus et, par conséquent, invalider nos résultats. Les preuves provenant des échantillons utilisés pour les contrôles de robustesse suggèrent qu’il existe une relation négative significative entre la probabilité de fumer et le nombre d’années de scolarité. Nous pouvons donc affirmer que l’instruction peut être un instrument politique pertinent pour lutter contre le tabagisme en Turquie. Cependant, il ne s’agit pas d’un instrument politique suffisant pour lutter contre l’obésité, contrairement aux pays développés. Cette étude fournit un socle pour la poursuite des recherches sur les divers aspects des comportements liés à la santé en Turquie.

JEL Classicification

I10 I12 I19 

Notes

Acknowledgements

This paper is based on Deniz Karaoğlan’s Ph.D. thesis prepared under the supervision of Aysıt Tansel at the Department of Economics, METU. Ms. Karaoğlan would like to thank Meltem Dayıoğlu-Tayfur, İlhan Can Özen, Çagla Ökten, Nur Asena Caner and Murat Kırdar for helpful comments on her PhD thesis. Thanks are also due to Mehmet Günal, responsible for health statistics group at the Turkish Statistical Institute and Tuna Kemali also of the Turkish Statistical Institute for their kind help in implementing this study. This paper is presented at the MEEA annual meeting in Boston USA, January 2015. It is also presented in the department of economics seminars of Ege University, Atılım University, Yıldırım Beyazıt University, Başkent University, Kadir Has University, TOBB ETU University and TED University in 2014 and 2015. We thank the participants of these meetings and seminars for their comments. Any errors are our own.

Compliance with Ethical Standards

Conflict of interest

Earlier versions of this paper are published as working papers in several institutions including Institute of Labor Economics (IZA), Economic Research Center (ERC) of Middle East Technical University, Turkish Economic Association, Munich Personal RaPEc Archieve, and Economic Research Forum (ERC) with the title “The Causal Effect of Health Behaviors: Evidence from Turkey”.

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Copyright information

© European Association of Development Research and Training Institutes (EADI) 2019

Authors and Affiliations

  1. 1.Department of Economics MiddleEast Technical UniversityAnkaraTurkey
  2. 2.Institute of Labor Economics (IZA)BonnGermany
  3. 3.Economic Research Forum (ERF)CairoEgypt
  4. 4.Department of EconomicsBahcesehir UniversityIstanbulTurkey

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