Türkiye’de Sağlık Davranışlarını ve Obeziteyi Belirleyici Faktörler

Yıl 2019, , 11 - 40, 31.07.2019

Aysıt Tansel , Deniz Karaoğlan

https://doi.org/10.17233/sosyoekonomi.2019.03.01

Cited By: 3

Öz

Bu çalışmanın amacı, Türkiye'deki sağlık davranışları ve obezite belirleyicilerini eğitim üzerine vurgu yaparak incelemektir. Çalışmanın analizleri 2008, 2010 ve 2012 yılları için Türkiye İstatistik Kurumu tarafından hazırlanan Sağlık Araştırması veri seti kullanılarak yapılmıştır. Çalışmada ele alınan sağlık davranışları sigara tüketimi, alkol tüketimi, meyve ve sebze tüketimi ve düzenli egzersizdir. Çalışmada kişinin eğitim seviyesi ve sağlık davranışları arasındaki ilişkiyi daha iyi anlamak için farklı analizlerde eğitim değişkeni olarak kişinin tamamlanmış okul yılı ve eğitim düzeylerini belirten kukla değişkenler kullanılmıştır. Çalışmanın sonunda eğitim seviyesinin kişinin hem sağlık davranışlarını hem de obez olma olasılığını açıklayan en önemli faktör olduğu saptanmıştır. Tamamlanan eğitimin her kademesinde sigara tüketimi ve okula gidilen yıl sayısı arasında pozitif bir ilişki bulunmuştur. Türkiye’de eğitim ve sigara tüketimi arasındaki bu pozitif ilişki, gelişmiş ülkeler için yapılan benzer çalışmalar ile çelişmektedir. Alkol tüketimi eğitim seviyesi ile pozitif ilişkilidir ve eğitim düzeyinin artması ile beraber bu ilişki kuvvetlenmektedir. Çalışmanın sonucunda eğitim seviyesi daha yüksek kişilerin daha fazla meyve, sebze tükettikleri ve egzersiz yaptıkları saptanmıştır. Eğitim seviyesi yüksek kişilerin obez olma olasılığının daha düşük olduğu sonucuna varılmıştır. Son olarak, çalışmada sağlık davranışlarının ve obez olma olasılığının belirlenmesinde demografik faktörlerin, kişinin işgücü piyasası durumunun ve hanehalkı gelirinin önemi vurgulanmıştır.

Anahtar Kelimeler

Sağlık Davranışları, Eğitim, Demografik Faktörler, Türkiye

Determinants of Health Behaviors and Obesity in Turkey

Öz

The purpose of this paper is to examine the determinants of health behaviors and obesity with an emphasis on education in Turkey. We use Health Survey of Turkish Statistical Institute for the years 2008, 2010 and 2012. The health behaviors considered are smoking, alcohol consumption, fruit and vegetable consumption, and exercise. We consider both the years of schooling and the different levels of education in order to better understand the association between education and health. We find that education is the most important factor associated with the health behaviors and obesity. Smoking is positively associated with education at all levels with a decreasing effect with the level of education unlike in the developed countries. Alcohol consumption is positively related with education and this association increases with the level of education. Higher educated individuals clearly eat more fruits, vegetables and exercise more and they are less likely to be obese compared to the less educated and the illiterate. We also highlight the importance of demographic factors, labor market status and household income in determining health behaviors and obesity.

Anahtar Kelimeler

Health Behaviors, Education, Demographic Factors, Turkey

Kaynakça

• Bolin, K. (2011) "Health Production." In: S. Glied and P.C. Smith (Eds), Oxford Handbook of Health Economics. New York: Oxford University Press. 95-123.
• Brunello, G., D. Fabbri, and M. Fort (2013) "The Causal Effect of Education on Body Mass: Evidence from Europe," Journal of Labor Economics 31(1): 195-223.
• Brunello, G., M. Fort, N. Schneeweis and R. Winter-Ebmer (2016). "The Causal Effect of Education on Health: What is the Role of Health Behaviors?." Health Economics 25(3): 314-336.
• Carbone, J. C., S. Kverndokk, and O. J. Røgeberg (2005) "Smoking, Health, Risk, and Perception," Journal of Health Economics 24(4): 631-653.
• Case, A. and C. Paxson (2005) “Sex Differences in Morbidity and Mortality,” Demography 42(2): 189-214.Cawley, J., and C. J. Ruhm (2012) "The Economics of Risky Health Behaviors" In: M.V. Pauly, T.C. McGuire, P.P. Barros (Eds), Handbook of Health Economics Vol. 2. Amsterdam: Elsevier. 97-153.
• Cesur R., B. Dursun, and N. Mocan (2014) “The Impact of Education on Health and Health Behavior in a Middle-Income, Low-Education Country” Cambridge, MA: National Bureau of Economic Research (NBER) Working Paper No. 20764.
• Chaloupka, F. J., and K. E. Warner (2000). "The Economics of Smoking." In: A.J. Culyer and J.P.Newhouse (Eds), Handbook of Health Economics Vol.1. Amsterdam: Elsevier. 1539-1627.
• Cutler, D. M., E. L. Glaeser, and J. M. Shapiro (2003) "Why Have Americans Become More Obese?" The Journal of Economic Perspectives 17(3): 93-118.
• Cutler, D. M., and E. L. Glaeser (2005) "What Explains Differences in Smoking, Drinking, and Other Health-Related Behaviors?" The American Economic Review 95(2): 238-242.
• Cutler, D. M., Lleras-Muney, A. (2008) “Education and Health: Evaluating Theories and Evidence,” In: James, S.H., Schoeni, R.F., Kaplan, G.A., Pollack, H. (Eds), Making Americans Healthier: Social and Economic Policy as Health Policy. New York: Russel Sage Foundation.
• Cutler, D. M. and A. Lleras-Muney (2010) “Understanding Differences in Health Behaviors by Education,” Journal of Health Economics 29(1):1-28.
• Cutler, D. M., A. Lleras-Muney, and T. Vogl (2011). “Socioeconomic Status and Health: Dimensions and Mechanisms”. In: S. Glied and P.C. Smith (Eds), Oxford Handbook of Health Economics. New York: Oxford University Press, 124-163.
• De Walque, D. (2007) "Does Education Affect Smoking Behaviors?: Evidence Using the Vietnam Draft as an Instrument for College Education," Journal of health economics 26(5): 877-895.
• Erem, C., Cengiz A., A. Hacıhasanoğlu, O. Değer, M. Topbaş, K. Ukinç, H.Ö. Ersöz and M. Telatar (2004) "Prevalence of Obesity and Associated Risk Factors in a Turkish Population (Trabzon City, Turkey)," Obesity Research 12 (7): 1117-1127.
• Erbaydar, T., S. Lawrance, E. Dağlı, O. Hayran and N. E. Collishaw (2005) "Influence of Social Environment in Smoking among Adolescents in Turkey," The European Journal of Public Health 15(4): 404-410.
• Ettner, S. L. (1996) "New Evidence on the Relationship between Income and Health," Journal of Health Economics 15(1): 67-85.
• Fletcher, G. F., G. Balady, S.N. Blair, J. Blumenthal, C. Caspersen, B. Chaitman, S. Epstein, E.S. Sivarajan Froelicher, V. F. Froelicher, I.L. Pina and M. L. Pollock (1996) "Statement on Exercise: Benefits and Recommendations for Physical Activity Programs for All Americans A Statement for Health Professionals by the Committee on Exercise and Cardiac Rehabilitation of the Council on Clinical Cardiology, American Heart Association," Circulation 94(4): 857-862.
• Fuchs, V. R. (2004) "Reflections on the Socio-Economic Correlates of Health," Journal of Health Economics 23(4): 653-661.
• García, V. J., and C. Quintana-Domeque (2009) "Income and Body Mass Index in Europe," Economics & Human Biology 7(1): 73-83.
• Grossman, M., (1972) “On the Concept of Health Capital and the Demand for Health,” Journal of Political Economy 80(2): 223-255.
• Grossman, M. (2000) "The Human Capital Model." In: A.J. Culyer and J.P.Newhouse (Eds). Handbook of Health Economics Vol.1. Amsterdam: Elsevier, 348-408.
• Grossman, M., (2004) "The Demand for Health, 30 Years Later: A Very Personal Retrospective and Prospective Reflection," Journal of Health Economics 23(4): 629-636.
• Gruber, J., and M. Frakes (2006) "Does Falling Smoking Lead to Rising Obesity?" Journal of Health economics 25(2): 183-197.
• Hatemi, H.,Yumuk, N. Turan and N. Arık (2003) "Prevalence of Overweight and Obesity in Turkey," Metabolic Syndrome and Related Disorders 1(4): 285-290.
• Hung, H-C., K.J. Joshipura, R. Jiang, F.B. Hu, D. Hunter, S.A. Smith-Warner, G.A. Colditz, B. Rosner, D. Spiegelman and W.C. Willett (2004) "Fruit and Vegetable Intake and Risk of Major Chronic Disease," Journal of the National Cancer Institute 96(21): 1577-1584.
• Idler, E. L. and Y. Benyamini (1997) “Self-Rated Health and Mortality: A Review of Twenty-Seven Community Studies,” Journal of Health and Social Behavior 38(1): 21-37.
• Karaoğlan, D. (2015) Essays on Education Gradient of Health in Turkey, Unpublished Ph.D. thesis. Ankara, Turkey: Department of Economics, Middle East Technical University.
• Karaoglan, D. and A. Tansel (2016) “ The Causal Effect of Education on Body Mass: Evidence from Turkey”, Mimeo. Ankara, Turkey: Department of Economics, Middle East Technical University.
• Kemptner, D., H. Jürges and S. Reinhold. (2011) “Changes in Compulsory Schooling and the Causal Effect of Education on Health: Evidence from Germany,” Journal of Health Economics 30(2):340-354.
• Kenkel, D. S. (1991) "Health Behavior, Health Knowledge, and Schooling," Journal of Political Economy 99(2): 287-305.
• Kocabas, A., et al. (1994) "Smoking Patterns at Different Medical Schools in Turkey," Tobacco Control 3(3): 228-235.
• Lantz, P. M., J.S. House, J. M. Lepkowski, D. R. Williams, R.P. Mero and J. Chen (1998) "Socioeconomic Factors, Health Behaviors, and Mortality," JAMA: The Journal of the American Medical Association 279(21): 1703-1708.
• Lantz, P. M., J.W. Lynch, J.S. House, J. M. Lepkowski, R.P. Mero, M.A. Musick and D. R. Williams (2001) “Socioeconomic Disparities in Health Change in a Longitudinal Study of US Adults: The Role of Health-Risk Behaviors,” Social Science & Medicine 53(1): 29-40.
• Lleras-Muney, A., (2005) “The Relationship between Education and Adult Mortality in the U.S,” Review of Economic Studies 72(1): 189-221.
• Metintaş, S., M.A. Sarıboyacı, S. Nuhoğlu, M. Metintaş, C. Kalyoncu, S. Etiz, N. Özdemir and C. Aktaş (1998) "Smoking Patterns of University Students in Eskişehir, Turkey," Public Health 112(4): 261-264.
• Mokdad, A. H., J. S. Marks, D. F. Stroup, and J. L. Gerberding (2004) “Actual Causes of Death in the United States 2000,” Journal of American Medical Association 291(10): 1238-1245.
• Mullahy, J. (1997) "Instrumental-Variable Estimation of Count Data Models: Applications to Models of Tobacco Smoking Behavior," Review of Economics and Statistics 79(4): 586-593.Organization for Economic Cooperation and Development (OECD) (2016) Health Data Set (http://stats.oecd.org) (Accessed on July 2016).
• Reijneveld, S. A. (2002) “Neighbourhood Socioeconomic Context and Self Reported Health and Smoking: a Secondary Analysis of Data on Seven Cities,” Journal of Epidemiol Community Health 56: 935-942.
• Stewart, S. T., D. M. Cutler, and A. B. Rosen (2009) "Forecasting the Effects of Obesity and Smoking on US Life Expectancy," New England Journal of Medicine 361(23): 2252-2260.
• Tansel, A. (1993) “Cigarette Demand, Health Scares and Education in Turkey”, Applied Economics 25(4): 521-529.
• Tansel, A. and D. Karaoğlan (2014) “Health Behaviors and Education in Turkey,” Bonn, Germany: Institute for the Study of Labor (IZA) Discussion Paper No.8262.
• Tansel, A. and D. Karaoglan (2016) Causal Effect of Education on Self Assessed Health and Clinical Health: Evidence from Turkey,” Mimeo. Ankara, Turkey: Department of Economics, Middle East Technical University.
• Tansel, A. and D. Karaoğlan (2016) “The Causal Effect of Education on Health Behaviors: Evidence from Turkey,” Ankara, Turkey: Middle East Technical University (METU) Economic Research Center (ERC) Working Papers in Economics. No. 16/06.
• Webbink, D., N. G. Martin and P. M. Visscher (2010) “Does Education Reduce the Probability of Being Overweight?” Journal of Health Economics 29(1): 29-38.
• Worldbank (2008) World Bank Report.(http://siteresources.worldbank.org/NUTRITION/Resources/281846-1271963823772/Turkey.pdf)
• Yumuk, V. D. (2005) "Prevalence of Obesity in Turkey," Obesity Reviews 6(1): 9-10.