Birth and death in France: four essays in health economics.

Summary This thesis consists of four essays related to health economics. On the one hand, we try to estimate the effects of activity on health and longevity, by analyzing the impact of recent pension reforms. On the other hand, we analyze the choice of pregnant women regarding the prenatal diagnosis of trisomy 21 (amniocentesis). The first essay shows that retirement has positive effects on the physical and social health of older people. The recently implemented reforms have the effect of degrading the physical health of seniors, mainly for individuals who do not have the baccalaureate, while the most qualified are affected in terms of social health. The second essay completes the first one by evaluating the effects of retirement not on health, but on mortality. We show that the 1993 pension reform has a negative effect on longevity. The third test shows that the terms of reimbursement for amniocentesis have a significant and important impact on women's decision to undergo amniocentesis or not. We also measure the impact of the amniocentesis procedure on fetal health outcomes using the discontinuity generated by the reimbursement scheme in France. The last essay complements the third one by developing a model of pregnant women's behavior regarding the decision to undergo amniocentesis or not.