nep-hea New Economics Papers
on Health Economics
Issue of 2011‒12‒13
twenty-six papers chosen by
Yong Yin
SUNY at Buffalo, USA

  1. The Health Impact Fund: More justice and efficiency in global health By Thomas Pogge
  2. Is Sex Like Driving? Risk Compensation Associated with Randomized Male Circumcision in Kisumu, Kenya By Nicholas Wilson; Wentao Xiong; Christine Mattson; Christine Mattson
  3. Medical Marijuana Laws, Traffic Fatalities, and Alcohol Consumption By Anderson, D. Mark; Rees, Daniel I.
  4. Work Hours Constraints and Health By Bell, David N.F.; Otterbach, Steffen; Sousa-Poza, Alfonso
  5. Financial Incentives, the Timing of Births, Birth Complications, and Newborns' Health: Evidence from the Abolition of Austria's Baby Bonus By Brunner, Beatrice; Kuhn, Andreas
  6. The Impact of the Macroeconomy on Health Insurance Coverage: Evidence from the Great Recession By Cawley, John; Moriya, Asako S.; Simon, Kosali
  7. Instrumental Variable Estimation of the Causal Effect of Hunger Early in Life on Health Later in Life By van den Berg, Gerard J.; Pinger, Pia; Schoch, Johannes
  8. Socioeconomic Heterogeneity in the Effect of Health Shocks on Earnings: Evidence from Population-Wide Data on Swedish Workers By Lundborg, Petter; Nilsson, Martin; Vikström, Johan
  9. Disability and Job Mismatches in the Australian Labour Market By Jones, Melanie K.; Mavromaras, Kostas G.; Sloane, Peter J.; Wei, Zhang
  10. Neighborhood Perceptions, Self-rated Health, and Personality Traits: Evidence from Japan By Oshio, Takashi; Urakawa, Kunio
  11. The Captain of the Men of Death and His Shadow: Long-Run Impacts of Early Life Pneumonia Exposure By Sonia Bhalotra; Atheendar Venkataramani
  12. Child Mental Health and Educational Attainment: Multiple Observers and the Measurement Error Problem By David Johnston; Carol Propper; Stephen Pudney; Michael Shields
  13. Willingness to pay for wholesome canteen takeaway By Nordström, Jonas
  14. The Impact of Changes in Educational Attainment on Life Expectancy in Ireland By FitzGerald, John; Byrne, David; Znuderl, Nu?a
  15. A successful model of regional healthcare information exchange in Japan: Case Study in Kagawa Prefecture By Yamakata, Daisuke; Nogawa, Hiroki; Ueda, Masashi
  16. A new track for technology: Can ICT take care for healthier lifestyles? By Baum, Peter
  17. Economic costs and benefits of promoting healthy takeaway meals at workplace canteens By Jørgen Dejgaard Jensen; Morten Raun Mørkbak; Jonas Nordström
  18. State Dependence and Heterogeneity in Health Using a Bias Corrected Fixed Effects Estimator By Jesus M. Carro; Alejandra Traferri
  19. Determinants of drug launch delay in pre-TRIPS India: A survival analysis approach By Saradindu Bhaduri; Thomas Brenner
  20. The Causal Effect of Education on Health: What is the Role of Health Behaviors? By Giorgio Brunello; Margherita Fort; Nichole Schneeweis; Rudolf Winter-Ebmer
  21. The Uniform World Model: A Methodology for Predicting the Health Impacts of Air Pollution By Joseph V. Spadaro
  22. Endogenous technological change in medicine and its impact on healthcare costs: evidence from the pharmaceutical market in Taiwan By Hsieh, Chee-Ruey; Liu, Ya-Ming; Chang, Chia-Lin
  23. Health, income inequality and climate related disasters at household level: reflections from an Orissa District By Narayanan, K.; Sahu, Santosh Kumar
  24. Effect of universal health coverage on marriage, cohabitation and labor force participation By Azuara, Oliver
  25. Optimal Expectations and Limited Medical Testing: Evidence from Huntington Disease By Emily Oster; Ira Shoulson; E. Ray Dorsey
  26. Alcohol and Student Performance: Estimating the Effect of Legal Access By Jason M. Lindo; Isaac D. Swensen; Glen R. Waddell

  1. By: Thomas Pogge
    Abstract: Some 18 million people die annually from poverty-related causes. Many more are suffering grievously from treatable medical conditions. These burdens can be substantially reduced by supplementing the rules governing pharmaceutical innovation. Established by the World Trade Organization's TRIPS Agreement, these rules cause advanced medicines to be priced beyond the reach of the poor and steer medical research away from diseases concentrated among them. We should complement these rules with the Health Impact Fund. Financed by many governments, the HIF would offer any new pharmaceutical product the opportunity to participate, during its first ten years, in the HIF's annual reward pools, receiving a share equal to its share of the assessed global health impact of all HIF-registered products. In exchange, the innovator would have to agree to make this product available worldwide at the lowest feasible cost of manufacture. Fully consistent with TRIPS, the HIF achieves three key advances. It directs some pharmaceutical innovation toward the most serious diseases, including those concentrated among the poor. It makes all HIF-registered medicines cheaply available to all. And it incentivizes innovators to promote the optimal use of their HIF-registered medicines. Magnifying one another's effects, these advances would engender large global health gains.
    Keywords: aid
    JEL: O19
    Date: 2011–08
  2. By: Nicholas Wilson (Williams College); Wentao Xiong (Williams College); Christine Mattson; Christine Mattson (University of Illinois at Chicago School of Public Health)
    Abstract: Mass adult male circumcision campaigns for HIV prevention are underway across much of Sub-Saharan Africa. However, concern remains about risk compensation associated with the reduction in the probability of HIV transmission per risky act. This paper examines the behavioral response to male circumcision using experimental data from Kisumu, Kenya. Contrary to the presumption of risk compensation, we find that the response due to the perceived reduction in HIV transmission appears to have been a reduction in risky sexual behavior. We suggest a mechanism for this finding: circumcision reduces fatalism about acquiring HIV and increases the salience of the tradeoff between engaging in additional risky behavior and living longer. We also find what appears to be a competing effect that does not operate through the circumcisioncrecipient's belief about the reduction in the risk of acquiring HIV.
    Keywords: HIV/AIDS, male circumcision, risk compensation, beliefs, Kenya
    JEL: D81 D84 I18
    Date: 2011–08
  3. By: Anderson, D. Mark (Montana State University); Rees, Daniel I. (University of Colorado Denver)
    Abstract: To date, 16 states have passed medical marijuana laws, yet very little is known about their effects. Using state-level data, we examine the relationship between medical marijuana laws and a variety of outcomes. Legalization of medical marijuana is associated with increased use of marijuana among adults, but not among minors. In addition, legalization is associated with a nearly 9 percent decrease in traffic fatalities, most likely to due to its impact on alcohol consumption. Our estimates provide strong evidence that marijuana and alcohol are substitutes.
    Keywords: medical marijuana, traffic fatalities, alcohol consumption
    JEL: I00 I1
    Date: 2011–11
  4. By: Bell, David N.F. (University of Stirling); Otterbach, Steffen (University of Hohenheim); Sousa-Poza, Alfonso (University of Hohenheim)
    Abstract: The issue of whether employees who work more hours than they want to suffer adverse health consequences is important not only at the individual level but also for governmental formation of work time policy. Our study investigates this question by analyzing the impact of the discrepancy between actual and desired work hours on self-perceived health outcomes in Germany and the United Kingdom. Based on nationally representative longitudinal data, our results show that work-hour mismatches (i.e., differences between actual and desired hours) have negative effects on workers’ health. In particular, we show that “overemployment” – working more hours than desired – has negative effects on different measures of self-perceived health.
    Keywords: work time, hours constraints, health, Germany, United Kingdom
    JEL: I10 J21 J22
    Date: 2011–11
  5. By: Brunner, Beatrice (University of Zurich); Kuhn, Andreas (University of Zurich)
    Abstract: We analyze the fertility and health effects resulting from the abolition of the Austrian baby bonus in January 1997. The abolition of the benefit was publicly announced about ten months in advance, creating the opportunity for prospective parents to (re-)schedule conceptions accordingly. We find robust evidence that, within the month before the abolition, about 8% more children were born as a result of (re-)scheduling conceptions. At the same time, there is no evidence that mothers deliberately manipulated the date of birth through medical intervention. We also find a substantial and significant increase in the fraction of birth complications, but no evidence for any resulting adverse effects on newborns' health.
    Keywords: baby bonus, scheduling of conceptions, timing of births, policy announcement, abolition effect, birth complications, medical intervention
    JEL: H31 J13
    Date: 2011–11
  6. By: Cawley, John (Cornell University); Moriya, Asako S. (Carnegie Mellon University); Simon, Kosali (Indiana University)
    Abstract: This paper investigates the impact of the macroeconomy on the health insurance coverage of Americans using panel data from the Survey of Income and Program Participation (SIPP) for 2004-2010, a period that includes the Great Recession of 2007-09. We find that a one percentage point increase in the state unemployment rate is associated with a 1.67 percentage point (2.12%) reduction in the probability that men have health insurance; this effect is strongest among college-educated, white, and older (50-64 year old) men. We estimate that 9.3 million Americans, the vast majority of whom were adult men, lost health insurance due to a higher unemployment rate alone during the 2007-09 recession. We conclude with a discussion of how components of recent health care reform may influence this relationship in the future.
    Keywords: health insurance, Medicaid, SCHIP, recession, unemployment
    JEL: I10 J3 J6 E32
    Date: 2011–11
  7. By: van den Berg, Gerard J. (University of Mannheim); Pinger, Pia (University of Mannheim); Schoch, Johannes (University of Mannheim)
    Abstract: Numerous studies have evaluated the effect of nutrition early in life on health much later in life by comparing individuals born during a famine to others. Nutritional intake is typically unobserved and endogenous, whereas famines arguably provide exogenous variation in the provision of nutrition. However, living through a famine early in life does not necessarily imply a lack of nutrition during that age interval, and vice versa, and in this sense the observed difference at most provides a qualitative assessment of the average causal effect of a nutritional shortage, which is the parameter of interest. In this paper we estimate this average causal effect on health outcomes later in life, by applying instrumental variable estimation, using data with self-reported periods of hunger earlier in life, with famines as instruments. The data contain samples from European countries and include birth cohorts exposed to various famines in the 20th century. We use two-sample IV estimation to deal with imperfect recollection of conditions at very early stages of life. The estimated average causal effects often exceed famine effects by a factor three.
    Keywords: 2SLS, obesity, high blood pressure, height, developmental origins, ageing, famine, nutrition, two-sample IV
    JEL: I12 J11 C21 C26
    Date: 2011–11
  8. By: Lundborg, Petter (Lund University); Nilsson, Martin (Uppsala University); Vikström, Johan (Uppsala University)
    Abstract: In this paper, we estimate socioeconomic heterogeneity in the effect of unexpected health shocks on labor market outcomes, using register-based data on the entire population of Swedish workers. We effectively exploit a Difference-in-Difference-in-Differences design, in which we compare the change in labor earnings across treated and control groups with high and low education levels. If the anticipation effects are similar for individuals with high and low education, any difference in the estimates across socioeconomic groups could plausibly be given a causal interpretation. Our results suggest a large amount of heterogeneity in the effects, in which individuals with a low education level suffer relatively more from a given health shock. These results hold across a wide range of different types of health shocks and become more pronounced with age. Our results suggest that socioeconomic heterogeneity in the effect of health shocks offers one explanation for how the socioeconomic gradient in health arises.
    Keywords: health, health shocks, socioeconomic status, life-cycle
    JEL: I10 I12 I14
    Date: 2011–11
  9. By: Jones, Melanie K. (Swansea University); Mavromaras, Kostas G. (NILS, Flinders University); Sloane, Peter J. (Swansea University); Wei, Zhang (NILS, Flinders University)
    Abstract: We examine the relationship between disability, job mismatch, earnings and job satisfaction, using panel estimation on data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey (2001-2008). While we do not find any relationship between work-limiting disability and over-skilling, it appears that there is a positive relationship between work-limiting disability and over-education, which is consistent with disability onset leading to downward occupational movement, at least in relative terms. We find a negative correlation between work-limiting disability and both earnings and job satisfaction. However, there is only evidence of a causal relationship in terms of the latter, where the impact of disability is found to be multifaceted.
    Keywords: job mismatch, disability, earnings, job satisfaction
    JEL: I0 J2 J3 J7 J24 J31
    Date: 2011–11
  10. By: Oshio, Takashi; Urakawa, Kunio
    Abstract: Although earlier studies have demonstrated an association between perceived neighborhood characteristics and self-rated health, these studies did not control for the psychological characteristics of participants, an important consideration when using self-reported data. In this study, we examined how self-rated health is associated with perceived neighborhood characteristics after controlling for personality traits as well as other individual- and area-level covariates. We employed multilevel analysis using microdata collected from a nationwide Internet survey in Japan in 2011 (N = 8,139). When controlling for personality traits, we observed that the odds for reporting poor health in response to negative neighborhood assessments declined but remained highly significant. We obtained similar results when additionally controlling for sense of coherence (SOC) or replacing personality traits with it. We also found no effect of personality traits or SOC on the sensitivity of self-rated health with negative neighborhood assessments.
    Keywords: Neighborhood perceptions, self-rated health, personality traits, sense of coherence
    Date: 2011–11
  11. By: Sonia Bhalotra; Atheendar Venkataramani
    Abstract: We exploit the introduction of sulfa drugs in 1937 to identify the causal impact of exposure to pneumonia in infancy on later life well-being and productivity in the United States. Using census data from 1980-2000, we find that cohorts born after the introduction of sulfa experienced increases in schooling, income, and the probability of employment, and reductions in disability rates. These improvements were larger for those born in states with higher pre-intervention levels of pneumonia as these were the areas that benefited most from the availability of sulfa drugs. These estimates are, in general, larger and more robust to specification for men than for women. With the exception of cognitive disability and poverty for men, the estimates for African Americans are smaller and less precisely estimated than those for whites. This is despite our finding that African Americans experienced larger absolute reductions in pneumonia mortality after the arrival of sulfa. We suggest that pre-Civil Rights barrers may have inhibited their translating improved endowments into gains in education and employment.
    Keywords: early childhood, infectious diseases, pneumonia, medical innovation, antibiotics, schooling, income, disability, mortality trends.
    JEL: I18 H41
    Date: 2011–10
  12. By: David Johnston; Carol Propper; Stephen Pudney; Michael Shields
    Abstract: We examine the effect of survey measurement error on the empirical relationship between child mental health and personal and family characteristics, and between child mental health and educational progress. Our contribution is to use unique UK survey data that contains (potentially biased) assessments of each child's mental state from three observers (parent, teacher and child), together with expert (quasi-) diagnoses, using an assumption of optimal diagnostic behaviour to adjust for reporting bias. We use three alternative restrictions to identify the effect of mental disorders on educational progress. Maternal education and mental health, family income, and major adverse life events, are all significant in explaining child mental health, and child mental health is found to have a large influence on educational progress. Our preferred estimate is that a 1-standard deviation reduction in ‘true' latent child mental health leads to a 2-5 months loss in educational progress. We also and a strong tendency for observers to understate the problems of older children and adolescents compared to expert diagnosis.
    Keywords: Child mental health; Education; Strengths and Difficulties Questionnaire; Measurement error
    JEL: C30 I10 I21 J24
    Date: 2011–07
  13. By: Nordström, Jonas (Department of Economics, Lund University)
    Abstract: The primary objective of this study was to estimate the willingness to pay (WTP) for a new intervention at the workplace: wholesome canteen takeaways (CTA), i.e. a low fat meal with a large amount of vegetables prepared at the workplace canteen that only requires re-heating. The contingent valuation method was used to elicit the WTP. Two surveys were carried out in Denmark; one large-scale Internet based survey and one survey at a workplace that introduced CTA. The results from the large-scale survey suggest that this concept attracts relevant target groups; groups of individuals with a less healthy diet, low physical activity and a high body mass index. For males and individuals with low education, who also constitute relevant target groups, the results suggest no significant difference in WTP between males and females, whereas low educated individuals have a significantly lower WTP than highly educated individuals. However, the workplace study, carried out at a hospital, found that females have a significantly higher WTP for CTA compared with males. In conclusion, the concept appears to attract relevant target groups, although for a given price a smaller fraction of low educated individuals compared to high educated individuals would be willing to buy CTA.
    Keywords: Workplace intervention; healthy; contingent valuation; diet; willingness to pay; fast food; takeaway meal; demand
    JEL: D12 I10
    Date: 2011–11–07
  14. By: FitzGerald, John; Byrne, David; Znuderl, Nu?a
    Keywords: Ireland
    Date: 2011–11
  15. By: Yamakata, Daisuke; Nogawa, Hiroki; Ueda, Masashi
    Abstract: In this study, we focused on analysis of healthcare data exchange over the network. For the advance of broadband capability development, many governments expect online medical information exchange between medical institutions. Japanese government also has tried to deploy ICT in the healthcare field. In Japan, many healthcare ICT projects started, but almost of all the projects face many issues and failed to continue. This situation caused us to clarify the success factor of healthcare information exchange network. For inspecting the success factors, we analyzed information access of healthcare systems in Kagawa prefecture of Japan. Kagawa prefecture is one of the most advance areas for healthcare information technology. We analyzed four medical ICT projects in Kagawa prefecture: K-MIX, Critical Pathway for Diabetes, E-prescription, and PHR. In addition, we inspected characteristics of exchanged data in the network, and stakeholder involved in these projects. This analysis lets us find various types of healthcare ICT projects. Characteristic of data processed in the projects caused differences of characteristic of the projects. On the other hand, multiple systems process same data, though the project does not share the data itself. Considering various types of medical information exchanges projects, we propose classification and standard format of exchanged data according to their characteristic are critical for efficient business deployment. --
    Keywords: e-Health,regional healthcare information exchange,EHR
    Date: 2011
  16. By: Baum, Peter
    Abstract: The paper takes a look on potential contribution of Information and Communication Technologies to abate public health challenges caused by demographics and lifestyle. From the current convergence of mhealth, and sport market products emerge targeting normal athletes to control their training in a quantified manner. The resulting feedback and transparency foster a healthier lifestyle. These products and services help overcome limitations to innovation typical to the health care market. The paper is based on research by the European Commission's Institute for Prospective Technological Studies on Integrated Personal Health/Care services. --
    Keywords: eHealth,Integrated Personal Health/Care services,sport,training,lifestyle related disease,innovation
    JEL: L86 I19 I29
    Date: 2011
  17. By: Jørgen Dejgaard Jensen (Institute of Food and Resource Economics, University of Copenhagen); Morten Raun Mørkbak (Institute of Food and Resource Economics, University of Copenhagen); Jonas Nordström (Institute of Food and Resource Economics, University of Copenhagen)
    Abstract: Canteen Takeaway is a novel concept, which entails workplace canteens to utilise existing production capacity to supply packaged meals for employees to bring home. The concept has a potential to raise the average nutritional quality of employees' diets. The purpose of the study is to assess the economic net gains for users, and for society as a whole, of promoting healthy canteen takeaway meals, using Danish workplaces as an example. The analytical framework for the study combines direct cost analyses, users’ willingness to pay estimated through a choice experiment and cost-of-illness methods to assess the net society costs and benefits associated with an extended use of canteen takeaway meals as a health promotion strategy. The results show that employees have a positive willingness to pay for health attributes in canteen takeaway meals, but with a minority having a highly negative willingness to pay for the canteen takeaway concept. The potential health effects of a healthy canteen takeaway programme are estimated to be positive, but modest in magnitude. The estimated costs of providing healthy canteen takeaway meals exceed the sum of average direct and indirect benefits. In conclusion, healthy CTA programmes seems to be an economically sustainable intervention at some workplaces, though the analysis does not fully support a full-scale implementation of healthy CTA programmes at Danish workplaces from a welfare economic perspective.
    Keywords: Cost-benefit analysis, Daly, Choice Experiment, Canteen take-away meals, Health
    Date: 2011–12
  18. By: Jesus M. Carro; Alejandra Traferri
    Abstract: This paper considers the estimation of a dynamic ordered probit of self-assessed health status with two fixed effects: one in the linear index equation and one in the cut points. The two fixed effects allow us to robustly control for heterogeneity in unobserved health status and in reporting behaviour, even though we can not separate both sources of heterogeneity. The contributions of this paper are twofold. First it contributes to the literature that studies the determinants and dynamics of Self-Assessed Health measures. Second, this paper contributes to the recent literature on bias correction in nonlinear panel data models with fixed effects by applying and studying the finite sample properties of two of the existing proposals to our model. The most direct and easily applicable correction to our model is not the best one, and has important biases in our sample sizes.
    Keywords: Dynamic ordered probit, ?fixed effects, self-assessed health, reporting bias, panel data, unobserved heterogeneity, incidental parameters, bias correction
    JEL: C23 C25 I19
    Date: 2011
  19. By: Saradindu Bhaduri (Centre for Studies in Science Policy, Jawaharlal Nehru University New Delhi); Thomas Brenner (Department of Geography, Philipps University Marburg)
    Abstract: The dynamics of drug launch has been an under-researched area. Most of the studies in this field focus on developed countries, quite uniform in terms of disease profile and regulatory framework, and analyse whether stringency in regulation influences launch delay. Developing countries, in contrast, have diverse disease profiles and weaker forms of regulation. A limited set of studies, undertaken in recent years, on the diffusion of new drugs in developing countries indeed conjectures importance of such factors in shaping drug launch dynamics. We investigate the delay of new drug launch in India for drugs launched in the German market during 1990-2004, when, due to weak IPR, not only the innovators but also the domestic firms could launch new drug molecules in the country, making drug launch dynamics interesting to explore. The paper finds that global commercial success of a new drug, market share, first mover advantage, and the threat of imposition of strong IPR system shortens delay. Innovativeness of a new drug, surprisingly, does not have much significant impact on delay.
    Keywords: Drug launch delay, Germany, India, survival analysis
    JEL: O10 O30 O33 O34 O53 L20 C14 L65
    Date: 2011–12
  20. By: Giorgio Brunello; Margherita Fort; Nichole Schneeweis; Rudolf Winter-Ebmer
    Abstract: We study the contribution of health-related behaviors to the health-education gradient by distinguishing between short-run and long-run mediating effects: while in the former only current or lagged behaviors are taken into account, in the latter we consider the entire history of behaviors. We use an empirical approach that addresses the endogeneity of education and behaviors in the health production function. Focusing on self-reported poor health as our health outcome, we find that education has a protective effect for European males and females aged 50+. We also find that the mediating effects of health behaviors - measured by smoking, drinking, exercising and the body mass index - account in the short run for 17% to 31% and in the long run for 23% to 45% of the entire effect of education on health, depending on gender.
    Keywords: Health, education, health behaviors, Europe.
    JEL: I1 I12 I21
    Date: 2011–07
  21. By: Joseph V. Spadaro
    Abstract: Throughout history, technological development and economic growth has led to greater prosperity and overall standard of living for many people in society. However, along with the benefits of economic development comes the social responsibility of minimizing the mortality and morbidity health impacts associated with human activities, safeguarding ecosystems, protecting world cultural heritage and preventing integrity and amenity losses of man-made environments. Effects are often irreversible, extend way beyond national borders and can occur over a long time lag. At current pollutant levels, the monetized impacts carry a significant burden to society, on the order of few percent of a country’s GDP, and upwards to 10% of GDP for countries in transition. A recent study for the European Union found that the aggregate damage burden from industrial air pollution alone costs every man, woman and child between 200 and 330 € a year, of which CO2 emissions contributed 40 to 60% (EEA 2011).<br /> <br /> In a sustainable world, an assessment of the environmental impacts (and damage costs) imposed by man\\\'s decisions on present and future generations is necessary when addressing the cost effectiveness of local and national policy options that aim at improving air quality and reducing greenhouse gas emissions. The aim of this paper is to present a methodology for calculating such adverse public health outcomes arising from exposure to routine atmospheric pollutant emissions using a simplified methodology, referred to as the Uniform World Model (UWM). The UWM clearly identifies the most relevant factors of the analysis, is easy to implement and requires only a few key input parameters that are easily obtained by the analyst, even to someone living in a developing country. The UWM is exact in the limit all parameters are uniformly distributed, due to mass conservation.<br /> <br /> The current approach can be applied to elevated and mobile sources. Its robustness has been validated (typical deviations are well within the ±50% range) by comparison with much more detailed air quality and environmental impact assessment models, such as ISC3, CALPUFF, EMEP and GAINS. Several comparisons illustrating the wide range of applicability of the UWM are presented in the paper, including estimation of mean concentrations at the local, country and continental level and calculation of local and country level intake factors and marginal damage costs of primary particulate matter and inorganic secondary aerosols. Relationships are also provided for computing spatial concentration profiles and cumulative impact or damage cost distributions. Assessments cover sources located in the USA, Europe, East Asia (China) and South Asia (India).<br />
    Keywords: Air Pollution, Urban Air Quality, Particulate Matter, Air Quality Modeling, Health Impact Assessment, Loss of Life Expectancy, Damage Costs of Air Pollution
    Date: 2011–12
  22. By: Hsieh, Chee-Ruey; Liu, Ya-Ming; Chang, Chia-Lin
    Abstract: Although the technological change in medicine has been widely recognized as the major driver of rising healthcare costs, there is very little research that directly estimates this effect. This paper uses both a single-equation and a simultaneous equations approach to empirically investigate the interactive relationship between technological innovation and the growth of health expenditure in the context of the pharmaceutical market in Taiwan. Based on observing 182 therapeutic groups between 1997 and 2006, we find evidence to support the argument that technological innovation and health expenditure are simultaneously determined as technological innovation and the growth of health expenditure are endogenous rather than exogenous. Specifically, we find that therapeutic groups associated with higher pharmaceutical expenditure are likely to attract more new products to the market. Meanwhile, therapeutic groups with more new products are associated with higher pharmaceutical expenditures. An important implication of the paper is that the cost containment policy will not only affect the growth of health expenditure, but will also affect the progress of technological innovation in the health sector.
    Keywords: Technological innovation; new drugs; health expenditure; simultaneous equation model
    JEL: I11 I19
    Date: 2011–11–25
  23. By: Narayanan, K.; Sahu, Santosh Kumar
    Abstract: Rural households tend to rely heavily on climate-sensitive resources. Climate Change can reduce the availability of these local natural resources, limiting the options for rural households that depend on natural resources for consumption or economic activities. During and after the climate related disasters the health condition of the rural households get adversely affected and hence, reduce the ability to employ themselves in economic activities and income of the households get adversely affected. In this connection, this paper is an attempt to analyze the adverse health effect due to climate related disasters; mostly due to flood. To understand this phenomenon, this work utilizes primary data collected at the household level from select villages of Kendrapada district in Orissa state in India. The sample consists of 150 rural households. We try to link income and health inequality of the sample households and analyze whether climate related disaster and climate shocks have any impact on their health behavior. We have further attempted to check the difference or similarity in health losses based on each coping strategies of the sample households. Using an econometric approach this study further finds the determinants of health impact of the households due to climate related disasters.
    Keywords: Climate change; Health; Energy Consumption; Income inequality; Orissa
    JEL: D31 I18 Q56 Q54
    Date: 2011
  24. By: Azuara, Oliver
    Abstract: This paper examines the impact of universal health coverage on cohabitation, marriage, and labor force participation. Economic gains from marriage when non-labor income increases among partners. I use the expansion of non-contributory health insurance in Mexico to test this. This insurance scheme, called Seguro Popular (SP), provides a minimum set of health benefits to the population not covered by formal social security. The rollout of SP started in 2002 across municipalities. This variation makes possible examine the effect of health insurance on marital status among workers. The analysis of this paper shows that non-contributory health insurance coverage has a significant negative effect on the probability of marriage among poor and low educated males and females, and a positive effect on the probability of cohabitation. SP, however, has no effect on labor force participation.
    Keywords: Marriage; cohabitation; health insurance; Seguro Popular; Oportunidades; Mexico
    JEL: J1 J0 I1
    Date: 2011–06–01
  25. By: Emily Oster; Ira Shoulson; E. Ray Dorsey
    Abstract: We use novel data to study the decision to undergo genetic testing by individuals at risk for Huntington disease (HD), a hereditary neurological disorder that reduces healthy life expectancy to about age 50. Although genetic testing is perfectly predictive and carries little financial or time cost, less than 10 percent of at-risk individuals are tested prior to the onset of symptoms. Testing rates are higher for individuals with higher ex ante risk of carrying the genetic expansion for HD. Untested individuals express optimistic beliefs about their probability of having HD and make fertility, savings, labor supply, and other decisions as if they do not have HD, even though individuals with confirmed HD behave quite differently. We show that these facts are qualitatively consistent with a model of optimal expectations (Brunnermeier and Parker, 2005) and can be reconciled quantitatively in this model with reasonable parameter values. This model nests the neoclassical framework and, we argue, provides strong evidence rejecting the assumptions of that framework. Finally, we briefly develop policy implications.
    JEL: D81 D84 I12
    Date: 2011–12
  26. By: Jason M. Lindo; Isaac D. Swensen; Glen R. Waddell
    Abstract: We consider the effect of legal access to alcohol on student achievement. We first estimate the effect using an RD design but argue that this approach is not well suited to the research question in our setting. Our preferred approach instead exploits the longitudinal nature of the data, identifying the effect by measuring the extent to which a student’s performance changes after he gains legal access to alcohol, controlling flexibly for the expected evolution of grades as students make progress towards their degrees. We find that students’ grades fall below their expected levels upon being able to drink legally, but by less than previously documented. We also show that there are effects on women and that the effects are persistent.
    JEL: I18 I21 K32
    Date: 2011–12

This nep-hea issue is ©2011 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.