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on Health Economics |
| By: | Olivier Marie; Judit Vall Castello |
| Abstract: | We investigate the impact on work absence of a massive reduction in paid sick leave benefits. We exploit a policy change that only affected public sector workers in Spain and compare changes in the number and length of spells they take relative to unaffected private sector workers. Our results highlight a large drop in frequency mostly offset by increases in duration. Overall, the policy did reduce the number of days lost to sick leave. For some however, return to work was premature as we document very large increases in both the proportion of relapses and, especially in the number of working accidents. The displacement towards this latter (unaffected) benefit cancels out almost two-fifths of the estimated gains in terms of days lost to absences from cutting sick leave generosity. |
| Keywords: | sickness insurance, paid sick leave, absenteeism, presenteeism, relapses, contagious diseases, benefit displacement, working accidents, Spain |
| JEL: | I12 I13 I18 J22 J28 J32 |
| Date: | 2022 |
| URL: | http://d.repec.org/n?u=RePEc:ces:ceswps:_9550&r= |
| By: | Benjamin Montmartin (SKEMA Business School, Université Côte-d'Azur); Marcos Herrera-Gómez (IEDLE-UNSa/CONICET) |
| Abstract: | During the last 30 years in France, concerns about healthcare access have grown as physician fees have increased threefold. In this paper, we developed an innovative structural framework to provide new insights into free-billing physician pricing behavior. We test our theoretical framework using a unique geolocalized database covering more than 4,000 private practitioners in three specializations (ophthalmology, gynecology and pediatrics). Our main findings highlight a low price competition environment driven by local imitative pricing between physicians, which increases with competition density. This evidence in the context ofgrowing spatial concentration and an increasing share of free-billing physicians calls for new policies to limitadditional fees. |
| Keywords: | Imitative pricing, Health care access, Local competition, Spatial eects. |
| JEL: | H51 C21 I11 I18 |
| Date: | 2022–03 |
| URL: | http://d.repec.org/n?u=RePEc:aoz:wpaper:123&r= |
| By: | Joan Costa-i-Font; Cristina Vilaplana-Prieto |
| Abstract: | We study the dynamic drivers of expenditure on long-term care (LTC) programs, and more specifically, the effects of labour market participation of traditional unpaid caregivers (women aged 40 and older) on LTC spending. Next, we examine the spillover effects of a rise in LTC expenditure on health care expenditures (HCE) and the economy (GDP). Our estimates draw from a panel of more than a decade worth of expenditure data from a sample of OECD countries. We use a panel Vector Auto-regressive (panel-VAR) system that considers the dynamics between the dependent variables. We find that LTC expenditure increases with the rise of the labour market participation of the traditional unpaid caregiver (women over 40 years of age), and that such expenditures rise exerts large spillover effects on health spending components. We find that a 1% increase in female labour participation gives rise to a 1.48% increase in LTC expenditure and a 0.88% reduction in HCE. The effect of LTC spending over HCE is mainly driven by a reduction in inpatient and medicine expenditures, exhibiting large country heterogeneity. Finally, we document significant spillover effects of LTC expenditures on per capita GDP. |
| Keywords: | long-term care spending, panel-VAR, dynamic panel data, female labour market participation, health spending, care spillovers |
| JEL: | I18 J10 |
| Date: | 2022 |
| URL: | http://d.repec.org/n?u=RePEc:ces:ceswps:_9553&r= |
| By: | Greta List; John List; Lina Ramirez; Anya Samek |
| Abstract: | We conduct experiments with 720 children ages 9-11 to evaluate the relationship of time and risk preferences with health. Children who are more patient report consuming fewer unhealthy calories and spending less time on sedentary activities such as video games. Children who are more risk seeking report engaging in more exercise and more screen time. However, time and risk preferences are not predictive of body mass index (BMI). Moreover, some of the negative health behaviors, such as screen time, are associated with lower - rather than higher - BMI. |
| Date: | 2022 |
| URL: | http://d.repec.org/n?u=RePEc:feb:artefa:00751&r= |
| By: | Nguyen, Ha Trong; Christian, Hayley; Le, Huong Thu; Connelly, Luke; Zubrick, Stephen R.; Mitrou, Francis |
| Abstract: | The relationship between physical activity and child health and development is well-documented, yet the extant literature provides limited causal insight into the amount of physical activity considered optimal for improving any given health or developmental outcome. This paper exploits exogenous variations in local weather conditions observed across random time use diary dates for the same individuals over time to investigate the causal impact of physical activity on a comprehensive set of health, non-cognitive development, and academic outcomes of children and adolescents. Applying an individual fixed-effects instrumental variables model to a nationally representative panel dataset from Australia, we find that physical activity leads to widespread benefits in child development. These include improved health, social and emotional development, and lower health expenditure. The results further indicate that physical activity offers greater developmental benefits for females. However, we find no evidence that physical activity improves academic performance. Our study highlights that the "optimal" amount of time that children and adolescents should spend physically active each day varies by the health or non-cognitive development outcome of interest. The results are robust to a series of specification and sensitivity tests, including an over-identification test and controlling for weather conditions recorded on the day when development outcomes were assessed. |
| Keywords: | Time Allocation,Physical Activity,Time Use Diary,Health,Child Development,Instrumental variable,Panel data |
| JEL: | C36 I10 I12 I14 J13 J22 J24 |
| Date: | 2022 |
| URL: | http://d.repec.org/n?u=RePEc:zbw:glodps:1081&r= |
| By: | Brewer, Mike (ISER, University of Essex); Dang, Thang (Norwegian Institute of Public Health); Tominey, Emma (University of York) |
| Abstract: | The UK Universal Credit (UC) welfare reform simplified the benefits system whilst strongly incentivising a return to sustainable employment. Exploiting a staggered roll-out, we estimate the differential effect of entering unemployment under UC versus the former system on mental health. Groups with fewer insurance possibilities - single adults and lone parents – experience a mental health deterioration of 8.4-13.9% sd. For couples, UC partially or fully mitigates mental health consequences of unemployment. Exploring mechanisms, for single adults and lone parents, reduced benefit income and strict job search requirements dominate any positive welfare effects of the reduced administrative burden of claiming benefits. |
| Keywords: | welfare reform, mental health, mediation, decomposition, universal credit |
| JEL: | D61 I10 I14 I38 |
| Date: | 2022–03 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp15178&r= |
| By: | Donati, Dante (Universitat Pompeu Fabra); Durante, Ruben (Universitat Pompeu Fabra); Sobbrio, Francesco (University of Rome Tor Vergata); Zejcirovic, Dijana (University of Vienna) |
| Abstract: | How does the internet affect young people's mental health? We study this question in the context of Italy using administrative data on the universe of cases of mental disorders diagnosed in Italian hospitals between 2001 and 2013, which we combine with information on the availability of highspeed internet at the municipal level. Our identification strategy exploits differences in the proximity of municipalities to the pre-existing voice telecommunication infrastructure, which was previously irrelevant but became salient after the advent of the internet. We find that access to high-speed internet has a significant positive effect on the incidence of mental disorders for young cohorts but not for older ones. In particular, internet access leads to an increase in diagnoses of depression, anxiety, drug abuse, and personality disorders - for both males and females - and of eating and sleep disorders - for females only. We find similar results for urgent and compulsory hospitalizations and self-harm episodes. These results suggest that the effect of broadband is driven by a rise in the underlying prevalence of mental disorders and not merely by increased awareness about these pathologies. |
| Keywords: | mental health, internet, ADSL, 3G |
| JEL: | I12 I31 L82 L86 |
| Date: | 2022–03 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp15202&r= |
| By: | Koning, Pierre (Vrije Universiteit Amsterdam); van Lent, Max (Leiden University) |
| Abstract: | Disability Insurance (DI) may affect workers' outcomes such as their probability to enter DI, to recover, and their employment. Supplementary insurance may increase these moral hazard effects, but also increases the financial gains of private insurers to reduce benefit costs. With increased insurer activities to prevent and reintegrate workers, the overall effects of increased insurance coverage on workers' outcomes are thus ambiguous. This paper aims to separate worker and insurer responses to increased insurance, using unique administrative data on firms' supplementary DI insurance contracts. Using a Two-Way Fixed-Effects model on the sickness and employment rates of worker cohorts with and without supplementary contracts at some point in time, we find that insurer efforts compensate workers' moral hazard effects. |
| Keywords: | disability insurance, private insurance, moral hazard, insurer effort, return-to-work policies |
| JEL: | G22 G52 J3 J21 |
| Date: | 2022–03 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp15164&r= |
| By: | Lordan, Grace (London School of Economics); Stringer, Eliza-Jane (London School of Economics) |
| Abstract: | This study explores the effect on mental health and life satisfaction of working in an automatable job. We utilise an Australian panel dataset (HILDA), and estimate models that include individual fixed effects, to estimate the association between automatable work and proxies of wellbeing. Overall, we find evidence that automatable work has a small, detrimental impact on the mental health and life satisfaction of workers within some industries, particularly those with higher levels of job automation risk, such as manufacturing. Furthermore, we find no strong trends to suggest that any particular demographic group is disproportionately impacted across industries. These findings are robust to a variety of specifications. We also find evidence of adaptation to these effects after one-year tenure on the job, indicating a limited role for firm policy. |
| Keywords: | automation, life satisfaction, mental health, job security |
| JEL: | I10 J20 |
| Date: | 2022–03 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp15182&r= |
| By: | Li Han (Division of Social Science, The Hong Kong University of Science and Technology); Xinzheng Shi (Tsinghua University); Ming-ang Zhang (Central University of Finance and Economics) |
| Abstract: | Information quality affects matching and marital outcomes. We show in a simple two-dimensional matching model that a noisier cue for one trait leads to a shift in sorting tradeoff toward the other, lowers average welfare but the impact is asymmetric. To test the predictions, we explore the repeal of mandatory premarital health examinations in China. The repeal, increasing health cue noise, is found to have reduced postmarital subjective well-being mainly through a reduction in child health associated with decreased sorting by health. The deterioration was particularly strong for women and the poor, suggesting entrenched inequality by gender and wealth. |
| Keywords: | Premarital Health Examination, Subjective Well-being, Assortative Matching, Sorting Tradeoff, Inequality |
| JEL: | J12 J13 I18 |
| Date: | 2022–03 |
| URL: | http://d.repec.org/n?u=RePEc:hke:wpaper:wp2022-02&r= |
| By: | Kai Barron; Charles D.H. Parry; Debbie Bradshaw; Rob Dorrington; Pam Groenewald; Ria Laubscher; Richard Matzopoulos |
| Abstract: | This paper evaluates the impact of a sudden and unexpected nation-wide alcohol sales ban in South Africa. We find that this policy causally reduced injury-induced mortality in the country by at least 14% during the five weeks of the ban. We argue that this estimate constitutes a lower bound on the true impact of alcohol on injury-induced mortality. We also document a sharp drop in violent crimes, indicating a tight link between alcohol and aggressive behaviour in society. Our results underscore the severe harm that alcohol can cause and point towards a role for policy measures that target the heaviest drinkers in society. |
| Keywords: | alcohol, mortality, economics, health, crime, South Africa, Covid-19, violence |
| JEL: | I18 I12 K42 |
| Date: | 2022 |
| URL: | http://d.repec.org/n?u=RePEc:ces:ceswps:_9595&r= |
| By: | Fan Wang; Esteban Puentes; Jere R. Behrman; Fl\'avio Cunha |
| Abstract: | Recent estimates are that about 150 million children under five years of age are stunted, with substantial negative consequences for their schooling, cognitive skills, health, and economic productivity. Therefore, understanding what determines such growth retardation is significant for designing public policies that aim to address this issue. We build a model for nutritional choices and health with reference-dependent preferences. Parents care about the health of their children relative to some reference population. In our empirical model, we use height as the health outcome that parents target. Reference height is an equilibrium object determined by earlier cohorts' parents' nutritional choices in the same village. We explore the exogenous variation in reference height produced by a protein-supplementation experiment in Guatemala to estimate our model's parameters. We use our model to decompose the impact of the protein intervention on height into price and reference-point effects. We find that the changes in reference points account for 65% of the height difference between two-year-old children in experimental and control villages in the sixth annual cohort born after the initiation of the intervention. |
| Date: | 2022–04 |
| URL: | http://d.repec.org/n?u=RePEc:arx:papers:2204.01933&r= |
| By: | Alice Jar Rein Aung; Chun Yee Wong (IUJ Research Institutey, International University of University) |
| Abstract: | The Philippines implemented the free secondary education policy in 1988, which offers a natural experiment to explore the effects of maternal education on fertility and child mortality. Exploiting age-specific exposure to this educational reform through the use of fuzzy regression discontinuity design, this study finds that on average, there is an increase of 0.536 year of schooling in for the cohort of women who had been affected by the policy. Moreover, the results of this study reveal that increasing education by one year reduces 0.829 child born per woman, and decreases child mortality by 1.659%. The empirical evidence supports that increasing opportunities for women to enter and complete secondary education can reduce fertility rates and cause a significant decline in child mortality in developing countries. |
| Keywords: | maternal education, fertility, child mortality, regression discontinuity, the Philippines |
| Date: | 2022–04 |
| URL: | http://d.repec.org/n?u=RePEc:iuj:wpaper:ems_2022_02&r= |
| By: | Mai, Nhat Chi |
| Abstract: | A perennial question for the pharmaceutical industry has been excessive drug prices. To alleviate patients’ burden of expensive medical bills and increase the affordability of medicines, China adopted the Two-Invoice System (TIS) in drug procurement for public medical institutions in 2017. In this paper, we study the impact of the TIS on pharmaceutical manufacturers’ selling expenses. Using a Difference-in-Differences (DID) methodology and a sample of the A-share pharmaceutical manufacturing firms listed on the Shanghai Stock Exchange and Shenzhen Stock Exchange from the years 2014 to 2020, we find that the TIS leads to a significant increase in pharmaceutical manufacturers’ selling expenses but gradually weakens over time. In addition, we further explore whether the impact of the TIS on pharmaceutical manufacturers’ selling expenses is affected by the pharmaceutical manufacturers’ previous drug circulation mode. The results indicate that the TIS could significantly increase the pharmaceutical manufacturers’ selling expenses in the agency mode group. However, there is no evidence to support the TIS having the same effect in the direct sales office model group. |
| Date: | 2022–04–05 |
| URL: | http://d.repec.org/n?u=RePEc:osf:osfxxx:68fsb&r= |
| By: | Francesca Marazzi (CEIS, University of Rome "Tor Vergata"); Andrea Piano Mortari (CEIS, University of Rome "Tor Vergata"); Federico Belotti (CEIS & DEF, University of Rome "Tor Vergata"); Giuseppe Carrà (University of Milano Bicocca, School of Medicine and Surgery); Ciro Cattuto (ISI Foundation & University of Turin, Department of Informatics); Joanna Kopinska (University of Rome La Sapienza); Daniela Paolotti (ISI Foundation); Vincenzo Atella (DEF & CEIS, University of Rome "Tor Vergata") |
| Abstract: | A recent literature investigating mental health consequences of social distancing measures, has found a substantial increase in self-reported sleep and anxiety disorders and depressive symptoms during lockdown periods. These evidence are in contrast with the results we obtain using data on monthly purchases of psychiatric drugs by the universe of Italian pharmacies over the period of interest. We argue that this discrepancy has three potential causes: i) use of non-pharmaceutical therapies and non-medical solutions during lockdown periods; ii) unmet needs due to both demand- and supply-side shortages in healthcare services and iii) the subjectivity of self-assessed psychological health in survey studies, capturing also mild mental distress which might not evolve into mental disorder needing pharmacological treatment. This last point seems to be confirmed by lack of statistical significance of any measure of mobility change and reason of mobility (which we proxy with mobile phone data) on antidepressants and anxiolytics purchases during the entire 2020 period. |
| Keywords: | Mental health, lockdown, anxiety, depression, drugs |
| JEL: | I18 R40 D91 |
| Date: | 2022–04–26 |
| URL: | http://d.repec.org/n?u=RePEc:rtv:ceisrp:541&r= |
| By: | Vincenzo Galasso; Vincent Pons; Paola Profeta; Michael Becher; Sylvain Brouard; Martial Foucault |
| Abstract: | Millions of people refuse COVID-19 vaccination. Using original data from two surveys in nine OECD countries, we analyze the determinants of anti-vax intentions in December 2020 and show that half of the anti-vax individuals were vaccinated by summer 2021. Vaccinations were more likely among individuals aged 50+, exposed to COVID-19, compliant with public restrictions, more informed on traditional media, trusting scientists, and less concerned about vaccines’ side effects. We run a survey experiment with informational messages. In EU countries, a message about protecting health largely increases vaccinations, even among anti-vax individuals. In the U.K. and U.S., a message about protecting the economy generates similar effects. Our findings suggest that informational campaigns should adopt adequate narratives and address concerns about vaccines’ side effects. |
| Keywords: | Covid-19 vaccination, randomized experiment, information transmission |
| JEL: | I12 D83 |
| Date: | 2022 |
| URL: | http://d.repec.org/n?u=RePEc:ces:ceswps:_9564&r= |
| By: | Silvia Angerer; Daniela Glätzle-Rützler; Philipp Lergetporer; Thomas Rittmannsberger |
| Abstract: | Peoples’ willingness to vaccinate is critical to combating the COVID-19 pandemic. We devise a representative experiment to study how the design of the vaccine approval procedure affects public attitudes towards vaccination. Compared to an Emergency Use Authorization, choosing the more thorough Accelerated Authorization approval procedure increases vaccination intentions by 13 percentage points. Effects of increased duration of the approval procedure are positive and significant only for Emergency Use Authorization. Treatment effects are homogenous across population subgroups. Increased trust in the vaccine is the key mediator of treatment effects on vaccination intentions. |
| Keywords: | vaccination, Covid-19, approval procedure, experiment |
| JEL: | I12 I18 C93 D83 |
| Date: | 2022 |
| URL: | http://d.repec.org/n?u=RePEc:ces:ceswps:_9648&r= |
| By: | Vincenzo Galasso; Vincent Pons (Harvard Business School - Harvard University [Cambridge]); Paola Profeta; Michael Becher (TSE - Toulouse School of Economics - UT1 - Université Toulouse 1 Capitole - Université Fédérale Toulouse Midi-Pyrénées - EHESS - École des hautes études en sciences sociales - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement); Sylvain Brouard (CEVIPOF - Centre de recherches politiques de Sciences Po (Sciences Po, CNRS) - Sciences Po - Sciences Po - CNRS - Centre National de la Recherche Scientifique); Martial Foucault (CEVIPOF - Centre de recherches politiques de Sciences Po (Sciences Po, CNRS) - Sciences Po - Sciences Po - CNRS - Centre National de la Recherche Scientifique) |
| Abstract: | Using original data from two waves of a survey conducted in March and April 2020 in eight OECD countries (N = 21,649), we show that women are more likely to see COVID-19 as a very serious health problem, to agree with restraining public policy measures adopted in response to it, and to comply with them. Gender differences in attitudes and behavior are substantial in all countries, robust to controlling for a large set of sociodemographic, employment, psychological, and behavioral factors, and only partially mitigated for individuals who cohabit or have direct exposure to COVID-19. The results are not driven by differential social desirability bias. They carry important implications for the spread of the pandemic and may contribute to explain gender differences in vulnerability to it. |
| Date: | 2020–06 |
| URL: | http://d.repec.org/n?u=RePEc:hal:journl:hal-03594437&r= |
| By: | Zeng, Xiangquan; Chu, Shuai; Chen, Xuan |
| Abstract: | Using data of the largest online job board in China, Zhaopin.com, we examine the impacts of the lockdown policy on the Chinese labor market demand during the coronavirus disease (COVID-19) pandemic. The analyses reveal that the lockdown policy, which was implemented in Wuhan on January 23, 2020, reduced the labor market demand drastically. Specifically, the "Number of Companies" that posted weekly job vacancies, "Number of Positions," and "Number of Employees" to be recruited reduced rapidly by 18.5%, 21.9%, and 30.0%, respectively. Furthermore, this impact of the lockdown policy began to reduce, thus allowing the labor demand to rebound four weeks after the outbreak. The heterogeneity analyses reveal that the industries with high physical proximity and those manufacturing non-essential products/services, as well as small-size firms, were greatly impacted by the policy. No statistical difference was observed between the impacts on the cities that implemented specific control measures and those that did not. This study quantifies the dynamic impacts of China's stringent control measures on the country's labor demand during the pandemic. These findings indicate that the effective management of public health crises in conjunction with economic policies is critical to revitalizing labor markets. |
| Keywords: | COVID-19,lockdown,job vacancy,online job board,labor demand |
| JEL: | I18 H51 J23 |
| Date: | 2022 |
| URL: | http://d.repec.org/n?u=RePEc:zbw:glodps:1074&r= |
| By: | Adetayo Adeniran (FUTA - Federal University of Technology of Akure); Samuel Olorunfemi (FUTA - Federal University of Technology of Akure); Feyisola Akinsehinwa (FUTA - Federal University of Technology of Akure); Taye Abdullahi (University of Ibadan) |
| Abstract: | The transportation of human beings from one location to the other could play a crucial role in the transmission of infectious diseases which could result in a major epidemic such as Tuberculosis, Ebola, Covid-19, and others that are currently invading the nations of the world. Concerning the high poverty level, much concentration on livestock farming, open grazing, rising urbanization, and globalization, the human being is exposed to more infectious diseases that can be transited and transmitted. The transmission of infectious diseases can be in the form of a chain; some are imported from high-risk countries and contacted by friends and families which will later spread into the larger society. It can also be contacted through imported livestock which will later spread among other animals and be contacted by a human. Importation of infectious diseases is not only applicable to humans but animals. Findings from the empirical studies reviewed show that a close nexus between urban mobility and the transmission of infectious diseases. To ensure adequate health safety, it is recommended that regional as well as international complementarity of trade should be checked such that high-risk countries should be banned from participating in trade with other low-risk countries; preventive measures should be enforced without any form of sentiment, human being should minimize or reduce traveling. |
| Keywords: | urban mobility,transportation,transmission,infectious diseases |
| Date: | 2021–09–30 |
| URL: | http://d.repec.org/n?u=RePEc:hal:journl:hal-03583997&r= |
| By: | Duha Altindag; Samuel Cole; R. Alan Seals Jr |
| Abstract: | We study the allocation of and compensation for occupational COVID-19 risk at Auburn University, a large public university in the U.S. In Spring 2021, approximately half of the face-to-face classes had enrollments above the legal capacity allowed by a public health order, which followed CDC social distancing guidelines. We find lower-ranked graduate student teaching assistants and adjunct instructors were systematically recruited to deliver riskier classes. Using an IV strategy in which teaching risk is shifted by classroom features (geometry and furniture), we show instructors who taught at least one risky class earned $7,400 more than those who did not. |
| Date: | 2022–04 |
| URL: | http://d.repec.org/n?u=RePEc:arx:papers:2204.00894&r= |
| By: | Andersson, Fredrik W. (Statistics Sweden); Wadensjö, Eskil (Stockholm University) |
| Abstract: | The pandemic has mainly affected the state of health and mortality, but has also had effects on the economy and the labor market. This article reports what happened to the total number of employees, their distribution by sectors and regions and changes in the number of employees for different groups in 2020 compared with 2019 in Sweden. We do not deal with the development of the number and composition of the self-employed. We also do not go into the development of employees' conditions in terms of wages, working hours and working environment. But we are studying something that is in focus for the general debate: How was the development of the number of employees and their composition in 2020, "the first year of the pandemic"? The main result is that we find large differences in the development for different groups. |
| Keywords: | Swedish labor market, COVID-19, employment, migrants |
| JEL: | I15 J15 J21 J23 J61 |
| Date: | 2022–03 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp15167&r= |