nep-hea New Economics Papers
on Health Economics
Issue of 2011‒11‒14
fourteen papers chosen by
Yong Yin
SUNY at Buffalo, USA

  1. The effects of Children’s ADHD on Parents’ Relationship Dissolution and Labor Supply By Anette Primdal Kvist; Helena Skyt Nielsen; Marianne Simonsen
  2. International Research Networks in Pharmaceuticals: Structure and Dynamics By Uwe Cantner; Bastian Rake
  3. Some problems with international comparisons of health spending – and a suggestion about how to quantify the size of the problems By Melberg, Hans Olav
  4. The impact of poverty on mental health and well-being and the necessity for integrated social policies in Romania By Carmen Beatrice Pauna; Raluca Sfetcu; Marioara Iordan
  5. Adult Mortality in Russian Rural Areas: Inter-regional Comparisons By Tatiana Blinova
  6. Investing in Health to Improve the Wellbeing of the Disadvantaged: Reversing the Augment of the Marmot Reports By David Canning; Diana Bowser
  7. The Effect of Maternal Tetanus Immunization on Children’s Schooling Attainment in Matlab, Bangladesh: Follow-up of a Randomized Trial By David Canning; Abdur Razzaque; Julia Driessen; Damian G. Walker; Peter Kim Streatfield; Mohammad Yunus
  8. The Effect of Malaria on Settlement and Land Use: Evidence from the Brazilian Amazon By Shufang Zhang; Marcia C. Castro; David Canning
  9. What do happiness and health satisfaction data tell us about relative risk aversion? By Néstor Gándelman; Rubén Hernández-Murillo
  10. The effects of female labor force participation on obesity By Pere Gomis-Porqueras; Oscar A. Mitnik; Adrian Peralta-Alva; Maximilian D. Schmeiser
  11. Would you train me with my mental illness? Evidence from a discrete choice experiment By Deuchert, Eva; Kauer, Lukas; Meisen Zannol, Flurina
  12. Long-Run Earnings Volatility and Health Insurance Coverage: Evidence from the SIPP Gold Standard File By Matthew Rutledge
  13. Socioeconomic Differences in the Impact of Smoking Tobacco and Alcohol Prices on Smoking in India By G. Emmanuel Guindon; Arindam Nandi; Frank J. Chaloupka, IV; Prabhat Jha

  1. By: Anette Primdal Kvist; Helena Skyt Nielsen; Marianne Simonsen (School of Economics and Management, Aarhus University, Denmark)
    Abstract: This paper uses Danish register-based data for the population of children born in 1990-1997 to investigate the effects on parents of having a child with attention-deficit/hyperactivity-disorder (ADHD). Ten years after birth, parents of children diagnosed with ADHD have a 75 % higher probability of having dissolved their relationship and a 7-13 % lower labor supply. Exploiting detailed information about documented risk factors behind ADHD, we find that roughly half of this gap is due to selection. However, a statistically and economically significant gap is left, which is likely related to the impact of high psychic costs of coping with a child with ADHD.
    Keywords: ADHD, child health, marital dissolution, labor supply
    JEL: I12 J12 J13 J22
    Date: 2011–10–28
  2. By: Uwe Cantner (School of Economics and Business Administration, Friedrich-Schiller-University Jena); Bastian Rake (Friedrich-Schiller-University Jena, Graduate College "The Economics of Innovative Change")
    Abstract: Knowledge production and scientific research have become increasingly more collaborative and international, particularly in pharmaceuticals. We analyze international research networks on the country level in different disease groups. Our empirical analysis is based on a unique dataset of scientific publications related to pharmaceutical research. Using social network analysis, we find that both the number of countries and their connectivity increase in almost all disease groups. The cores of the networks consist of high income OECD countries and remain rather stable over time. We use network regression techniques in order to analyze the dynamics of the networks. Our results indicate that an accumulative advantage based on preferential attachment and point connectivity as a proxy for multi-connectivity are positively related to changes in the countries' collaboration intensity.
    Keywords: International Cooperation, Pharmaceuticals, Research Networks, Network Dynamics, MRQAP
    JEL: R10 O31
    Date: 2011–11–08
  3. By: Melberg, Hans Olav (Department of Health Management and Health Economics)
    Abstract: This paper investigates the extent to which conclusions from international comparison of health spending depend on different adjustment methods. The analysis shows, first, that health spending figures differ significantly because of different accounting standards. More specifically, spending on long term nursing care is not treated the same way in all the countries. Next, the rankings differ depending on whether spending is adjusted for purchasing power parity and health specific purchasing power adjustment. Finally, the paper examines the problem of how to quantify the degree to which an adjustment method changes the outcome of a comparison. A rank based approach sum changes in rank and compare this to maximum rank change possible. A share based approach sum changes in each units share of the total. Both approaches create a measure that is bounded between zero and one, but the share based approach also captures changes that do not result in rank differences. <p>
    Keywords: Income inequality; health inequality; socioeconomic status; welfare states; concentration index; health spending per capita; OECD; Norway;
    JEL: H51
    Date: 2011–11–07
  4. By: Carmen Beatrice Pauna; Raluca Sfetcu; Marioara Iordan
    Abstract: On almost every account people with mental health problems are among the most excluded groups in society and they consistently identify stigmatisation, discrimination and exclusion as major barriers to health, welfare and quality of life. The links between poverty and ill health are well known. Poverty and illness together make people much more vulnerable and needy at all stages of their lives, and even more so in old age. Mental health is often both a cause and a consequence of poverty, compromised education, vulnerability, difficulty accessing housing, health care and employment, and lack of access to welfare, social security, and community public services. Inequalities between social classes in the incidence of chronic illness and mental illness and in life expectancy are also well documented. The working class poor with health problems are a particularly vulnerable group. Moreover people with mental health problems are more likely to experience physical health problems, which can further compromise the efforts of the individual in an already disadvantaged situation. When the experience of mental illness is the cause or a factor in the experience of exclusion, the effects can be still more damaging. This mutual interaction linking mental health and development can work positively with good mental health facilitating the active and successful involvement of individuals and communities in development, and negatively with poor mental health increasing the risk of descending into a vicious cycle of poverty and adverse social and health outcomes. Designing social policies and interventions - both within and outside the health sector - which strengthen social inclusion, represent a key action recommended by the European Pact for Mental Health and Wellbeing. This paper explores the situation of persons affected by severe mental illness on regional level in Romania. The need for policy development and improvement strategies are also highlighted.
    Date: 2011–09
  5. By: Tatiana Blinova
    Abstract: Regions of the Russian Federation draw up purpose-oriented programs aiming at improving the health and reducing the mortality among the population. The task of decreasing the mortality among the rural population, especially overcoming the phenomenon of “excess mor-tality†among the people of the able-bodied age, is considered a priority in the federal and re-gional programs for social-economic development for the nearest future. In view of this, the task of this research is to develop taxonomy of regions of RF according to the structure of mortality among their rural population, analyze the inter-regional comparisons and regression equations that include demographic, economic, social and ecological explanatory variables for different types of the regions. The paper presents a comparative analysis of mortality structure dynamics for urban and rural population of RF. The inter-regional comparisons of the Russian rural mortality structure are made. The inter-regional differentiation in terms of the level of mortality of the population and the differences between the city and the countryside are substantiated by using a set of causes and factors of both demographic and social-economic nature. For the purpose of making a deeper analysis of the territorial aspects of rural mortality, the rural territories are classified according to the structure of mortality from basic causes of death. The description of the territorial features of mortality determinants for the regions of each typological group is given. The structure of the classification groups and average parameter values are presented in the form of cartograms and tables. The regression equations including the demographic, economic, social and ecological explanatory variables are considered for both the entire RF and different types of its regions. The models derived are described from the viewpoint of significance of the influence the chosen parameters produce on the level of mortality among the rural population belonging to each classified group of the regions. The territorial features of causes of death identified in the course of the research should be taken into account when substantiating regional programs aiming to de-crease the rural mortality and increase the life expectancy, as well as when drawing up and implementing rural social development programs.
    Date: 2011–09
  6. By: David Canning (Harvard School of Public Health); Diana Bowser (Harvard School of Public Health)
    Abstract: The Marmot reports have argued that health inequalities are the result of social inequalities. They advocate reducing health inequalities by undertaking fundamental changes that make society fairer. We argue that the focus should be on improving the health and wellbeing of the disadvantaged, even if the policies that do this also raise the health of the better off, and worsen inequality. We also argue that the causality runs from health to social status, and that health interventions are needed to improve socioeconomic outcomes. While we disagree on goals and mechanisms we are in surprisingly close agreement with Marmot Reports on policies. In particular, we agree with the focus on in early childhood investments in health and physical and cognitive development that have long term socioeconomic payoffs. We also endorse making society fairer, though mainly as a goal in itself rather than an instrument to reduce health inequality.
    Keywords: health inequality, early childhood investments, Marmot Reports
    Date: 2011–11
  7. By: David Canning (Harvard School of Public Health); Abdur Razzaque (ICDDR,B); Julia Driessen (Johns Hopkins University); Damian G. Walker (Johns Hopkins University); Peter Kim Streatfield (ICDDR,B); Mohammad Yunus (ICDDR,B)
    Abstract: We investigate the effects of ante-natal maternal vaccination against tetanus on the schooling attained by children in Bangladesh. Maternal vaccination prevents the child from acquiring tetanus at birth through blood infection and substantially reduces infant mortality and may prevent impairment in children who would otherwise acquire tetanus but survive. We follow up on a 1974 randomized trial of maternal tetanus toxoid, looking at outcomes for children born in the period 1975-1979. We find significant schooling gains from maternal tetanus vaccination for children whose parents had no schooling, showing a large impact on a small number of children.
    Keywords: Vaccination, tetanus, schooling, education, Bangladesh
    Date: 2011–11
  8. By: Shufang Zhang; Marcia C. Castro (Harvard School of Public Health); David Canning (Harvard School of Public Health)
    Abstract: We estimate the effect of malaria on settlement and land use patterns in the Brazilian Amazon, where potential settlers were randomly assigned to plots in a newly opened settlement area. The random assignment allows us to estimate the risk of malaria on each plot based only on its characteristics. Using survey data, we find that a high malaria risk significantly reduces the probability that a plot is inhabited. Using satellite images, we find that a high malaria risk does not reduce forest clearance or crop coverage on a plot. Non-resident farming substitutes for physical inhabitation when malaria risk is high.
    Keywords: malaria, settlement, land use, Brazil, Amazon
    Date: 2011–11
  9. By: Néstor Gándelman; Rubén Hernández-Murillo
    Abstract: In this paper we provide estimates of the coefficient of relative risk aversion using information on self-reports of subjective personal well-being from the 2006 Gallup World Poll. We expand the existing literature on the use of happiness data to analyze economic issues by considering the implications of allowing for health state dependence in the utility function. Our estimates of relative risk aversion using pooled data from various country groupings are smaller than one, suggesting less concavity than log utility. We also find that controlling for health dependence generally reduces these estimates. Our results also suggest that the marginal utility of income increases when health deteriorates.
    Keywords: Happiness ; Health ; Risk-taking (Psychology)
    Date: 2011
  10. By: Pere Gomis-Porqueras; Oscar A. Mitnik; Adrian Peralta-Alva; Maximilian D. Schmeiser
    Abstract: This paper assesses whether a causal relationship exists between recent increases in female labor force participation and the increased prevalence of obesity amongst women. The expansions of the Earned Income Tax Credit (EITC) in the 1980s and 1990s have been established by prior literature as having generated variation in female labor supply, particularly amongst single mothers. Here, we use this plausibly exogenous variation in female labor supply to identify the effect of labor force participation on obesity status. We use data from the National Health Interview Survey (NHIS) and replicate labor supply effects of the EITC expansions found in previous literature. This validates employing a difference-in-differences estimation strategy in the NHIS data, as has been done in several other data sets. Depending on the specification, we find that increased labor force participation can account for at most 19% of the observed change in obesity prevalence over our sample period. Our preferred specification, however, suggests that there is no causal link between increased female labor force participation and increased obesity.
    Keywords: Women - Employment ; Obesity ; Tax credits
    Date: 2011
  11. By: Deuchert, Eva; Kauer, Lukas; Meisen Zannol, Flurina
    Abstract: The low employment among people with disabilities in general, and mental disorders in particular, generates high costs to the society. This raises the need to develop effective vocational rehabilitation methods. Supported Education/Employment is effective in increasing sustainable employment for people with mental disorders. This vocational rehabilitation method places patients directly in realistic work settings instead of training them in a protected work environment. Supported Education and Employment has not yet been widely implemented. Using a discrete choice experiment, we demonstrate that one of the key problems is to find employers willing to provide training. Non-cognitive dysfunctions are the main deterrents.
    Keywords: upported Vocational Education & Training; vocational rehabilitation; mental disorders; discrete choice experiment
    JEL: J24 M53
    Date: 2011–10
  12. By: Matthew Rutledge
    Abstract: Despite the notable increase in earnings volatility and the attention paid to the growing ranks of the uninsured, the relationship between career earnings and short- and mediumrun health insurance status has been ignored due to a lack of data. I use a new dataset, the SIPP Gold Standard File, that merges health insurance status and demographics from the Survey of Income and Program Participation with career earnings records from the Social Security Administration (SSA) and the Internal Revenue Service (IRS) to examine the relationship between long-run family earnings volatility and health insurance coverage. I find that more volatile career earnings are associated with an increased probability of experiencing an uninsured episode, with larger effects for men, young workers, and the unmarried. These findings are consistent with the “scarring” literature, and suggest the importance of safety-net measures for job losses and health insurance coverage.
    Date: 2011–10
  13. By: G. Emmanuel Guindon; Arindam Nandi; Frank J. Chaloupka, IV; Prabhat Jha
    Abstract: The threat posed by smoking to health in India is severe. Already 1 in 5 of all adult male deaths and 1 in 20 of all adult female deaths at ages 30-69 are due to smoking and India will soon have 1 million smoking deaths a year. Increasing tobacco prices has been found to be the single most effective method to reduce smoking. Yet, bidis, the most common form of smoked tobacco in India, are largely untaxed, while cigarettes are taxed at about 40% of retail price, well below the 65–80% rate noted by the World Bank in countries with effective tobacco control policies. Moreover, low and stagnant tax rates have occurred in a period in which all tobacco products have become more affordable with income growth. First, we use data from the most recent three consecutive quinquennial National Sample Survey (NSS) rounds (NSS 50, 55 and 61 conducted in 1993/94, 1999/00 and 200/05) and a two-equation system of budget shares and unit values that attempts to correct for quality and measurement error. Second, we pool data from the most recent nine rounds of NSS (NSS 55-57, 59-64, conducted between 1999/00 to 2007/08). Our analyses of single and repeated cross-sections yield own-price elasticity for bidis that are roughly in keeping with existing evidence. We find that a 10% increase in bidi prices would reduce the demand for bidis by about 6 to 9.5%. We find, however, that own-price elasticity for cigarettes in India is substantially larger than previously thought. Our estimates suggest that cigarette users are at least as responsive as bidi users to price changes. On the whole, our analyses suggest that low SES households are likely more responsive to price changes than high SES households. Our analyses also uncovers important and policy-relevant cross-prices effects. Findings from this study provide additional evidence of the effectiveness of tobacco prices at reducing tobacco use.
    JEL: H2 I18
    Date: 2011–11
    Date: 2011

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