An econometric analysis of alternative medicine and health-related behaviours in Italy and England

Abstract

The thesis deals with the relations between Complementary and Alternative Medicine (CAM) and health-related behaviours and analyses the relationships between "Leisure Time Physical Activity" (LTPA) and other health-related lifestyles. Particularly, the thesis is divided into three chapters. A systematic review of literature about the determinants of the CAM use is firstly carried out and some economics aspects related to alternative cure are emphasised. The review outlines that several topics still need further investigation to allow a convenient and efficient introduction of CAM therapies in the health care system. The thesis aims to give a causal interpretation for the relations between CAM and healthrelated habits in Italy and England. In particular, in the second chapter, two econometric models - probit and recursive - are built to highlight the importance to take into account the issue of endogeneity. The results suggest that regular physical activity affects, in a significant way, CAM use in Italy. On the other hand, no causal interpretation may be given to the relationships between CAM and healthy lifestyles in England. In addition, a complete profile of the CAM users is outlined; globally, the estimates for Italian and English people indicate that CAM may be considered part of primary and tertiary prevention. A causal relation between physical activity and other healthy behaviours is investigated. This is the first study that tries to assess the effect of LTPA on smoking and diet behaviours for a representative sample of general population. This is due to the remarkable difficulty in controlling for unobservable individual heterogeneity, which likely influences the estimates. To deal with this topic, the third chapter of the thesis focuses on the identification issue; in particular recursive probit models with both one and two exclusion restrictions are used to tackle the endogeneity of physical activity. Several tests are carried out to assess the validity of the instruments. The results suggest a positive and significant effect of leisure time physical activity on non-smoking habit and healthy diet. Finally, the main conclusions of the work and the future developments are discussed. [edited by Author]