nep-hea New Economics Papers
on Health Economics
Issue of 2009‒04‒18
twelve papers chosen by
Yong Yin
SUNY at Buffalo, USA

  1. A dynamic theory of fidelity networks with an application to the spread of HIV/AIDS By Roland Pongou; Roberto Serrano
  2. Columbia Medical Center and the Cocaine-Addicted Pharmacist: Unjust Termination? (B) By Cumber, Carol J.; Carson, Charles M.; Spies, Alan R.
  3. Household Food Consumption, Individual Caloric Intake and Obesity in France By BONNET, Céline; DUBOIS, Pierre; OROZCO, Valérie
  4. The Dynamic Effects of Family Income on Child Health in the United States By Mayu Fujii
  5. Evaluating the Impact of Community-Based Health Interventions: Evidence from Brazil's Family Health Program By Rocha, Romero; Soares, Rodrigo R.
  6. Occupational Health and Work Climate. A healh study using survey data By Mohn, Klaus
  7. Income and the Demand for Complementary Health Insurance in France By Michel Grignon; Bidénam Kambia-Chopin
  8. The Impacts of Smoking Bans on Smoking in Korea By Beomsoo Kim; Ahram Kim
  9. Toxic exposure in America: estimating fetal and infant health outcomes By Nikhil Agarwal; Chanont Banternghansa; Linda T.M. Bui
  10. Valuing A Life: An Assessment from Metro Manila By Rosalina Palanca Tan
  11. The Valur of Mortality Risk Reduction for Children in Metro Manila, Inferred from Parent's Willingness to Pay for Dengue Vaccines By Rosalina Palanca Tan
  12. Can You Get What You Pay For? Pay-For-Performance and the Quality of Healthcare Providers By Kathleen J. Mullen; Richard G. Frank; Meredith B. Rosenthal

  1. By: Roland Pongou (Brown University); Roberto Serrano (Brown University and IMDEA Social Sciences)
    Abstract: We study the dynamic stability of fidelity networks, which are networks that form in a mating economy of agents of two types (say men and women), where each agent desires direct links with opposite type agents, while engaging in multiple partnerships is considered an act of infidelity. Infidelity is punished more severely for women than for men. We consider two stochastic processes in which agents form and sever links over time based on the reward from doing so, but may also take non-beneficial actions with small probability. In the first process, an agent who invests more time in a relationship makes it stronger and harder to break by his/her partner; in the second, such an agent is perceived as weak. Under the first process, only egalitarian pairwise stable networks (in which all agents have the same number of partners) are visited in the long run, while under the second, only anti-egalitarian pairwise stable networks (in which all women are matched to a small number of men) are. Next, we apply these results to find that under the first process, HIV/AIDS is equally prevalent among men and women, while under the second, women bear a greater burden. The key message is that anti-female discrimination does not necessarily lead to higher HIV/AIDS prevalence among women in the short run, but it does in the long run.
    Keywords: fidelity networks; anti-female discrimination; stochastic stability; HIV/AIDS; union formation models
    JEL: A14 C7 I12 J00
    Date: 2009–04–10
  2. By: Cumber, Carol J. (Department of Economics, South Dakota State University); Carson, Charles M. (Samford University); Spies, Alan R. (Southwestern Oklahoma State University)
    Abstract: Tom Zenor, a pharmacist for Columbia Medical Center, became addicted to cocaine. He checked himself into a rehabilitation center and, upon request, was placed on leave as allowed by the Family Medical Leave Act (FMLA). Upon his return, the company decided to terminate his employment. Zenor was upset at the dismissal, which he saw as unjust. Columbia Medical Center, in an attempt to be proactive, sought to consider any legal recourse Zenor might attempt. Columbia’s Human Resources manager, Carmen Estrada, attempted to construct evidence to defend the company against a potential unjust discharge case. The company operated in Texas, which was an “at-will” state. Nonetheless, Estrada had concerns which included whether Zenor could claim an exception to the Doctrine of Employment at-will, and if including a disclaimer in an employee handbook that employees are retained “at-will” provided adequate legal protection for the organization. (Contact author for a copy of the complete report.)
    Keywords: Personnel, Addiction, ADA
    JEL: J7 M5
    Date: 2009–01
  3. By: BONNET, Céline; DUBOIS, Pierre; OROZCO, Valérie
    Date: 2009–01
  4. By: Mayu Fujii
    Abstract: Recent studies on the relationship between family income and child health show that children from poorer families have worse health than those from wealthier families, and that the negative effects of low income on health accumulate during childhood. In this paper, we aim to disaggregate the accumulated effects of income on child health found in the past studies into the gmarginalh (i.e., contemporaneous) effects and investigate how the contemporaneous effects evolve as children become older. Using data from the two waves of the Child Development Supplement (CDS) of the Panel Study of Income Dynamics (PSID), we found weak evidence that the contemporaneous effects of family income on child health seem to accumulate with a decreasing rate throughout childhood.
    Date: 2009–03
  5. By: Rocha, Romero (Pontifical Catholic University of Rio de Janeiro (PUC-Rio)); Soares, Rodrigo R. (Pontifical Catholic University of Rio de Janeiro (PUC-Rio))
    Abstract: This paper analyzes the direct and indirect impacts of Brazil's Family Health Program. We estimate the effects of the program on mortality and on household behavior related to child labor and schooling, employment of adults, and fertility. We find consistent effects of the program on reductions in mortality throughout the age distribution, but mainly at earlier ages. Municipalities in the poorest regions of the country benefit particularly from the program. For these regions, implementation of the program is also robustly associated with increased labor supply of adults, reduced fertility, and increased schooling. Evidence suggests that the Family Health Program is a highly cost-effective tool for improving health in poor areas.
    Keywords: family health program, mortality, household behavior, impact evaluation, Brazil
    JEL: I12 I18 J10 J13 J24 O54
    Date: 2009–04
  6. By: Mohn, Klaus (University of Stavanger)
    Abstract: ,
    Keywords: Health problems; Work environment
    JEL: A10
    Date: 2009–04–09
  7. By: Michel Grignon (McMaster University, Department of Economics and Department of Health, Aging, and Society, Hamilton, Ontario, Canada); Bidénam Kambia-Chopin (IRDES institut for research and information in health economics)
    Abstract: This paper examines the demand for complementary health insurance (CHI) in the non-group market in France and the reasons why the near poor seem price insensitive. First we develop a theoretical model based on a simple tradeoff between two goods: CHI and a composite good reflecting all other consumptions. Then we estimate a model of CHI consumption and empirically test the impact of potential determinants of demand for coverage: risk aversion, asymmetrical information, non-expected utility, the demand for quality and health, and supply-side factors such as price discrimination. We interpret our empirical findings in terms of crossed price and income elasticity of the demand for CHI. Last, we use these estimates of elasticity to simulate the effect of various levels of price subsidies on the demand for CHI among those with incomes around the poverty level in France. We find that the main motivation for purchasing CHI in France is protection against the financial risk associated with co-payments in the public health insurance scheme. We also observe a strong income effect suggesting that affordability might be an important determinant. Our simulations indicate that no policy of price subsidy can significantly increase the take-up of CHI among the near poor; any increase in the level of subsidy generates a windfall benefit for richer households.
    Keywords: Demand for health insurance, Uninsured, Premium subsidies
    JEL: D12 D81 I11 I18
    Date: 2009–04
  8. By: Beomsoo Kim (Department of Economics, Korea University, Seoul, South Korea); Ahram Kim (Department of Economics, Korea University, Seoul, South Korea)
    Abstract: There is a growing concern about potential harmful effect of second-hand or environmental tobacco smoke. As a result, smoking bans in workplace become more prevalent. In Korea, workplace smoking ban policy become more restrictive in 2003 when National health enhancing law was changed. Using Korea National Health and Nutrition survey in 2001 and 2005 we examine the impacts of law change on current smoker and cigarettes smoked per day. We compare indoor working occupations which are constrained by the law change and ourdoor working occupations which are less impacted. The estimated impacts on current smoker is 4.6 percentage point decline and cigarettes per day show statistically significant decline of 1.1.
    Keywords: Smoking ban, current smoker, cigarettes per day
    JEL: J28 I18
    Date: 2009
  9. By: Nikhil Agarwal; Chanont Banternghansa; Linda T.M. Bui
    Abstract: We examine the effect of toxic exposure on U.S. infant and fetal mortality rates between 1989 and 2002 from toxic pollution released by facilities reporting to the Toxic Release Inventory (TRI). Unlike previous studies, we control for toxic pollution from mobile sources and from non-TRI reporting facilities. We find significant adverse effects of TRI exposure on infant mortality. There is evidence that health effects vary across media: air and water having a larger impact than land pollution. And, within air, we find that releases of carcinogens are particularly problematic for infant health outcomes. We estimate that the average county-level decreases in TRI concentrations between 1988 and 2002 saved in excess of 13,800 infant lives.
    Keywords: Newborn infants - Mortality ; Public welfare
    Date: 2009
  10. By: Rosalina Palanca Tan (Department of Economics, Ateneo de Manila University)
    Abstract: Many environmental policies and programmes help save people's lives. However, it can be difficult to assign this key benefit a value.' Because of this, mortality reduction is often not taken into account when potential projects are assessed. This omission can result in projects being undervalued and cancelled. To try and help fill this crucial information gap, a new EEPSEA study from the Philippines has calculated a 'value of life' estimate for children in Metro Manila of between US$0.70 million and US$o.80 million.
    Keywords: Value of life, Manila
    JEL: Q51
    Date: 2008–08
  11. By: Rosalina Palanca Tan (Department of Economics, Ateneo de Manila University)
    Abstract: This study presents a 'value of life' estimate for children in Metro Manila of between US$0.70 million and US$0.80 million. It was carried out by Rosalina Palanca-Tan, from the Department of Economics at the Ateneo de Manila University in Quezon City. Palanca-Tan's assessment is based on parents' willingness to pay for two hypothetical dengue vaccines for their children. It takes an innovative approach to the valuation challenge, one that removes much of the uncertainty surrounding similar past studies. This method involves isolating people's willingness to pay for the reduction in mortality risk that the vaccines bring. This is done by disentangling it from their willingness to pay for other related benefits that the vaccines bring (such as reducing the pain associated with illness). The study succeeds in producing a result that can be used generally to value life in a range of scenarios and situations. As children are most vulnerable to environmental degradation such as air pollution and water pollution, this valuation will be particularly useful to environmental policy makers and campaigners looking to estimate the overall benefit of their work.
    Keywords: Value of life, Manila
    JEL: Q51
    Date: 2008–08
  12. By: Kathleen J. Mullen; Richard G. Frank; Meredith B. Rosenthal
    Abstract: Despite the popularity of pay-for-performance (P4P) among health policymakers and private insurers as a tool for improving quality of care, there is little empirical basis for its effectiveness. We use data from published performance reports of physician medical groups contracting with a large network HMO to compare clinical quality before and after the implementation of P4P, relative to a control group. We consider the effect of P4P on both rewarded and unrewarded dimensions of quality. In the end, we fail to find evidence that a large P4P initiative either resulted in major improvement in quality or notable disruption in care.
    JEL: D23 H51 I12
    Date: 2009–04

This nep-hea issue is ©2009 by Yong Yin. It is provided as is without any express or implied warranty. It may be freely redistributed in whole or in part for any purpose. If distributed in part, please include this notice.
General information on the NEP project can be found at For comments please write to the director of NEP, Marco Novarese at <>. Put “NEP” in the subject, otherwise your mail may be rejected.
NEP’s infrastructure is sponsored by the School of Economics and Finance of Massey University in New Zealand.