Spousal Peer Effects in Specialty Behavioral Health Services Use: Do Spillovers Vary by Gender, Subscriber Status and Sexual Orientation?

Myra Yazbeck (), Xu H, Azocar F and Ettner Sl
Additional contact information
Xu H: Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California - Los Angeles, Los Angeles, California.
Azocar F: Optum Health Behavioral Solutions. San Francisco.
Ettner Sl: Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California - Los Angeles, Los Angeles, California

No 630, Discussion Papers Series from University of Queensland, School of Economics

Abstract: This paper fills gaps in the literature on spousal peer effects in mental health outcomes by investigating spousal spillover effects in a potential mediator, health investment decisions. We relate the subject’s behavioral healthcare use to her partner’s lagged decision, and exploit the rich set of characteristics available (including the subject’s past use and diagnoses) to control for assortative mating. Given that spillover effects may be asymmetric, we stratify analyses by subscriber’s status, gender and couple type. Results show positive significant spousal peer effects in behavioural healthcare use, driven primarily by individual psychotherapy visits. Spillover effects are stronger for females than males in heterosexual couples and for males in same-sex vs. heterosexual couples. Estimates are robust to various sensitivity analyses. Spousal spillover effects in individual psychotherapy use represent up to 76% of the impact of depression for female in heterosexual couples and up 91% for men who are in same-sex couples.

Keywords: Health care use; Spillovers; Mental Health; Household behaviour. (search for similar items in EconPapers)
JEL-codes: D19 I12 I31 J15 (search for similar items in EconPapers)
Date: 2020-07
New Economics Papers: this item is included in nep-hea
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Persistent link: https://EconPapers.repec.org/RePEc:qld:uq2004:630

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