nep-hea New Economics Papers
on Health Economics
Issue of 2022‒10‒31
27 papers chosen by
Nicolas R. Ziebarth
Cornell University

  1. Equilibrium Effects of Food Labeling Policies By Barahona, Nano; Otero, Cristobal; Otero, Sebastian
  2. Can the child penalty be reduced?. Evaluating multiple policy interventions By Martin Eckhoff Andresen; Emily Nix
  3. Air pollution and child development in India By A. Balietti; S. Datta; S. Veljanoska
  4. Two Sides of Gender : Sex, Power, and Adolescence By Shah,Manisha; Seager,Jennifer; Montalvao Machado,Joao H. C.; Goldstein,Markus P.
  5. When do reminders work? Memory constraints and medical adherence By Kai Barron; Mette Trier Damgaard; Christina Gravert
  6. Long-term returns to local health-care spending By Jakub Cerveny; Jan C. van Ours
  7. Are the grandparents alright? The health consequences of grandparental childcare provision By Peter Eibich; Xianhua Zai
  8. The financial situation of people with severe mental illness in an advanced welfare state By Eliason, Marcus
  9. Analyzing Nurses‘ Decisions to Leave Their Profession – a Duration Analysis By Martin Kroczek;
  10. Wage expectation, information and the decision to become a nurse By Philipp Kugler;
  11. Blood and Gender Bias in Informal Care within the Family? By Canta, Chiara; Pestieau, Pierre; Schoenmaeckers, Jérôme
  12. Gender or class – What determines voting? Lessons from expanding the suffrage in early 1900s Norway By Edda Torsdatter Solbakken
  13. Does Devolution Alter the Choice of Public versus Private Health Care? By Joan Costa-Font; Ada Ferrer-i-Carbonell
  14. The Critical Role of Web Accessibility in Health Information Access, Understanding, and Use By Amanda Krupa; Jill B. Roark; Kirsten Barrett
  15. Study of the wholesale distribution market for medicines By Comisión Nacional de los Mercados y la Competencia (CNMC)
  16. Lessons from ten years of the World Happiness Report By Maria Cotofan
  17. Health Technology Assessment (HTA) of GLP-1 receptor agonists and SGLT-2 inhibitors in combination with metformin as first-line treatment in patient with type 2 diabetes mellitus (T2DM) and established cardiovascular or chronic kidney disease By Aas, Eline; Gomez, Monica; Tariq, Fawaz
  18. Cost-Effectiveness of an Organized Lung Cancer Screening Program for Asbestos-Exposed Subjects By Sébastien Gendarme; Jean-Claude Pairon; Pascal Andujar; François Laurent; Patrick Brochard; Fleur Delva; Bénédicte Clin; Antoine Gislard; Christophe Paris; Isabelle Thaon; Helene Goussault; Florence Canoui-Poitrine; Christos Chouaïd
  19. Influenza Mortality in French Regions after the Hong Kong Flu Pandemic By Florian Bonnet; Hippolyte d'Albis; Josselin Thuilliez
  20. Effects of Work-From-Home on University Students and Faculty By Avni Singh
  21. The Hammer and the Dance: Equilibrium and Optimal Policy during a Pandemic Crisis By Christian Hellwig; Tiziana Assenza; Fabrice Collard; Martial Dupaigne; Patrick Fève; Sumudu Kankanamge; Nicolas Werquin
  22. Assessing School District Decision-Making: Evidence from the COVID-19 Pandemic By Alvin Christian; Brian Jacob; John D. Singleton
  23. Excess Death Rates for Republicans and Democrats During the COVID-19 Pandemic By Jacob Wallace; Paul Goldsmith-Pinkham; Jason L. Schwartz
  24. The Economic Impact of COVID-19 around the World By Fernando M. Martin; Juan M. Sanchez; Olivia Wilkinson
  25. Impacts of COVID-19 on the Income and Mental Well-Being of Cismen, Ciswomen, Transgender, andNon-Binary Individuals : Evidence from the 2020 COVID-19 Disparities Survey By Ahmed,Tanima; Lebbos,Toni Joe; Howell,Sean; Lamontagne,Erik; Wimpey,Joshua Seth
  26. Long-term Care in Spain By Joan Costa-Font; Sergi Jiménez; Cristina Vilaplana Prieto; Analía Viola
  27. COVID-19 Vaccine Hesitancy in 53 Developing Countries : Levels, Trends, and Reasons for Hesitancy By Dayton,Julia M.; Edochie,Ifeanyi Nzegwu; Newhouse,David Locke; Cojocaru,Alexandru; Deudibe,Gildas Bopahbe; Kakietek,Jakub Jan; Kim,Yeon Soo; Montes,Jose

  1. By: Barahona, Nano; Otero, Cristobal; Otero, Sebastian
    Abstract: We study a regulation in Chile that mandates warning labels on products whose sugar or caloric concentration exceeds certain thresholds. We show that consumers substitute from labeled to unlabeled products—a pattern mostly driven by products that consumers mistakenly believe to be healthy. On the supply side, we find substantial reformulation of products and bunching at the thresholds. We develop and estimate an equilibrium model of demand for food and firms’ pricing and nutritional choices. We find that food labels increase consumer welfare by 1.6% of total expenditure, and that these effects are enhanced by firms’ responses. We then use the model to study alternative policy designs. Under optimal policy thresholds, food labels and sugar taxes generate similar gains in consumer welfare, but food labels benefit the poor relatively more
    Keywords: Food labels, equilibrium effects, misinformation, sugar taxes.
    JEL: D12 D22 I12 I18 L11 L81
    Date: 2022–04
    URL: http://d.repec.org/n?u=RePEc:pra:mprapa:114597&r=
  2. By: Martin Eckhoff Andresen (Statistics Norway); Emily Nix
    Abstract: Children cause large earnings drops for mothers but not fathers, a stylized fact known as the “child penalty” that explains a substantial portion of remaining gender income gaps. Can policy reduce the child penalty? We first document how changes in the child penalty over a long time horizon in Norway correlate with major family policy reforms. Next, we evaluate two possible interventions: paternity leave and high-quality childcare. We find no impact of paternity leave on child penalties or a measure of father’s preferences for childcare. In contrast, a year of publicly provided childcare reduces child penalties by 23% during the years of use. These results suggest governments can act to reduce child penalties, but providing alternatives to the mother’s time, such as quality childcare, is more effective than paternity leave.
    Keywords: Gender wage gap; child penalty; paternity leave; childcare
    JEL: J21 J23 J22 J71
    Date: 2022–07
    URL: http://d.repec.org/n?u=RePEc:ssb:dispap:983&r=
  3. By: A. Balietti (Heidelberg University); S. Datta (ETH Zürich - Eidgenössische Technische Hochschule - Swiss Federal Institute of Technology [Zürich]); S. Veljanoska (CREM - Centre de recherche en économie et management - UNICAEN - Université de Caen Normandie - NU - Normandie Université - UR1 - Université de Rennes 1 - UNIV-RENNES - Université de Rennes - CNRS - Centre National de la Recherche Scientifique)
    Abstract: In this paper, we study the impact of air pollution on child growth in India. We rely on wind direction to capture quasi-random variation in three main criteria air pollutants. We show that an increase in the average concentration of fine particulate matter by one standard deviation is accountable for almost 5 and 2.4 percentage points of stunting and severe stunting rates, respectively. We also find that ozone and carbon monoxide impact weight-related outcomes. Stunting has critical long-term health and economic consequences; through its impact on stunting, pollution exacerbates the height premium in earnings, with girls being more adversely affected than boys in India. © 2022 Elsevier Inc.
    Keywords: Ambient air pollution,Anthropometry,Child health,Height premium,Wind direction
    Date: 2022
    URL: http://d.repec.org/n?u=RePEc:hal:journl:hal-03662124&r=
  4. By: Shah,Manisha; Seager,Jennifer; Montalvao Machado,Joao H. C.; Goldstein,Markus P.
    Abstract: Adolescents in Sub-Saharan Africa have some of the highest rates of intimate partner violenceacross the globe. This paper evaluates the impact of a randomized controlled trial that offers females a goalsetting activity to improve their sexual and reproductive health outcomes and offers their male partners a soccerintervention, which educates and inspires young men to make better sexual and reproductive health choices. Bothinterventions reduce female reports of intimate partner violence. Impacts are larger among females who were alreadysexually active at baseline. The paper develops a game theoretic model to understand the mechanisms at play. Inline with the model, the soccer intervention improves male attitudes around violence and sexual and reproductive healthand reduces sexual activity. In the goal setting arm, females take more control of their sexual and reproductivehealth by exiting violent relationships. Females in this arm have higher quality partners at endline.
    Date: 2022–06–01
    URL: http://d.repec.org/n?u=RePEc:wbk:wbrwps:10072&r=
  5. By: Kai Barron (WZB Berlin); Mette Trier Damgaard (Department of Economics and Business Economics, CIBP & TrygFonden’s Centre for Child Research, Aarhus University); Christina Gravert (University of Copenhagen & CEBI)
    Abstract: An extensive literature shows that reminders can successfully change behavior. Yet, there exists substantial unexplained heterogeneity in their effectiveness, both: (i) across studies, and (ii) across individuals within a particular study. This paper investigates when and why reminders work. We develop a theoretical model that highlights three key mechanisms through which reminders may operate. To test the predictions of the model, we run a nationwide field experiment on medical adherence with over 4000 pregnant women in South Africa and document several key results. First, we find an extremely strong baseline demand for reminders. This demand increases after exposure to reminders, suggesting that individuals learn how valuable they are for freeing up memory resources. Second, stated adherence is increased by pure reminders and reminders containing a moral suasion component, but interestingly, reminders containing health information reduce adherence in our setting. Using a structural model, we show that heterogeneity in memory costs (or, equivalently, annoyance costs) is crucial for explaining the observed behavior.
    Keywords: Nudging, Reminders, Memory, Attention, Medication adherence, Structural model
    JEL: D04 D91 C93 I12
    Date: 2022–10–03
    URL: http://d.repec.org/n?u=RePEc:kud:kucebi:2218&r=
  6. By: Jakub Cerveny (Ministry of Health of the Slovak Republic); Jan C. van Ours (Erasmus University Rotterdam)
    Abstract: This paper investigates the effects of health-care spending on mortality rates of heart attack patients. We relate in-hospital deaths to in-hospital end-of-life spending and post-discharge deaths to post-discharge health-care spending. In our analysis, we use detailed administrative data on individual personal characteristics and information about health-care expenses at the regional level. To account for potential selectivity in the region of health-care treatment we compare local patients with visitors and stayers with recent movers from a different region. In regions with higher health-care spending mortality after heart attacks is substantially lower. Apparently, there are long-term returns to local health-care spending.
    Keywords: Health-care spending, heart attack, mortality, duration models
    JEL: C41 H75 I11 I18
    Date: 2022–10–10
    URL: http://d.repec.org/n?u=RePEc:tin:wpaper:20220072&r=
  7. By: Peter Eibich (Max Planck Institute for Demographic Research, Rostock, Germany); Xianhua Zai (Max Planck Institute for Demographic Research, Rostock, Germany)
    Abstract: This paper examines the causal effect of childcare provision on grandparents’ health in the US. We propose the sex ratio among older adults’ children as a novel instrument for grandparental childcare provision. Our instrument is rooted in the demographic literature on grandparenthood and exploits that parents of daughters transition to grandparenthood earlier and invest more in their grandchildren than parents of sons. We estimate 2SLS regressions using data from the Health and Retirement Study. The results suggest that childcare provision is not beneficial for grandparents’ health and may even be detrimental for physical functioning and subjective health.
    Keywords: America, child care, health
    JEL: J1 Z0
    Date: 2022
    URL: http://d.repec.org/n?u=RePEc:dem:wpaper:wp-2022-023&r=
  8. By: Eliason, Marcus (IFAU - Institute for Evaluation of Labour Market and Education Policy)
    Abstract: Schizophrenia spectrum, bipolar, and major depressive disorders are severe mental illnesses (SMIs) that not only entail great suffering for those affected but also major societal costs. In this study, I use administrative register data to provide a detailed picture of the economic situation of people with SMI in Sweden during a period of 10 years around first-time in-patient diagnosis. First-time in-patient diagnosis was associated with a considerable drop in earnings, which was largely compensated for by social transfers: mainly sickness and disability insurance. However, there were also large and increasing pre-diagnosis earnings gaps, relative to matched comparison groups, especially among those with schizophrenia spectrum disorders. This gap was to lesser extent compensated for by social transfers. Consequently, there was a permanent and increasing – due to lost earnings growth – income differential. Hence, findings in previous studies are confirmed: even in an advanced welfare state, people with SMI – especially those with schizophrenia – have an extremely weak position on the labour market and an equally difficult financial situation.
    Keywords: Schizophrenia spectrum disorder; bipolar disorder; major depressive disorder; social insurances; labour market situation
    JEL: I13 I14 J14 J65
    Date: 2022–10–19
    URL: http://d.repec.org/n?u=RePEc:hhs:ifauwp:2022_019&r=
  9. By: Martin Kroczek;
    Abstract: Many countries suffer from skilled labor shortages in nursing. One way to increase the nurse labor supply is to raise their retention rates. Yet, though several studies exist on factors associated with the nurse labor supply at different levels, literature on factors associated with nurses’ decisions to leave their occupation is relatively scarce. Based on German administrative data, I analyze the determinants of nurses’ decisions to leave their profession. My results suggest that younger nurses, nurses in the social sector, and nurses working with smaller employers leave their occupation more often than their counterparts, irrespective of their specific nursing occupations and care settings (inpatient or outpatient care). Nurses leave more often where more alternative occupational options are available. Nurses who have been unemployed and nurses who have been employed in a different field have a higher probability of leaving the occupation, whereas nurses who just finished vocational training only have a moderate propensity to leave. Female nurses leave less often if employed part time. Female nurses in part time leave even more seldom if they have children. A change in the hospital reimbursement system and introducing a nursing minimum wage during the first decade of the century did not change nurses’ occupation durations.
    Keywords: nurses; duration analysis; quitting
    JEL: J63 J62 I18
    Date: 2021–12–21
    URL: http://d.repec.org/n?u=RePEc:iaw:iawdip:136&r=
  10. By: Philipp Kugler;
    Abstract: In light of skilled-labor shortage in nursing, the effect of a change in the wage of nurses on their labor supply is intensely discussed in recent literature. However, most results show a wage elasticity close to zero. Using extensive data of former German 9th graders, I analyze the role of the expected wage as an incentive to become a nurse. To estimate a causal effect, I select controls and their functional form using post-double-selection, which is a data driven selection method based on regression shrinkage via the lasso. Contrary to common perceptions, the expected wage plays a positive and statistically significant role in the decision to become a nurse. Further, understating a nurse's wage decreases the probability of becoming one. Concerning omitted variable bias, I assess the sensitivity of the results using a novel approach. It evaluates the minimum strength that unobserved confounders would need to change the conclusion. The sensitivity analysis shows that potential unobserved confounders would have to be very strong to overrule the conclusions. The empirical results lead to two important policy implications. First, increasing the wage may help to overcome the shortage observed in many countries. Second, providing information on the (relative) wage may be a successful strategy to attract more individuals into this profession.
    Keywords: health professional, expected wage, wage information, machine learning, sensitivity analysis
    JEL: I11 I21 J24 J31
    Date: 2022–01–19
    URL: http://d.repec.org/n?u=RePEc:iaw:iawdip:135&r=
  11. By: Canta, Chiara; Pestieau, Pierre (Université catholique de Louvain, LIDAM/CORE, Belgium); Schoenmaeckers, Jérôme
    Abstract: This paper deals with the question of the relative contribution of children to the informal long- term care of their dependent parents. Starting from a theoretical model and using SHARE data, the paper focuses on the role of gender and blood relationships as well as the effect of differential opportunity costs within the couple. The results tend to confirm the existence of gender and blood biases in the level of informal care provided, whereas the probability of providing any care is only affected by the blood bias. If children are working, their time devoted to informal care decreases with their wage. There is no difference in the level of care provided by single children and married children. Finally, when only couples are considered, gender and blood biases are confirmed but the wage ratio has no impact on the relative level of informal care of the spouses. These results have two main policy implications: tagging public LTC transfers on the gender of children, and the adjustment of public LTC transfers to different levels of insurance coverage.
    Keywords: Informal long-term care ; couple decision-making ; altruism
    JEL: D1 D6 H21 H31
    Date: 2021–11–08
    URL: http://d.repec.org/n?u=RePEc:cor:louvco:2021015&r=
  12. By: Edda Torsdatter Solbakken (Statistics Norway)
    Abstract: Previous literature has found that extending the suffrage to both females and poorer voters increases the supply of public goods. This paper investigates whether the difference in voting between men and women can be explained by differences in income alone, or if there exist gender specific differences in preferences. I exploit two key features of the expansion of suffrage in municipality elections in early 20th century Norway. First, the time at which people gained the right to vote depended on both their gender and their household income. Second, the income threshold for suffrage was set nationally, creating variation across municipalities in the share of new voters following each extension of the suffrage. This variation allows me to estimate separate effects for the change in supply of health personnel following the extension of suffrage to poor men, rich women, and poor women, respectively. I find that the enfranchisement of both poor men and rich women increases the supply of doctors relative to when only rich men had the right to vote. These results are consistent with gender specific preferences for health services to the community.
    Keywords: Enfranchisement; women’s suffrage; public goods; welfare state
    JEL: P16 H42 D72 J16 N24 N44
    Date: 2022–09
    URL: http://d.repec.org/n?u=RePEc:ssb:dispap:988&r=
  13. By: Joan Costa-Font; Ada Ferrer-i-Carbonell
    Abstract: Government decentralisation (GD) can provide an alternative to the ‘build in’ accountability mechanism of markets by influencing the choice of and preference for public versus private health care. To test this hypothesis, this paper exploits the gradual decentralisation of the political stewardship of the Spanish National Health System (NHS) to study the effect of GD on the individual choice of public (NHS) and private health care drawing on a difference-in-differences design. We find that ‘turning on’ the decentralization treatment (abandoning centralised governance) increases the preference for public health care (NHS) compared to control regions that did not exhibit any major change in the health care governance in the least a decade. Specifically, we find that GD increases the perceptions of, satisfaction with, and preference for the NHS. Consistently, we also find that the GD reduces the uptake of private health insurance among higher income and education groups. The effects are mainly driven by improvements in health care quality as well as policy innovation and diffusion.
    Keywords: devolution, National Health Service (NHS), private health care, private health insurance, health system satisfaction, health care quality
    JEL: H7 I18
    Date: 2021–09
    URL: http://d.repec.org/n?u=RePEc:bge:wpaper:1291&r=
  14. By: Amanda Krupa; Jill B. Roark; Kirsten Barrett
    Abstract: This brief describes the state of accessibility of digital tools and top U.S. hospitals websites and provides guidance on how to start improving access to health care information.
    Keywords: Health information, Accessibility, Websites, Digital tools, Hospitals, Health systems, Disability, Older adults
    URL: http://d.repec.org/n?u=RePEc:mpr:mprres:ee42eef265664b968c48908badd33b65&r=
  15. By: Comisión Nacional de los Mercados y la Competencia (CNMC) (Comisión Nacional de los Mercados y la Competencia (CNMC))
    Abstract: The study analyses the market for the sale and distribution of prescription medicines for human use that are dispensed through pharmacies in Spain, from the perspective of competition and the principles of efficient economic regulation. The study identifies areas where public health objectives can be achieved more effectively by incentivising competition and economic efficiency and makes some recommendations for regulatory improvement in this regard.
    Keywords: Medicines for human use, Spanish National Health System, Wholesale distribution of medicines, Competition promotion
    JEL: H4 I11 I18 K2 K32
    Date: 2022–03–24
    URL: http://d.repec.org/n?u=RePEc:awo:epaper:e/cnmc/002/2017_eng&r=
  16. By: Maria Cotofan
    Abstract: The World Happiness Report gives us an annual insight into global wellbeing. Maria Cotofan looks at what we have learned about the determinants of wellbeing in the past ten years - and what challenges and opportunities lie ahead.
    Keywords: wellbeing, happiness, world happiness report
    Date: 2022–06–21
    URL: http://d.repec.org/n?u=RePEc:cep:cepcnp:633&r=
  17. By: Aas, Eline (Division of Health Services, Norwegian Institute of Public Health,); Gomez, Monica (Department of Health Management and Health Economics); Tariq, Fawaz (Department of Health Management and Health Economics)
    Abstract: Type 2 diabetes mellitus (T2DM) is one of the most prevalent lifestyle-related diseases, causing increased mortality, morbidity and reduction in health-related quality of life (HRQoL), as well as costs to society related to treatment, follow-up and production losses.In the current guidelines, SGLT-2 inhibitors and GLP-1 analogs are recommended as second-line treatment for T2DM. Based on results from recent studies, we have in this report analyzed whether these drugs can be considered cost-effective as first-line treatment (in combination with metformin) for patients with T2DM with either established cardiovascular disease or chronic renal failure (only SGLT-2 inhibitors considered). Based on two decision analytic models we estimated the incremental cost per QALYs gained. For the patients with T2DM and established CVD, SGLT-2 i is the preferred alternative (ICER NOK 59,811 per LY gained and NOK 89,517 per QALY gained) and is superior to GLP-1 RA, as SGLT-2 I resulted in higher health outcomes than GLP-1 RA. For patients with T2DM and established renal failure when comparing SGLT-2 i to metformin results in an ICER of NOK 168,872 per LY gained and NOK 193,656 per QALY gained. Both ICERs fall below the the threshold for these two patient groups are NOK 475,000
    Keywords: Type 2 diabetes; retningslinjer; kostnadseffektivitetsanalyse; SGLT-2 I; GLP1-RA
    JEL: C52 D61 H51
    Date: 2022–10–19
    URL: http://d.repec.org/n?u=RePEc:hhs:oslohe:2022_003&r=
  18. By: Sébastien Gendarme (CHIC - Centre Hospitalier Intercommunal de Créteil, IMRB - Institut Mondor de Recherche Biomédicale - INSERM - Institut National de la Santé et de la Recherche Médicale - IFR10 - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12, CEpiA - Clinical Epidemiology and Ageing : Geriatrie Soins Primaires et Santé Publique - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12); Jean-Claude Pairon (IMRB - Institut Mondor de Recherche Biomédicale - INSERM - Institut National de la Santé et de la Recherche Médicale - IFR10 - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12, CHIC - Centre Hospitalier Intercommunal de Créteil, IIMTPIF - Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France); Pascal Andujar (IMRB - Institut Mondor de Recherche Biomédicale - INSERM - Institut National de la Santé et de la Recherche Médicale - IFR10 - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12, CHIC - Centre Hospitalier Intercommunal de Créteil, IIMTPIF - Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France); François Laurent (CRCTB - Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] - Université Bordeaux Segalen - Bordeaux 2 - CHU Bordeaux [Bordeaux] - INSERM - Institut National de la Santé et de la Recherche Médicale); Patrick Brochard (CHU Bordeaux [Bordeaux], EPICENE - Cancer environnement - BPH - Bordeaux population health - UB - Université de Bordeaux - Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED) - INSERM - Institut National de la Santé et de la Recherche Médicale); Fleur Delva (EPICENE - Cancer environnement - BPH - Bordeaux population health - UB - Université de Bordeaux - Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED) - INSERM - Institut National de la Santé et de la Recherche Médicale); Bénédicte Clin (CHU Caen - NU - Normandie Université - TCBN - Tumorothèque de Caen Basse-Normandie, UNICAEN - Université de Caen Normandie - NU - Normandie Université); Antoine Gislard (ABTE - Aliments Bioprocédés Toxicologie Environnements - UNICAEN - Université de Caen Normandie - NU - Normandie Université - UNIROUEN - Université de Rouen Normandie - NU - Normandie Université, CHU Rouen - NU - Normandie Université); Christophe Paris (CHIC - Centre Hospitalier Intercommunal de Créteil); Isabelle Thaon (CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy); Helene Goussault (IMRB - Institut Mondor de Recherche Biomédicale - INSERM - Institut National de la Santé et de la Recherche Médicale - IFR10 - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12, CHIC - Centre Hospitalier Intercommunal de Créteil, IIMTPIF - Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France); Florence Canoui-Poitrine (IMRB - Institut Mondor de Recherche Biomédicale - INSERM - Institut National de la Santé et de la Recherche Médicale - IFR10 - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12, U955 Inserm - UPEC - IMRB - CEPIA/"Clinical Epidemiology And Ageing : Geriatrics, Primary Care and Public Health" [Créteil] - IMRB - Institut Mondor de Recherche Biomédicale - INSERM - Institut National de la Santé et de la Recherche Médicale - IFR10 - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12); Christos Chouaïd (CHIC - Centre Hospitalier Intercommunal de Créteil, U955 Inserm - UPEC - IMRB - CEPIA/"Clinical Epidemiology And Ageing : Geriatrics, Primary Care and Public Health" [Créteil] - IMRB - Institut Mondor de Recherche Biomédicale - INSERM - Institut National de la Santé et de la Recherche Médicale - IFR10 - UPEC UP12 - Université Paris-Est Créteil Val-de-Marne - Paris 12)
    Abstract: Background: The National Lung Screening Trial (NLST) and NELSON study opened the debate on the relevance of lung cancer (LC) screening in subjects exposed to occupational respiratory carcinogens. This analysis reported the incremental cost-effectiveness ratios (ICER) of an organized LC screening program for an asbestos-exposed population. Methods: Using Markov modelization, individuals with asbestos exposure were either monitored without intervention or annual low-dose thoracic computed-tomography (LDTCT) scan LC screening. LC incidence came from a prospective observational cohort of subjects with occupational asbestos exposure. The intervention parameters were those of the NLST study. Utilities and LC-management costs came from published reports. A sensitivity analysis evaluated different screening strategies. Results: The respective quality-adjusted life year (QALY) gain, supplementary costs and ICER [95% confidence interval] were: 0.040 [0.010–0.065] QALY, 6900 [3700–11,800] € and 170,000 [75,000–645,000] €/QALY for all asbestos-exposed subjects; and 0.144 [0.071–0.216] QALY, 13,000 [5700–26,800] € and 90,000 [35,000–276,000] €/QALY for smokers with high exposure. When screening was based on biennial LDTCT scans, the ICER was 45,000 [95% CI: 15,000–116,000] €/QALY. Conclusions: Compared to the usual ICER thresholds, biennial LDTCT scan LC screening for smokers with high occupational exposure to asbestos is acceptable and preferable to annual scans.
    Keywords: lung neoplasms,screening,occupational diseases,asbestos,cost-effectiveness
    Date: 2022–08–24
    URL: http://d.repec.org/n?u=RePEc:hal:journl:hal-03783819&r=
  19. By: Florian Bonnet (INED - Institut national d'études démographiques); Hippolyte d'Albis (PSE - Paris School of Economics - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris sciences et lettres - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement, PJSE - Paris Jourdan Sciences Economiques - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris sciences et lettres - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement); Josselin Thuilliez (CES - Centre d'économie de la Sorbonne - UP1 - Université Paris 1 Panthéon-Sorbonne - CNRS - Centre National de la Recherche Scientifique)
    Abstract: Influenza mortality has dramatically decreased in France since the 1950s. Annual death rates peaked during two pandemics: the Asian flu (1956-57) and the Hong-Kong flu (1969-1970). This study's objective is to evaluate whether the second pandemic created a structural change in the dynamics of influenza mortality in France. We employ a new database on influenza mortality since 1950 at the subnational level (90 geographic areas) to estimate statistical models to find whether a structural change happened and to explain the differences in mortality rates across geographic areas. Influenza mortality increased between 1950 and 1969, and decreased from 1970 onward. The Hong-Kong flu is identified as the event of a structural break. After the break, geographical differences are less explained by regional characteristics such as income, density or aging ratio. Hong Kong flu was found to be associated with a major change in influenza mortality in France. Change in health practices and policies induced a decline in mortality that started in 1970, just after the pandemics. The health benefits are notably important for senior citizens and for the poorest regions.
    Date: 2022–08
    URL: http://d.repec.org/n?u=RePEc:hal:wpaper:halshs-03763371&r=
  20. By: Avni Singh
    Abstract: The work-from-home policy affected people of all demographics and professions, including students and faculty at universities. After the onset of the COVID-19 pandemic in 2020, institutions moved their operations online, affecting the motivation levels, communication abilities, and mental health of students and faculty around the world. This paper is based mainly on primary data collected from students from around the world, and professors at universities in Bengaluru, India. It explores the effects of work-from-home as a policy in terms of how it changed learning during the pandemic and how it has permanently altered it in a post-pandemic future. Further, it suggests and evaluates policies on how certain negative effects of the work-from-home policy can be mitigated.
    Date: 2022–09
    URL: http://d.repec.org/n?u=RePEc:arx:papers:2209.10405&r=
  21. By: Christian Hellwig (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); Tiziana Assenza (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); Fabrice Collard (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); Martial Dupaigne (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); Patrick Fève (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); Sumudu Kankanamge (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); Nicolas Werquin (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)
    Abstract: We develop a comprehensive framework for analyzing optimal economic policy during a Pandemic crisis in a dynamic economic model that trades off pandemic-induced mortality costs against the adverse economic impact of policy interventions. We use the comparison between planner problem and dynamic decentralized equilibrium to highlight the margins of policy intervention and describe optimal policy actions. As our main conclusion, we provide a strong and novel economic justification for the current approach to dealing with the Pandemic, which is different from the existing health policy rationales. This justification is based on a simple economic concept, the shadow price of infection risks, which succinctly captures the static and dynamic tradeoffs between economic prosperity and mortality risk as the Pandemic unfolds.
    Date: 2022–08–29
    URL: http://d.repec.org/n?u=RePEc:hal:wpaper:hal-03763122&r=
  22. By: Alvin Christian; Brian Jacob; John D. Singleton
    Abstract: The COVID-19 pandemic drew new attention to the role of school boards in the U.S. In this paper, we examine school districts’ choices of learning modality—whether and when to offer in-person, virtual, or hybrid instruction—over the course of the 2020-21 pandemic school year. The analysis takes advantage of granular weekly data on learning mode and COVID-19 cases for Ohio school districts. We show that districts respond on the margin to health risks: all else equal, a marginal increase in new cases reduces the probability that a district offers in-person instruction the next week. Moreover, this negative response is magnified when the district was in-person the prior week and attenuates in magnitude over the school year. These findings are consistent with districts learning from experience about the effect of in-person learning on disease transmission in schools. We also find evidence that districts are influenced by the decisions of their peers.
    JEL: H0 H10 H30 I20 I21
    Date: 2022–09
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:30520&r=
  23. By: Jacob Wallace; Paul Goldsmith-Pinkham; Jason L. Schwartz
    Abstract: Political affiliation has emerged as a potential risk factor for COVID-19, amid evidence that Republican-leaning counties have had higher COVID-19 death rates than Democrat- leaning counties and evidence of a link between political party affiliation and vaccination views. This study constructs an individual-level dataset with political affiliation and excess death rates during the COVID-19 pandemic via a linkage of 2017 voter registration in Ohio and Florida to mortality data from 2018 to 2021. We estimate substantially higher excess death rates for registered Republicans when compared to registered Democrats, with almost all of the difference concentrated in the period after vaccines were widely available in our study states. Overall, the excess death rate for Republicans was 5.4 percentage points (pp), or 76%, higher than the excess death rate for Democrats. Post- vaccines, the excess death rate gap between Republicans and Democrats widened from 1.6 pp (22% of the Democrat excess death rate) to 10.4 pp (153% of the Democrat excess death rate). The gap in excess death rates between Republicans and Democrats is concentrated in counties with low vaccination rates and only materializes after vaccines became widely available.
    JEL: I0
    Date: 2022–09
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:30512&r=
  24. By: Fernando M. Martin; Juan M. Sanchez; Olivia Wilkinson
    Abstract: For over two years, the world has been battling the health and economic consequences of the COVID-19 pandemic. This paper provides an account of the worldwide economic impact of the COVID-19 shock, measured by GDP growth, employment, government spending, monetary policy, and trade. We find that the COVID-19 shock severely impacted output growth and employment in 2020, particularly in middle-income countries. The government response, mainly consisting of increased expenditure, implied a rise in debt levels. Advanced countries, having easier access to credit markets, experienced the highest increase in indebtedness. All regions also relied on monetary policy to support the fiscal expansion. The specific circumstances surrounding the COVID-19 shock implied that the expansionary fiscal and monetary policies did not put upward pressure on prices until 2021. We also find that the adverse effects of the COVID-19 shock on output and prices have been significant and persistent, especially in emerging and developing countries.
    Keywords: COVID-19; government debt; fiscal policy; monetary policy; emerging markets; inflation; international trade; employment
    JEL: E52 E62 F34 F41 G15
    Date: 2022–09
    URL: http://d.repec.org/n?u=RePEc:fip:fedlwp:94816&r=
  25. By: Ahmed,Tanima; Lebbos,Toni Joe; Howell,Sean; Lamontagne,Erik; Wimpey,Joshua Seth
    Abstract: This paper uses the first round of the 2020 COVID-19 Disparities Survey to examine the impactsof the COVID-19 pandemic on the income and mental well-being of cismen, ciswomen, transgender, and non-binaryindividuals. The analysis shows that the pandemic led to high job and income loss expectations among transgender andnon-binary individuals. The pandemic has also led to a disproportionate reported decrease in consumption fortransgender and non-binary people compared to cismen, potentially related to a high rate of anxiety, loneliness,and depression observed in the group. The results highlight that the disproportionate economic impacts resulting fromthe COVID-19 pandemic might cause further declines in the economic conditions of transgender and non-binary people,thus exacerbating existing vulnerabilities in the community.
    Date: 2022–09–15
    URL: http://d.repec.org/n?u=RePEc:wbk:wbrwps:10184&r=
  26. By: Joan Costa-Font; Sergi Jiménez; Cristina Vilaplana Prieto; Analía Viola
    Abstract: This paper is part of an international effort to review the characteristics of Long Term Care in many developed countries. The provision of care for older age adults in Spain has greatly developed after the introduction of SAAD in 2007, which has expanded care universally under need criteria alone. As a consequence, LTC expenditure as % of GDP has increased from 0.5% (2003) to nearly 0.9% (2019) where private insurance for LTC plays a negligible role. As other long term care systems, the Spanish system still relies heavily on informal care. Replacing informal caregivers with personal home help services would imply a rise in care expenditure of 2.3%-3.8% of GDP. Caregiving allowances have benefitted about 50% of SAAD beneficiaries. Finally, the majority of caregivers in both the formal (83%) and informal (65%) sectors are women.
    Date: 2022–10
    URL: http://d.repec.org/n?u=RePEc:fda:fdaeee:eee2022-23&r=
  27. By: Dayton,Julia M.; Edochie,Ifeanyi Nzegwu; Newhouse,David Locke; Cojocaru,Alexandru; Deudibe,Gildas Bopahbe; Kakietek,Jakub Jan; Kim,Yeon Soo; Montes,Jose
    Abstract: This paper presents new evidence on the levels and trends of vaccine hesitancy in developingcountries based on harmonized high-frequency phone surveys from more than 120,000 respondents in 53 low- andmiddle-income countries. These countries represent a combined 30 percent of the population of low- andmiddle-income countries. On average across countries, one in five adults is hesitant about the COVID-19 vaccine, with themost cited reasons for hesitancy being concerns about the safety of the vaccine, followed by concerns about itsefficacy. Between late 2020 and the first half of 2021, there tended to be little change in levels of hesitancyexcept in Iraq, Malawi, and Uzbekistan, where hesitancy increased. COVID-19 vaccine hesitancy is higher amongfemale, young, less educated, and rural respondents, after controlling for selected observable characteristics. Countryestimates of vaccine hesitancy from the high-frequency phone surveys are correlated with but lower than those fromearlier studies, which often relied on less representative survey samples. The results suggest that vaccine hesitancyin developing countries, while less prevalent than previously thought, will be an important and enduringobstacle to recovery from the pandemic.
    Date: 2022–09–26
    URL: http://d.repec.org/n?u=RePEc:wbk:wbrwps:10191&r=

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