Academic journal article Theoretical and Empirical Researches in Urban Management

Positive Externalities of Congestion on Health: A Case Study of Chronic Illness in Japan for the Period 1988-2009

Academic journal article Theoretical and Empirical Researches in Urban Management

Positive Externalities of Congestion on Health: A Case Study of Chronic Illness in Japan for the Period 1988-2009

Article excerpt


It is widely acknowledged that maintenance of health in the general population is one of the major issues of government policy. Especially in developed countries, modern lifestyles are thought harmful to individual's health status, especially as reflected in the high prevalence of obesity (e.g. Chou et al, 2004; Loureiro and Nayga, 2005; Knai et al., 2007). Accordingly, a number of studies concerning obesity have been carried out in the USA (e.g. Cutler et al., 2003; Boumtje et al., 2005), Europe (e.g. Vigenerova et al., 2007; Zellner et al., 2007), and Japan (Kobayashi and Kobayashi, 2006). According to the Japanese Ministry of Health, Labour and Welfare (2004) the prevalence of obesity in men in Japan is 1.5 times greater than it was 20 years ago. Obesity is considered as a key factor causing chronic illnesses that lead to undesirable outcomes (Costa-Font and Gil, 2005).

Individual lifestyles depend on socio-economic circumstances. Previous reports have demonstrated that individual health status is better in larger cities in the USA than in small and medium ones (Ray and Ghoshi 2007). (1) This might be due not only to more economic resources such as a higher level of income (Blumenthal and Kagen, 2002) (2) but also to easier access to health care facilities and medical services (Rabinowitz and Paynter, 2002). On the other hand, congestion in urban areas tends to cause higher land prices leading to increases of housing expenditure. In addition, higher crime rates and pollution levels in urban areas may negatively affect health status. Thus it is important to evaluate the benefits and risks associated with urban living so as to determine optimal sizes of cities and populations (Henderson, 1982; Herzog and Schlottmann, 1993).

The importance of the role played by spatial density rather than size in improving productivity in companies has been emphasized by Ciccone and Hall (1996). (3) This appears to hold true also with respect to households, since the degree of congestion might be more closely related to the density of the population relative to physical space than it is to the overall population size. In densely populated areas such as Tokyo, congestion is expected to cause traffic jams, therefore inducing individuals to take overloaded trains to business districts when they commute at rush hours. (4) This undoubtedly represents an exacerbation of daily life. Nonetheless, from the point of view of health, rail commuters who walk to and from local stations may have increased amount of daily exercise than those who drive to work and thus are less likely to become obese, leading to prevention of chronic illnesses. This implies that congestion could have positive externality in improvement and maintenance of health. Little evidence is available, however, on this facet of congestion. Furthermore, changing socio- economic circumstance over time may be a determinant of chronic illness prevalence. This paper mainly attempts to investigate how population density and human capital influence chronic diseases by comparing their effects between two time periods such as 1988-98 and 1999-2009 using panel data for Japan, which is a densely populated and highly educated country. Fixed effects 2SLS estimation was used to analyze the influences of population density and human capital on death rates caused by chronic illness in the two study periods.


According to the World Bank (2006), the population of Japan in 2002 was 126 million, living in 364,500 [km.sup.2], giving a population density 346 people/[km.sup.2]. The population densities of the USA, Germany, and France are 30, 107, and 235 people/[km.sup.2], respectively. Hence Japan is distinctly more densely populated than many other industrialized countries. For closer investigation, let us look at the density distribution among prefectures in Japan. (5) From Figure 1, it can be seen that population density is remarkably skewed towards the lower end. …

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