The Dynamic Response of Physical and Mental Health to Subjective Expectations of Mortality and Disease: The Case of Mature Adults in Rural Malawi

Julio E. Romero, University of Pennsylvania and Banco de la República, Colombia
Iliana V. Kohler, University of Pennsylvania

We investigate the dynamic response of physical and mental health to subjective expectations of mortality and disease, emphasizing behavioral adaptations to disease. We use data from the Malawi Longitudinal Study of Families and Health (MLSFH) and focus on rural individuals aged 45+. We estimate a Structural Equation Model (SEM), controlling for individual heterogeneity. Our results suggest that negative shocks of physical or mental health produce a significant increase in the subjective probability of death and disease for both sexes. The opposite effect is lagged by two years: an increasing subjective probability of death and disease has a negative effect on male physical health. We infer that this is an adaptive response of males who adjust their behaviors to a shorter time horizon of planning, and consequentially jeopardizing their health. The dynamic response of females shows no significant effect, suggesting a different pathway of adaptation with more control of their lives.