|
on Health Economics |
| By: | Bénédicte H. Apouey (EEP-PSE - Ecole d'Économie de Paris - Paris School of Economics - Ecole d'Économie de Paris, PSE - Paris-Jourdan Sciences Economiques - CNRS : UMR8545 - École des Hautes Études en Sciences Sociales (EHESS) - École des Ponts ParisTech (ENPC) - École normale supérieure [ENS] - Paris - Institut national de la recherche agronomique (INRA)); Gabriel Picone (Department of Economics - University of South Florida) |
| Abstract: | This paper examines the existence of social interactions in malaria preventive behaviors in Sub-Saharan Africa, i.e. whether an individual's social environment has an influence on the individual's preventive behaviors. We focus on the two population groups which are the most vulnerable to malaria (children under 5 and pregnant women) and on two preventive behaviors (sleeping under a bednet and taking intermittent preventive treatment during pregnancy). We define the social environment of the individual as people living in the same region. To detect social interactions, we calculate the size of the social multiplier by comparing the effects of an exogenous variable at the individual level and at the regional level. Our data come from 92 surveys for 29 Sub-Saharan countries between 1999 and 2012, and they cover approximately 660,000 children and 95,000 women. Our results indicate that social interactions are important in malaria preventive behaviors, since the social multipliers for women's education and household wealth are greater than one - which means that education and wealth generates larger effects on preventive behaviors in the long run than we would expect from the individual-level specifications, once we account for social interactions. |
| Keywords: | Social interactions ; Social multiplier ; Malaria preventive behavior |
| Date: | 2014–02 |
| URL: | http://d.repec.org/n?u=RePEc:hal:psewpa:halshs-00940084&r=hea |
| By: | Thomas Barnay (TEPP - Travail, Emploi et Politiques Publiques - CNRS : FR3435 - Université Paris-Est Marne-la-Vallée (UPEMLV), ERUDITE - Equipe de Recherche sur l'Utilisation des Données Individuelles Temporelles en Economie - Université Paris-Est Créteil Val-de-Marne (UPEC) : EA437 - Université Paris-Est Marne-la-Vallée (UPEMLV)); Sandrine Juin (TEPP - Travail, Emploi et Politiques Publiques - CNRS : FR3435 - Université Paris-Est Marne-la-Vallée (UPEMLV), ERUDITE - Equipe de Recherche sur l'Utilisation des Données Individuelles Temporelles en Economie - Université Paris-Est Créteil Val-de-Marne (UPEC) : EA437 - Université Paris-Est Marne-la-Vallée (UPEMLV), INED - Institut National d'Etudes Démographiques Paris - INED); Renaud Legal (DREES - Centre de Recherche du DREES - Ministère de l'Emploi et de la Solidarité) |
| Abstract: | The main objective of this study is to analyse the effect of the professional environment on sick leaves. The professional context is approximated by the sector of activity. The database used - Hygie (2005-2008) - allows taking individual heterogeneity into account thanks to the longitudinal dimension. Sick leave probability is estimated through a fixed effects logit model and the duration (number of days absent due to sickness) is estimated through a fixed effects Poisson model. The results show that sectors of activity differ in sick leave duration rather than in the occurrence. Indeed, taking into account individual heterogeneity and differences in health status and wages reduces the variability in sick leave probability between sectors by half. On the other hand, the sector remains decisive in explaining sick leave durations. This residual variability may refer to unobserved differences in working conditions, in the generosity of daily sick pay benefits or in job insecurity. |
| Keywords: | sick leaves; health insurance; government policy; longitudinal data; fixed-effects; conditional maximum likelihood |
| Date: | 2014 |
| URL: | http://d.repec.org/n?u=RePEc:hal:wpaper:halshs-00943327&r=hea |
| By: | Andersson, Henrik (Toulouse School of Economics); Risa Hole, Arne (University of Sheffield); Svensson, Mikael (Dept. of Economics) |
| Abstract: | This study elicits individual preferences for reducing morbidity and mortality risk in the context of an infectious disease (campylobacter) using choice experiments. Respondents are in the survey asked to choose between different policies that, in addition to the two health risks, also vary with respect to source of disease being targeted (food or water), when the policy takes place (in time), and the monetary cost. Our results in our baseline model are in line with expectations; respondents prefer the benefits of the program sooner than later, programs that reduce both the mortality and morbidity risk, and less costly programs. Moreover, our results suggest that respondents prefer water- compared with food-safety programs. However, a main objective of this study is to examine scope sensitivity of mortality risk reductions using a novel approach. Our results from a split-sample design suggest that the value of the mortality risk reduction, defined as the value of a statistical life, is SEK 3 177 (USD 483 million) and SEK 50 million (USD 8 million), respectively, in our two sub-samples. This result cast doubt on the standard scope sensitivity tests in choice experiments, and the results also cast doubt on the validity and reliability of VSL estimates based on stated preference (and revealed preference) studies in general. This is important due to the large empirical literature on non-market evaluation and the elicited values’ central role in policy making, such as benefit-cost analysis. |
| Keywords: | Choice experiments; Morbidity risk; Mortality risk; Scope sensitivity; Willingness to pay |
| JEL: | D61 H41 I18 Q51 |
| Date: | 2014–02–06 |
| URL: | http://d.repec.org/n?u=RePEc:hhs:kaunek:0011&r=hea |
| By: | Caliendo, Marco (University of Potsdam); Gehrsitz, Markus (City University of New York) |
| Abstract: | This paper applies semiparametric regression models to shed light on the relationship between body weight and labor market outcomes in Germany. We find conclusive evidence that these relationships are poorly described by linear or quadratic OLS specifications, which have been the main approaches in previous studies. Women's wages and employment probabilities do not follow a linear relationship and are highest at a body weight far below the clinical threshold of obesity. This indicates that looks, rather than health, is the driving force behind the adverse labor market outcomes to which overweight women are subject. Further support is lent to this notion by the fact that wage penalties for overweight and obese women are only observable in white-collar occupations. On the other hand, bigger appears to be better in the case of men, for whom employment prospects increase with weight, albeit with diminishing returns. However, underweight men in blue-collar jobs earn lower wages because they lack the muscular strength required in such occupations. |
| Keywords: | obesity, wages, employment, semiparametric regression, gender differences |
| JEL: | J31 J71 C14 |
| Date: | 2014–02 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp7947&r=hea |
| By: | Fabrizio Mazzonna (IDEP and CEPRA, Facoltà di scienze economiche, Università della Svizzera italiana, Svizzera.); Franco Peracchi (Istituto Einaudi per l'Economia e la Finanza (EIEF) and Dipartimento di Economia e Finanza Facoltà di Economia Università degli Studi di Roma "Tor Vergataâ€, Roma, Italia.) |
| Abstract: | We investigate the causal effect of retirement on health and cognitive abilities by exploiting the variation between and within European countries in old age retirement rules. We show negative and significant effect of retirement on both health and cognitive abilities. We also show evidence of significant heterogeneity across occupational groups. In particular, the negative effect of retirement disappears and turn to be even positive for those working in very physically demanding jobs. |
| Keywords: | Aging, cognitive abilities, retirement, occupation, SHARE |
| JEL: | C26 I14 J14 J24 J26 |
| Date: | 2014–02–08 |
| URL: | http://d.repec.org/n?u=RePEc:lug:wpidep:1401&r=hea |
| By: | Jeffrey E. Harris; Beatriz G. López-Valcárcel; Patricia Barber; Vicente Ortún |
| Abstract: | Background. In Spain’s “MIR” system of allocating residency training positions, medical school graduates are ranked according to their performance on a national exam and then sequentially choose from the remaining available training slots. We studied how changes in the MIR system might address the inadequate supply of practitioners of family and community medicine in that country. Data. Our data included: a registry of the actual residency positions chosen by medical school graduates in the 2012 MIR cycle; a 2012 post-MIR survey in which graduates made counterfactual choices as to what they would have chosen but for their position in the national rankings; and a 2011 survey of the relative importance of specialty attributes among final-year medical students in the same cohort. Methods. We modeled the MIR system as a one-sided matching mechanism based priority rankings, also called “serial dictatorship.” Within this model, we developed a framework for evaluating the tradeoff between the efficiency gains from increasing the supply of practitioners of family and community medicine and the equity-related benefits of permitting the most talented medical students to make their specialty choices first. We then applied our framework to real data on medical school graduates’ specialty choices during 2012 MIR cycle. Our empirical analysis, based on the multinomial logit model with random coefficients, took account of the endogeneity of choice sets induced by the MIR scheme. We then used the parameter estimates to simulate various alternative public policies, including random ranking of candidates, restrictions on the supply of training positions, and policies designed to upgrade medical school graduates’ valuations of a career in family and community medicine. Results: Both random ranking and restrictions in supply resulted in a relatively small efficiency gains from training more productive medical school graduates in family and community medicine, but at the same time a substantial equity losses. Improvements in two key attributes of family and community medicine – professional prestige and the proportion of income from private practice – resulted in substantial gains in both equity and efficiency. Conclusions: Policies designed to increase the prestige and remuneration of practitioners of family and community medicine have the potential to be more efficient and equitable than other alternatives. |
| JEL: | C25 C78 D82 I11 I18 |
| Date: | 2014–02 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:19896&r=hea |
| By: | Alan L. Gustman; Thomas L. Steinmeier |
| Abstract: | This paper constructs and estimates a dynamic model of the evolution of health for those over the age of 50 and then embeds that model of health dynamics in a structural, econometric model of retirement and saving. The health model traces the effects of smoking, obesity, alcohol consumption, depression and other proclivities on medical conditions, including hypertension, diabetes, cancer, lung disease, heart problems, stroke, psychiatric problems and arthritis. These in turn influence an overall index of health status based on self-reported health, work limitations and ADLs, which is used to classify the population into good, fair, poor or terrible health. Compared to a situation where the entire population is in good health, the current health status of the population reduces the retirement age of the entire population by an average of about one year. While poor health or terrible health have a great impact on the disutility of work and thus on retirement, fair health as opposed to good health has a relatively minor effect. Smoking depresses full-time work effort by up to 3.5 percentage points by those in the early sixties, reducing the average retirement age by four to five months. Effects of trends in health care and health policies on retirement are also analyzed. Including detailed measurement of health dynamics in a retirement model improves understanding of the effects of health on retirement. It does not, however, influence estimates of the marginal effects of economic incentives on retirement. |
| JEL: | D31 D91 E21 H55 I1 I3 J14 J18 J26 J3 J32 |
| Date: | 2014–02 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:19902&r=hea |
| By: | Jeffrey Clemens |
| Abstract: | In the early 1990s, several U.S. states enacted community rating regulations to equalize the health insurance premiums paid by the healthy and the sick. Consistent with severe adverse selection pressures, their private coverage rates fell by around 8 percentage points more than rates in comparable markets over subsequent years. By the early 2000s, following substantial public insurance expansions, coverage rates in several of these states had improved significantly. As theory predicts, recoveries were largest where public coverage expanded disproportionately for high cost populations. The analysis highlights that the incidence of public insurance and community rating regulations are tightly intertwined. |
| JEL: | H51 H53 I13 I18 |
| Date: | 2014–02 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:19904&r=hea |