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on Health Economics |
| By: | Bhalotra, Sonia (University of Warwick); Clarke, Damian (Universidad de Chile); Gomes, Joseph F. (UC Louvain); Venkataramani, Atheendar (University of Pennsylvania) |
| Abstract: | Millions of women continue to die during and soon after childbirth, even where the knowledge and resources to avoid this are available. We posit that raising the share of women in parliament can trigger action. Leveraging the timing of gender quota legislation across developing countries, we identify sharp sustained reductions of 8–10 percent in maternal mortality. Investigating mechanisms, we find that gender quotas lead to increases in percentage points of 5–8 in skilled birth attendance and 4–8 in prenatal care utilization, alongside a decline in fertility of 6–7 percent and an increase in the schooling of young women of about 0.5 years. The results are robust to numerous robustness checks. They suggest a new policy tool for tackling maternal mortality. |
| Keywords: | maternal mortality ; women’s political representation ; gender ; quotas ; reproductive health services ; fertility ; schooling JEL Classification: I14 ; I15 ; O15 |
| Date: | 2021 |
| URL: | http://d.repec.org/n?u=RePEc:wrk:warwec:1353&r= |
| By: | Jorge M. Agüero (University of Connecticut); Catalina Herrera-Almanza (University of Illinois, Urbana-Champaign); Kira Villa (University of New Mexico) |
| Abstract: | Domestic violence is a major public health issue worldwide with detrimental consequences not only for its victims but also for the next generations. Despite a large literature documenting the persistent intergenerational transmission of domestic violence, few studies explore the mechanisms underlying this transmission. We advance this literature by exploring human capital as a mechanism using unique longitudinal data from the Philippines. These data allow us to consider broad measures of human capital over the life course, including cognitive skills and psycho-social traits, in addition to the traditional measures of schooling and health. We find that 22 percent of the transmission of domestic violence is explained by these human capital measures. Our results indicate that depression at age 18 and cognitive ability at age 11 are the primary human capital channels, suggesting that interventions targeting these human capital investments hold potential for reducing the cycle of violence across generations, thus, expanding the window of opportunity for effective interventions in developing countries. |
| Keywords: | Intergenerational transmission; domestic violence; human capital; cognitive; psycho-social traits; noncognitive |
| JEL: | J12 J13 O15 |
| Date: | 2021–05 |
| URL: | http://d.repec.org/n?u=RePEc:uct:uconnp:2021-07&r= |
| By: | Hamory, Joan; Miguel, Edward; Walker, Michael; Kremer, Michael; Baird, Sarah |
| Abstract: | Estimating the impact of child health investments on adult living standards entails multiple methodological challenges, including the lack of experimental variation in health status, an inability to track individuals over time, and accurately measuring living standards and productivity in low-income settings. This study exploits a randomized school health intervention that provided deworming treatment to Kenyan children, and uses longitudinal data to estimate impacts on economic outcomes up to 20 y later. The effective respondent tracking rate was 84%. Individuals who received two to three additional years of childhood deworming experienced a 14% gain in consumption expenditures and 13% increase in hourly earnings. There are also shifts in sectors of residence and employment: treatment group individuals are 9% more likely to live in urban areas, and experience a 9% increase in nonagricultural work hours. Most effects are concentrated among males and older individuals. The observed consumption and earnings benefits, together with deworming's low cost when distributed at scale, imply that a conservative estimate of its annualized social internal rate of return is 37%, a high return by any standard. |
| Keywords: | Kenya, child health, deworming, long-run impacts |
| Date: | 2021–04–01 |
| URL: | http://d.repec.org/n?u=RePEc:cdl:econwp:qt1mv5691c&r= |
| By: | Betsy Q. Cliff; Sarah Miller; Jeffrey T. Kullgren; John Z. Ayanian; Richard Hirth |
| Abstract: | Recent expansions of Medicaid eligibility have come with increased experimentation with enrollee cost-sharing. In this paper, we exploit a discontinuous premium increase at the federal poverty level in Michigan’s Medicaid expansion program to test low-income individuals’ sensitivity to premiums using linked enrollment and claims data. At the cutoff, average premiums increase by $3.15 and the probability of disenrollment increases by 2.3 percentage points. Increased disenrollment occurs among those with fewer documented medical needs at baseline, but not among those with greater medical needs. These results suggest healthier low-income individuals may be sensitive to even modest health insurance premiums, and that premiums may induce adverse selection in Medicaid plans. |
| JEL: | I1 I12 I13 |
| Date: | 2021–05 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:28762&r= |
| By: | Victoria R. Marone; Adrienne Sabety |
| Abstract: | We study the welfare effects of offering choice over financial coverage levels––"vertical choice''––in regulated health insurance markets. Though the efficient level of coverage, which trades off the value of risk protection and the social cost from moral hazard, likely varies across consumers, we emphasize that this variation alone is not sufficient to motivate choice. When premiums cannot reflect individual costs, consumers may not select their efficient coverage level. We show that vertical choice is efficient only if consumers with higher willingness to pay for insurance have a higher efficient level of coverage. Using administrative data from a large public employer, we investigate this condition empirically and find that the welfare gains from vertical choice are either zero or economically small. |
| JEL: | D82 G22 I13 |
| Date: | 2021–05 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:28779&r= |
| By: | Wolfgang Frimmel; Martin Halla; Jörg Paetzold; Julia Schmieder |
| Abstract: | We estimate the impact of parental health on adult children's labor market outcomes. We focus on health shocks which increase care dependency abruptly. Our estimation strategy exploits the variation in the timing of shocks across treated families. Empirical results based on Austrian administrative data show a significant negative impact on labor market activities of children. This effect is more pronounced for daughters and for children who live close to their parents. Further analyses suggest informal caregiving as the most likely mechanism. The effect is muted after a liberalization of the formal care market, which sharply increased the supply of foreign care workers. |
| Keywords: | informal care, formal care, aging, health, labor supply, labor migration |
| JEL: | J14 J22 I11 I18 R23 |
| Date: | 2020 |
| URL: | http://d.repec.org/n?u=RePEc:diw:diwwpp:dp13774&r= |
| By: | Black, Nicole; De Gruyter, Elaine; Petrie, Dennis; Smith, Sarah |
| Abstract: | 'Altruism born of suffering' (ABS) predicts that, following an adverse life event such as a health shock, individuals may become motivated to act pro-socially. However, this has not yet been examined systematically. Using data from the United States Panel Study of Income Dynamics, we find that a health shock does not lead to a general increase in pro-social behaviour. Instead, ABS is akin to a specific shock that affects giving to health charities, with an increase in the probability of giving and amounts donated to health charities coming at the expense of other non-religious charities. |
| JEL: | D64 H41 I12 |
| Date: | 2020–12 |
| URL: | http://d.repec.org/n?u=RePEc:cpr:ceprdp:15535&r= |
| By: | Barrenho, Eliana; Gautier, Eric; Miraldo, Marisa; Propper, Carol; Rose, Christiern |
| Abstract: | We examine the effect of a physician network on medical innovation using novel matched patient-physician-hospital panel data. The data include every relevant physician and all patients in the English NHS for 15 years and physicians' workplace histories for more than 20. The dynamic network arising from physician mobility between hospitals over time allows us to separate unobserved physician and hospital heterogeneity from the effect of the network. We build on standard peer-effects models by adding cumulative peer behaviour and allow for particularly influential physicians ('key players'), whose identities we estimate. We find positive effects of peer innovation take-up, number of peers, and proximity in the network to both pioneers of the innovation and key players. Counterfactual estimates suggest that early intervention targeting young, connected physicians with early take-up can significantly increase aggregate take-up." |
| Keywords: | Innovation; medical practice; networks; peer-effects |
| Date: | 2020–12 |
| URL: | http://d.repec.org/n?u=RePEc:cpr:ceprdp:15515&r= |
| By: | Craig Garthwaite; Rebecca Sachs; Ariel Dora Stern |
| Abstract: | Pharmaceutical innovation policy involves managing a tradeoff between high prices for new products in the short-term and stronger incentives to develop products for the future. Prior research has documented a causal relationship between market size and pharmaceutical research and development (R&D) activities. The existing literature, however, provides no evidence of how this relationship varies across markets. We investigate whether recent expansions in state Medicaid programs caused an increase in R&D. We find no evidence of a response, potentially a result of Medicaid’s low reimbursement for pharmaceuticals, suggesting low(er) price markets may have different dynamics with respect to innovation policy. |
| JEL: | H0 I1 L43 L5 O3 |
| Date: | 2021–05 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:28755&r= |
| By: | Jacks, David S.; Pendakur, Krishna; Shigeoka, Hitoshi |
| Abstract: | Federal prohibition from 1920 to 1933 was one of the most ambitious policy interventions in US history. However, due to the political concessions necessary to bring about repeal, the removal of restrictions on alcohol after 1933 was not uniform. Using new data on city-level variation in alcohol prohibition from 1933 to 1936, we investigate whether the repeal of federal prohibition affected multiple causes of urban (non-infant) mortality. We find that city-level repeal is associated with a 14.7% decrease in homicide rates and a 10.1% decrease in mortality rates associated with other accidents (including accidental poisonings). Thus, the repeal of federal prohibition could have led to an annual reduction of as many as 3,400 urban deaths. Combined with previous results showing large increases in infant mortality, this suggests that nonetheless repeal most likely had negative effects on all-cause mortality and, thereby, public health in the US. |
| Keywords: | Federal prohibition; local option; Urban Mortality |
| JEL: | H73 I18 J1 N3 |
| Date: | 2020–12 |
| URL: | http://d.repec.org/n?u=RePEc:cpr:ceprdp:15510&r= |
| By: | Griffith, Rachel; O'Connell, Martin; Smith, Kate |
| Abstract: | We study the introduction of a price floor for alcohol that is aimed at correcting for negative consumption externalities. Policy effectiveness depends on whether the measure achieves large reductions in the most socially costly consumption. We exploit a natural experiment to show the policy raised prices of cheap products favored by heavy consumers, and achieved large demand reductions among this group. We use pre-reform data to estimate a model of consumer demand that is able to match these patterns, and use this to compare the welfare performance of a price floor with the counterfactual introduction of an ethanol tax. We show that if the marginal external cost of drinking is at least moderately higher for heavy drinkers, then a price floor is better targeted at the most socially costly consumption and therefore achieves larger welfare gains than an ethanol tax. Although the price floor leads to a larger fraction of the consumer burden falling on those with low incomes compared with the tax reform, it leads to a consumer burden that is smaller for all income groups. |
| Keywords: | Alcohol; corrective taxes; externality; price floors |
| JEL: | D12 D62 H21 H23 |
| Date: | 2020–11 |
| URL: | http://d.repec.org/n?u=RePEc:cpr:ceprdp:15476&r= |
| By: | Puhani, Patrick; Sterrenberg, Margret |
| Abstract: | In this paper, we estimate the effects of mandatory military service by exploiting the post-cold war decrease in the need for soldiers causing a substantial number of potential conscripts not to be drafted into the German military. Specifically, using previously unavailable information on degree of fitness in the military’s medical exam as a control variable, we test for the effects of mandatory military service on wages; employment; marriage/partnership status; and satisfaction with work, financial situation, health, family life, friends, and life in general. We find almost no statistically significant effects of this 6 to 9 month career interruption for young German men, with the exception of hourly wage, which shows a negative point estimate of -15 percent with a large confidence interval of between -30 and -0.2 percent. This interval estimate is consistent with previous findings for the United States, Denmark, and the Netherlands. |
| Keywords: | Career breaks, conscription, wages, employment, life satisfaction, natural experiment |
| JEL: | J12 J24 J47 |
| Date: | 2021–05 |
| URL: | http://d.repec.org/n?u=RePEc:usg:econwp:2021:05&r= |
| By: | Daniel Graeber; Felicitas Schikora |
| Abstract: | Against a background of increasing violence against non-natives, we estimate the effect of hate crime on refugees’ mental health in Germany. For this purpose, we combine two datasets: administrative records on xenophobic crime against refugee shelters by the Federal Criminal Office and the IAB-BAMF-SOEP Survey of Refugees. We apply a regression discontinuity design in time to estimate the effect of interest. Our results indicate that hate crime has a substantial negative effect on several mental health indicators, including the Mental Component Summary score and the Patient Health Questionnaire-4 score. The effects are stronger for refugees with closer geographic proximity to the focal hate crime and refugees with low country-specific human capital. While the estimated effect is only transitory, we argue that negative mental health shocks during the critical period after arrival have important long-term consequences. |
| Keywords: | Mental health, hate crime, migration, refugees, human capital |
| JEL: | I10 J15 J24 F22 O15 |
| Date: | 2021 |
| URL: | http://d.repec.org/n?u=RePEc:diw:diwsop:diw_sp1130&r= |
| By: | Mika Akesaka; Peter Eibich; Chie Hanaoka; Hitoshi Shigeoka |
| Abstract: | The poor live paycheck to paycheck and are repeatedly exposed to strong cyclical income fluctuations. We investigate whether such income fluctuations affect risk preference among the poor. If risk preference temporarily changes around payday, optimal decisions made before payday may no longer be optimal afterward, which could reinforce poverty. By exploiting Social Security payday cycles in the US, we find that risk preference among the poor relying heavily on Social Security changes around payday. Rather than cognitive decline before payday, the deterioration of mental health and relative deprivation may play a role. We find similar evidence among the Japanese elderly. |
| Date: | 2021–05 |
| URL: | http://d.repec.org/n?u=RePEc:dpr:wpaper:1133&r= |
| By: | Toxvaerd, F.M.O. |
| Abstract: | This paper considers voluntary transmissive contacts between partially altruistic individuals in the presence of asymptomatic infection. Two different types of externalities from contacts are considered, infection externalities and socioeconomic externalities. When contacts are incidental, then externalities work through disease propagation. When contacts are essential, both infection and socioeconomic externalities are present. It is shown that for incidental contacts, equilibrium involves suboptimally high exposure whereas for essential contacts, equilibrium exposure is suboptimally low. An increase in altruism may thus increase or decrease disease transmission, depending on the type of contact under consideration. The analysis implies that policy to manage the epidemic should differentiate between different types of tranmissive activities. |
| Keywords: | Epidemics, altruism, infection externalities, socioeconomic externalities, disease control |
| JEL: | D83 I12 |
| Date: | 2021–02–24 |
| URL: | http://d.repec.org/n?u=RePEc:cam:camdae:2135&r= |
| By: | Galasso, Alberto; Schankerman, Mark |
| Abstract: | We study the effects of a patent pool on the licensing and adoption of life-saving drugs in low- and middle-income countries. Using data on licensing and sales for HIV, hepatitis C and tuberculosis drugs, we show that there is an immediate and large increase in licensing by generic firms when a patent is included in the Medicines Patent Pool (MPP). This finding is robust to identification strategies to deal with endogeneity of MPP patents and countries. The impact of the MPP is especially large for small, non-Sub-Saharan countries. The impact on actual entry and sales, however, is much smaller than on licensing, which is due to geographic bundling of licenses by the MPP. More broadly, the paper highlights the potential of pools in promoting technology diffusion of biomedical innovation. |
| Keywords: | developing countries; HIV; licensing; Patent pool; patents; pharmaceuticals; Public health |
| JEL: | I18 O31 O34 |
| Date: | 2020–12 |
| URL: | http://d.repec.org/n?u=RePEc:cpr:ceprdp:15544&r= |
| By: | Sosson Tadadjeu (University of Dschang , Cameroon); Henri Njangang (University of Dschang , Cameroon); Simplice A. Asongu (Yaoundé, Cameroon); Brice Kamguia (University of Dschang , Cameroon) |
| Abstract: | This paper contributes to the literature by investigating the effect of natural resources on under-five mortality in a sample of 50 African countries over the period 1996 to 2018. We also examine the extent to which governance shapes the relationship between natural resources and under-five mortality. Our results show that natural resources have increased under-five mortality. Resource rents also have detrimental effects on child mortality by age, gender, and the three major causes of infant mortality from infectious diseases. However, an extended analysis of different types of natural resources suggests that point resources (such as oil, natural gas and mineral rents) increase under-five mortality, in contrast to the diffuse resources (such as forest rent). We also find that governance mitigates the positive effect of natural resources on child mortality. Corresponding governance policy thresholds that should be attained in order to reverse the positive effects of natural resources on child mortality are provided. We thus suggest an increase in the funds allocated to the health sector from resource rents and encourage efforts to improve governance standards in sampled countries. |
| Keywords: | Natural resources; Child mortality; Governance; Africa |
| JEL: | J13 O55 Q33 Q34 Q38 |
| Date: | 2021–05 |
| URL: | http://d.repec.org/n?u=RePEc:agd:wpaper:21/027&r= |
| By: | Gartner, Jean-Baptiste (Laval University, Québec QC, Canada); Said Abasse, Kassim (Universite Laval); ghita, ben zagguou; Bergeron, Frédéric; Landa, Paolo; Lemaire, Célia; Côté, André |
| Abstract: | Background: Faced with increased expectations regarding the quality and safety of health care delivery systems, a number of stakeholders are increasingly looking for more qualitative and efficient ways to deliver care. This study is conducted to provide a clear definition of the patient-centered care pathway and its characteristics to meet the need for an international consensus. Methods: This qualitative systematic review aims to perform a systematic synthesis of published evidence concerning (1) the definition of the patient trajectory, patient pathway or patient journey and (2) their characteristics. With a consulting librarian, a comprehensive and systematic search in three databases was conducted (PUBMED, Embase, ABI/Inform), from 1995 to 2020 without language criteria. Eligibility criteria guiding data selection will follow the PICo mnemonic criteria consisting of (1) Population : all types of patients managed by health care delivery systems for an acute or chronic condition regardless of age or condition, (2) Phenomena : studies that contribute to the definition and conceptualization of the concepts of care trajectory, care pathway and patient journey resulting in a theoretical and conceptual contribution, and (3) Context : health care providers include all providers of primary, secondary, tertiary, and quaternary care in any geographic area. Two reviewers will independently screen, select, extract data and make a critical assessment of the methodology used with the JBI Qualitative Assessment and Review Instrument (JBI QARI). Discussion: This systematic review will provide much-needed knowledge regarding patient-centered pathways. The results will benefit clinicians, decision makers, and researchers by giving them a clear and integrated definition and understanding of the patient-centered care pathways and their characteristics to finally meet the need for an international consensus. |
| Date: | 2021–05–10 |
| URL: | http://d.repec.org/n?u=RePEc:osf:osfxxx:c6asn&r= |
| By: | Mahayosnand, Ponn P; Essa, Saman; Sabra, ZM |
| Abstract: | Similar to how physicians practice evidence-based medicine to treat individual patients, policymakers should govern the public's health according to evidence-based data. Initiated by the World Health Organization's directive to make COVID-19 research open and freely accessible, (1,2) multidisciplinary studies are still published daily. Collectively, policymakers worldwide have not used available data effectively to make noteworthy reductions in the pandemic that is now over a year old. This brief commentary introduces a policy problem, then shares 3 categories of successful case studies as possible solutions: [1] Low- and Middle-Income Countries (LMIC): Vietnam and Iran, (3,4) [2] public health practitioners: social workers in Africa and pharmacists in Zambia, (5,6) and [3] public health programs: a smoking cessation program and inmate health program. (7,8) Examples from LMIC were selected to demonstrate practical, cost-effective and duplicable methods. A collaborative multidisciplinary approach with community health partners is also proposed. (2,9) |
| Date: | 2021–05–05 |
| URL: | http://d.repec.org/n?u=RePEc:osf:socarx:5yp6h&r= |
| By: | Pablo Brañas-Garza (Universidad Loyola); Diego Jorrat (Universidad Loyola); Antonio Alfonso-Costillo (Universidad Pablo de Olavide); Antonio Espín (Universidad de Granada); Teresa García (Universidad de Granada); Kovárík Jaromír (Universidad del País Vasco) |
| Abstract: | We report data from an online experiment, which allow us to study whether generosity has changed during the early Covid-19 pandemic. We have gathered data from Spanish participants over a six-day period in which Covid-19-associated deaths in Spain, one of the most affected countries, increased fourfold. In our experiment, participants could donate a fraction of a €100 prize to a charity. Our data are particularly rich in the age distribution and we complement them with daily public information about the Covid-19-related deaths, infections, and hospital admissions. We find that donations decreased in the period under study and scale down with the public information about the life and health impact of the pandemic. The effect is particularly pronounced among older subjects. Our analysis of the mechanisms behind the detected decrease in solidarity highlights the key—but independent—role of expectations about others’ behavior, perceived mortality risk, and (alarming) information in behavioral adaptation. |
| Keywords: | Generosity Covid-19 Experiments Social Preferences |
| Date: | 2021–04 |
| URL: | http://d.repec.org/n?u=RePEc:aoz:wpaper:59&r= |
| By: | Etilé, Fabrice; Geoffard, Pierre-Yves |
| Abstract: | The COVID-19 outbreak has generated significant uncertainty about the future, especially for young adults. Health and economic threats, as well as more diffuse concerns about the consequences of COVID-19, can trigger feelings of anxiety, leading individuals to adopt uncertainty-reducing behaviors. We tested whether anxiety was associated with an increase in willingness to be exposed to the risk of COVID-19 infection (WiRE) using an online survey administered to 3,110 French individuals aged between 18 and 35 years old during the lockdown period (April 2020). Overall, 56.5% of the sample declared a positive WiRE. Unemployment was associated with a higher WiRE (+8.2 percentage points (pp); 95% CI +0.9- 15.4 pp). One standard deviation increases in income (+1160â?¬) and psychological state anxiety raised the WiRE by +2.7 pp (95% CI: +1.1-4.4 pp) and +3.9 pp (95% CI: +1.6-6.2 pp), respectively. A one standard deviation increase in perceived hospitalisation risk was associated with a -4.1 pp (95% CI: -6.2-2.1 pp) decrease in the WiRE. Overall, our results suggest that both the prospect of economic losses and psychological anxiety can undermine young adults' adherence to physical distancing recommendations. Public policies targeting young adults must consider both their economic situation and their mental health, and they must use uncertainty- reducing communication strategies. |
| Keywords: | Anxiety; COVID-19 |
| JEL: | D81 D91 I12 I18 |
| Date: | 2020–12 |
| URL: | http://d.repec.org/n?u=RePEc:cpr:ceprdp:15560&r= |
| By: | Andrew Atkeson |
| Abstract: | I use a model of private and public behavior to mitigate disease transmission during the COVID pandemic over the past year in the United States to address two questions: What dynamics of infections and deaths should we expect to see from a pandemic? What are our options for mitigating the impact of a pandemic on public health? I find that behavior turns what would be a short and extremely sharp epidemic into a long, drawn out one. Absent the development of a technological solution such as vaccines or life-saving therapeutics, additional public health interventions suffer from rapidly diminishing returns in improving long-run outcomes. In contrast, rapidly implemented non-pharmaceutical interventions, in combination with the rapid development of technological solutions, could have saved nearly 300,000 lives relative to what is now projected to occur. |
| JEL: | C0 I0 |
| Date: | 2021–05 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:28760&r= |
| By: | Yoo, Sunbin; Kawabata, Yuta; Kumagai, Junya; Keeley, Alexander; Managi, Shunsuke |
| Abstract: | We examine the impact of life and health insurance spending on subjective well-being. Taking advantage of insurance spending and subjective well-being data on more than 700,000 individuals in Japan, we examine whether insurance spending can buffer declines in subjective well-being due to exposure to mass disaster. We find that insurance spending can buffer drops in subjective well-being by approximately 3-6% among those who experienced the mass disaster of the great East Japan earthquake. Subjective health increases the most, followed by life satisfaction and happiness. On the other hand, insurance spending decreases the subjective well-being of those who did not experience the earthquake by approximately 3-7%. We conclude by monetizing the subjective well-being loss and calculating the extent to which insurance spending can compensate for it. The monetary value of subjective well-being buffered through insurance spending is approximately 33,128 USD for happiness, 33,287 USD for life satisfaction, and 19,597 USD for subjective health for a person in one year. Therefore, we confirm that life/health insurance serves as an ideal option for disaster adaptation. Our findings indicate the importance of considering subjective well-being, which is often neglected when assessing disaster losses. |
| Keywords: | Risk; Insurance; Great East Japan Earthquake; Subjective Well-being; |
| JEL: | H0 I13 Q5 Q54 |
| Date: | 2021–04 |
| URL: | http://d.repec.org/n?u=RePEc:pra:mprapa:107632&r= |
| By: | Ager, Philipp; Eriksson, Katherine; Karger, Ezra; Nencka, Peter; Thomasson, Melissa A. |
| Abstract: | The COVID-19 pandemic has reignited interest in responses to the 1918-19 influenza pandemic, the last comparable U.S. public health emergency. During both pandemics, many state and local governments made the controversial decision to close schools. We study the short- and long-run effects of 1918-19 pandemic-related school closures on children. We find precise null effects of school closures in 1918 on school attendance in 1919-20 using newly collected data on the exact timing of school closures for 168 cities in 1918-19. Linking affected children to their adult outcomes in the 1940 census, we also find precise null effects of school closures on adult educational attainment, wage income, non-wage income, and hours worked in 1940. Our results are not inconsistent with an emerging literature that finds negative short-run effects of COVID-19-related school closures on learning. The situation in 1918 was starkly different from today: (1) schools closed in 1918 for many fewer days on average, (2) the 1918 virus was much deadlier to young adults and children, boosting absenteeism even in schools that stayed open, and (3) the lack of effective remote learning platforms in 1918 may have reduced the scope for school closures to increase socioeconomic inequality. |
| Keywords: | 1918-19 Influenza Pandemic; Educational Attainment; School Closures |
| JEL: | I18 I26 N32 |
| Date: | 2020–12 |
| URL: | http://d.repec.org/n?u=RePEc:cpr:ceprdp:15575&r= |
| By: | Maroto, Michelle Lee (University of Alberta); Pettinicchio, David; Lukk, Martin |
| Abstract: | The COVID-19 pandemic has drastically changed employment situations for workers everywhere. This is especially true among people with disabilities and chronic health conditions who face greater risks in contracting COVID-19 and experience larger disadvantages within the labor market. Drawing from original data gathered through a national online survey (N = 1,027) and integrated set of virtual interviews (N = 50) with Canadians with disabilities and chronic health conditions, our findings show that although the pandemic has not directly led to job losses for most people with disabilities and chronic health conditions, respondents who have lost employment due to COVID-19 are struggling. Even though employed workers have been faring better, half were concerned about losing their jobs within the next year, and these concerns were more prevalent among part-time and non-union workers. Our findings emphasize the potential for growing economic insecurity as the pandemic continues to wreak havoc on employment situations among marginalized groups. |
| Date: | 2021–05–06 |
| URL: | http://d.repec.org/n?u=RePEc:osf:socarx:yjfse&r= |
| By: | Serrano-Alarcon, Manuel; Kentikelenis, Alexander; McKee, Martin; Stuckler, David |
| Abstract: | The Covid-19 pandemic has been associated with worsening mental health but it is unclear whether this is a direct consequence of containment measures, like ‘Stay at Home’ orders, or due to other considerations such as fear and uncertainty about becoming infected. It is also unclear how responsive mental health is to a changing situation. Exploiting the different policy responses to COVID-19 in England and Scotland and using a difference-in-difference analysis, we show that easing lockdown measures significantly improves mental health in a short time span. Additionally, we show that those with lower socioeconomic status benefit more from relaxing the restrictions, whereas they suffered a larger deterioration in mental health where the lockdown was extended. As lockdown measures may continue to be necessary in the future, further efforts (both financial and mental health support) are required to minimize the consequences of COVID-19 containment policies for mental health. |
| Date: | 2021–05–12 |
| URL: | http://d.repec.org/n?u=RePEc:osf:socarx:rjvc2&r= |
| By: | Acharya, Viral V.; Jiang, Zhengyang; Richmond, Robert; von Thadden, Ernst-Ludwig |
| Abstract: | We analyse the role of international trade and health coordination in times of a pandemic by building a two-economy, two-good trade model integrated into a micro-founded SIR model of infection dynamics. Uncoordinated governments with national mandates can adopt (i) containment policies to suppress infection spread domestically, and (ii) (import) tariffs to prevent infection coming from abroad. The efficient, i.e., coordinated, risk-sharing arrangement dynamically adjusts both policy instruments to share infection and economic risks internationally. However, in Nash equilibrium, uncoordinated trade policies robustly feature inefficiently high tariffs that peak with the pandemic in the foreign economy. This distorts terms of trade dynamics and magnifies the welfare costs of tariff wars during a pandemic due to lower levels of consumption and production as well as smaller gains via diversification of infection curves across economies. |
| Date: | 2021–01 |
| URL: | http://d.repec.org/n?u=RePEc:cpr:ceprdp:15649&r= |
| By: | Bailey, Michael; Johnston, Drew; Koenen, Martin; Kuchler, Theresa; Russel, Dominic; Ströbel, Johannes |
| Abstract: | We explore how social network exposure to COVID-19 cases shapes individuals' social distancing behavior during the early months of the ongoing pandemic. We work with de-identified data from Facebook to show that U.S. users whose friends live in areas with worse coronavirus outbreaks reduce their mobility more than otherwise similar users whose friends live in areas with smaller outbreaks. The effects are quantitatively large: a one standard deviation increase in friend-exposure to COVID-19 cases early in the pandemic results in a 1.2 percentage point increase in the probability that an individual stays home on a given day. As the pandemic progresses, changes in friend-exposure drive changes in social distancing behavior. Given the evolving nature and geography of the pandemic --- and hence friend-exposure --- these results rule out many alternative explanations for the observed relationships. We also analyze data on public posts and membership in groups advocating to "reopen" the economy to show that our findings can be explained by friend-exposure raising awareness about the risks of the disease and inducing individuals to participate in mitigating public health behavior. |
| Keywords: | COVID-19; peer effects; Social distancing; Social Networks |
| JEL: | I0 |
| Date: | 2020–12 |
| URL: | http://d.repec.org/n?u=RePEc:cpr:ceprdp:15593&r= |
| By: | Daniel Goller; Stefan C. Wolter |
| Abstract: | This study is, to the best of our knowledge, the first analysis of apprenticeship supply that allows us to analyse the effects of the shutdowns triggered by the COVID-19 pandemic before, during and after these shutdowns by means of daily searches for vacant apprenticeships. Analysing over 10 million search queries on the national administrative platform for apprenticeship offers from February 2020 until April 2021 we find a sharp reduction of up to 40% in the daily number of search queries associated to the first shutdown in March 2020, followed by some catch-up effect thereafter. Although we find a strong relationship between the intensity of the politically imposed restrictions due to the COVID-19 pandemic and daily search queries, this relationship weakens over time as the pandemic progresses. Finally, we find a large heterogeneity of effects, but all regions and occupational groups studied show a statistically significant negative effect of the measures on the search intensity for apprenticeships. |
| Keywords: | Covid-19, Switzerland, stringency index, apprenticeship |
| JEL: | I20 J22 |
| Date: | 2021 |
| URL: | http://d.repec.org/n?u=RePEc:ces:ceswps:_9060&r= |
| By: | Ben Shepherd |
| Abstract: | This paper reviews trade in pharmaceutical products, focusing on ASEAN countries. Trade in this sector is of singular policy importance as a result of the COVID-19 pandemic. First, the paper shows that pharmaceuticals are traded within Global Value Chains, which in turn means that international linkages are complex. Second, the paper shows that policy reforms can help boost trade in the sector, which has important human development implications during the pandemic period. |
| Keywords: | COVID-19, global value chains, public health, gravity model |
| JEL: | F15 O24 |
| Date: | 2021–04–23 |
| URL: | http://d.repec.org/n?u=RePEc:era:wpaper:dp-2021-05&r= |
| By: | Alberto Posso (Centre for International Development, RMIT University) |
| Abstract: | Debates on resilience to economic shocks in the ASEAN region focus on what policymakers can do to mitigate negative impacts associated with financial-economic crises. The COVID-19 pandemic has made it clear that the region is also vulnerable to health-economic crises. This study applies a difference-in-difference strategy to data from the 2003 SARS epidemic to shed light on how a global pandemic can affect labour supply and remittances in ASEAN economies. Findings suggest that even a relatively short-lived epidemic can have long-lasting effects on labour supply. |
| Keywords: | SARS, ASEAN, labour supply; remittances |
| JEL: | O11 J21 F24 |
| Date: | 2021–04–28 |
| URL: | http://d.repec.org/n?u=RePEc:era:wpaper:dp-2021-06&r= |
| By: | Charles J. Courtemanche; Anh H. Le; Aaron Yelowitz; Ron Zimmer |
| Abstract: | This paper examines the effect of fall 2020 school reopenings in Texas on county-level COVID-19 cases and fatalities. Previous evidence suggests that schools can be reopened safely if community spread is low and public health guidelines are followed. However, in Texas, reopenings often occurred alongside high community spread and at near capacity, making it difficult to meet social distancing recommendations. Using event-study models and hand-collected instruction modality and start dates for all school districts, we find robust evidence that reopening Texas schools gradually but substantially accelerated the community spread of COVID-19. Results from our preferred specification imply that school reopenings led to at least 43,000 additional COVID-19 cases and 800 additional fatalities within the first two months. We then use SafeGraph mobility data to provide evidence that spillovers to adults’ behaviors contributed to these large effects. Median time spent outside the home on a typical weekday increased substantially in neighborhoods with large numbers of school-age children, suggesting a return to in-person work or increased outside-of-home leisure activities among parents. |
| JEL: | I18 I28 |
| Date: | 2021–05 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:28753&r= |
| By: | Rachid Laajaj; Duncan Webb; Danilo Aristizabal; Eduardo Behrentz; Raquel Bernal; Giancarlo Buitrago; Zulma Cucunubá; Fernando de la Hoz |
| Abstract: | Across the world, the SARS-CoV-2 (COVID-19) pandemic has disproportionately affected economically disadvantaged groups. This differential impact has numerous possible explanations, each with significantly different policy implications. We examine, for the first time in a low- or middle-income country, which mechanisms best explain the disproportionate impact of the virus on the poor. Combining an epidemiological model with rich data from Bogotá, Colombia, we show that total infections and inequalities in infections are largely driven by inequalities in the inability to work remotely and in within-home secondary attack rates. Inequalities in isolation behavior are less important but non-negligible, while access to testing and contract-tracing plays practically no role. Interventions that mitigate transmission are often more effective when targeted on socioeconomically disadvantaged groups. |
| Keywords: | COVID-19, inequality, infections, socioeconomic strata |
| JEL: | I14 I15 I18 O54 |
| Date: | 2021–05–03 |
| URL: | http://d.repec.org/n?u=RePEc:col:000089:019241&r= |
| By: | Cassandra Castle (University of Technology Sydney); Corrado Di Guilmi (University of Technology Sydney); Olena Stavrunova (University of Technology Sydney) |
| Abstract: | The 2019 coronavirus (COVID-19) pandemic has presented a complex problem to policymakers and researchers. To slow the rate of infection, governments across the world have implemented similar lockdown procedures and recommended behavioural changes, yet the rates of compliance with these measures have varied significantly across communities. This directly impacts the level of severity of measures required to fight the pandemic and the degree to which these measures impact economic activity. Previous studies have highlighted how culture plays a role in determining values, which impact decision making and therefore influence responses to social and collective coordination. Our study builds on this literature by developing a survey that explores how cultural dispositions impact public health safety behaviours in NSW. We refer to the Individualism index from Hofstede’s model of culture as our predictor of COVID-19 behaviours. We also present recommendations to improve compliance and reduce the impact of the pandemic. We find that Horizontal Collectivism (HC) is positively associated with social distancing and face mask behaviours, and Vertical Collectivism (VC) is positively linked to increased hand hygiene behaviours. We also find that Horizontal Individualism (HI) is negatively related to social distancing in general. Interestingly, both Vertical Individualism (VI) and Collectivism relate positively to worries about health, whilst high scores of HI indicate lower probabilities of being worried about personal health and the well-being of friends and family. From these findings, we recommend that policymakers spread unifying messages and emphasise the pandemic as a group problem to promote compliance and minimise uncertainty. |
| Keywords: | COVID-19; Health-protective behaviour; IND-COL scale; Online survey |
| JEL: | H12 D91 I18 D80 |
| Date: | 2021–05–03 |
| URL: | http://d.repec.org/n?u=RePEc:uts:ecowps:2021/03&r= |
| By: | Boppart, Timo; Harmenberg, Karl; Hassler, John; Krusell, Per; Olsson, Jonna |
| Abstract: | We formulate an economic time use model and add to it an epidemiological SIR block. In the event of an epidemic, households shift their leisure time from activities with a high degree of social interaction to activities with less, and also choose to work more from home. Our model highlights the different actions taken by young individuals, who are less severely affected by the disease, and by old individuals, who are more vulnerable. We calibrate our model to time use data from ATUS, employment data, epidemiological data, and estimates of the value of a statistical life. There are qualitative as well as quantitative differences between the competitive equilibrium and social planner allocation and, moreover, these depend critically on when a cure arrives. Due to the role played by social activities in people's welfare, simple indicators such as deaths and GDP are insufficient for judging outcomes in our economy. |
| JEL: | E10 I10 |
| Date: | 2020–12 |
| URL: | http://d.repec.org/n?u=RePEc:cpr:ceprdp:15595&r= |
| By: | Auld, C.; Toxvaerd, F.M.O. |
| Abstract: | Using daily data on vaccinations, disease spread, and measures of social interaction from Google Mobility reports aggregated at the country level for 112 countries, we present estimates of behavioral responses to the global rollout of COVID-19 vaccines. We first estimate correlates of the timing and intensity of the vaccination rollout, finding that countries which vaccinated more of their population earlier strongly tended to be richer, whereas measures of the state of pandemic or its death toll up to the time of the initial vaccine rollout had little predictive ability after controlling for income. Estimates of models of social distancing and disease spread suggest that countries which vaccinated more quickly also experienced decreases in some measures of social distancing, yet also lower incidence of disease, and in these countries policy makers relaxed social distancing measures relative to countries which rolled out vaccinations more slowly |
| Keywords: | Economic epidemiology, econometrics, COVID-19, vaccination |
| JEL: | I12 C50 |
| Date: | 2021–04–26 |
| URL: | http://d.repec.org/n?u=RePEc:cam:camdae:2136&r= |
| By: | Kubinec, Robert (New York University Abu Dhabi); Barceló, Joan (New York University - Abu Dhabi); Goldszmidt, Rafael; Grujic, Vanja; Model, Timothy; Schenk, Caress; Cheng, Cindy (Technical University of Munich); Hale, Thomas; Hartnett, Allison Spencer; Messerschmidt, Luca |
| Abstract: | In this paper we present six new indices generated from a Bayesian measurement model that allow us to combine policy data from two of the most comprehensive COVID-19 policy datasets, the CoronaNet COVID-19 Government Response Event Dataset and the Oxford COVID-19 Government Response Tracker. By doing so we can validate both independent sources of data and provide more information than either dataset on its own. We estimate these time-varying indices with summary scores for each day from January 1st, 2020 to January 15th, 2021 for over 180 countries and six policy categories: social distancing policies, school-related policies, business-related policies, health monitoring policies, health resources policies and mask-related policies. We also estimate models that predict these indices with a range of social, public health, political and economic covariates. Our results show that business restrictions and social distancing restrictions are strongly associated with reduced general anxiety while school restrictions much less so. Furthermore, school restrictions are associated with higher rates of personal contact with people outside the home, higher levels of income inequality and bureaucratic corruption. Finally, we also find that heads of state who are women are more likely to implement a broad array of pandemic-related restrictions than male leaders. |
| Date: | 2021–05–01 |
| URL: | http://d.repec.org/n?u=RePEc:osf:socarx:rn9xk&r= |
| By: | Anirban Ghatak (Indian Institute of Management Kozhikode); Ranraj Singh (Indian Institute of Technology Dhanbad) |
| Abstract: | In this policy paper, we implement a compartment based epidemiological model that incorporates control measures such as Lockdown and Social Distancing for the top fifteen most affected states in India using data upto 3rd May, 2020. This is the only study till date in India that estimates the time varying effects of these control measures on the transmission rate of Covid-19 directly from the data and applies that to an extended epidemiological model. We predict the disease progression using the eSIR model for nine scenarios with different possible dates of lockdown relaxation followed by different levels of social distancing guidelines adopted post lockdown. Using the results of the simulations, we propose possible exit strategies for each state depending on factors such as the fraction of the population that will be infected at the peak and the hospital bed capacity. |
| Date: | 2021–03 |
| URL: | http://d.repec.org/n?u=RePEc:iik:wpaper:449&r= |
| By: | Abad, Leticia Arroyo; Maurer, Noel |
| Abstract: | In 2020, many observers were surprised that the Covid-19 outbreak did not appear to have swung the election. Early returns showed little indication that harder-hit areas swung away from the incumbent GOP. In 1918, however, the United States also held an election in the middle of a devastating pandemic. Using county-level epidemiological, electoral, and documentary evidence from 1918-20 we find that flu mortality had a statistically-significant negative effect on the Congressional or gubernatorial vote. The swing, while precise however, was relatively small and not enough to determine the results. We find no effect from flu mortality on turnout rates or on the 1920 presidential election. Our results hold using overall mortality in 1917 and distance to military camps as instruments for 1918 flu deaths. They also withstand tests of coefficient stability and alternative specifications. Considering that the 1918 flu was much more severe than the 2020 Covid pandemic, the historical evidence implies that surprised observers of the 2020 election should not have been so surprised. |
| Keywords: | Elections; Pandemics |
| JEL: | N0 |
| Date: | 2021–01 |
| URL: | http://d.repec.org/n?u=RePEc:cpr:ceprdp:15678&r= |
| By: | Marion Davin (CEE-M, Univ Montpellier, CNRS, INRAE, SupAgro, Montpellier, France.); Mouez Fodha (University Paris 1 Panthéon-Sorbonne and Paris School of Economics, Paris, France.); Thomas Seegmuller (Aix Marseille Univ, CNRS, AMSE, Marseille, France.) |
| Abstract: | We study whether fiscal policies, especially public debt, can help to curb the macroeconomic and health consequences of epidemics. Our approach is based on three main features: we introduce the dynamics of epidemics in an overlapping generations model to take into account that old people are more vulnerable; people are more easily infected when pollution is high; public spending and public debt can be used to tackle the effects of epidemics. We show that fiscal policies can promote the convergence to a stable steady state with no epidemics. When public policies are not able to permanently eradicate the epidemic, public debt and income transfers could reduce the number of infected people and increase capital and GDP per capita. As a prerequisite, pollution intensity should not be too high. Finally, we define a household subsidy policy which eliminates income and welfare inequalities between healthy and infected individuals. |
| Keywords: | epidemics, pollution, overlapping generations, public debt |
| JEL: | E6 I18 Q59 |
| Date: | 2021–05 |
| URL: | http://d.repec.org/n?u=RePEc:aim:wpaimx:2128&r= |
| By: | Nicolás Ajzenman (Sao Paulo School of Economics - FGV); Tiago Cavalcanti (University of Cambridge/CEPR/Sao Paulo School of Economics); Daniel Da Mata (Sao Paulo School of Economics - FGV) |
| Abstract: | How do political leader’s words and actions affect people’s behavior? We address this question in the context of Brazil by combining electoral information and geo-localized mobile phone data for more than 60 million devices throughout the entire country. We find that after Brazil’s president publicly and emphatically dismissed the risks associated with the COVID-19 pandemic and advised against isolation, the social distancing measures taken by citizens in pro-government localities weakened compared to places where political support of the president is less strong, while pre-event effects are insignificant. The impact is large and robust to different empirical model specifications. Moreover, we find suggestive evidence that this impact is driven by localities with relatively higher levels of media penetration and is stronger in municipalities with a larger proportion of Evangelic parishioners, a key group in terms of support for the president. |
| Keywords: | Health Coronavirus Leadership Persuasion Risky Behavior |
| JEL: | D1 I31 Z13 |
| Date: | 2021–03 |
| URL: | http://d.repec.org/n?u=RePEc:aoz:wpaper:40&r= |