nep-hea New Economics Papers
on Health Economics
Issue of 2011‒07‒02
sixteen papers chosen by
Yong Yin
SUNY at Buffalo, USA

  1. Fat Chance! Obesity and the Transition from Unemployment to Employment By Caliendo, Marco; Lee, Wang-Sheng
  2. Public Expenditures on Education and Health in the Kyrgyz Republic before and during the Global Crisis By Roman Mogilevsky
  3. Disability and poverty in developing countries : a snapshot from the world health survey By Mitra, Sophie; Posarac, Aleksandra; Vick, Brandon
  4. Portability of pension, health, and other social benefits : facts, concepts, issues By Holzmann, Robert; Koettl, Johannes
  5. Health information and health outcomes: an application of the regression discontinuity design to the 1995 UK contraceptive pill scare case By Del Bono, Emilia; Francesconi, Marco; Best, Nicky G.
  6. Accidents and illnesses at the workplace Evidence from Italy By Martina Cioni; Marco savioli
  7. In brief: Chernobyl: the long-term health and economic consequences By Hartmut Lehmann; Jonathan Wadsworth
  8. Increased paid maternitiy leave and children's development measured at age four to five. An empirical analysis By Catherine HAECK
  9. Avoidable mortality: what it means and how it is measured By Adriana Castelli; Olena Nizalova
  10. Surveying HIV/AIDS Incidence in Sudan By Mohamed, Issam A.W.
  11. Measurement of SF-6D utility among patients with active tuberculosis By Awan, Masood Sarwar; Waqas, Muhammad; Aslam, Muhammad Amir; Sarwar, Muhammad
  12. Does improved sanitation reduce diarrhea in children in rural India? By Kumar, Santosh; Vollmer, Sebastian
  13. Empirical Analysis of Field Data on HIV/AIDS Epidemic in Khartoum State, Sudan By Mohamed, Issam A.W.
  14. Health related quality of life assessment in patients with hepatitis: a case of Pakistan By Awan, Masood Sarwar; Waqas, Muhammad; Aslam, Muhammad Amir; Abbas, Faisal
  15. The Impacts of the Affordable Care Act: How Reasonable Are the Projections? By Jonathan Gruber
  16. Smoking Policies and Birth Outcomes: Estimates From a New Era By Sara Markowitz; E. Kathleen Adams; Patricia M. Dietz; Viji Kannan; Van Tong

  1. By: Caliendo, Marco (IZA); Lee, Wang-Sheng (RMIT University)
    Abstract: This paper focuses on estimating the magnitude of any potential weight discrimination by examining whether obese job applicants in Germany get treated or behave differently from non-obese applicants. Based on two waves of rich survey data from the IZA Evaluation dataset, which includes measures that control for education, demographic characteristics, labor market history, psychological factors and health, we estimate differences in job search behavior and labor market outcomes between obese/overweight and healthy weight individuals. Unlike other observational studies which are generally based on obese and non-obese individuals who might already be at different points in the job ladder (e.g., household surveys), in our data, individuals are newly unemployed and all start from the same point. The only subgroup we find in our data experiencing any possible form of labor market discrimination is obese women. Despite making more job applications and engaging more in job training programs, we find some indications that they experienced worse (or at best similar) employment outcomes than healthy weight women. Obese women who found a job also had significantly lower wages than healthy weight women.
    Keywords: obesity, discrimination, employment, labor demand
    JEL: I10 I12 J23 J70
    Date: 2011–06
    URL: http://d.repec.org/n?u=RePEc:iza:izadps:dp5795&r=hea
  2. By: Roman Mogilevsky
    Abstract: This paper analyses the public finance performance and the dynamics of government expenditures on education and health in the Kyrgyz Republic in 2007- 2010, when the country was hit by the global economic crisis and then by an internal political crisis in 2010. Despite these crisis conditions, public health expenditures have increased substantially. In education, recurrent expenditures have been protected, while capital investments have been cut dramatically. Both sectors suffer from chronic under-financing, which results in an insufficient quality of services. The country’s fiscal situation in the medium-term is going to be difficult, so efficiency-oriented reforms need to be implemented in health care and especially in education in order to sustain the development of these critical services in Kyrgyzstan.
    Keywords: Fiscal policy, Kyrgyzstan, Education financing, Health financing, Global economic crisis
    JEL: E62 H50 H51 H52 I18 I22
    Date: 2011
    URL: http://d.repec.org/n?u=RePEc:sec:cnrepo:0097&r=hea
  3. By: Mitra, Sophie; Posarac, Aleksandra; Vick, Brandon
    Abstract: Disability and poverty are dynamic and intricately linked phenomena. In developed countries, a large body of empirical research shows that persons with disabilities experience inter alia comparatively lower educational attainment, lower employment and higher unemployment rates, worse living conditions, and higher poverty rates. This study aims to contribute to the empirical research on social and economic conditions of people with disabilities in developing countries. Using comparable data and methods across countries, this study presents a snapshot of economic and poverty situation of working-age persons with disabilities and their households in fifteen developing countries. This research is relevant for several reasons. First, it contributes to a currently small body of empirical evidence on the economic status of persons with disabilities in developing countries. Second, by providing a baseline data on the economic well-being and the poverty status of working-age persons with disabilities and their households in 2003 in the countries under study, it can inform national disability policies. Finally, this study can also inform future data and research efforts on disability in developing countries. This study is structured as follows. Section two provides definitions and some background on disability and poverty. Section three describes the data and methods. Section four presents disability prevalence estimates in the fifteen developing countries under study and results on the economic well-being of working-age population at the individual and household levels. Section five gives results of an analysis of multidimensional poverty across disability status. Section six concludes definitions and some background information on disability and poverty, describes some of the linkages between them and reviews recent literature on the socioeconomic status of persons with disability.
    Keywords: Health Monitoring&Evaluation,Population Policies,Disability,Disease Control&Prevention,Gender and Health
    Date: 2011–04–01
    URL: http://d.repec.org/n?u=RePEc:wbk:hdnspu:62564&r=hea
  4. By: Holzmann, Robert; Koettl, Johannes
    Abstract: Portability of social benefits across professions and countries is an increasing concern for individuals and policy makers. Lacking or incomplete transfers of acquired social rights are feared to negatively impact individual labor market decisions as well as capacity to address social risks with consequences for economic and social outcomes. The paper gives a fresh and provocative look on the international perspective of the topic that has so far been dominated by social policy lawyers working within the framework of bilateral agreements; the input by economists has been very limited. It offers an analytical framework for portability analysis that suggests separating the risk pooling, (implicit or actual) pre-funding and redistributive elements in the benefit designand explores the proposed alternative approach for pensions and health care benefits. This promising approach may serve both as a substitute and complement to bi- and multilateral agreements.
    Keywords: Gender and Law,Health Monitoring&Evaluation,Population Policies,Pensions&Retirement Systems,Debt Markets
    Date: 2011–05–11
    URL: http://d.repec.org/n?u=RePEc:wbk:hdnspu:62725&r=hea
  5. By: Del Bono, Emilia; Francesconi, Marco; Best, Nicky G.
    Abstract: This paper provides a general formulation of the regression discontinuity (RD) design and applies this method to analyse the effects of the 1995 UK pill scare. We show that in the five months following a health warning on the third generation pill, conception rates rose by more than 7%, abortion rates shot up by more than 9%, and birth rates increased by 6-7%. By contrast, no or small effects were found on the resulting babies general health, with the exception of a reduction in the incidence of congenital anomalies. Heterogeneity by mothers age and social class was very pronounced, with most of the effects being experienced by women aged less than 25 and of lower socioeconomic status.
    Date: 2011–06–23
    URL: http://d.repec.org/n?u=RePEc:ese:iserwp:2011-16&r=hea
  6. By: Martina Cioni; Marco savioli
    Abstract: The 2007 Italian Labour Force Survey contains employee-level data that allow us to analyse the determinants of work safety. Among the most significant determinants of accidents and illnesses occurring at work we find bad working conditions, not being in the first job, dissatisfaction with the current job, gender, and a latent proneness observed with occurrence of accident on the way to work. In line with the majority of economic literature, we do not find having a fixed-term contract significant. Other important findings point out that work accidents and work illnesses are two deeply correlated phenomena, and that there is a structural break after three years of tenure to be taken into account.
    Keywords: Work safety, Work accidents, Work illnesses, Fixed-term contracts, Working Conditions.
    JEL: J24 J28 J41
    Date: 2011–02
    URL: http://d.repec.org/n?u=RePEc:usi:wpaper:608&r=hea
  7. By: Hartmut Lehmann; Jonathan Wadsworth
    Abstract: Hartmut Lehmann and Jonathan Wadsworth assess the long-lasting effects of radiation exposure from the Chernobyl disaster on the people of Ukraine.
    Keywords: Chernobyl, health, labour market performance
    JEL: H00 J00
    Date: 2011–06
    URL: http://d.repec.org/n?u=RePEc:cep:cepcnp:342&r=hea
  8. By: Catherine HAECK
    Abstract: Parental leave policies are often enacted based on the premise that children will bene.t from an extended period of time spent with their parent. A number of research studies have looked at the effect of maternal time investments on the early development of skills, behavioral well-being and health, but the results thus far are mixed and mainly based on multivariate analysis. This approach can often not eliminate selection bias and can rarely predict the sign and magnitude of the bias. In this paper, I evaluate the effect of extended maternal care on children’s development at age 4 to 5 using observational data prior to and after the Canadian parental leave reform, which extended total paid leave from 25 to 50 weeks on December 31st, 2000. Previous research exploiting this labor supply shock found that mothers significantly increased their time at home in the first year, but generally found no significant effects on parent-reported measures of development between age 7 and 24 months. For the first time in this literature, children of mothers receiving maternity leave benefits are identified and compared with all other children. Using matching difference-in-differences, I find that the policy change had positive effects on cognitive development, measured using different standardized tests for children aged 4 and 5. Behavioral development effects are mixed and mainly not significant. Effects on the family environment and parent-reported health measures are positive and significant.
    Date: 2011–06
    URL: http://d.repec.org/n?u=RePEc:ete:ceswps:ces11.15&r=hea
  9. By: Adriana Castelli (Centre for Health Economics, University of York, UK); Olena Nizalova (Kyiv School of Economics and Kyiv Economics Institute)
    Abstract: We explore in this research paper the concept of avoidable mortality and how the way it is measured has evolved over time. Starting from an earlier review by Nolte and McKee (2004), we review the empirical studies which have been produced since then. Finally we appraise the empirical applications of the most recent literature. The concept of “avoidable mortality” refers, broadly speaking, to all those deaths that, given current medical knowledge and technology, could be avoided by the healthcare system through either prevention and/or treatment. It originates from the pioneering work by Rutstein, Berenberg et al. (1976) which introduced the notion of 'unnecessary untimely deaths' as a new way to measuring the quality of medical care. The most recent empirical literature shows that the notion of avoidable mortality continues to be used to establish the extent to which people are dying from amenable conditions within and/or across countries and over time, and whether socio-economic status and ethnicity are related to mortality from amenable conditions. Most studies use data taken from national death registries, with only two which link the concept of avoidable mortality to routinely collected administrative data of healthcare provision, such as hospitals. A number of criticisms are raised, with probably the most remarkable being the lack of association found between avoidable mortality and healthcare inputs. No study has actually attempted to use the concept of avoidable mortality within the original aim envisaged by Rutstein, i.e. as a quality indicator of healthcare provision. We recommend for future work in this area to focus on investigating the link between the provision of healthcare and the concept of avoidable mortality, with a particular emphasis on using routinely collected administrative data, such as hospital discharge data.
    Date: 2011–06
    URL: http://d.repec.org/n?u=RePEc:chy:respap:63cherp&r=hea
  10. By: Mohamed, Issam A.W.
    Abstract: The present paper introduces results of an analysis conducted on data collected from Khartoum state for the yea 2009. It aims to apply statistical models for the HIV/AIDS data in Khartoum state centers of testing blood and counseling. AIDS is recognized as an emerging disease only in the early 1980s, AIDS has rapidly established itself throughout the world, and is likely to endure and persist well into the 21s century. AIDS has evolved from a mysterious illness to a global pandemic which has infected tens of millions less than 20 years. The importance of the study is to emphasize that the disease exists even under the special conditions of the country and its status. The study constructs three main hypotheses that non-linear models fit the HIV/AIDS data well especially binary logistic regression. Moreover, it is assumed that demographic variables affect the HIV/AIDS incidence in Khartoum state. It is also assumed that incidences of HIV/AIDS are increasing as manifested among volunteers in the three centers Khartoum, Khartoum North, and Omdurman. The main objective of the paper was to apply statistical models for HIV/AIDS in Khartoum state so as to obtain a good analysis, beside other sub objectives. Data were from secondary sources and volunteers centers for blood testing and counseling inside Omdurman, Khartoum, and Khartoum North teaching hospitals. Also data were collected through questionnaires designed to get all the information registered inside the three centers. The main idea of analysis was to apply and identify statistical model that related to AIDS by using statistical packages to construct the models depends on the collected data about HIV/AIDS of Khartoum state. The focus was on binary logistic regression, because it’s suitable to the data collected from the three centers inside the three hospitals in Khartoum. Estimated coefficients and statistical tests were conducted to distinguish between the variables that related to HIV/AIDS incidence and spread through people in the three cities Khartoum, Khartoum North, and Omdurman. It is concluded that there is no effect of education level on n HIV/AIDS infection for the data collected from Omdurman. However, there is dependency between HIV/AIDS incidence and occupation of volunteers. So the job of individuals affects the HIV/AIDS incidence inside Omdurman area. Also there is an association between HIV/AIDS incidence and social status of individuals. High numbers of positive HIV/AIDS in Omdurman center are among married people.
    Keywords: Sudan; HIV; AIDS; Incidence; Prevalence;Khartoum; Refugees; Economic Activities
    JEL: I11 H55 I12 H5 K32 H51 I18 H7 H75
    Date: 2011
    URL: http://d.repec.org/n?u=RePEc:pra:mprapa:31781&r=hea
  11. By: Awan, Masood Sarwar; Waqas, Muhammad; Aslam, Muhammad Amir; Sarwar, Muhammad
    Abstract: Inspite of so much development in medical technology, Tuberculosis (TB) is still the problem for humans. Few studies, in Pakistan highlighted the factors that affect patients health related quality of life (HRQOL) with active TB. The aim of this study is to measure short form six dimension (Sf-6D) utility scores of patients with active TB of Sargodha district. 120 active TB patients were interviewed and short form-36 questionnaire was followed. District TB hospital of Sargodha district was visited. Results show that Utility scores of female patients were better than male, while patients belong to urban areas have better utility scores as compared to rural patients of TB. Indoor patient’s utility scores were better than outdoor patients. Disease severity, use of drugs, depression, pain and death threat were the factors that negatively affect the patients health related quality of life, while opportunity of leisure and income level increase patients HRQOL.
    Keywords: Sf-6D; Pakistan; TB
    JEL: I12 I18 I10
    Date: 2011
    URL: http://d.repec.org/n?u=RePEc:pra:mprapa:31816&r=hea
  12. By: Kumar, Santosh; Vollmer, Sebastian
    Abstract: Nearly nine million children under five years of age die annually. Diarrhea is considered to be the second leading cause of Under-5 mortality in developing countries. About one out of five deaths are caused by diarrhea. In this paper, we use the newly available data set DLHS-3 to quantify the impact of access to improved sanitation on diarrheal morbidity for children under five years of age in India. Using Propensity Score Matching (PSM) and propensity-based weighted regression, we find that access to improved sanitation reduces the risk of contracting diarrhea. Access to improved sanitation decreases child diarrhea incidence by 2.2 percentage points. There is considerable heterogeneity in the impacts of improved sanitation. We neither find statistically significant treatment eects for children in poor household nor for girls, however, boys and high socioeconomic status (SES) children experienced larger treatment effects. The results show that it is important to complement public policies on sanitation with policies that alleviate poverty, improve parent's education and promote gender equity.
    Keywords: Water, Sanitation, Diarrhea, Propensity score, Matching, India.
    JEL: C35 D10 I10 O12
    Date: 2011–03–21
    URL: http://d.repec.org/n?u=RePEc:pra:mprapa:31804&r=hea
  13. By: Mohamed, Issam A.W.
    Abstract: The study focuses on the HIV/AIDS in Khartoum state during the period (2003-2007). The main objectives are to study the situation of HIV/AIDS in Khartoum state through a sample of 1439 of volunteers for the three selected blood testing and counseling centers in Khartoum, Omdurman, and Khartoum North teaching hospitals. The data of the study were collected from secondary source namely the registered information about volunteers after testing blood for HIV. The data were analyzed by using descriptive statistics, chi-square test for dependency between demographic variables and HIV/AIDS incidence, and logistic regression model to discover the effect of predictors variables on the dependent HIV/AIDS incidence. The infected percent is found to be very high in Khartoum center (36.0), 33.5 for Omdurman center. The incidence rate of HIV/AIDS is found to 14.3 for Khartoum North center. The logistic regression model results have concluded social status, Occupation, and education level affect the HIV/AIDS incidence Khartoum state. The trends of the disease during 2007 have indicated that, the pandemic is at increasing rate for both sexes males and females positive although the positive cases for males were greater than females positive cases, except in one or two months. It is recommended that there must be assessment for the current situation of the HIV/AIDS so as to construct strategic plan to stop or eradicate the spread among the people mainly adults. The study has focused on the HIV/AIDS in Khartoum state during the period (2003-2007).Its main objective was to study the situation of HIV/AIDS in Khartoum state through a sample of 1439 of volunteers for the three selected blood testing and counseling centers in Khartoum, Omdurman, and Khartoum North teaching hospitals. The data of the study were collected from secondary source namely the registered information about volunteers after testing blood for HIV checking The data were analyzed by using descriptive statistics, chi-square test for dependency between demographic variables and HIV/AIDS incidence, and logistic regression model to discover the effect of predictors variables on the dependent HIV/AIDS incidence. The infected percent is found to be very high in Khartoum center (36.0), 33.5 for Omdurman center, and The incidence rate of HIV/AIDS is found to 14.3 for Khartoum North center. The logistic regression model results have concluded social status, occupation, and education level affect the HIV/AIDS incidence Khartoum state. The trends of the disease during 2007 have indicated that, the pandemic is at increasing rate for both sexes males and females positive although the positive cases for males were greater than females positive cases, except in one or two months. The study recommended that there must be assessment for the current situation of the HIV/AIDS so as to construct strategic plan to stop or eradicate the spread among the people mainly adults.
    Keywords: Sudan; HIV/AIDS; Prevalence; Incidences; Khartoum State; Pandemic; Socioeconomic Status
    JEL: I11 K3 A1 I12 C46 H5 A10 C4 O1 K32 H51 J28 H75 I18 I1
    Date: 2011
    URL: http://d.repec.org/n?u=RePEc:pra:mprapa:31783&r=hea
  14. By: Awan, Masood Sarwar; Waqas, Muhammad; Aslam, Muhammad Amir; Abbas, Faisal
    Abstract: The intention of this study is to dig out the demographic, medical, economic and psychosocial factors that affect the health related quality of life of the hepatitis B and C patient in district Sargodha. 120 patients of hepatitis B and C virus were interviewed. WHOQOL-BREF questionnaire was followed for the construction of health-related quality of life (HRQOL) instrument. Age of the patient, disease severity, use of drug, pain, depression, financial hindrance and threat of death negatively affect the HRQOL of the hepatitis patient while, vaccination, income, education, sleep, opportunity of leisure and better living condition affect HRQOL positively.
    Keywords: HRQOL; HBV; HCV; Pakistan
    JEL: I0 I18 A14
    Date: 2011
    URL: http://d.repec.org/n?u=RePEc:pra:mprapa:30770&r=hea
  15. By: Jonathan Gruber
    Abstract: The Patient Protection and Affordable Care Act (ACA) is the most comprehensive reform of the U.S. medical system in at least 45 years. The ACA transforms the non-group insurance market in the United States, mandates that most residents have health insurance, significantly expands public insurance and subsidizes private insurance coverage, raises revenues from a variety of new taxes, and reduces and reorganizes spending under the nation’s largest health insurance plan, Medicare. Projecting the impacts of such fundamental reform to the health care system is fraught with difficulty. But such projections were required for the legislative process, and were delivered by the Congressional Budget Office (CBO). This paper discusses the projected impact of the ACA in more detail, and describes the evidence that sheds light upon the accuracy of the projections. It begins by reviewing in broad details the structure of the ACA and then reviews evidence from a key case study that informs our understanding of the ACA’s impacts: a comparable health reform that was carried out in Massachusetts four years earlier. The paper discusses the key results from that earlier reform and what they might imply for the impacts of the ACA. The paper ends with a discussion of the projected impact of the ACA and offers some observations on those estimates.
    JEL: H3 I18
    Date: 2011–06
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:17168&r=hea
  16. By: Sara Markowitz; E. Kathleen Adams; Patricia M. Dietz; Viji Kannan; Van Tong
    Abstract: Smoking during pregnancy has been shown to have significant adverse health effects for new born babies. Smoking is the leading preventable cause of low birth weight of infants who in turn, need more resources at delivery and are more likely to have related health problems in infancy and beyond. Despite these outcomes, many women still smoke during pregnancy. The main question for policy makers is whether tobacco control policies can influence maternal smoking and reduce adverse birth outcomes. We examine this question using data from the Pregnancy Risk Assessment Monitoring System data from 2000 to 2005. This is a time period during which states significantly changed their tobacco control policies by raising excise taxes and imposing strong restrictions on indoor smoking. We estimate reduced form models of birth weight and gestational weeks, focusing on the effects of taxes and workplace restrictions on smoking as the policies of interest. We also estimate demand equations for the probability of smoking during the third trimester. Results show that the smoking policies are effective, but limited to babies born to mothers of certain age groups. For babies born to teenage mothers, higher cigarette taxes are associated with small increases in birth weight and gestational weeks. For babies born to mothers ages 25-34, restrictions on smoking in the workplace are associated with small increases in gestational weeks.
    JEL: I1 K0
    Date: 2011–06
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:17160&r=hea

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