nep-dem New Economics Papers
on Demographic Economics
Issue of 2020‒12‒14
six papers chosen by
Héctor Pifarré i Arolas
Universitat Pompeu Fabra

  1. Unmet health care need and income-related horizontal equity in access during the COVID-19 pandemic By Davillas, Apostolos; Jones, Andrew M.
  2. Optimal Lockdown and Social Welfare By Pierre Pestieau; Grégory Ponthiere
  3. Consequences of War: Japan's Demographic Transition and the Marriage Market By Ogasawara, Kota; Komura, Mizuki
  4. Gender-Specific Effects of Import Competition on Individual Fertility Decisions By Piriu, Andreea A.
  5. Demographic change and regional labour markets By Böhm, Michael; Gregory, Terry; Qendrai, Pamela; Siegel, Christian
  6. Pension and Health Services Utilization: Evidence from Social Pension Expansion in China By Chen, Shanquan; Chen, Xi; Law, Stephen; Lucas, Henry; Tang, Shenlan; Long, Qian; Xue, Lei; Wang, Zheng

  1. By: Davillas, Apostolos; Jones, Andrew M.
    Abstract: Using monthly data from the Understanding Society (UKHLS) COVID-19 Survey we analyse the evolution of unmet need and assess how the UK health care system performed against the norm of horizontal equity in health care access during the first wave of COVID-19 wave. Unmet need was most evident for hospital care, and less pronounced for primary health services (medical helplines, GP consultations, local pharmacist advice, over the counter medications and prescriptions). Despite this, there is no evidence that horizontal equity, with respect to income, was violated for NHS hospital outpatient and inpatient care during the first wave of the pandemic. There is evidence of pro-rich inequities in access to GP consultations, prescriptions and medical helplines at the peak of the first wave, but these were eliminated as the pandemic progressed. There are persistent pro-rich inequities for services that relate to individuals' ability to pay (over the counter medications and advice from the local pharmacist).
    Keywords: inequity,COVID-19,unmet need,health care,UKHLS
    JEL: C1 D63 I14
    Date: 2020
  2. By: Pierre Pestieau; Grégory Ponthiere
    Abstract: This paper reexamines the design of the optimal lockdown strategy by paying attention to its robustness to the postulated social welfare criterion. We first characterize optimal lockdown under utilitarianism, and we show that this social criterion can, under some conditions, imply a COVID-19 variant of Parfit’s (1984) Repugnant Conclusion: for any non-maximal lockdown saving lives at the cost of reducing average utility at a given period, there exists always a stricter lockdown, which further reduces average utility, but leads to a larger aggregate welfare. The optimal lock-down under utilitarianism is also shown to deteriorate the situation of the worst-off, against Hammond Equity. In order to do justice to Hammond Equity, we characterize optimal lockdown under the ex post egalitarian criterion, which gives absolute priority to the worst-o¤ ex post. Under general conditions, the ex post egalitarian optimum involves a zero lockdown. Varying between zero and its maximal level, the optimal lockdown policy is not robust to the postulated ethical criterion.
    Keywords: Covid-19, lockdown, optimal policy, social welfare
    JEL: I18 I31 J18
    Date: 2020
  3. By: Ogasawara, Kota (Tokyo Institute of Technology); Komura, Mizuki (Musashi Unniversity)
    Abstract: This study explores the effects of imbalances in the sex ratio, and their impact on intra-household bargaining, on both the quantity and the quality of children. We first present the theoretical model of intra-household bargaining in the presence of conflicting family goals within a couple, and show that male scarcity (a decrease in the male to female sex ratio) induces an increase in the number of children, but a decrease in the quality of children. Second, using the impact of World War II on the sex ratio, as a quasi-natural experiment, we establish empirically that the decrease in the male to female sex ratio in World War II contributed to a lower decline in fertility and child mortality rates in postwar Japan. In particular, the fertility rate would have fallen by an additional 12% and the child mortality rate by an additional 13% between 1948 and 1970, in the absence of the decrease in the sex ratio.
    Keywords: quantity–quality trade-off of children, bargaining power, marriage market, sex ratio
    JEL: J11 J12 J13 J16 N15 N35
    Date: 2020–11
  4. By: Piriu, Andreea A.
    Abstract: This paper studies the effects of import competition from China and Eastern Europe (EE) on the fertility decisions of individuals in German manufacturing. Through the lens of gender, the paper uniquely contributes to the literature by linking import competition to longitudinal individual data to examine individual fertility. Two separate measures of import exposure are computed for competition from China and EE (amassing five countries), whose trade volumes with Germany have increased remarkably during the panel years. Fixed-effects instrumental variable (FEIV) estimation results show that individual fertility decreases by 1.6 p.p. and by 2.0 p.p. with rising competition from China and EE, respectively. The effects are robust and consistent across different subgroups of individuals. Effects of import competition are then inspected by gender, alongside potential mechanisms underlying fertility decisions. Both male and female workers' fertility is affected via reduced earnings, though differently. The effect on male fertility is negative, with shortened employment duration. Conversely, the effect on female workers' fertility is positive, with worsened working conditions. Furthermore, in line with family economics theory, these results suggest that there is a substitution effect in the labour supply of women, here prevalently concentrated in low-technology sectors: as female earnings fall and their opportunity cost of work is lower, the prospect of having children possibly becomes a more rewarding alternative.
    Keywords: trade-induced shocks,labour market conditions,import competition,individual fertility,female labour supply,FEIV estimation,Germany
    JEL: F14 F16 J11 J13 J16
    Date: 2020
  5. By: Böhm, Michael; Gregory, Terry; Qendrai, Pamela; Siegel, Christian
    Abstract: Like many other countries, Germany has experienced rapid population and workforce ageing, yet with substantial variation across regions. In this paper we first use this spatial variation between 1975 and 2014 to estimate quasi- causal supply effects of ageing on regional labour market outcomes, drawing on the identification strategy of Böhm and Siegel (2020). We find in our panel of German labour market regions that workforce mean age has considerable negative effects on the wage returns to age. We also obtain suggestive evidence that relative employment rates of older workers decline when mean age rises. A decomposition of the heterogeneous regional trends using our estimates shows that ageing of rural regions is mainly driven by supply (reflecting local population dynamics) whereas urban ageing is driven by demand (reflecting responses to economic conditions). We discuss the differential implications of these drivers for regional policy.
    Keywords: ageing,demographic change,regional differences,wage returns to age
    JEL: J11 J31 R23
    Date: 2020
  6. By: Chen, Shanquan (University of Cambridge); Chen, Xi (Yale University); Law, Stephen (University of Sydney); Lucas, Henry (University of Sussex); Tang, Shenlan (Duke University); Long, Qian (Duke Kunshan University); Xue, Lei (Tsinghua University); Wang, Zheng (Tsinghua University)
    Abstract: The proportion of people aged 60 years or over is growing faster than other age groups. The well-being older adults depend heavily on their state of health. This study evaluates the effects of pensions on older adults' health service utilization, and estimates the size of pension required to influence such utilization. Using a nationally representative survey, the China Health and Retirement Longitudinal Study (CHARLS), we adopted a fuzzy regression discontinuity design and undertook segmented regression analysis. Pension demonstrated heterogeneous effects on health service utilization by income. We show that pension encouraged low-income individuals to use both outpatient (OR = 1.219, 95% 1.018-1.460) and inpatient services (OR = 1.269, 95% 1.020-1.579). In the meantime, it promoted self-treatment, specifically over-the-counter (OR = 1.208, 95% 1.037-1.407; OR = 1.206, 95% 1.024-1.419; respectively) and traditional Chinese medicines (OR = 1.452, 95% 1.094-1.932; OR = 1.456, 95% 1.079-1.955; respectively) among all income groups. However, receiving a pension had no effect on the frequency of outpatient or inpatient service use. Breakpoints for pension to promote health service utilization were mainly located in the range 55-95 CNY (7.1-12.3 EUR or 8.0-13.8 USD). Our study enriches the literature on pension and healthcare-seeking behaviour, and can be helpful in policy design and model formulation.
    Keywords: pension, health services utilization, regression discontinuity design, segmented regression
    JEL: I11 I18 J14 H55
    Date: 2020–11

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