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					  Health Economists:
Who We Are, What We Do,
and How Much We Earn

     Michael A. Morrisey, Ph.D.
 University of Alabama at Birmingham
                  and
          John Cawley, Ph.D.
           Cornell University
                Thanks to:

                        Advisory Committee:
                            Roger Feldman
   AcademyHealth           Richard Arnould
                            Kate Bundorf
                            Michael Hagan
   iHEA                    David Knutson
                            Kristine Metter
                            Sharron Arnold
                       Surveying Issues:
   Web based survey:
     Invitation & two follow-up emails issued
     October 21 – November 21, 2005

   Sample Universe:
     All U.S. members of iHEA
     All members of AcademyHealth
      Health Economics Interest Group
     Unduplicated total . . . . . . . . . . . . . . . . . . . . . 1,439

   Response Rate. . . . . . . . . . . . . . . . . . . . . . 32 %
       Do You Consider Yourself To Be:


A.   A health economist               53%
B.   An economist who works in health 21%
C.   Neither                          26%


      For this presentation we exclude those
                answering neither.
Who Are Health Economists?



        Gender & Age
        Race & Ethnicity
        Marital Status
        Dual Career Status
              - Gender -

70          62%
60

50                            38%
40

30

20

10

0
     Male                  Female
                      - Age -

40%           37%

                          29%
30%                                27%


20%


10%
       4%                                  4%

0%
      22-30   31-40       41-50    51-60   61+
                       Age Group
      Are More Women Entering the Field?
Percent Women
60%

                           46%
                41%
40%     36%                                 36%

                                    25%

20%




0%
       22-30    31-40      41-50    51-60   61+

                        Age Group
    - Race & Ethnicity -

Asian                       10.5 %
Black or African-American    1.3 %
White                       88.2 %


Hispanic or Latino           4.1 %
Not Hispanic or Latino      95.9 %
       - Marital Status and Dual Careers -

100%
                   81%
                                         Dual Career Couples:
75%
                                             70%
50%
                                         Of Dual Career Couples:
25%                                          27% dual academic
         13%
                             6%              10% dual economics
 0%
        Never     Crrently Formerly
        Married   Married Married
       - Education and Training -


   Degrees & fields of study
   Formal field offered/taken
   Health dissertation
   Top econ schools for health economists
- Degrees Received -
                    Percent
Masters only              3
Doctoral only
 Ph.D.                  87
 Other                   3
Doctoral Plus
 - MD                    3
 - RN                    1
 - JD                    0

Professional only        2
          - Ph.D. Field of Study -

100%


75%      71.8%
                   84.2% in 1989

50%


25%                     18.6%
                                     9.6%

 0%
       Economics        HSR+         Other
     - Formal Health Economics Field -

Of those with an academic doctoral degree --

   Health economics field offered . . . . . 33%

   Health economics field completed. . . 30%

   Completed a health dissertation. . . . . 76%
       Schools Awarding 5 or More PhDs in
        Economics to Health Economists
   Wisconsin    -16              CUNY         -7
   Chicago      -11              Maryland     -7
   Michigan       -9             Berkeley     -6
   Yale           -9             Stanford     -6
   Harvard       -8              Boston U     -5
   MIT           -8              Washington U - 5
   Washington    -8                   St Louis
                        48 % of PhDs in economics
                        reported by health economists
                        granted by these 13 schools
How Are Health Economists Employed?

       Employment by sector
       Time spent in research, etc.
       Hours worked per week
       Time spent consulting
       External funding expectations
       Amount of teaching
Where Do Health Economists Work?


                  Government
                     12%

                     Nonprofit
                       15%
     Academia
       64%
                    For Profit
                       9%
                      Of Those in Academia…

Public Health                                                      26%

    Medicine                                         18%

   Arts & Sci.                                  17%
                                                            24% are in
    Business                                   16%          Economics
                                                            Departments
Public Policy                 6%

        Other                                   17%

                 0%      5%        10%   15%          20%    25%         30%

         Economics departments may be in A&S or B-Schools
     Faculty Rank of Those in Academia…

                                              51% Tenured
     Full                           34%       35% Tenure Track
                                              14% ~ Tenure Track
Associate                    23%

                                               8% Dept Chair
Assistant                            38%      15% Center Director


   Other         4%


            0%   10%   20%    30%   40%
 Of Those in Government & Private Sector…

    Federal Gov't
       State Gov't
      Consulting
Contract Research
         Provider
    Pharaceutical
                                       35% also have an
     Trade Assoc.
                                       academic
            NGO
                                       appointment
          Insurer
      Foundation
            Other

                 0%   5%   10%   15%   20%   25%     30%   35%
  How Do We Spend Our Professional Time?


Private sector


                                                     Research
                                                     Teaching
 Government
                                                     Mgt/Adm
                                                     Other


   Academia



                 0%   20%   40%   60%   80%   100%
 How Much Of Our Time Do We Spend?


  Hours          Academia        Gov’t      Private
  Per Week                                  Sector
  <40                10%          12%         11%
  40-49              29            62         31
  50-59              43            24         46
  60+                18            3          13


Overall Mean = 47.2 hours   Overall Median = 50 hours
   How Much Consulting Do We Do?


                        Average         Median
                       Days/Year       Days/Year
 All Respondents           10.7              5

 Academic                  15.2             10
 Respondents

Average consulting income of those with any: $19,445
  How Much Grant/Contract Coverage?

                           Expected           Actual
                           Mean [Median]    Mean [Median]
                                            3-year Average
    All Academics         28% [20%]         39% [30%]
    Medical School        49% [50%]         61% [70%]
    Public Health         48% [50%]         62% [70%]


31 % report explicit rewards or penalties tied to salary coverage
  How Much Did We Teach in Last 2 Years?

                                   Median       Percentage
                                                   =0
Undergrad Courses Taught               1          46 %

Graduate Courses Taught                2               22%
Doctoral Committees                    1               41%

  Academics only.

   * Excludes readings and independent study courses
What Does It Take To Get Promoted?

   Percentage of respondents considering
    activities essential or recommended

     Research/Teaching/Service
     In Which Journals to Publish
       What Does It Take to Get Promoted?

                                                       91
Teaching           18
                   18


                                                  85              Academics
  Grants                 30                                       Government
                                   60                             Priv Sector

                                                  85
  Service                                          88
                                             77


            0       25        50        75                  100

            Percent Essential or Recommended
     What Does It Take to Get Promoted in
                  Academia?

Teaching


                                                     A&S
                                                     Business
  Grants
                                                     Public Health
                                                     Medicine


  Service



            0       25      50       75        100

            Percent Essential or Recommended
         Where to Publish to Get Promoted?


  Economics J


Health Econ J
                                                  Academics
Hlth Services J                                   Government
                                                  Priv Sector
Health Policy J


     Medical J


                  0   25    50     75       100

         Percent Essential or Recommended
       Where to Publish to Get Promoted in
                  Academia?

  Economics J


Health Econ J
                                                  A&S
                                                  Business
Hlth Services J
                                                  Public Health
                                                  Medicine
Health Policy J


     Medical J


                  0   25   50     75        100

         Percent Essential or Recommended
How Much & Where Do We Actually Publish?



         Articles and Book Chapters
           Career
           Last 5-Years

         Mix of Journals
        How Much Do Academics Publish?
 Mean Number of Articles and Book Chapters

100
                           84.6

75

                                                                Assistant
50                                                              Associate
                                                                Full
                   29.9
                                                         22.1
25                                                 17
           10.6                              8.8

 0
                  Career                       Last 5 Years
In Which Journals Do Academics Publish?
                                            Entire   Last 5-
                                            Career   Years
Economics Journals                          13.3%     8.9%

Health Economics Journals                   10.7     11.6

Health Services Research Journals 14.9               27.4

Health Policy Journals                      26.6     15.8

Medical Journals                            34.4     36.3

 Percentages within these categories only
    How Much & Where Do Non-Academics
                Publish?
   Government                              9%
                              Econ            15%
       Career: 19
       Last 5 Years: 8.2     Hlth                    20%
                              Econ         6%

                              HSR                              38%
   Private Sector                                18%

       Career: 22.5          Hlth              12%
                             Policy                    24%
       Last 5 Years: 9.6
                            Medical                   20%
                                                               37%

                                      0%                             50%

                                            Private         Gov't
What Sort of Training Do We Want for New
                  Hires?


     Economics Ph.D. with Health Field
     Economics Ph.D. with Health Interest
     Economics Ph.D. with No Health
     Health Services/Health Policy Ph.D.
     MD
      Acceptable Training for New Health
               Economist Hire
 Percent Acceptable
100

75
                                                                              Academics
50                                                                            Government
                                                                              Private
25

 0
         Ec             Ec              Ec              HS          MD
           on             on              on                R/
                w/               w/            w/             He
                     He             He             oH           alt
                       alt            alt              eal         hP
                             h            hi               th        oli
                                             nte                         cy
                                                 res
                                                     t
      Acceptable Training for New Health
         Economist Hire in Academia
 Percent Acceptable
100

75                                                                              A&S
                                                                                Business
50
                                                                                Pub Hlth
25                                                                              Medicine

 0
         Ec              Ec              Ec              HS            MD
           on              on              on                 R/
                w/               w/             w/              He
                     He             He              oH            alt
                       alt            alt              eal           hP
                             h            hi               th          oli
                                             nte                           cy
                                                 res
                                                     t
Our Perceptions of Professional Experience

      On publications for promotion
      On pressure to cover full indirects
      On likelihood of changing jobs soon
      On parental leave
      On journal/conference/grant reviews
      On professional life
 The quality of publications counts more for
 promotion and tenure at my institution than
     does the quantity of publications.
50%

                 39%
40%

30%
                                        25%

20%                         17%
        15%

10%
                                                   4%

0%
      Strongly   Agree   Don't Know   Disagree   Strongly
       Agree                                     Disagree
 I am pressured to bring in grants/contracts
    than cover the full indirect rate at my
                 institution.
30%
                                        26%


        19%      20%                               20%
20%
                            14%

10%



0%
      Strongly   Agree   Don't Know   Disagree   Strongly
       Agree                                     Disagree
There is a greater than 50% chance that I will
be employed by another organization within 3
                     years.
40%                                     38%


30%

                            21%                    20%
20%
                 13%

10%     8%


0%
      Strongly   Agree   Don't Know   Disagree   Strongly
       Agree                                     Disagree
  The culture in my department is such that
 colleagues feel pressured to decline parental
leave ... for fear it would hurt their chances for
            tenure and/or promotion.
40%
                            35%         34%

30%
                                                   22%
20%


10%               7%
        2%
 0%
      Strongly   Agree   Don't Know   Disagree   Strongly
       Agree                                     Disagree
Overall, I am satisfied with the review process
         at health economics journals.

60%

50%              48%

40%

30%                         27%
                                        20%
20%

10%
        2%                                         3%
0%
      Strongly   Agree   Don't Know   Disagree   Strongly
       Agree                                     Disagree
Overall, I am satisfied with the review process
 for papers considered for inclusion at health
            economics conferences.
70%
                 61%
60%

50%

40%

30%
                            22%
20%
                                        9%
10%     6%
                                                   2%
0%
      Strongly   Agree   Don't Know   Disagree   Strongly
       Agree                                     Disagree
Overall, I am satisfied with the review process
 for federal/foundation grants & contracts.

50%                    44%
                 40%                    38%
40%
                                  30%
30%
                                                20%
20%                                                   14%
10%                                                         7%
      3% 4%
                                                                 1%
0%
      Strongly    Agree         Don't Know      Disagree    Strongly
       Agree                                                Disagree

                             Federal    Foundation
      Overall, I am satisfied with my current
                   employment.

60%
                  50%
50%

40%     36%

30%

20%

10%                          7%          5%
                                                    2%
0%
       Strongly   Agree   Don't Know   Disagree   Strongly
        Agree                                     Disagree
               What Do We Earn?

   Mean annual incomes
     By type of employer
     Academic rank & contract

     Type of academic school

   Mean consulting income
   Income and Consulting Regressions
                 Sample Restrictions
   Self-designated health economists or economists
    working in health
     Academic doctoral degree holders only
     Employed only
            Exclude: self-employed, retired, unemployed
       Responded to all relevant questions
   222 usable observations in regressions
     145 academics
     77 non-academics
           Earnings Definition


“In the last 12 months, how much did you earn
 from your primary employer (including summer
 support, bonuses, and profit sharing but not
 housing allowance)?”
      Earnings by Type of Employer

                  Mean       S. D.     N
Academic         $117,573   (43,048)   162
Government       $104,786   (25,018)   30
Not-for-profit   $122,472   (39,504)   36
For-profit       $170,962   (76,456)   22
All              $119,040   (48,005)   251
 Academic Earnings by Rank & Degree
             Economics Ph.D.s      Other Doctoral Degrees
            9-Month    12-Month     9-Month     12-Month
Assistant   $82,315     $84,100     $94,116      $91,777
Professor   (29,196)    (23,961)     (22,258)    (21,100)
             N=21        N=16         N=12        N=18
Associate   $91,847    $108,428        ---       $96,167
Professor   (25,867)    (20,851)                 (16,448)
             N=16        N=16                      N=6
Full        $150,645   $171,357     $105,000    $135,600
Professor   (34,786)    (49,085)     (22,913)    (29,177)
             N=28        N=21          N=3         N=5
     Earnings By Academic Unit

             A&S       B-School     SPH       Medicine

            9-month 9-month 12-month 12-month
Assistant   $71,917    $110,561    $77,588    $90,428
Professor   (19,331)    (32,996)   (28,478)    (15,628)
             N=12        N=10        N=9        N=14
Associate   $83,167       ---      $102,167   $111,736
Professor   (23,353)               (13,763)    (20,824)
              N=6                   N=12         N=4
Full        $144,000   $135,305    $151,653   $194,500
Professor   (47,571)    (32,637)   (39,859)    (54,881)
              N=9        N=10       N=13         N=8
     Consulting Income Definition


“Over the past three years, how much did you
 earn per year outside of your primary
 employment (e.g., book royalties, consulting or
 expert witness fees, etc.)?
           Consulting Income - Academics

   Percentage of academics reporting
    any consulting income in past 3 years:   82.8%

   Mean annual consulting income of
    those reporting any:                     $20,602
                                             (28,590)

   Median annual consulting income of
    those reporting any:                     $10,000
                        Regressions

   ln Wage = f(education, experience, employer
                type, effort, publications,
                employment characteristics,
                demographics)
          Estimated separately for academics and non-academics


   Probit Consulting = f( “ )
   ln Conditional Consulting $ = f( “ )
         Regression Highlights - Academics

   10 more publications increased income at a
    decreasing rate:
     With 10 pubs – 10 more increased income 7.2%
     With 50 pubs – 10 more increased income 5.5%
     With 100 pubs – 10 more increased income 3.4%

   Greater percentage of time allocated to research
    increased income:
       10% more research time per week associated with
        2.5% higher income
        Regression Highlights - Academics

   No effect of Econ vs HSR vs Other Degree

   Marginal MD – 43% higher income
     Marginal masters/professional degree – no effect



   Degree from Top 5 econ dept – 18.5% higher
    income
      Top 6-20 econ dept – no effect
        Regression Highlights - Academics

   Years since degree – no effect

   Years with current employer – income declines at a
    decreasing rate for first 15.8 years

   Average hours worked per week – no effect
        Regression Highlights - Academics

   Compared to an Arts & Sciences Econ. Dept.:

     B-School – 18.4% higher incomes
     Public health – no effect

     Medicine – no effect



   No effects of demographics
        Regression Highlights - Academics

   Administrative Position – 16% higher income
   Tenured – 21% higher income

   No Effects of:
     Academic rank
     Non-tenure track

     9-month contract
        Regression Highlights: Consulting

   Model does not predict who consults!
   Higher consulting income associated with:
     HSR degree
     Male

     Fewer hours worked

     More publications
                      Conclusions

Few differences across schools, degrees, rank and
  9 – 12 month contract
 But:
     Top-5 econ program matters
     B-School matters
     Tenure matters
     Administrative position matters
     Marginal MD matters

   Paid for performance

				
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