|
on Health Economics |
| By: | Richard Layard |
| Abstract: | As societies become richer, they do not become happier. This paradox has led to a growing interest in the science of wellbeing, and how policymakers can evaluate policies in terms of what will improve wellbeing. Economists investigate what is important for wellbeing and the influence of wellbeing on working life, education and health. |
| Keywords: | Climate Change, Education, Employment, Health, Inequality, Unemployment, Wellbeing, Wages, Happiness, Public Policy |
| Date: | 2022–03–14 |
| URL: | http://d.repec.org/n?u=RePEc:cep:cepins:08&r= |
| By: | Kotschy, Rainer (Harvard School of Public Health); Bloom, David E. (Harvard University) |
| Abstract: | This paper investigates challenges of aging for long-term care. Our analysis proceeds in three steps. In the first step, we estimate the prospective care demand for 30 developed countries based on projected aging and disabilities among the elderly. In the second step, we outline challenges for care systems with respect to shortages of care workers, increasing skill requirements for care workers, barriers to universal and equitable access to care, and cost containment subject to adequate care quality. In the third step, we identify solutions for these challenges by comparing the care systems of Germany, Israel, Japan, the Netherlands, and South Korea. |
| Keywords: | long-term care insurance, population aging, care demand, ADL, IADL |
| JEL: | I18 I38 H51 H75 |
| Date: | 2022–04 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp15228&r= |
| By: | Christopher Blattman (Department of Political Science, University of Chicago); Sebastian Chaskel (Instiglio); Julian C. Jamison (Department of Economics, University of Exeter); Margaret Sheridan (Department of Psychology and Neuroscience, University of North Carolina) |
| Abstract: | In most societies, a small number of people commit most of the serious crimes and violence. Short-term studies have shown that cognitive behavioral therapy (CBT) can reduce such antisocial behaviors. There are some signs that these behavior changes may be temporary, however, especially from therapy on its own. This is unsettled, however, for there has been little randomized and long-term research on the question. We follow 999 high-risk men in Liberia 10 years after randomization into one of four arms: 8 weeks of a low-cost therapy; a $200 cash grant; both therapy and cash; or a control group. Together, the two interventions cost just $530 to deliver. We find that, a decade later, both therapy alone and therapy with economic assistance produce dramatic reductions in antisocial behaviors. Reported drug-selling and participation in thefts and robberies, for example, fall by about half. These impacts are greatest among the very highest-risk men. The effects of therapy alone, however, are somewhat smaller and more fragile. The effects of therapy plus economic assistance are more sustained and precise. Since the cash did not increase earnings for more than a few months after the grants, we hypothesize that the grant, and those few months of legitimate business activity, reinforced the learning-by-doing and habit formation embodied in CBT. Overall, the results suggest that highly-targeted CBT plus economic assistance could be an inexpensive and effective way to prevent violence, especially when policymakers are searching for alternatives to aggressive policing and incarceration. |
| Keywords: | cognitive behavior therapy, cash transfers, crime, violence, mental health, Africa, field experiments |
| JEL: | K42 O15 O17 D83 |
| Date: | 2022–05–11 |
| URL: | http://d.repec.org/n?u=RePEc:exe:wpaper:2203&r= |
| By: | Thomas Mariotti (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, CNRS - Centre National de la Recherche Scientifique); Nikolaus Schweizer (Tilburg University [Netherlands]); Nora Szech (KIT - Karlsruhe Institute of Technology); Jonas von Wangenheim (University of Bonn) |
| Abstract: | We study the optimal design of information nudges for present-biased consumers who make sequential consumption decisions without exact prior knowledge of their long-term consequences. For any distribution of risks, there exists a consumer-optimal information nudge that is of cutoff type, recommending abstinence if riskiness is high enough. Depending on the distribution of risks, more or less consumers may have to be sacriced in that they cannot be warned even though they would like to be. Under a stronger bias for the present, the target group receiving a credible warning to abstain must be tightened, but this need not increase the probability of harmful consumption. If some consumers are more strongly present-biased than others, traffic-light nudges turn out to be optimal and, when subgroups of consumers differ sufficiently, the optimal traffic-light nudge is also subgroup-optimal. We finally compare the consumer-optimal nudge with those a health authority or a lobbyist would favor. |
| Keywords: | Nudges,Information Design,Present-Biased Preferences,Self-Control |
| Date: | 2022–04–04 |
| URL: | http://d.repec.org/n?u=RePEc:hal:wpaper:hal-03629566&r= |
| By: | Andrej Woerner; Giorgia Romagnoli; Birgit M. Probst; Nina Bartmann; Jonathan N. Cloughesy; Jan Willem Lindemans |
| Abstract: | This paper theoretically and empirically investigates the effects of letting people choose from a menu of increasingly challenging incentive schemes. We derive the conditions under which a policy maker profits from leaving the choice to the individuals by leveraging their private information about the expected benefits from the targeted behavior. We test the theoretical predictions in a field experiment in which we pay participants monetary rewards for completing daily meditation sessions. We randomly assign some participants to one of two incentive schemes and allow others to choose between the two schemes. As predicted, participants sort into schemes in (partial) agreement with the objectives of the policy maker. In contrast to our theoretical predictions, participants who could choose complete significantly fewer meditation sessions than participants that were randomly assigned. Since the results are not driven by poor selection, we infer that letting people choose between incentive schemes may bring in psychological effects that discourage adherence. |
| Keywords: | monetary incentives, dynamic incentives, field experiment, mental health |
| JEL: | C90 D03 D80 I10 |
| Date: | 2021 |
| URL: | http://d.repec.org/n?u=RePEc:ces:ceswps:_9494&r= |
| By: | Brosig-Koch, Jeannette; Hehenkamp, Burkhard; Kokot, Johanna |
| Abstract: | We study how competition between physicians affects the provision of medical care. In our theoretical model physicians are faced with a heterogeneous patient population, in which patients systematically vary with regard to both, their responsiveness to the provided quality of care and their state of health. We test the behavioral predictions derived from this model in a controlled laboratory experiment. In line with the model, we observe that competition significantly improves patient benefits as long as patients are able to respond to the quality provided. For those patients, who are not able to choose a physician, competition even decreases the patient benefit compared to a situation without competition. This decrease is in contrast to our theoretical prediction implying no change in benefits for passive patients. Deviations from patient-optimal treatment are highest for passive patients in need of a low quantity of medical services. With repetition, both, the positive effects of competition for active patients as well as the negative effects of competition for passive patients become more pronounced. Our results imply that competition can not only improve but also worsen patient outcome and that patients' responsiveness to quality is decisive. |
| Keywords: | physician competition,patient characteristics,heterogeneity in quality responses,fee-for-service,laboratory experiment |
| JEL: | I11 D43 C91 |
| Date: | 2022 |
| URL: | http://d.repec.org/n?u=RePEc:zbw:hcherp:202227&r= |
| By: | Helge Liebert; Beatrice Mäder |
| Abstract: | This paper investigates the returns to health care provision during the mortality transition. We construct a new panel data set covering German municipalities from 1928 to 1936. The endogeneity of health care supply is addressed by using the expulsion of Jewish physicians from statutory health insurance as exogenous variation in regional physician supply. Increases in the supply of physicians reduce infant mortality and mortality from common childhood diseases. Using a semiparametric control function approach, we find diminishing marginal returns to health care provision. The results are consistent with historical trends in infant mortality over the 20th century. |
| Keywords: | infant mortality, physicians, health care supply, mortality transition, semiparametric IV |
| JEL: | I10 I18 N34 |
| Date: | 2022 |
| URL: | http://d.repec.org/n?u=RePEc:ces:ceswps:_9699&r= |
| By: | Luca Braghieri; Ro'ee Levy; Alexey Makarin |
| Abstract: | The diffusion of social media coincided with a worsening of mental health conditions among adolescents and young adults in the United States, giving rise to speculation that social media might be detrimental to mental health. In this paper, we provide quasi-experimental estimates of the impact of social media on mental health by leveraging a unique natural experiment: the staggered introduction of Facebook across U.S. colleges. Our analysis couples data on student mental health around the years of Facebook’s expansion with a generalized difference-in-differences empirical strategy. We find that the roll-out of Facebook at a college increased symptoms of poor mental health, especially depression. We also find that, among students predicted to be most susceptible to mental illness, the introduction of Facebook led to increased utilization of mental healthcare services. Lastly, we find that, after the introduction of Facebook, students were more likely to report experiencing impairments to academic performance resulting from poor mental health. Additional evidence on mechanisms suggests that the results are due to Facebook fostering unfavorable social comparisons. |
| JEL: | D12 D72 D90 I10 L82 L86 |
| Date: | 2022 |
| URL: | http://d.repec.org/n?u=RePEc:ces:ceswps:_9723&r= |
| By: | Zhen, Chen; Chen, Yu; Lin, Biing-Hwan; Karns, Shawn; Mancino, Lisa; Ver Ploeg, Michele |
| Abstract: | Preference heterogeneity in food demand has important health and equity implications for targeted taxes and subsidies intended to enhance diet quality and reduce obesity. We study the role of obesity in the purchases of food at home and food away from home using data from the nationally representative National Household Food Acquisition and Purchase Survey. We develop a method for incorporating the complex survey design and retail scanner data into the estimation of a 21-good Exact Affine Stone Index demand system with endogenous prices and truncated purchases. We find significant preference heterogeneity associated with the obesity status of household members. Counterfactual simulations find that 1) a sweetened beverage tax is effective in increasing the healthfulness of grocery purchases by lower-income obese consumers; 2) the nutritional benefits of a fruit and vegetable subsidy are concentrated on nonobese consumers with little improvement in obese consumers’ Healthy Eating Index and an increase in their total calories purchased; and 3) a fiscally neutral healthy food subsidy fully funded by an unhealthy food tax benefits nonobese consumers both financially and nutritionally more than it does obese consumers. These findings show that lowering healthy food prices without raising the cost of unhealthy foods is unlikely to reduce obesity. Policymakers in favor of a systems approach of simultaneously taxing unhealthy foods and subsidizing healthy foods should be mindful of the distributional effects of this policy on obese consumers and the lower-income population. |
| Keywords: | soda tax, fruit and vegetable subsidy, FoodAPS, EASI demand, preference heterogeneity, nutrition inequality |
| JEL: | D12 H23 I14 I18 |
| Date: | 2021–12–06 |
| URL: | http://d.repec.org/n?u=RePEc:pra:mprapa:112697&r= |
| By: | Ahmad Shabir Faizi; Weerachart Kilenthong |
| Abstract: | This paper investigates the socioeconomic determinants of parenting style in the context of a developing country using early childhood panel data from rural Thailand. Our key findings are that more patient caregivers tend to be more authoritative than authoritarian, caregivers are more likely to be authoritative than authoritarian when they observed more behavioral problems from their children, and caregivers exhibit more authoritarian than authoritative parenting if they perceived the community to be more dangerous. We also find that families with less resources, proxied by wealth, marital status and parental absence, are more likely to be authoritarian. |
| Keywords: | Parenting style; Time preferences; Child behavioral problems; Community risk factors; Developing country |
| JEL: | D91 J24 O15 |
| Date: | 2022–05 |
| URL: | http://d.repec.org/n?u=RePEc:pui:dpaper:180&r= |
| By: | Krieger, Tim; Meemann, Christine; Traub, Stefan |
| Abstract: | In most OECD countries, pension reform policy has decreased the level of intragenerational redistribution over the last three decades, that is, redistribution among members of the same generation with high and low pension entitlements. This trend has occurred despite heterogeneity in life expectancy linked to socioeconomic status having a regressive impact on outcomes. This paper contributes to solving this puzzle by means of a controlled laboratory experiment. We study the causal relationship between inequality of entitlements, mortality risk, and the size of redistribution in a stylized social security system. We find that mortality risk, when negatively correlated with entitlements, significantly lowers subjects' willingness to redistribute payoffs from high-entitlement to low-entitlement subjects. We explain this finding with efficiency preferences and an alienation effect. The alienation effect is the tendency to attach a lower social weight to the short-lived poor. |
| Keywords: | Inequality,Life Expectancy,Risk,Redistribution,Pension Reform,Efficiency Preferences,Alienation Effect,Experiment |
| JEL: | D63 D81 H55 I14 |
| Date: | 2022 |
| URL: | http://d.repec.org/n?u=RePEc:zbw:wgspdp:202202&r= |
| By: | Osuagwu, Eze Simpson |
| Abstract: | This paper investigates whether the Affordable Care Act of 2010 adequately provides for preventive care services, which is a major element for the provision of universal healthcare for the American people. The paper relies on a historical review of the provisions of the Act and empirical evidence from literature to conclude that the Affordable Care Act has adequate provisions for preventive care services. The paper therefore suggests that policy makers should expand the enrollment period to accommodate individuals who may not be able to register within the enrolment period but may stand in need of a comprehensive periodic care, especially pregnant women who need prenatal care during the term of their pregnancy. The paper also recommends that those states yet to establish exchanges should set aside political differences, to enable the citizens take appropriate steps to benefit from the preventive care services provided by the healthcare program. The paper then concludes that the universality of the Affordable Care Act implies a good implementation of preventive care services. |
| Keywords: | Affordable Care Act, Preventive Care, Healthcare Services, United States |
| JEL: | I15 I18 |
| Date: | 2021–01 |
| URL: | http://d.repec.org/n?u=RePEc:pra:mprapa:112946&r= |
| By: | Mika Akesaka; Nobuyoshi Kikuchi |
| Abstract: | We examine the effects of local labor market conditions during early pregnancy on birth and later outcomes. Using a longitudinal survey of newborns in Japan, we find that improvements in employment opportunities increase the probability of low birth weight, attributable to shortened gestation. This negative effect is mainly driven by the impact of economic shocks on the female labor market. However, we do not find a lasting effect of economic shocks during early pregnancy on severe health conditions or developmental delays in early childhood. Using prefecture-level panel data, we confirm that improvements in female employment opportunities are significantly negatively associated with infant birth weight, but not with the fertility and infant mortality rate. |
| Date: | 2021–12 |
| URL: | http://d.repec.org/n?u=RePEc:dpr:wpaper:1153r&r= |
| By: | Dominic Rohner |
| Abstract: | Conflicts such as civil wars have manifold negative consequences on human development. In this survey article the existing literature is reviewed on the impact of conflict on educational attainment, health outcomes, inter-group trust and generalized social capital, as well as economic outcomes. It is stressed that four dimensions of adverse consequences from war exposure can give birth to four corresponding vicious cycles and war traps. Finally, a series of policies for peace are discussed, including policies that boost productivity and human capital accumulation, that foster inter-group trust and interaction, and that strengthen democratic institutions and governance. |
| Date: | 2022–04 |
| URL: | http://d.repec.org/n?u=RePEc:lau:crdeep:22.08&r= |
| By: | Simone Balestra; Helge Liebert; Nicole Maestas; Tisamarie B. Sherry |
| Abstract: | We investigate behavioral responses to a staggered disruption in the supply of prescription opioids across U.S. states: the introduction of electronic Prescription Drug Monitoring Programs (PDMPs). Using administrative datasets, we find PDMPs curtail the proliferation of prescription opioids. Physicians respond to monitoring on the extensive margin, limiting the number of patients to whom they prescribe opioids without adjusting dosage or duration. This decreases supply to long-term opioid users, who evade the restrictions by acquiring prescriptions from out-of-state prescribers and by substituting to heroin. This causes a surge in heroin overdoses, which offsets reductions in hospitalizations and deaths from prescription opioids. |
| Keywords: | prescription drugs, opioid crisis, heroin, prescription drug monitoring programs |
| JEL: | H75 I11 I12 I18 |
| Date: | 2022 |
| URL: | http://d.repec.org/n?u=RePEc:ces:ceswps:_9704&r= |
| By: | Neeraj Kumar; Arup Mitra (Institute of Economic Growth, Delhi) |
| Abstract: | This paper based on the data from the NFHS-5 examines various indicators of child health in India. A variety of correlates have been considered in order to understand the causes of poor health outcomes and reflect on effective strategies which may contribute to better health of the children. The inter-spatial variations bring out certain specific patterns based on which insights are developed. A major deterioration in the food value seems to have occurred, causing stunting, wasting, underweight and anemia among the children. Mothers’ diet, access to medicines, antenatal care and education and participation in the decision-making process within the household are some of the important factors to bring in improvement in child health. Besides, the role of sanitation, vaccine and breast feeding comes out clearly in restoring the health of the children. |
| Keywords: | health, food, nutrition, NFHS |
| Date: | 2021–01 |
| URL: | http://d.repec.org/n?u=RePEc:awe:wpaper:414&r= |
| By: | Di Novi, Cinzia (European Commission); Paruolo, Paolo (European Commission); Verzillo, Stefano (European Commission) |
| Abstract: | This study exploits individual data from the 8th wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) and the SHARE Corona Survey to investigate the mental health consequences of COVID-19 job disruption across different European countries. It focuses on older workers (aged 50 and over) who were exposed to a higher risk of infection from COVID-19 and were also more vulnerable to the risk of long-term unemployment and permanent labour market exits during economic downturns. The relationship between job disruption in times of COVID-19 and older workers' mental health is investigated using differences in country-level employment legislation regimes in the EU. European countries are clustered into three macro-regions with high, intermediate and low employment regulatory protection regulations, using the Employment Protection Legislation (EPL) aggregate score proposed by the OECD. Results reveal a clear EPL gradient: job disruption has a positive and significant impact on older workers' psychological distress especially in those countries where EPL is more binding. The present findings suggest possible mitigating measures for older unemployed in the EU countries with higher Employment Protection legislation. |
| Keywords: | European Countries; COVID-19 pandemic; job disruption; mental health; older workers; EPL |
| JEL: | I14 I18 J08 |
| Date: | 2022–04 |
| URL: | http://d.repec.org/n?u=RePEc:jrs:wpaper:202202&r= |
| By: | Jan-Emmanuel De Neve; Daisy Fancourt; Christian Krekel; Sarah Swanke |
| Abstract: | Around the world, governments have been asking their citizens to practice physical distancing and stay at home to contain the spread of Covid-19. Are happier people more willing to comply with these measures? Using three independent surveys covering over 119,000 adult respondents across 35 countries, including longitudinal data from the UK, we test competing psychological theories, and find that past and present happiness predicts compliance during lockdown. The relationship is stronger for those with higher levels of happiness. A negative mood, or loss in happiness, predicts lower compliance. We explore risk-avoidance and pro-social motivations for compliance, and find that these are not uniform but dependent on personal characteristics and context: people who are older or have certain medical preconditions seem to be predominantly motivated by risk-avoidance, whereas motivations of people who are less at risk of Covid-19 seem more mixed. Our findings have implications for policy design, targeting, and communication. |
| Keywords: | COVID-19, happiness, lockdown compliance, mood maintenance, pro-sociality, risk avoidance |
| JEL: | D91 I12 I31 |
| Date: | 2020–09–28 |
| URL: | http://d.repec.org/n?u=RePEc:cep:cepops:54&r= |
| By: | Rodrigo Barra Novoa (UCJC - Universidad Camilo José Cela) |
| Abstract: | The article describes and analyzes the main regional differences, the response capacity and the main lessons learned from the COVID-19 pandemic in Chile. In addition, it analyzes the impacts derived from the pandemic crisis on local productive systems and establishes a series of future perspectives that could strengthen the Chilean health system. The article provides an updated review of the impact of the COVID-19 pandemic in the country, as well as an explanatory narrative of the most relevant events to confront the pandemic crisis. |
| Abstract: | L'article décrit et analyse les principales différences régionales, la capacité de réponse et les principaux enseignements tirés de la pandémie de COVID-19 au Chili. En outre, il analyse les impacts dérivés de la crise pandémique sur les systèmes productifs locaux et établit une série de perspectives futures qui pourraient renforcer le système de santé chilien. L'article fournit une revue actualisée de l'impact de la pandémie de COVID-19 dans le pays, ainsi qu'un récit explicatif des événements les plus pertinents pour affronter la crise pandémique. |
| Date: | 2022 |
| URL: | http://d.repec.org/n?u=RePEc:hal:journl:hal-03633275&r= |
| By: | RADICS Miklos (European Commission - JRC); CHRISTIDIS Panayotis (European Commission - JRC) |
| Abstract: | This report presents the results of an analysis on mobility related consequences of the COVID-19 pandemic and the applied restricting measures in Spain covering the period of March 1, 2020 – October 1, 2021. The analysis focuses on how the number of trips changed on national, autonomous community and provincial levels as well as on the potential causes behind the changes. Multiple open mobility data sources were used that describe the evolution of the number of trips published by the Spanish Ministry of Transport and tech companies. Results show that due to the unpredictable consequences of the coronavirus disease and strict governmental responses, the number of trips dropped drastically in all Spanish autonomous communities to 40-50 % compared pre-pandemic levels after the first state of alarm was introduced in March 2020. After hard lockdown was lifted, mobility levels gradually returned to 70-80% compared to the baseline level regardless of the number of coronavirus infections and deaths of the subsequent waves of infection that exceeded the first wave. The pandemic brought significant changes in the individual behaviour that also has an impact on trip demand and distribution. Although the second state of alarm ended in May 2021, and since then only minor restrictions influence mobility, after 1.5 years of pandemic public transport is still underperforming and teleworking levels are higher compared to the pre-pandemic situation in major Spanish cities. |
| Keywords: | COVID-19 |
| Date: | 2022–04 |
| URL: | http://d.repec.org/n?u=RePEc:ipt:iptwpa:jrc128451&r= |
| By: | Bellatin, Alejandra (University of Toronto); Galassi, Gabriela (Bank of Canada) |
| Abstract: | We use data from online job postings listed on a job board to study how the demand for jobs linked to new technologies during the COVID-19 crisis responded to pandemic mitigation policies. We classify job postings into a standard occupation classification, using text analytics, and we group occupations according to their involvement in the production and use of digital technologies. We leverage the variation in the stringency of containment policies over time and across provinces. We find that when policies become more stringent, job postings in occupations that are related to digital infrastructure or that allow for remote work fare relatively better than postings in more traditional occupations. Job postings for positions in occupations with low risk of automation recover faster during reopenings than postings for more traditional occupations. Occupations typically populated by disadvantaged groups (e.g., women and low-wage workers) gather relatively few job postings if they are not linked to new technologies. We also find that cities with scarce pre-pandemic job postings related to digital technologies post fewer job ads overall when policies become more stringent. |
| Keywords: | COVID-19, job vacancies, technology adoption |
| JEL: | J23 J24 O14 |
| Date: | 2022–04 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp15209&r= |
| By: | Simon Porcher (IAE Paris - Sorbonne Business School); Thomas Renault (CES - Centre d'économie de la Sorbonne - UP1 - Université Paris 1 Panthéon-Sorbonne - CNRS - Centre National de la Recherche Scientifique) |
| Abstract: | We construct a novel database containing hundreds of thousands geotagged messages related to the COVID-19 pandemic sent on Twitter. We create a daily index of social distancing—at the state level—to capture social distancing beliefs by analyzing the number of tweets containing keywords such as "stay home", "stay safe", "wear mask", "wash hands" and "social distancing". We find that an increase in the Twitter index of social distancing on day t-1 is associated with a decrease in mobility on day t. We also find that state orders, an increase in the number of COVID-19 cases, precipitation and temperature contribute to reducing human mobility. Republican states are also less likely to enforce social distancing. Beliefs shared on social networks could both reveal the behavior of individuals and influence the behavior of others. Our findings suggest that policy makers can use geotagged Twitter data—in conjunction with mobility data—to better understand individual voluntary social distancing actions. |
| Date: | 2021 |
| URL: | http://d.repec.org/n?u=RePEc:hal:cesptp:hal-03205158&r= |