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on Health Economics |
| By: | Mireille Jacobson; David Powell |
| Abstract: | We conducted a field experiment that randomized advertisements, advertisement content, and prices across 2, 204 counties in the United States to study the impacts on online purchases of naloxone, an opioid overdose reversal drug. Advertising increased website users but only impacted purchases when combined with a price reduction. Messages emphasizing the discreet nature of online sales had no additional impact on purchases. Comparing counties with advertisements featuring a highly discounted price to those featuring the full price, we estimate a price elasticity of demand for online naloxone of -1.3. Price is a significant barrier to online purchases of this life-saving medication |
| JEL: | I12 I18 M37 |
| Date: | 2024–01 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:32029&r=hea |
| By: | Sébastien Fontanay; Libertad González |
| Abstract: | We investigate the impact of paternity leave policies on gender role attitudes in the next generation. We measure gender-stereotypical attitudes using an Implicit Association Test with 3, 000 online respondents in six countries. Using an RD design, we observe a significant reduction (-0.20 SD) in gender-stereotypical attitudes among men born post-paternity leave implementation. This shift influences career choices, as men whose fathers were affected by the reform are more inclined to pursue counter-stereotypical jobs, particularly in high-skilled occupations like healthcare and education. Our findings highlight how paternity leave fosters egalitarian gender norms and affects the occupational choices of the next generation. |
| Keywords: | gender norms, paternity leave, female-dominated occupations, regression discontinuity |
| JEL: | J08 J13 J16 J18 |
| Date: | 2024–01 |
| URL: | http://d.repec.org/n?u=RePEc:bge:wpaper:1422&r=hea |
| By: | Won Fy Lee (Stanford University); Aaron Sojourner (W.E. Upjohn Institute for Employment Research); Elizabeth E. Davis (University of Minnesota); Jonathan Borowsky (University of Minnesota) |
| Abstract: | Harnessing changes in funding for a voucher program that subsidizes consumers’ use of child care services at private providers, this study quantifies effects on local markets’ service capacity and prices. We also estimate how increased funding effects provider entry rate, exit rate, and highly rated provider market share. The evidence shows that an additional $100 in private voucher funding per local young child would 1) raise the number of private-provider slots by 0.026per local young child, 2) raise average prices by $0.56 per week, mainly driven by a price increase among incumbent providers, and 3) induce new provider entry to the market by 0.4 percentage points. The estimates imply a highly elastic supply elasticity of 10.7. Thus an increase in public funding and subsequent increase in demand is expected to result in expansion of available slots accompanied by a limited increase in price. |
| Keywords: | child care, vouchers, prices, capacity, supply elasticity, entry rate, exit rate |
| JEL: | D24 H25 H42 J13 J22 J28 |
| Date: | 2024–01 |
| URL: | http://d.repec.org/n?u=RePEc:upj:weupjo:23-394&r=hea |
| By: | Tuuli Paukkeri (VATT Institute for Economic Research and Finnish Centre of Excellence in Tax Systems Research (FIT)); Terhi Ravaska (Tampere University, VATT Institute for Economic Research, Finnish Centre of Excellence in Tax Systems Research (FIT) and CESifo) |
| Abstract: | We study whether disability insurance (DI) recipients increase their labour supply after the introduction of an automatic reinstatement policy, i.e. a programme mitigating the risk of losing eligibility for DI benefits due to a trial period of substantially increased work. We use Finnish administrative data and identify the effect of the policy on partial DI recipients by using partial DI applicants whose application was rejected as a control group. Partial DI recipients by definition have substantial remaining work capacity and are therefore potentially more responsive to programmes affecting work incentives than full DI benefit recipients. The rejected individuals have similar work histories, health impairments and remaining work capacity to those who are allowed benefits, enabling us to estimate the effects of automatic reinstatement on labour supply with a credible control group. Based on our estimation results, automatic reinstatement of benefits increases annual earnings modestly, but for those with mental disorders the effect is larger. |
| Keywords: | disability insurance, labour supply, automatic reinstatement |
| JEL: | J14 H55 |
| Date: | 2024–01 |
| URL: | http://d.repec.org/n?u=RePEc:fit:wpaper:20&r=hea |
| By: | Ahammer, Alexander (University of Linz); Packham, Analisa (Vanderbilt University); Smith, Jonathan (Georgia State University) |
| Abstract: | We estimate the role of firms in worker health care utilization. Using linked administrative data on Austrian workers from 1998–2018, we exploit mobility between firms to estimate how much a firm contributes to worker-level differences in utilization in a setting with non-employer provided universal health care. We find that firms are responsible for nearly 30 percent of the variation in across-worker health care expenditures. Effects are not driven by changes in geography or industry. We then estimate a measure of relative firm-specific utilization and explore existing correlates to help explain these effects. |
| Keywords: | firms, health care utilization, sick leave |
| JEL: | H51 I1 J2 |
| Date: | 2024–01 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp16708&r=hea |
| By: | Adamopoulou, Effrosyni (ZEW Mannheim); Greenwood, Jeremy (University of Pennsylvania); Guner, Nezih (CEMFI); Kopecky, Karen A. (Federal Reserve Bank of Atlanta) |
| Abstract: | The role of friends in the US opioid epidemic is examined. Using data from the National Longitudinal Survey of Adolescent Health (Add Health), adults aged 25-34 and their high school best friends are focused on. An instrumental variable technique is employed to estimate peer effects in opioid misuse. Severe injuries in the previous year are used as an instrument for opioid misuse in order to estimate the causal impact of someone misusing opioids on the probability that their best friends also misuse. The estimated peer effects are significant: Having a best friend with a reported serious injury in the previous year increases the probability of own opioid misuse by around 7 percentage points in a population where 17 percent ever misuses opioids. The effect is driven by individuals without a college degree and those who live in the same county as their best friends. |
| Keywords: | opioid, peer-group effects, friends, instrumental variables, Add Health, severe injuries |
| JEL: | C26 D10 I12 J11 |
| Date: | 2024–01 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp16709&r=hea |
| By: | Motta, Matt (Boston University School of Public Health); Haglin, Kathryn |
| Abstract: | Universal Basic Income (UBI) policies have the potential to promote a wide range of public health objectives – including the consumption of healthful food, reducing anxiety associated with financial stressors (e.g., bill payments), and seeing a physician when sick – by providing those who qualify with direct cash payments. One overlooked mechanism of particular importance to health researchers is the possibility that guaranteed income might increase consultation of primary and preventive care (e.g., annual doctors’ visits; regular vaccination against infectious disease) by providing people with both the time and monetary resources to do so, thereby improving general health. We remedy this shortcoming by studying the effects of an exogenous shock to Alaska’s UBI payments to all state residents: the decision in 2022 to render the dividend’s “energy relief” provisions as non-taxable (thereby increasing payments by approximately $2, 000 inflation-adjusted dollars). Quasi-experimental random effects regression modeling procedures suggest that the number of Alaskans who sought primary care post-reform (relative to beforehand) increased by 6pp, which was significantly greater than the same difference (2pp) observed across all other (non-UBI) US States (∆ = 4pp, p < 0.01). Relatedly, we detect suggestive evidence that comparatively fewer Alaskans had difficulty affording primary care during this period, although we find less consistent evidence that increased UBI payments increased flu vaccine uptake rates relative to the national average. Our results suggest that basic income policy ought to be thought about as a form of health policy, as it has the potential to advance a wide range of health objectives related to primary and preventive care. |
| Date: | 2024–01–11 |
| URL: | http://d.repec.org/n?u=RePEc:osf:socarx:zpgn3&r=hea |
| By: | Lee, Donghoon; Kim, SangJune; Dugan, Jerome A. |
| Abstract: | The Medicare Part D program has been documented to increase the affordability and accessibility of drugs and improve the quality of prescription drug use; however, less is known about the equity impact of the Part D program on potentially inappropriate prescribing—specifically, incidences of polypharmacy and potentially inappropriate medication (PIM) use based on different racial/ethnic groups. Using a difference in the regression discontinuity design, we found that among Whites, Part D was associated with increases in polypharmacy and “broadly defined” PIM use, while the use of “always avoid” PIM remained unchanged. Conversely, Blacks and Hispanics reported no changes in such drug utilization patterns. |
| Keywords: | Medicare Part D; polypharmacy; potentially inappropriate prescribing |
| JEL: | I10 I18 |
| Date: | 2024–01–01 |
| URL: | http://d.repec.org/n?u=RePEc:ehl:lserod:121189&r=hea |
| By: | Shen, Chi; Chen, Xi |
| Abstract: | There is mounting evidence indicating that the aging process initiates during early life stages, with in utero the individual's environment playing a significant role. Consequently, it is crucial to comprehend the enduring effects of early life circumstances on health in old age. In this study, we conducted a meta-analysis to examine the effects of the Great Chinese Famine (1959-1961) on the health of older adults. We also explored potential mechanisms underlying these effects. The complex interplay between early life circumstances, multiple health-related sectors, and healthy aging necessitates a comprehensive life-course approach and strategic interventions to enhance public health in an aging society. |
| Keywords: | Meta-Analysis, Aging, Life Course Health, Famine, Early Life Circumstances |
| JEL: | I14 J14 J13 I18 |
| Date: | 2024 |
| URL: | http://d.repec.org/n?u=RePEc:zbw:glodps:1373&r=hea |
| By: | Andrews, Brendon P. (University of Alberta, Department of Economics) |
| Abstract: | This paper provides an institutional economics framework for analyzing medical ethics: ethical policies are partitions of a set of possible physician actions into ethical and unethical subsets, where unethical actions are unavailable (or sufficiently heavily penalized) in future decision making. Individual doctors' preferences over these policies combined with a political process determine equilibrium constraints. Examining a general model of physician support for `liberal' versus `restrictive' ethics, I show that altruism for one's own patients and concern for all patients have different implications. The latter motivation may justify restrictions on physician behavior, but this argument rests on heavy assumptions. Even identical physicians might ban actions they would otherwise select for reasons varying from solving commons-type problems in patient welfare to differences in the costs of maintaining ethical policies, but heightened altruism for others' patients makes the former reasoning less credible. Novel models for the ethics `Provide Free Care to Physicians' and `Duty to Treat in a Pandemic' demonstrate how shifting economic parameters predict the realized evolution of formal ethical rules. Key model predictions include: (i) rising physician income can explain long-run weakening of both formal ethics in the United States; and (ii) the duty to treat can deteriorate as the ability for a small number of physicians to improve pandemic outcomes increases. |
| Keywords: | Physician Behavior; Altruism; Medical Ethics; Institutions |
| JEL: | D71 I12 I18 J44 N30 |
| Date: | 2024–01–25 |
| URL: | http://d.repec.org/n?u=RePEc:ris:albaec:2024_001&r=hea |
| By: | Bharat Barik |
| Abstract: | This study delves into the nuanced relationship between heightened health awareness amid the COVID-19 pandemic with household intoxicant consumption patterns in India. The central hypothesis posits the pandemic as a transformative shock, shaping both health awareness and intoxicant consumption, guided by risk aversion. Analysis using a difference-in-differences approach underscores a substantial reduction in intoxicant expenditures for households without health insurance compared to households with health insurance during the pandemic, with specific categories like cigarettes, tobacco and liquor expenditure experiencing a drop for uninsured households. In rural areas households lacking health insurance exhibit a notable reduction in intoxicant expenditures than the rural areas. This study contributes to the understanding of economic and behavioural responses to health crises, offering valuable insights into the complex interplay between risk perception, health awareness, and consumption choices in challenging times. |
| Date: | 2024–01–08 |
| URL: | http://d.repec.org/n?u=RePEc:iim:iimawp:14708&r=hea |
| By: | Marcén, Miriam; Morales, Marina |
| Abstract: | We examine changes in the gender gap in working from home (WFH) in response to the unanticipated first wave of the COVID-19 pandemic. Using data from the American Time Use Survey, we find a non-negligible widening of the gender gap with WFH being more prevalent among women than among men. Respondents' job traits played a significant role in the gender gap variations, those working in the private sector being the most affected. Young individuals, those more educated, and those living with a dependent person increased the gender gap more in terms of the proportion of time devoted to WFH. We further show evidence suggesting the mitigating effect of non-pharmaceutical interventions during the first wave of the pandemic, positively affecting the WFH tendency for men but not for women. Overall, the gender gap change proves robust to identification checks. In addition, the gender gap response has had a long-lasting impact on the gender gap. |
| Keywords: | COVID-19, working from home (WFH), gender, American Time Use Survey (ATUS) |
| JEL: | D10 J16 J21 J22 |
| Date: | 2024 |
| URL: | http://d.repec.org/n?u=RePEc:zbw:glodps:1379&r=hea |
| By: | Sefa Awaworyi Churchill (School of Economics, Finance & Marketing, RMIT University, VIC, Australia); Russell Smyth (Monash Business School, Monash University, VIC, Australia); Trong-Anh Trinh (Centre for Health Economics, Monash University, VIC, Australia) |
| Abstract: | We employ a natural experiment – the transport of convicts to the British colonies of New South Wales and Van Diemen’s Land in the eighteenth and nineteenth centuries – to examine the long-run effect of gender norms on the evolution of mateship and the formation of social capital in modern-day Australia. We find that people who live in areas in which sex ratios were historically male-biased, have higher social capital. Our instrumental variable estimates suggest that a standard deviation increase in the historical population sex ratio causes a 12.3% increase in social capital, while the reduced form estimates indicate that a standard deviation increase in the convict sex ratio causes a 5.4% increase in social capital. We show that gender norms have been transmitted within families and via marriage through assortative matching, as well as through shared remembrance in the form of war memorials in neighbourhoods in which sex ratios were historically male-biased. We explore the effect of gender norms on specific facets of social capital and find that in neighbourhoods characterised by conservative gender norms and well-defined masculinity norms due to historically high sex ratios, people are more likely to help each other, more likely to do things together and are more close-knit. |
| Keywords: | sex ratios, gender norms, convicts, social capital, Australia |
| JEL: | I31 J16 N37 N47 O10 Z13 Z18 |
| Date: | 2024–01 |
| URL: | http://d.repec.org/n?u=RePEc:mos:moswps:2024-02&r=hea |