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on Health Economics |
| By: | Richard G. Frank; Richard J. Zeckhauser |
| Abstract: | Drug pricing in the U.S. is a persistently vexing policy problem. While there is agreement among many policy analysts that supra competitive prices are necessary to promote innovation; significant disagreements arise over how much pricing discretion prescription drug manufacturers should be permitted, and what portion of the sum of producer plus consumer surplus in the prescription drug market should be claimed by manufacturers relative to consumers and other payers. This paper focuses on an extremely costly component of the Medicare Part D program the region of coverage that kicks in once a consumer has spent $4,950 on drugs in a calendar year (roughly $8,100 in total drug spending). At that point there are high levels of insurance for the consumer and reinsurance for the prescription drug plan. Consumers pay 5% of costs; plans pay 15% and the government 80%. That design generates serious inefficiencies. The significant subsidies to plans in the reinsurance region combined with the launch of unique high cost prescription drugs could be expected to lead to and has led to substantial departures from cost-effective outcomes in treatments delivered. We investigate two, possibly complementary, strategies for reducing these inefficiencies. The first follows on the MedPac recommendation that the government reduce its share of risk bearing for the Part D reinsurance benefit. The second focuses on curbing price inefficiencies. It has two components: eliminating monopolistic overpricing, and rewarding the quality of drugs brought to market. It is grounded in the economics of two part tariffs, research on innovation prizes, performance-based contracts, and draws on the mechanism design literature. |
| JEL: | I11 I18 |
| Date: | 2018–01 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:24240&r=hea |
| By: | Gail D’Onofrio (Yale University School of Medicine) |
| Date: | 2017–10 |
| URL: | http://d.repec.org/n?u=RePEc:max:cprpbr:52&r=hea |
| By: | Strulik, Holger |
| Abstract: | In this paper, I introduce depression to the economics of human health and aging. Based on studies from happiness research, depression is conceptualized as a drastic loss of utility and value of life (life satisfaction) for unchanged fundamentals. The model is used to explain how untreated depression leads to unhealthy behavior and adverse health outcomes: depressed individuals are predicted to save less, invest less in their health, consume more unhealthy goods, and exercise less. As a result, they age faster and die earlier than non-depressed individuals. I calibrate the model for an average American and discus the socioeconomic gradient of health and depression as well as the hump-shaped association of antidepressant use with age. Delays in treatment for depression in young adulthood are predicted to have significant repercussions on late-life health outcomes and longevity. |
| Keywords: | depression,depression therapy,health behavior,aging,longevity |
| JEL: | D91 I10 I12 |
| Date: | 2018 |
| URL: | http://d.repec.org/n?u=RePEc:zbw:cegedp:337&r=hea |
| By: | Péter Hudomiet (RAND); Michael D. Hurd (RAND); Susann Rohwedder (RAND); Robert J. Willis (University of Michigan) |
| Abstract: | As workers age, their physical and cognitive abilities tend to decline. This could lead to a mismatch between workers’ resources and the demands of their jobs, restricting future work. We use longitudinal data from the Health and Retirement Study (HRS) linked to detailed occupational characteristics from the O*NET project to investigate how mismatches between job demands and workers’ resources in two physical and two cognitive domains affect retirement outcomes. We estimate how changes in physical and cognitive resources as well as their interactions with occupational job-demands affect changes in 1) subjective reports of work-limiting health problems; 2) mental health; and 3) subjective probabilities of working past age 65. We also estimate hazard models for transitions from full-time work to retirement. We found that declines in physical and cognitive resources are strong predictors of all outcomes: Fewer resources lead to greater reporting of work-limiting health problems; decline in mental health; smaller subjective probabilities of working full-time past age 65; and more transitions from work to retirement. The interaction of resources with job demands, however, is only statistically significant for workers with large-muscle limitations who are more likely to report changes in outcomes when they work in occupations that rely heavily on physical strength. In contrast, the effects of declines in fine motor skills and cognition do not show statistically significant differences by occupational job demands. It appears cognitive and fine motor skills, at least as measured in the HRS, are universally important determinants of working, not specific to certain occupations. |
| Date: | 2017–10 |
| URL: | http://d.repec.org/n?u=RePEc:mrr:papers:wp372&r=hea |
| By: | Jin Liu; Bingdong Hou; Xiao-Wei Ma; Hua Liao |
| Abstract: | Indoor air pollution is mainly caused by solid fuel use for cooking in developing countries. Many previous studies focused on its health risks on the children and in specific local area. This paper investigates household energy usage and transition for cooking in rural China and the health effects on the elderly. A national large-scale dataset CHARLS (China Health and Retirement Longitudinal Study) covering 450 villages and communities is employed. Logit regressions were used to quantitatively estimate the effects, after controlling for some factors such as income, demographic and geographical variables. The results robustly show that compared to non-solid fuels, solid fuel use significantly increases the possibility of chronic lung diseases (30%), exacerbation of chronic lung diseases (95%), seizure of heart disease (1.80 times), and decreases self-evaluated health status of the elderly (1.38 times). Thus, it is urgent to improve clean energy access for cooking in rural China. |
| Keywords: | indoor air pollution; household solid fuel; health risks; elderly; rural; China |
| JEL: | Q54 Q40 |
| Date: | 2018–01–03 |
| URL: | http://d.repec.org/n?u=RePEc:biw:wpaper:111&r=hea |
| By: | Henry Saffer; Daniel Dench; Dhaval Dave; Michael Grossman |
| Abstract: | Over the past few years adult use of e-cigs has been increasing while adult smoking has been declining. It is important to determine if there is a causal effect of e-cig use on smoking because of the known health hazards associated with smoking. An important concern with most prior studies of e-cigs and smoking is that endogeneity between e-cig use and cigarette use is ignored. One contribution of this paper is to instrument e-cig use in order to avoid this endogeneity problem. The data employed to estimate the empirical models come from the 2014-2015 Tobacco Use Supplements (TUS). The data employed in this study rely on the combined July 2014, January 2015 and May 2015 waves of the TUS. The results show that e-cig use increases the probability of a quit attempt, the probability of a quit failure and the number of quit failures. E-cig use is also found to reduce smoking by failed quitters and non-attempters. Past studies have shown that successful quitting may follow after a few years of e-cig use but the TUS is limited to a one year retrospective window, which may be too short to observe the causal effect of e-cigs on successful quit attempts. Although there is no evidence in the TUS regressions that e-cigs use affects the probability of a successful quit, the results for attempts, failures and reduction of smoking suggest that e-cigs create a path toward cessation. |
| JEL: | I18 |
| Date: | 2018–01 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:24212&r=hea |
| By: | Damon Jones; David Molitor; Julian Reif |
| Abstract: | Workplace wellness programs cover over 50 million workers and are intended to reduce medical spending, increase productivity, and improve well-being. Yet, limited evidence exists to support these claims. We designed and implemented a comprehensive workplace wellness program for a large employer with over 12,000 employees, and randomly assigned program eligibility and financial incentives at the individual level. Over 56 percent of eligible (treatment group) employees participated in the program. We find strong patterns of selection: during the year prior to the intervention, program participants had lower medical expenditures and healthier behaviors than non-participants. However, we do not find significant causal effects of treatment on total medical expenditures, health behaviors, employee productivity, or self-reported health status in the first year. Our 95% confidence intervals rule out 78 percent of previous estimates on medical spending and absenteeism. Our selection results suggest these programs may act as a screening mechanism: even in the absence of any direct savings, differential recruitment or retention of lower-cost participants could result in net savings for employers. |
| JEL: | I1 J3 M5 |
| Date: | 2018–01 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:24229&r=hea |
| By: | Barry Bosworth; John Bieler; Michael Kleinrock; Eric Koepcke; Ernst R. Berndt |
| Abstract: | The prescription drug component of the Consumer Price Index (CPI measures recent and past drug price changes, and provides the basis for projecting future price trends and health care expenditures. However, there are concerns about the adequacy of the price data because of recent changes in the structure of the market for prescription drugs. We compare the prescription drug data of the CPI with a large alternative data set from the IQVIA Institute for Human Data Science. We analyze the overall consistency if the data from the two sources, and examine the influence of the large shift from brand to generic drug sales and the increased reliance on third party insurance plans that are excluded from the CPI sampling frame. |
| JEL: | D04 I11 I18 L11 L65 |
| Date: | 2018–01 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:24210&r=hea |
| By: | Cooper, Zack; Kowalski, Amanda; Neff Powell, Eleanor; Wu, Jennifer |
| Abstract: | This paper examines the link between legislative politics, hospital behaviour, and health care spending. When trying to pass sweeping legislation, congressional leaders can attract votes by adding targeted provisions that steer money toward the districts of reluctant legislators. This targeted spending provides tangible local benefits that legislators can highlight when fundraising or running for re-election. We study a provision - Section 508 – that was added to the 2003 Medicare Modernization Act (MMA). Section 508 created a pathway for hospitals to apply to get their Medicare payment rates increased. We find that hospitals represented by members of the House of Representatives who voted ‘Yea’ on the MMA were significantly more likely to receive a 508 waiver than hospitals represented by members who voted ‘Nay.’ Following the payment increase generated by the 508 program, recipient hospitals treated more patients, increased payroll, hired nurses, added new technology, raised CEO pay, and ultimately increased their spending by over $100 million annually. Section 508 recipient hospitals formed the Section 508 Hospital Coalition, which spent millions of dollars lobbying Congress to extend the program. After the vote on the MMA and before the vote to reauthorize the 508 program, members of Congress with a 508 hospital in their district received a 22% increase in total campaign contributions and a 65% increase in contributions from individuals working in the health care industry in the members’ home states. Our work demonstrates a pathway through which the link between politics and Medicare policy can dramatically affect US health spending. |
| Keywords: | health care; US; hospital; politics |
| JEL: | D72 H51 I10 P16 |
| URL: | http://d.repec.org/n?u=RePEc:ehl:lserod:86620&r=hea |
| By: | Bhaskar, V.; Linacre, Robin; Machin, Stephen |
| Abstract: | The economic functioning of online drug markets using data scraped from online platforms is studied. Analysis of over 1.5 million online drugs sales shows online drugs markets tend to function without the significant moral hazard problems that, a priori, one might think would plague them. Only a small proportion of online drugs deals receive bad ratings from buyers, and online markets suffer less from problems of adulteration and low quality that are a common feature of street sales of illegal drugs. Furthermore, as with legal online markets, the market penalizes bad ratings, which subsequently lead to significant sales reductions and to market exit. The impact of the well-known seizure by law enforcement of the original Silk Road and the shutdown of Silk Road 2.0 are also studied, together with the exit scam of the market leader at the time, Evolution. There is no evidence that these exits deterred buyers or sellers from online drugs trading, as new platforms rapidly replaced those taken down, with the online market for drugs continuing to grow |
| Keywords: | dark web; drugs |
| JEL: | K42 |
| Date: | 2017–08–01 |
| URL: | http://d.repec.org/n?u=RePEc:ehl:lserod:86585&r=hea |
| By: | Ethan M.J. Lieber; Lee M. Lockwood |
| Abstract: | Many of the most important government programs make transfers in kind as opposed to in cash. Making transfers in kind has the obvious cost that recipients would often prefer cost-equivalent cash transfers. But making transfers in kind can have benefits as well, including better targeting transfers to desired recipients or states of the world. In this paper, we develop a framework for evaluating this tradeoff and apply it to home care. Exploiting large-scale randomized experiments run by three state Medicaid programs, we find that in-kind provision of formal home care significantly reduces the value of benefits to recipients while targeting benefits to a small fraction of the eligible population that has greater demand for formal home care, is sicker, and has worse informal care options than the average eligible. Under a wide range of assumptions within a standard model, the targeting benefit of in-kind provision exceeds the distortion cost. This highlights an important cost of recent reforms that move toward more flexible, cash-like benefits. |
| JEL: | H21 H51 I13 I38 |
| Date: | 2018–01 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:24267&r=hea |
| By: | Hoyt Bleakley |
| Abstract: | While health affects economic development and wellbeing through a variety of pathways, one commonly suggested mechanism is a "horizon" channel in which increased longevity induces additional education. A recent literature devotes much attention to how much education responds to increasing longevity, while this study asks instead what impact this specific channel has on wellbeing (welfare). I note that death is like a tax on human-capital investments, which suggests the use of a standard public-economics tool: triangles. I construct estimates of the triangle gain if education adjusts to lower adult mortality. Even for implausibly large responses of education to survival differences, almost all of today's low-human-development countries, if switched instantaneously to Japan's survival curve, would place a value on this channel of less than 15% of income. Calibrating the model with well-identified micro- and cohort-level studies, I find that the horizon triangle for the typical low-income country is instead less than a percent of lifetime income. Gains from increased survival in the 20th-century are similarly sized. |
| JEL: | J24 N3 O1 |
| Date: | 2018–01 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:24247&r=hea |
| By: | Dubois, Pierre; Saethre, Morten |
| Abstract: | Differences in regulated pharmaceutical prices within the European Economic Area create arbitrage opportunities that pharmacy retailers can use through parallel imports. For prescription drugs under patent, such provision decisions affect the sharing of profits among an innovating pharmaceutical company, retailers, and parallel traders. We develop a structural model of demand and supply in which retailers can choose the set of goods to sell to consumers, thus foreclosing the consumers' access to some less-profitable drugs, which allows retailers to bargain and obtain lower wholesale prices with the manufacturer and parallel trader. With detailed transaction data, we identify a demand model with unobserved choice sets using supply-side conditions for optimal assortment decisions of pharmacies. Estimating our model, we find that retailer incentives play a significant role in fostering parallel trade penetration. Our counterfactual simulations show that parallel imports of drugs allows retailers to gain profits at the expense of the manufacturer, whereas parallel traders also gain but earn more modest profits. Finally, a policy preventing pharmacies from foreclosing the manufacturer's product is demonstrated to partially shift profits from pharmacists to both the parallel trader and the manufacturer, and a reduction in the regulated retail price favors the manufacturer even more. |
| Keywords: | Demand estimation; foreclosure; Parallel trade; pharmaceuticals; vertical contracts |
| JEL: | I11 L22 |
| Date: | 2018–01 |
| URL: | http://d.repec.org/n?u=RePEc:cpr:ceprdp:12649&r=hea |
| By: | Manuela Alcañiz (Riskcenter, Department of Econometrics, Statistics and Applied Economy, Universitat de Barcelona); Aïda Solé-Auró (DemoSoc Research Group, Department of Political and Social Sciences, Universitat Pompeu Fabra) |
| Abstract: | Background, Reaching advanced old age is more common now than ever. The sustained growth in longevity raises questions about why some people can feel in good quality of life until the last stages, while others seem to accuse the natural deterioration to a larger extent. The self-perceived quality of life has a subjective component, but is also mediated by some easily measurable factors such as sociodemography, health, functioning and lifestyles. Methods, This study uses nationally representative data for Catalonia (Spain) to explain the health-related quality of life (HRQL) of the population aged 80 and above. Cross-sectional data from 2011 to 2016 was provided by an official face-to-face survey. HRQL was measured through the EuroQol-5D, consisting of a 5-question descriptive system (EQ-5D), plus a visual analogue scale (EQ-VAS) that summarizes the current self-perceived health. Linear regression was used to identify variables influencing the EQ-VAS score. Results, The dimensions of the EQ-5D that more severily disturbed the HRQL were mobility problems, pain/discomfort and anxiety/depression. Self-care or usual activity problems had a milder impact. Other variables were significantly associated with HRQL. Adjusting for age and sex, low education, low social class, being underweighted or obese, having chronic conditions and disabilities, the presence of hospitalizations or visits to the emergency department, taking prescription drugs and limitations in sensory-related abilites were predictors of a poor HRQL. Conclusions, Our study identified the impact of several social, health and healthcare variables on the HRQL on 80-plus population. The multidimensional nature of the results suggests the need for a comprehensive approach to HRQL. Health prevention and promotion policies must address the old age as a specially sensitive stage of life. |
| Keywords: | longevity, health-related quality of life, EuroQol-5D, Spain. |
| Date: | 2017–07 |
| URL: | http://d.repec.org/n?u=RePEc:bak:wpaper:201801&r=hea |
| By: | Hugh Gravelle (Centre for Health Economics, University of York, York, UK); Dan Liu (Centre for Health Economics, University of York, York, UK); Carol Propper (Imperial College London, UK); Rita Santos (Centre for Health Economics, University of York, York, UK) |
| Abstract: | We examine whether family doctor firms in England respond to local competition by increasing their quality. We measure quality in terms of clinical performance and patient-reported satisfaction to capture its multi-dimensional nature. We use a panel covering 8 years for over 8000 English general practices, allowing us to control for unobserved local area effects. We measure competition by the number of rival doctors within a small distance. We find that increases in local competition are associated with increases in clinical quality and patient satisfaction, particularly for firms with lower quality. However, the magnitude of the effect is small. |
| Keywords: | Quality, healthcare, choice, competition, family physicians |
| JEL: | I11 I18 |
| Date: | 2018–02 |
| URL: | http://d.repec.org/n?u=RePEc:chy:respap:151cherp&r=hea |
| By: | Bénédicte H. Apouey (PJSE - Paris Jourdan Sciences Economiques - UP1 - Université Panthéon-Sorbonne - ENS Paris - École normale supérieure - Paris - INRA - Institut National de la Recherche Agronomique - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique, PSE - Paris School of Economics); Jacques Silber (Bar-Ilan University [Israël]) |
| Abstract: | A country's performance in health attainment refers to both its achievement (level) and its improvement (evolution) in the health domain. Studies on performance generally measure health attainment using the average health level of the population, and quantify health improvement employing the change in attainment over time. However this approach is flawed because the change in attainment does not satisfy good properties, on the one hand, and because health attainment should not only account for the average health level, but also for disparities in health in the population, on the other hand. We propose a solution to the first limitation by following the lead of Kakwani (1993), who uses achievement and improvement measures which are based on attainment measures and which satisfy important properties. For the second limitation, we extend the work of Kakwani and propose new definitions of attainment that account for the average health level but also for health inequalities in the population. Specifically, we focus on overall and social health inequalities and on the health of the poor. By including these new attainment variables into Kakwani's indices, we generate new classes of achievement and improvement indices. Using data on 11 low and middle-income Asian countries in the twenty-first century, we highlight that child and maternal health have generally improved in recent decades, due to both an increase in the average health level and a decrease in inequalities. |
| Date: | 2016 |
| URL: | http://d.repec.org/n?u=RePEc:hal:journl:halshs-01599558&r=hea |
| By: | Makate, Marshall; Makate, Clifton |
| Abstract: | Abstract: Inequalities in maternal healthcare are pervasive in the developing world, a fact that has led to questions about the extent of these inequalities across socioeconomic groups. Yet, despite a growing literature on maternal health across Sub-Saharan African countries, relatively little is known about the evolution of these inequalities over time for specific countries. This study sought to examine and document the trends in the inequalities in prenatal care use, professional delivery assistance, and the receipt of information on pregnancy complications in Zimbabwe. We assess the extent to which the observed inequalities have been pro-poor or pro-rich. The empirical analysis uses data from four rounds of the nationally representative Demographic and Health Survey for Zimbabwe conducted in 1994, 1999, 2005/06 and 2010/11. Three binary indicators were used as measures of maternal health care utilization; (1) the receipt of four or more antenatal care visits, (2) the use of professional delivery assistance, and (3) the receipt of information regarding pregnancy complications for the most recent pregnancy. We measure and explain inequalities in maternal health care use using Erreyger’s corrected concentration index. A decomposition analysis was conducted to determine the contributions of each determining factor to the measured inequalities. We found a significant and persistently pro-rich distribution of inequalities in professional delivery assistance and knowledge regarding pregnancy complications was observed between 1994 and 2010/11. Also, inequalities in prenatal care use were pro-rich in 1994, 2005/06 and 2010/11 periods and pro-poor in 1999. Furthermore, we stratified the results by rural or urban status. The results reveal a rising trend in observed inequalities in maternal health care use over time. Our findings suggest that addressing inequalities in maternal healthcare utilization requires coordinated public health policies targeting the more poor and vulnerable segments of the population in Zimbabwe. |
| Keywords: | Socioeconomic-related inequality; maternal healthcare utilization; Erreygers concentration index; Zimbabwe |
| JEL: | I12 I14 |
| Date: | 2016–04–28 |
| URL: | http://d.repec.org/n?u=RePEc:pra:mprapa:83897&r=hea |
| By: | Eric T. Roberts; J. Michael McWilliams; Laura A. Hatfield; Sule Gerovich; Michael E. Chernew; Lauren G. Gilstrap; Ateev Mehrotra |
| Abstract: | In 2014, the State of Maryland placed the majority of its hospitals under all-payer global budgets for inpatient, hospital outpatient, and emergency department care. |
| Keywords: | Health care, Hospital budgets, Maryland |
| JEL: | I |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:02b8a816a5624a41991cea1ed484e511&r=hea |
| By: | So O'Neil; Ella Douglas-Durham; Jon Collins; Pat Jones; Alicia Cooper |
| Abstract: | This presentation describes approaches that state Medicaid programs can consider when developing the benchmarks, or standards against which to judge performance, for value-based payment programs. |
| Keywords: | Benchmarking, performance, metrics, value-based, payment, Medicaid, IAP, Innovation Accelerator Program, Webinar |
| JEL: | I |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:5e57ca9dd8494f859480ce9b8e3d7bb0&r=hea |
| By: | Crystal Blyler; Priyanka Anand; Melissa Azur; Emily Caffery; Grace Ferry; Benjamin Fischer; Angela Gerolamo; Rosalind Keith; Jung Kim; Brenda Natzke; Bonnie O'Day; Allison Siegwarth |
| Abstract: | This report presents the initial steps taken to implement the demonstration and early evaluation results. |
| Keywords: | Report to Congress, Medicaid Emergency Psychiatric Demonstration |
| JEL: | I |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:7545894bc3b9428482974674ef0e0e96&r=hea |
| By: | John Schurrer; Ann O'Malley; Claire Wilson; Nancy McCall; Neetu Jain |
| Abstract: | In January 2015, the Centers for Medicare & Medicaid Services (CMS) introduced a separately billable non-face-to-face Chronic Care Management (CCM) service. |
| Keywords: | Medicare, CCM, chronic condition management, chronic care management services, CMS, 99490, 99487, 99489 |
| JEL: | I |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:c219754a6edb4f7193fe92b9e2ba94d7&r=hea |
| By: | Anne M. Williams; Christine P. Stewart; Setareh Shahab-Ferdows; Daniela Hampel; Marion Kiprotich; Beryl Achando; Audrie Lin; Clair A. Null; Lindsay H. Allen; Caroline J. Chantry |
| Abstract: | Vitamin B-12 is an essential nutrient required for many functions including DNA synthesis, erythropoiesis, and brain development. If maternal milk vitamin B-12 concentrations are low, infants may face elevated risks of deficiency when exclusively breastfed. |
| Keywords: | vitamin B-12, human milk, micronutrient deficiency, infant feeding, breastfeeding, lactation, Kenya |
| JEL: | F Z I0 I1 |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:55bcededb3af4ba69fc5c24c9aca4e6d&r=hea |
| By: | Benjamin Fischer; Jane Ahn; Claire Brindley; Kathryn Dovgala; Cyrus Jadun; Sean Kirk; Rebecca Lester; Jenna Libersky; Debra Lipson; Jessica Nysenbaum; Karina Wagnerman |
| Abstract: | The data and information presented in this report were collected directly from all states, the District of Columbia, and US territories |
| Keywords: | Medicaid managed care, primary care case management, primary care provider, enrollment data, Medicare-Medicaid eligibles, dual eligibles, MLTSS, managed long-term services and supports, Section 1115, Section 1902, Section 1905, Affordable Care Act, ACA, behavioral health organization, fee-for-service, Medicaid waivers, mental health |
| JEL: | I |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:6059dfec411d468a848d9a3c4f0c0a00&r=hea |
| By: | Robert G. Wood; Ellen Kisker |
| Abstract: | This brief summarizes the key findings on implementing Steps to Success in San Angelo Texas. The program is being operated as part of a research study in which young mothers are randomly assigned to receive one of two home visiting interventions, a traditional program focused on parenting and child development, and Steps to Success, focused on contraception and adequate birth spacing, as well as parenting and child development. |
| Keywords: | adolescent pregnancy, rapid repeat pregnancy, steps to success, home visiting, teen pregnancy prevention, Personal Responsibility Education Program (PREP) Evaluation |
| JEL: | I |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:ee891ac99f2946fc82939f4fc6e4d01c&r=hea |
| By: | Blanchflower, David G. (Dartmouth College, Stirling, NBER, Bloomberg and IZA); Oswald, Andrew J (University of Warwick, CAGE, and IZA) |
| Abstract: | In Happiness for All?, Carol Graham raises disquieting ideas about today’s United States. The challenge she puts forward is an important one. Here we review the intellectual case and offer additional evidence. We conclude broadly on the author’s side. Strikingly, Americans appear to be in greater pain than citizens of other countries, and most subgroups of citizens have downwardly trended happiness levels. There is, however, one bright side to an otherwise dark story. The happiness of black Americans has risen strongly since the 1970s. It is now almost equal to that of white Americans. |
| Keywords: | Happiness ; well-being ; GHQ ; mental-health ; depression ; life-course |
| JEL: | I3 I31 |
| Date: | 2018 |
| URL: | http://d.repec.org/n?u=RePEc:wrk:warwec:1153&r=hea |
| By: | Marie Blaise |
| Abstract: | Using panel data from the Survey of Health, Ageing and Retirement in Europe (SHARE), I examine the incentives underlying care provision including the effects of altruism (1), the exchange motive (2) and the family norms (3) on the informal care decision in an ascendant family model. These estimates suggest that altruism and the exchange motive are the main drivers of the caregiver's decision. Furthermore, the empirical results are in favour of a North-South gradient since the motives driving the care decision differ according to the countries. Finally, the findings confirm well-known results: females are the main caregivers and having siblings relieves the care burden. |
| Keywords: | IInformal care, altruism, exchange model, norm transmission. |
| JEL: | D12 D64 I12 |
| Date: | 2018 |
| URL: | http://d.repec.org/n?u=RePEc:ulp:sbbeta:2018-12&r=hea |
| By: | Akogun,Oladele B; Dillon,Andrew S.; Friedman,Jed; Prasann,Ashesh; Serneels,Pieter Maria |
| Abstract: | This paper investigates an alternative proxy for individual worker productivity in physical work settings: a direct measure of physical activity using an accelerometer. First, the paper compares worker labor outcomes, such as labor supply and daily productivity obtained from firm personnel data, with physical activity; they are strongly related. Second, the paper investigates the effect of a health intervention on physical activity, using a temporally randomized offer of malaria testing and treatment. Workers who are offered this program reallocate time from lower intensity activities in favor of higher intensity activities when they work. |
| Keywords: | Inequality,Social Protections&Assistance |
| Date: | 2017–10–30 |
| URL: | http://d.repec.org/n?u=RePEc:wbk:wbrwps:8228&r=hea |
| By: | Mujcic, Redzo; Oswald, Andrew J (University of Warwick, CAGE, and IZA) |
| Abstract: | Nearly 100 years ago, the philosopher and mathematician Bertrand Russell warned of the social dangers of widespread envy. One view of modern society is that it is systematically developing a set of institutions -- such as social media and new forms of advertising -- that make people feel inadequate and envious of others. If so, how might that be influencing the psychological health of our citizens? This paper reports the first large-scale longitudinal research into envy and its possible repercussions. The paper studies 18,000 randomly selected individuals over the years 2005, 2009, and 2013. Using measures of SF-36 mental health and psychological well-being, four main conclusions emerge. First, the young are especially susceptible. Levels of envy fall as people grow older. This longitudinal finding is consistent with a cross-sectional pattern noted recently by Nicole E. Henniger and Christine R. Harris, and with the theory of socioemotional regulation suggested by scholars such as Laura L. Carstensen. Second, using fixed-effects equations and prospective analysis, the analysis reveals that envy today is a powerful predictor of worse SF-36 mental health and well-being in the future. A change from the lowest to the highest level of envy, for example, is associated with a worsening of SF-36 mental health by approximately half a standard deviation (p |
| Keywords: | Envy ; age ; SF-36 ; mental health ; well-being ; longitudinal data |
| Date: | 2018 |
| URL: | http://d.repec.org/n?u=RePEc:wrk:warwec:1154&r=hea |
| By: | So O'Neil; Ella Douglas-Durham |
| Abstract: | This brief describes approaches that state Medicaid programs can consider when developing the benchmarks, or standards against which to judge performance, for value-based payment programs. |
| Keywords: | Benchmarking, performance, metrics, value-based, payment, Medicaid, IAP, Innovation Accelerator Program |
| JEL: | I |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:f5e12d36a547427397b35e62549e6a24&r=hea |
| By: | Danielle Shapiro; Jesse Chandler |
| Keywords: | Traumatic Brain Injury |
| JEL: | I |
| URL: | http://d.repec.org/n?u=RePEc:mpr:mprres:4455f582d47d40338e5d5b6bca166e90&r=hea |
| By: | Bertoni, M.;; Brunello, G.;; Mazzarella, G.; |
| Abstract: | By increasing the residual working horizon of employed individuals, pension reforms that rise minimum retirement age can affect individual investment in health-promoting behaviors before retirement. Using the expected increase in minimum retirement age induced by a 2004 Italian pension reform and a difference-in-differences research design, we show that middleaged Italian males affected by the reform reacted to the longer working horizon by increasing regular exercise, with positive consequences for obesity and self-reported satisfaction with health. |
| Keywords: | retirement; working horizon; healthy behaviors; pension reforms; |
| JEL: | H55 I12 J26 |
| Date: | 2018–02 |
| URL: | http://d.repec.org/n?u=RePEc:yor:hectdg:18/03&r=hea |