nep-hea New Economics Papers
on Health Economics
Issue of 2012‒07‒14
twelve papers chosen by
Yong Yin
SUNY at Buffalo, USA

  1. Health: Analysis of the NIDS Wave 1 and 2 Datasets By Cally Ardington; Boingotlo Gasealahwe
  2. Taxes, Cigarette Consumption, and Smoking Intensity: Reply By Adda, Jérôme; Cornaglia, Francesca
  3. The Effects of EITC Payment Expansion on Maternal Smoking By Averett, Susan L; Wang, Yang
  4. The Effect of Breastfeeding on Children's Cognitive and Noncognitive Development By Borra, Cristina; Iacovou, Maria; Sevilla-Sanz, Almudena
  5. Filling the Gaps: Dentist Disparities along the Rural Urban Continuum By Terance J. Rephann; Tanya Wanchek
  6. Long-run effects of gestation during the Dutch hunger winter famine on labor market and hospitalization outcomes By S. Scholte, Robert; van den Berg, Gerard J.; Lindeboom, Maarten
  7. Universal health care and informal labor markets : the case of Thailand By Wagstaff, Adam; Manachotphong, Wanwiphang
  8. Eating Behavior and Social Interactions from Adolescence to Adulthood By Luisa Corrado; Roberta Distante
  9. What Happens the Morning After? The Costs and Benets of Expanding Access to Emergency Contraception By Tal Grossy; Jeanne Lafortune; Corinne Low
  10. Revisiting Health and Income Inequality Relationship:Evidence from Developing Countries By Pulok, Mohammad Habibullah
  11. Income, the Earned Income Tax Credit, and Infant Health By Hilary W. Hoynes; Douglas L. Miller; David Simon
  12. The Need for (long) Chains in Kidney Exchange By Itai Ashlagi; David Gamarnik; Michael A. Rees; Alvin E. Roth

  1. By: Cally Ardington (SALDRU, School of Economics, University of Cape Town); Boingotlo Gasealahwe
    Abstract: This report examines the health data from the second wave of the NIDS with a view to assessing the strengths and weakness of the data and highlighting the potential of the NIDS panel for the analysis of the relationship between health status and socio-economic status in South Africa. We begin by investigating associations between health and changes in the panel composition. We then examine data quality both within and between the waves, focussing on item non-response within waves and data consistency between waves. The final section examines changes in nutritional status between the waves of the panel. The analyses in this report are descriptive, preliminary and very much intended to illustrate the potential of the NIDS panel for furthering our understanding of the links between health and socio-economic status.
    Keywords: Nids Data
    Date: 2012
  2. By: Adda, Jérôme (European University Institute); Cornaglia, Francesca (Queen Mary, University of London)
    Abstract: This paper shows that smoking intensity, i.e. the amount of nicotine extracted per cigarette smoked, responds to changes in excise taxes and tobacco prices. We exploit data covering the period 1988 to 2006 across many US states. Moreover, we provide new evidence on the importance of cotinine measures in explaining long-run smoking behavior and we investigate the sensitivity of smoking cessation to changes in excise taxes and their interaction with smoking intensity.
    Keywords: tobacco, public health, compensatory behavior, excise taxes
    JEL: D12 H25 I12
    Date: 2012–06
  3. By: Averett, Susan L (Lafayette College); Wang, Yang (Lafayette College)
    Abstract: The Earned Income Tax Credit (EITC) is the largest anti-poverty program in the U.S. In 1993, the EITC benefit levels were changed significantly based on the number of children in the family such that families with two or more children experienced an exogenous expansion in their incomes. Using data from the National Longitudinal Survey of Youth 1979 cohort, we employ a triple differences plus Fixed-Effects framework to examine the effect of this change on the probability of smoking among low-educated mothers. We find that the probability of smoking for white and Hispanic low-educated mothers of two or more children decreased statistically significantly relative to those with only one child, and the results are robust to various specification tests. These results provide new evidence on the protective effect of income on health through changes in health behaviors, and therefore have important policy implications.
    Keywords: low-income mothers, EITC, smoking
    JEL: I12 I38
    Date: 2012–06
  4. By: Borra, Cristina (University of Seville); Iacovou, Maria (University of Essex); Sevilla-Sanz, Almudena (Queen Mary, University of London)
    Abstract: This paper uses propensity score matching methods to investigate the relationship between breastfeeding and children's cognitive and noncognitive development. We find that breastfeeding for four weeks is positively and statistically significantly associated with higher cognitive test scores, by around one tenth of a standard deviation. The association between breastfeeding and noncognitive development is weaker, and is restricted to children of less educated mothers. We conclude that interventions which increase breastfeeding rates would improve not only children's health, but also their cognitive skills, and possibly also their noncognitive development.
    Keywords: breastfeeding
    JEL: I10 J0
    Date: 2012–06
  5. By: Terance J. Rephann (Center for Economic and Policy Studies); Tanya Wanchek (Center for Economic and Policy Studies)
    Abstract: This paper examines the distribution of dentists among U.S. counties along the rural-urban continuum. Dentist workforce availability has implications for oral health care access and utilization, which in turn can affect the quality of life, health, and productivity of rural residents. In addition, dentists form part of the non-tradable services sector, and its erosion may affect the vitality of rural economies. Nonmetropolitan counties have significantly lower levels of dentists per 100,000 residents than metropolitan areas and face the prospect of future attrition in the dentist workforce because of an aging workforce and increasing difficulty attracting newly minted dentists who favor more urbanized practice locations. The paper develops spatial econometric models of dentist location to help identify factors amenable to policy intervention. Results indicate that demand factors such as income, private insurance coverage, educational levels, and demographic composition play a role in dentist disparities. Also, private practice dentists tend to cluster near counties with urban areas consisting of at least 10,000 residents, higher net in-commuting, a greater presence of other health care and creative class professionals, and natural amenities. More stringent regulation for dental hygienists also boosts the relative quantity of dentists. Dental schools and public dentists are associated with a greater availability of private practice dentists.
    Keywords: dentists, distribution, spatial econometrics, rural-urban continuum
    JEL: I11 J44 R12
    Date: 2012–05–22
  6. By: S. Scholte, Robert (VU University Amsterdam); van den Berg, Gerard J. (IFAU - Institute for Evaluation of Labour Market and Education Policy); Lindeboom, Maarten (VU University Amsterdam)
    Abstract: The Dutch Hunger Winter (1944/45) is the most-studied famine in the literature on long-run effects of malnutrition in utero. Its temporal and spatial dermacations are clear, it was severe, it was anticipated, and nutritional conditions in society were favorable and stable before and after the famine. This is the first study to analyze effects of in utero exposure on labor market outcomes and hospitalization, and the first to use register data covering the full dutch population to examine long-run effects of this famine. We provide results of famine exposure by sub-interval of gestation. We find a significantly negative effect of exposure during the first trimester of gestation on employment outcomes 53 or more years after birth. Hospitalization rates in the years before retirement are higher after middle or late gestational exposure.
    Keywords: Nutrition; ageing; developmental origins; morbidity; income; health; employment
    JEL: I10 I12 J01 J10 J13 J14
    Date: 2012–07–03
  7. By: Wagstaff, Adam; Manachotphong, Wanwiphang
    Abstract: This paper explores the possibility that universal health coverage may inadvertently result in distorted labor market choices, with workers preferring informal employment over formal employment, leading to negative effects on investment and growth, as well as reduced protection against non-health risks and the income risks associated with ill health. It explores this hypothesis in the context of the Thai universal coverage scheme, which was rolled out in four waves over a 12-month period starting in April 2001. It identifies the effects of universal coverage through the staggered rollout, and gains statistical power by using no less than 68 consecutive labor force surveys, each containing an average of 62,000 respondents. The analysis finds that universal coverage appears to have encouraged employment especially among married women, to have reduced formal-sector employment among married men but not among other groups, and to have increased informal-sector employment especially among married women. The largest positive informal-sector employment effects are found in the agricultural sector.
    Keywords: Health Monitoring&Evaluation,Labor Markets,Population Policies,Labor Policies,Access to Finance
    Date: 2012–07–01
  8. By: Luisa Corrado (Department of Economics; Faculty of Economics, University of Rome; University of Cambridge); Roberta Distante (Department of Economics)
    Abstract: This paper analyzes the importance of social ties for eating behavior of US youth. We propose a novel approach that addresses identification of social endogenous effects. We overcome the problem of measuring the separate impact of endogenous and contextual effects on individual Body Mass Index (BMI) in a dynamic linear-in-means model, where individual- and group-specifi?c unobservable effects are controlled for. We show that the main drivers of eating behavior are habituation and imitation effects. Imitation effects explain most of the variation in BMI of individuals who were normal-weight and overweight during adolescence. Obese adolescents, instead, become future obese adults through wrong habits enforced by imitative behavior.
    Keywords: Overweight, Obesity, Peer Effects, Social Networks, Personal History, Dynamic Linear-in-means Mode
    JEL: D10 D71 I19 J11 Z13
    Date: 2012–06–19
  9. By: Tal Grossy; Jeanne Lafortune; Corinne Low
    Abstract: Emergency contraception (EC) can prevent pregnancy after sex, but only if taken within 72 hours of intercourse. Over the past 15 years, access to EC has been expanded at both the state and federal level. This paper studies the impact of those policies. We find that expanded access to EC has had no statistically significant effect on birth or abortion rates. Expansions of access, however, have changed the venue in which the drug is obtained, shifting its provision from hospital emergency departments to pharmacies. We find evidence that this shift may have led to a decrease in reports of sexual assault.
    Keywords: Desalination, Emergency contraception, Fertility, Abortion, Sexual assault
    JEL: J13 I18
    Date: 2012
  10. By: Pulok, Mohammad Habibullah
    Abstract: In general, countries with more equal income distribution generally enjoy better health. Earlier empirical studies on the relationship between income distribution and health at country level present strong evidence that income inequality on an average impedes the improvement of population health. However, a majority of these empirical studies are based on data from either only developed countries or pooled data from developing and developed countries. They mainly study the relationship at a single point of time or at an average of several years. These studies also fail to control for country specific unobserved heterogeneity. Departing from the general trend of current literature, this paper examines the health-income inequality hypothesis using panel data from 31 low income and low middle income countries for the period of 1982-2002. The results from the simple pooled OLS analysis indicate that health and income inequality is negatively related in these countries. This finding is in line with the most of the earlier cross country studies. However, application of fixed effects and random effects model to control country specific heterogeneity provides contradictory results. In other words, my findings from this study confirm that there is a positive relation between health and income distribution in this set of developing countries over this period.
    Keywords: Health; Fixed Effects; Income Inequality; Random Effects
    JEL: I0 C23 N3 O50
    Date: 2012–06–15
  11. By: Hilary W. Hoynes; Douglas L. Miller; David Simon
    Abstract: This paper evaluates the health impact of a central piece in the U.S. safety net for families with children: the Earned Income Tax Credit. Using tax-reform induced variation in the federal EITC, we examine the impact of the credit on infant health outcomes. We find that increased EITC income reduces the incidence of low birth weight and increases mean birth weight. For single low education (<= 12 years) mothers, a policy-induced treatment on the treated increase of $1000 in EITC income is associated with 6.7 to 10.8% reduction in the low birth weight rate, with larger impacts for births to African American mothers. These impacts are evident with difference-in-difference models and event study analyses. Our results suggest that part of the mechanism for this improvement in birth outcomes is the result of more prenatal care and less negative health behaviors (smoking). We find little role for changes in health insurance. We contribute to the literature by establishing that an exogenous increase in income can improve health, and illustrating a health impact of a non-health program. More generally, we demonstrate the potential for positive external benefits of the social safety net.
    JEL: H2 H51 I38
    Date: 2012–07
  12. By: Itai Ashlagi; David Gamarnik; Michael A. Rees; Alvin E. Roth
    Abstract: It has been previously shown that for sufficiently large pools of patient-donor pairs, (almost) efficient kidney exchange can be achieved by using at most 3-way cycles, i.e. by using cycles among no more than 3 patient-donor pairs. However, as kidney exchange has grown in practice, cycles among n>3 pairs have proved useful, and long chains initiated by non-directed, altruistic donors have proven to be very effective. We explore why this is the case, both empirically and theoretically. We provide an analytical model of exchange when there are many highly sensitized patients, and show that large cycles of exchange or long chains can significantly increase efficiency when the opportunities for exchange are sparse. As very large cycles of exchange cannot be used in practice, long non-simultaneous chains initiated by non-directed donors significantly increase efficiency in patient pools of the size and composition that presently exist. Most importantly, long chains benefit highly sensitized patients without harming low-sensitized patients.
    JEL: C78 D02 I11
    Date: 2012–07

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