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on Health Economics |
| By: | Pichler, Stefan (University of Groningen); Ziebarth, Nicolas R. (ZEW) |
| Abstract: | This article reviews the current debate about sick pay mandates and medical leave in the United States. The United States is one of three industrialized countries that do not guarantee access to paid sick leave for all employees. We first provide a categorization of the different paid leave concepts such as sick leave, medical leave, or temporary disability insurance, both in a domestic and an international context. Then we use data from the National Compensation Survey to sketch employee coverage rates by type of job. We also document changes since 2010, focusing on paid sick leave. Although gaps in access have decreased over the past decade, we still find large inequalities in access to paid sick leave: While overall coverage increased to 78% in 2023 from 64% in 2015, about half of all part-time employees, employees in the bottom quarter of the wage distribution, and employees in the accommodation and food industry still have no access to paid sick leave benefits. In the last part, we discuss implications of the lack of access to paid sick and medical leave benefits. Moreover, building on international research findings and experiences, we discuss what a possible integration, coordination, and expansion of the co-existing programs could look like. |
| Keywords: | sick pay mandates, sick leave, medical leave, paid leave, inequality, employer mandates, fringe benefits, moral hazard, unintended consequences, labor costs, National Compensation Survey (NCS) |
| JEL: | I12 I13 I18 J22 J28 J32 |
| Date: | 2024–01 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izapps:pp206&r=hea |
| By: | Bronsoler, Ari; Doyle, Joseph; Schmit, Cason; Van Reenen, John |
| Abstract: | It is widely agreed that health information sharing holds enormous potential to improve health care productivity. Although the adoption of electronic health records in the United States over the past 15 years has been impressive, the use of data - and subsequent improvements in health care productivity - has been disappointing. This article considers the role that state policy plays in the adoption and use of health information exchange (HIE) across providers. The authors built a novel database of state laws from 2000 through 2019 that tracks 12 dimensions of policies that may facilitate HIE usage. The dimensions fall along four categories: clarifying HIE governance, strengthening financial stability, specifying the uses and users of an HIE, and protecting the underlying data. The authors find that regulations related to privacy protections and HIE financial viability have substantial effects on information sharing. The category that has the strongest relationship with health information sharing is related to data protection. In states that add a dimension making the protection of data less costly, HIE usage increases by 18%. Within the category of data-protection measures, one stands out: enacting legislation that has patients participate by default leads to a 16% increase in usage. Adding a dimension for each of the other three categories leads to a 4% increase in HIE usage, although only the relationship with financial sustainability is measured precisely enough to be statistically significant. In particular, states that set up the ability to charge participant fees and authorize the HIE to request state, federal, and private funding achieve greater HIE. These results point to policy levers that can catalyze the use of digital tools to improve health and lower health care costs. |
| Keywords: | health technology |
| JEL: | J50 J1 |
| Date: | 2022–12–21 |
| URL: | http://d.repec.org/n?u=RePEc:ehl:lserod:119702&r=hea |
| By: | Masuda, Kazuya; Shigeoka, Hitoshi |
| Abstract: | We examine the mortality effects of a 1947 school reform in Japan, which extended compulsory schooling from primary to secondary school by as much as 3 years. The abolition of secondary school fees also indicates that those affected by the reform likely came from disadvantaged families who could have benefited the most from schooling. Even in this relatively favorable setting, we fail to find that the reform improved later-life mortality up to the age of 87 years, although it significantly increased years of schooling. This finding suggests limited health returns to schooling at the lower level of educational attainment. |
| Keywords: | Education, Later-life mortality, Japan, Regression discontinuity design |
| Date: | 2023–07–17 |
| URL: | http://d.repec.org/n?u=RePEc:ajt:wcinch:78763&r=hea |
| By: | Borra, Cristina (University of Seville); González, Libertad (Universitat Pompeu Fabra); Patiño, David (University of Seville) |
| Abstract: | We study the effects of school starting age on siblings' infant health. In Spain, children born in December start school a year earlier than those born the following January, despite being essentially the same age. We follow a regression discontinuity design to compare the health at birth of the children of women born in January versus the previous December, using administrative, population-level data. We find small and insignificant effects on average weight at birth, but, compared to the children of December-born mothers, the children of January-born mothers are more likely to have very low birthweight. We then show that January-born women have the same educational attainment and the same partnership dynamics as December-born women. However, they finish school later and are (several months) older when they have their first child. Our results suggest that maternal age is a plausible mechanism behind our estimated impacts of school starting age on infant health. |
| Keywords: | school starting age, infant health, maternal age, school cohort |
| JEL: | I12 J12 J13 |
| Date: | 2023–12 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp16676&r=hea |
| By: | Molitor, David (University of Illinois at Urbana-Champaign); White, Corey (Monash University) |
| Abstract: | Do environmental conditions pose greater health risks to individuals living in urban or rural areas? The answer is theoretically ambiguous: while urban areas have traditionally been associated with heightened exposure to environmental pollutants, the economies of scale and density inherent to urban environments offer unique opportunities for mitigating or adapting to these harmful exposures. To make progress on this question, we focus on the United States and consider how exposures—to air pollution, drinking water pollution, and extreme temperatures—and the response to those exposures differ across urban and rural settings. While prior studies have addressed some aspects of these issues, substantial gaps in knowledge remain, in large part due to historical deficiencies in monitoring and reporting, especially in rural areas. As a step toward closing these gaps, we present new evidence on urban-rural differences in air quality and population sensitivity to air pollution, leveraging recent advances in remote sensing measurement and machine learning. We find that the urban-rural gap in fine particulate matter (PM2.5) has converged over the last two decades and the remaining gap is small relative to the overall declines. Furthermore, we find that residents of urban counties are, on average, less vulnerable to the mortality effects of PM2.5 exposure. We also discuss promising areas for future research. |
| Keywords: | environment, urban, rural, pollution, health |
| JEL: | I10 Q53 Q54 |
| Date: | 2023–12 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp16678&r=hea |
| By: | Kolsrud, Jonas; Landais, Camille; Reck, Daniel; Spinnewijn, Johannes |
| Abstract: | This paper analyzes consumption to evaluate the distributional effects of pension reforms. Using Swedish administrative data, we show that on average, workers who retire earlier consume less while retired and experience larger drops in consumption around retirement. Interpreted via a theoretical model, these findings imply that reforms incentivizing later retirement incur a substantial consumption smoothing cost. Turning to other features of pension policy, we find that reforms that redistribute based on early-career labor supply would have opposite-signed redistributive effects, while differentiating on wealth may help to target pension benefits toward those who are vulnerable to larger drops in consumption around retirement. |
| JEL: | E21 H23 H55 J22 J26 |
| Date: | 2024–01–01 |
| URL: | http://d.repec.org/n?u=RePEc:ehl:lserod:121131&r=hea |
| By: | Silvia Castro (LMU Munich); Clarissa Mang (LMU Munich) |
| Abstract: | Social pressure and stigma can hinder the adoption of available technologies, especially in the context of sensitive health issues. We run a field experiment on the take-up of menstrual products in Bangladesh and test a discussion-based intervention in a work setting. We vary participation in group discussions designed to break the silence around menstruation, where colleagues share their personal experiences. We find positive effects on the willingness to pay for a known menstrual product (sanitary pads) and on the adoption of a new technology (anti-bacterial menstrual underwear). Our results show changes in restrictive social norms around purchasing the products and lower perceived stigma around menstruation in general. |
| Keywords: | social norms; social pressure; stigma; technology adoption; group discussions; menstrual health management; menstrual hygiene; adverse health behavior; |
| JEL: | D91 I12 I15 O12 |
| Date: | 2023–12–07 |
| URL: | http://d.repec.org/n?u=RePEc:rco:dpaper:474&r=hea |
| By: | Andrej Woerner (LMU Munich); Giorgia Romagnoli (University of Amsterdam – CREED); Birgit M. Probst (TU Munich); Nina Bartmann (Duke University); Jonathan N. Cloughesy (Duke University & University of Southern California); Jan Willem Lindemans (Duke University) |
| Abstract: | Traditionally, incentives to promote behavioral change are assigned rather than chosen. In this paper, we theoretically and empirically investigate the alternative approach of letting people choose their own incentives from a menu of increasingly challenging and rewarding options. When individuals are heterogeneous and have private information about their costs and benefits, we theoretically show that leaving them the choice of incentives can improve both adherence and welfare. We test the theoretical predictions in a field experiment based on 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. However, in contrast to our prediction, participants who could choose complete significantly fewer 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: | D03 |
| Date: | 2023–12–08 |
| URL: | http://d.repec.org/n?u=RePEc:rco:dpaper:475&r=hea |
| By: | Andrej Woerner (LMU Munich) |
| Abstract: | This paper introduces the matched-bet mechanism. The matched bet is an easily applicable and strictly budget-balanced mechanism that aims to help people overcome time-inconsistent behavior. I show theoretically that offering a matched bet helps both sophisticated and naive procrastinators to reduce time-inconsistent behavior. A field experiment on exercising confirms the theoretical predictions: offering a matched bet has a significant positive effect on gym attendance. Self-reported procrastinators are significantly more likely to take up the matched bet. Overall, the matched bet proves a promising device to help people not to procrastinate. |
| Keywords: | monetary incentives; market design; field experiment; health behavior; |
| JEL: | C93 D47 D90 I12 |
| Date: | 2023–12–10 |
| URL: | http://d.repec.org/n?u=RePEc:rco:dpaper:476&r=hea |
| By: | Berger, Michael; Six, Eva; Czypionka, Thomas |
| Abstract: | Cost-sharing is a prominent tool in many healthcare systems, both for raising revenue and steering patient behaviour. Although the effect of cost-sharing on demand for healthcare services has been heavily studied in the literature, researchers often apply a macro-perspective to these issues, opening the door for policy makers to the fallacy of assuming uniform demand reactions across a spectrum of different forms of treatments and diagnostic procedures. We use a simple classification system to categorize 11 such healthcare services along the dimensions of urgency and price to estimate patients’ (anticipatory) demand reactions to a reduction in the co-insurance rate by a sickness fund in the Austrian social health insurance system. We use a two-stage study design combining matching and two-way fixed effects difference-in-differences estimation. Our results highlight how an overall joint estimate of an average increase in healthcare service utilization (0.8%) across all healthcare services can be driven by healthcare services that are deferrable (+1%), comparatively costly (+1.4%) or both (+1.6%) and for which patients also postponed their consumption until after the cost-sharing reduction. In contrast, we do not find a clear demand reaction for inexpensive or urgent services. The detailed analysis of the demand reaction for each individual healthcare service further illustrates their heterogeneity. We show that even comparatively minor changes to the costs borne by patients may already evoke tangible (anticipatory) demand reactions. Our findings help policy makers better understand the implications of heterogeneous demand reactions across healthcare services for using cost-sharing as a policy tool. |
| Keywords: | cost-sharing; price elasticity; healthcare service consumption; two-way fixed-effects difference-in-differences; entropy balancing |
| JEL: | C13 I18 L31 |
| Date: | 2024–01–01 |
| URL: | http://d.repec.org/n?u=RePEc:ehl:lserod:121162&r=hea |
| By: | Moran Koren |
| Abstract: | We study the problem of screening in decision-making processes under uncertainty, focusing on the impact of adding an additional screening stage, commonly known as a 'gatekeeper.' While our primary analysis is rooted in the context of job market hiring, the principles and findings are broadly applicable to areas such as educational admissions, healthcare patient selection, and financial loan approvals. The gatekeeper's role is to assess applicants' suitability before significant investments are made. Our study reveals that while gatekeepers are designed to streamline the selection process by filtering out less likely candidates, they can sometimes inadvertently affect the candidates' own decision-making process. We explore the conditions under which the introduction of a gatekeeper can enhance or impede the efficiency of these processes. Additionally, we consider how adjusting gatekeeping strategies might impact the accuracy of selection decisions. Our research also extends to scenarios where gatekeeping is influenced by historical biases, particularly in competitive settings like hiring. We discover that candidates confronted with a statistically biased gatekeeping process are more likely to withdraw from applying, thereby perpetuating the previously mentioned historical biases. The study suggests that measures such as affirmative action can be effective in addressing these biases. While centered on hiring, the insights and methodologies from our study have significant implications for a wide range of fields where screening and gatekeeping are integral. |
| Date: | 2023–12 |
| URL: | http://d.repec.org/n?u=RePEc:arx:papers:2312.17167&r=hea |
| By: | Hu, Bo; Cartagena-Farias, Javiera; Brimblecombe, Nicola; Jadoolal, Shari; Wittenberg, Raphael |
| Abstract: | Background Health economics research and economic evaluation have increasingly taken a societal perspective, accounting for the economic impacts of informal care. Projected economic costs of informal care help researchers and policymakers understand better the long-term consequences of policy reforms and health interventions. This study makes projections of the economic costs of informal care for older people in England. Methods Data come from two national surveys: the English Longitudinal Study of Ageing (ELSA, N = 35, 425) and the Health Survey for England (N = 17, 292). We combine a Markov model with a macrosimulation model to make the projections. We explore a range of assumptions about future demographic and epidemiological trends to capture model uncertainty and take a Bayesian approach to capture parameter uncertainty. Results We estimate that the economic costs of informal care were £54.2 billion in 2019, three times larger than the expenditure on formal long-term care. Those costs are projected to rise by 87% by 2039, faster than public expenditure but slower than private expenditure on formal long-term care. These results are sensitive to assumptions about future life expectancy, fertility rates, and progression of disabilities in the population. Conclusions Prevention schemes aiming to promote healthy aging and independence will be important to alleviate the costs of informal care. The government should strengthen support for informal caregivers and care recipients to ensure the adequacy of care, protect the well-being of caregivers, and prevent the costs of informal care from spilling over to other sectors of the economy. |
| Keywords: | informal care costs; economic valuation; functional disabilities; long-term care projections; England; This study; as part of the Care and Place (CAPE) project; was supported by the School for Social Care Research (SSCR) and the National Institute for Health Research (NIHR). |
| JEL: | I11 J11 E26 E27 |
| Date: | 2023–12–12 |
| URL: | http://d.repec.org/n?u=RePEc:ehl:lserod:121157&r=hea |
| By: | Shnece Duncan; Andrea Menclova (University of Canterbury); Maggie-Lee Huckabee; Dominique Cadilhac; Anna Ranta |
| Abstract: | INTRODUCTION: Stroke-related dysphagia poses a substantial challenge, both in terms of its prevalence and the economic costs associated with its management. Despite its significance, there is a lack of comprehensive studies focusing on the economic burden of stroke-related dysphagia in the New Zealand context. The aims of this research are to estimate the economic costs and quality of life of patients with stroke-related dysphagia in New Zealand, emphasising the importance of understanding and addressing this issue from a healthcare management perspective. METHODS: Secondary analysis of data from the REGIONS Care study, a New Zealand wide sample of all patients hospitalised with stroke within a 6-month period (between 1st May 2018 and 30th October 2018) including follow-up up to 12 months. Patients were identified as dysphagic if they received a swallow screen during hospital admission and were seen by a Speech Language Therapist (SLT). Severe dysphagia was identified if the patients had a nasogastric feeding tube during their hospital admission and were seen by an SLT. Optimal linear propensity score matching was utilised to acquire a better counterfactual group for dysphagic stroke patients. All cost estimates were converted to NZ$2021 to compare to existing literature. RESULTS: Of all patients with stroke in the REGIONs Care study, 40% (952/2, 379) were identified as dysphagic and 5% (119/2, 379) as severely dysphagic. Using these percentages and the total number of reported strokes in 2021/22 in New Zealand, we estimated that 3, 588 were dysphagic and 449 were severely dysphagic. These stroke-related dysphagic patients in 2021 presented a total additional cost of $89.6 million to New Zealand society, or a marginal cost of $25, 000 per dysphagic patient. This estimate includes the additional hospitalisation costs ($16, 100), community rehabilitation services ($1, 370), hospital-level aged residential care ($4, 030) and reduced quality of life (QoL) over a 12-month period post-hospital admission ($3, 470). The total marginal cost of severely dysphagic stroke -related patients was $19.9 million overall, or $44, 300 per patient. DISCUSSION/CONCLUSION: The costs derived from the REGIONS Care study and the estimates of reduced QoL due to dysphagia provide a novel contribution for New Zealand, and internationally. While there is international literature estimating the marginal cost of dysphagic stroke-related hospitalisation, few extend this analysis to post-hospitalisation care and even fewer to the costs of reduced QoL. By quantifying this economic burden, we can advocate for improved dysphagia management strategies and ultimately enhance the overall quality of care for stroke survivors. |
| Keywords: | Dysphagia, stroke-related, economic cost, quality of life, New Zealand |
| JEL: | I1 |
| Date: | 2023–12–01 |
| URL: | http://d.repec.org/n?u=RePEc:cbt:econwp:23/16&r=hea |
| By: | Thomas, Ranjeeta; Galizzi, Matteo M.; Moorhouse, Louisa; Nyamukapa, Constance; Hallett, Timothy B. |
| Abstract: | Young people in sub-Saharan Africa are particularly at high risk of sexually transmitted infections. Little is known about their preferences and even less about their association with risky sexual behaviour. We conducted incentivized economic experiments to measure risk, time and prosocial preferences in Zimbabwe. Preferences measured at baseline predict biomarker and self-reported measures of risky sexual behaviour gathered 12 months later. We find robust evidence that individuals more altruistic at baseline are more likely to be Herpes Simplex Virus Type-2 (HSV-2) positive 12 months later. Analysis by sex shows this association is driven by our sample of women. Having more sexual partners is associated with greater risk tolerance amongst men and greater impatience amongst women. Results highlight heterogeneity in the association between preferences and risky sexual behaviour. |
| Keywords: | risk preference; time preference; altruism; social proximity; risky sexual behaviour; OPP1161471; Centre for Global Infectious Disease Analysis funding from the UK Medical Research Council and Department for International Development MR/R015600/1; R01MH114562-01; Elsevier deal |
| JEL: | I12 D91 |
| Date: | 2024–01–01 |
| URL: | http://d.repec.org/n?u=RePEc:ehl:lserod:121013&r=hea |
| By: | Abrigo, Michael R.M. |
| Abstract: | The impact of sex education on various behavioral outcomes has been studied in the literature. However, these studies failed to account for the simultaneity between knowledge demand and sexual behavior, leading to inconsistent effect estimates using a simple comparison of means from randomized control interventions. This paper employs a theoretical model of sexual behavior and demand for information on sexually transmitted infections (STIs). It shows that the impact of STI knowledge on sexual behavior depends on how information alters the anticipated costs associated with sexual activity. Empirical findings indicate that heightened awareness of STIs delays sexual initiation, constrains sexual activity, and enhances condom use among subpopulations of female young adults in the country. |
| Keywords: | health behavior;sex education;reproductive health;sexually transmitted infections;HIV;AIDS |
| Date: | 2023 |
| URL: | http://d.repec.org/n?u=RePEc:phd:pjdevt:pjd_2023_vol__47_no__2a&r=hea |
| By: | Taisuke Nakata; Daisuke Fujii; Sohta Kawawaki; Yuta Maeda; Masataka Mori |
| Abstract: | There is a large heterogeneity in health and macroeconomic outcomes across countries during the COVID-19 pandemic. We present a novel framework to understand the source of this heterogeneity, combining an estimated macro-epidemiological model and the idea of revealed preference. Our framework allows us to decompose the difference in health and macroeconomic outcomes across countries into two components: preference and constraint. We find that there is a large heterogeneity in both components across countries and that some countries such as Japan or Australia are willing to accept a large output loss to reduce the number of COVID-19 deaths. |
| Date: | 2023–12 |
| URL: | http://d.repec.org/n?u=RePEc:tcr:wpaper:e195&r=hea |
| By: | Christian Alemán-Pericón; Daniela Iorio; Raül Santaeulàlia-Llopis |
| Abstract: | We explore learning about HIV infection odds from risky sex as a new mechanism explaining the Sub-Saharan Africa HIV epidemic. Our novel empirical evidence reveals a U-shaped relationship between education and being HIV positive across epidemic stages, which prompts the idea of asymmetric learning: more educated individuals potentially learn faster and update their (latent) beliefs about infection odds more accurately than less educated individuals, inducing earlier sexual behavioral change among the more educated. Our nonstationary model incorporates three HIV epidemic stages, chronologically: a myopic stage where agents are unaware of how risky sex causes infections, a learning stage where agents update beliefs on infection odds, and an ARV stage reflecting treatment introduction. Anchored in the micro evidence -explaining the HIV-education gradient- we find that our learning mechanism is powerful: a 5-year earlier learning reduces new AIDS deaths by almost 45%, and a 10-year earlier learning results in a 60% drop. |
| Keywords: | quantitative, macroeconomics, equilibrium, HIV, epidemic, stages, risky sex, asymmetric learning |
| JEL: | E00 |
| Date: | 2024–01 |
| URL: | http://d.repec.org/n?u=RePEc:bge:wpaper:1418&r=hea |
| By: | Taisuke Nakata; Daisuke Fujii; Shotaro Beppu; Kohei Machi; Yuta Maeda; Hiroyuki Kubota; Haruki Shibuya |
| Abstract: | Health and macroeconomic outcomes varied substantially across prefectures in Japan during the COVID-19 crisis. Using an estimated macro-epidemiological model as well as the idea of revealed preference, we compute the marginal rate of substitution (MRS) and the conditional trade-off curve between health and economic outcomes in each prefecture. We find that there is a large heterogeneity in the MRS as well as the location and shape of the conditional trade-off curve. |
| Date: | 2023–12 |
| URL: | http://d.repec.org/n?u=RePEc:tcr:wpaper:e190&r=hea |
| By: | Choi, Heewon; Epstein-Deutsch, Eli |
| Abstract: | Background: This comparative policy analysis studies government responses to the COVID-19 pandemic, with a focus on countries severely impacted by the virus. The study aims to assess the impact of various confounding variables, including GDP, healthcare spending per capita, poverty rate, and population density, on the effectiveness of pandemic response policies. Methods: The data obtained for the policies employs a multifaceted approach that incorporates both economic and non-economic policies. The analysis includes fiscal policies encompassing healthcare and economic sectors, adaptability in policy adjustments, and non-economic measures. The study also utilizes a principal component analysis (PCA) to identify similarities and differences among countries with varying levels of success. Results: Key findings indicate that successful countries adopted proactive fiscal policies addressing healthcare and economic challenges simultaneously. Flexibility and adaptability in policy adjustments emerged as significant traits among effective responses. Stricter non-economic policies were generally associated with improved pandemic outcomes. Additionally, effective contact tracing played a pivotal role in case identification and isolation. Conclusions: This research underscores the importance of a comprehensive and adaptable approach to pandemic response, considering economic, healthcare, and social factors. The study's insights offer valuable guidance to governments and policymakers seeking to enhance preparedness plans for future global health crises. As the world continues to grapple with ongoing and evolving pandemic challenges, the lessons drawn from the pandemic can be used as a model of future success. |
| Date: | 2024–01–02 |
| URL: | http://d.repec.org/n?u=RePEc:osf:socarx:7mwbj&r=hea |
| By: | Abeliansky, Ana Lucia; Prettner, Klaus; Stöllinger, Roman |
| Abstract: | We propose a model of production featuring the trade-off between employing workers versus employing robots and analyze the extent to which this trade-off is altered by the emergence of a highly transmissible infectious disease. Since workers are - in contrast to robots - susceptible to pathogens and also spread them at the workplace, the emergence of a new infectious disease should reduce demand for human labor. According to the model, the reduction in labor demand concerns automatable occupations and increases with the viral transmission risk. We test the model's predictions using Austrian employment data over the period 2015-2021, during which the COVID-19 pandemic increased the infection risk at the workplace substantially. We find a negative effect on occupation-level employment emanating from the higher viral transmission risk in the COVID years. As predicted by the model, a reduction in employment is detectable for automatable occupations but not for non-automatable occupations. |
| Keywords: | automation; robots; pandemics; viral transmission risk; occupational employment; shadow cost of human labor |
| Date: | 2023–12 |
| URL: | http://d.repec.org/n?u=RePEc:wiw:wus005:59341739&r=hea |
| By: | Taisuke Nakata; Daisuke Fujii; Quentin Batista; Takeki Sunakawa |
| Abstract: | We quantify the effects of the COVID-19 crisis on suicides in Japan using a time-series model relating the number of suicides to the unemployment rate as well as private-sector forecasts of the unemployment rate before the crisis. We find that (i) the COVID-19 crisis increased suicides in Japan by about 7, 000 from March 2020 to April 2022, (ii) the increase in the unemployment rate can only account for one third of the excess suicides, (iii) the excess suicides are skewed towards younger generations and female, and (iv) lost years of life expectancy associated with the excess suicides are almost as large as those associated with COVID-19 deaths. |
| Date: | 2023–12 |
| URL: | http://d.repec.org/n?u=RePEc:tcr:wpaper:e193&r=hea |
| By: | Taisuke Nakata; Daisuke Fujii; Takeshi Ojima |
| Abstract: | Many countries have experienced multiple waves of infection during the COVID-19 pandemic. We propose a novel but parsimonious extension of the SIR model, a CSIR model, that can endogenously generate waves. In the model, cautious individuals take appropriate prevention measures against the virus and are not exposed to infection risk. Incautious individuals do not take any measures and are susceptible to the risk of infection. Depending on the size of incautious and susceptible population, some cautious people lower their guard and become incautious--thus susceptible to the virus. When the virus spreads sufficiently, the population reaches ``temporary" herd immunity and infection subsides thereafter. Yet, the inflow from the cautious to the susceptible eventually expands the susceptible population and leads to the next wave. We also show that the CSIR model is isomorphic to the SIR model with time-varying parameters. |
| Date: | 2023–12 |
| URL: | http://d.repec.org/n?u=RePEc:tcr:wpaper:e192&r=hea |