Working Paper
Intra-Household Arrangements and Health Satisfaction

This paper uses a subjective wellbeing approach to study the role of household arrangements on the health satisfaction of an individual. It also studies the impact of household arrangements on health satisfaction across different income groups, by contrasting two main theories of the family: the altruistic/communitarian theory, which emphasizes altruism within the family, implies that the within-the-household allocation of relevant health satisfaction resources leads towards an egalitarian distribution of health satisfaction, and second, the cooperative bargaining theory according to which the family emerges as the cooperative equilibrium outcome from the unilateral interests of each household member. Thus, each household member takes advantage of their bargaining power to attain an equilibrium that favours their personal interests. According to the latter approach, the intra-household allocation of relevant health satisfaction resources leads to a distribution of health satisfaction that closely follows the distribution of bargaining power. Using data from a large survey in Mexico, the paper examines the relevance of these alternative approaches and studies intra-household health distribution. It is argued that the study of health satisfaction—and the subjective wellbeing approach in general—provides additional useful information about household arrangements. Since it is not the same to be ill (an objective condition) as it is to suffer from an illness (a subjective condition), objective health indicators cannot fully capture the richness of how families react to illness and how they subsequently allocate household resources (not only economic ones) to reduce the impact of illness on the wellbeing of the family. Using family status and breadwinner status as proxies for intra-household bargaining power, the paper examines the intra-household distribution of health satisfaction in economically poor families, where an unequal distribution of relevant health-satisfaction resources is expected to be more harmful.