nep-hea New Economics Papers
on Health Economics
Issue of 2012‒11‒24
ten papers chosen by
Yong Yin
SUNY at Buffalo, USA

  1. Working Conditions, Lifestyles and Health By Elena Cottini; Paolo Ghinetti
  2. Obesity, Weight Loss, and Employment Prospects – Evidence from a Randomized Trial By Arndt Reichert
  3. Explaining Variations in Breast Cancer Screening Across European Countries By Ansgar Wübker
  4. Assessing Inequalities in Preventive Care Use in Europe By Vincenzo Carrieri; Ansgar Wübker
  5. The Effect of a Bonus Program for Preventive Health Behavior on Health Expenditures By Boris Augurzky; Arndt Reichert; Christoph M. Schmidt
  6. Mental Health and Labour Supply – Evidence from Mexico‘s Ongoing Violent Conflicts By Maren M. Michaelsen
  7. Children at Risk: The Effect of Crop Loss on Child Health in Rural Mexico By Maren M. Michaelsen; Songül Tolan
  8. Longevity and Schooling: The Case of Retirement By Nina Boberg-Fazlic
  10. The Cost of Treating Chronic Non-Communicable Diseases: Does it Matter? By Conrad, Daren A.; Webb, Marquitta C.

  1. By: Elena Cottini (Dondena Center for Research on Social Dynamics, Bocconi University and Center for Corporate Performance, Aarhus University); Paolo Ghinetti (Dipartimento di Studi per l’Economia e l’Impresa, Università del Piemonte Orientale)
    Abstract: The aim of this paper is to investigate whether employee health is affected by the environment in which the individual works - in terms of both physical and psychosocial working conditions - and by his or her lifestyle. Health measures are computed from Danish data, and refer to both self assessed general health and two more objective health measures: mental health specific to work-related problems, and physical health. We find that both bad working conditions and bad lifestyles reduce health, especially in its self-assessed component. The impact of lifetsyle indicators have a more modest health impact on both physical and mental health.
    Keywords: working conditions, lifestyle, health
    JEL: I1 C0
    Date: 2012–11–12
  2. By: Arndt Reichert
    Abstract: This study presents credible estimates for the causal effect of a variation in obesity on employment. By exploring random assignment of a weight loss intervention based on monetary rewards, I provide convincing evidence that weight loss positively affects the employment prospects of obese women but not of obese men. Consistent with this, significant effects of weight loss on proxy variables for labor productivity are found only for obese women.
    Keywords: Obesity; weight loss intervention; IV estimation; sample selection; labor productivity; employment
    JEL: I10 I18 J24 J21
    Date: 2012–11
  3. By: Ansgar Wübker
    Abstract: This paper explores variations in the uptake of breast cancer screening and associated factors influencing utilisation of mammography screening among women aged 50 to 69 years in 13 European countries. We focus on the relative importance of individual (e.g. age, education, etc.) and institutional (e.g. public screening program) factors in explaining cross-country variation in the utilisation of mammograms. We take advantage of (a) newly available individual level data from the SHARE as well as (b) regional and country level data on institutional factors. We find that observed individual factors like age, education, health status, etc. are associated with screening uptake within countries but cannot statistically explain cross-country differences. In contrast, observed institutional factors like the availability of an organized screening program can statistically explain about 40 per cent of the between country differences in screening rates.
    Keywords: Health economics; prevention; multilevel models; SHARE; cross country differences
    JEL: C01 I11 I18
    Date: 2012–10
  4. By: Vincenzo Carrieri; Ansgar Wübker
    Abstract: This paper presents the first cross-country estimation of needs-adjusted income and education-related inequalities in the use of a whole set of preventive care treatments. Analysis is based on the first three waves of the Survey of Health, Ageing and Retirement (SHARE) for individuals aged 50 and over living in 13 European countries. We employ alternative concentration indices based on the CI-corrections for binary outcomes to compute inequalities in the use of breast cancer screening, of colorectal cancer screening, of influenza vaccination, and of routine prevention tests (blood pressure, cholesterol, and blood sugar tests). After controlling for needs, we find that in many European countries strong pro-rich and educational inequalities exist with respect to breast and colon cancer screening, blood tests and flu-vaccination. Furthermore, poor and less educated people are more likely than the better off to use preventive care late, e.g. when health shocks occurred or health problems already display symptoms. Finally, results suggest that access to treatments within a specialist setting is generally less equal than access to treatments provided within a GP setting.
    Keywords: Preventive care; socio-economic related inequalities; concentration indices
    JEL: I14 D63
    Date: 2012–10
  5. By: Boris Augurzky; Arndt Reichert; Christoph M. Schmidt
    Abstract: This paper contributes to the analysis of policy measures that attempt to reduce health care expenditures of insurers. We examine the impact of a cash bonus program for preventive health behavior of a German health insurer on prevention effort and health care expenditures using a unique administrative dataset that covers all insurants of the health insurer between 2003 and 2008. We find that the program has been successful in both increasing individual prevention effort and achieving net savings every year since its implementation in 2004. However, while the estimated effect on health care expenditures is statistically significant in the first year, the effects for the second, third, and fourth years turn insignificant. In the fifth year, results for net savings are sensitive in terms of statistical significance when accounting for dynamic selection into the treatment.
    Keywords: Financial incentives; health care expenditures; dynamic treatment effect; health prevention; inverse probability weighting; bonus program
    JEL: I10 I12 I18
    Date: 2012–10
  6. By: Maren M. Michaelsen
    Abstract: In Mexico, conflicts between drug-trafficking organisations result in a high number of deaths and immense suffering among both victims and non-victims every year. Little scientific research exists which identifi es and quantifi es the monetary and nonmonetary consequences of ongoing violent conflicts on individuals. Using the Mexican Family Life Survey for 2002 and 2005, the causal effect of mental health (symptoms of depression / anxiety) on the extensive and intensive margin of labour supply for working-aged men and women is estimated. Measures of the ongoing drug-related violent conflicts both at the macro level using intentional homicide rates by region, and at the micro level indicated by the presence of armed groups in the neighbourhood, serve as instruments for mental health. The results show a significant adverse impact of the conflicts on anxiety for men and women. Based on IV-Tobit model results, a worse mental health state decreases individual labour supply strongly and significantly for men. The findings demonstrate that Mexico‘s population not only suffers from the violent conflicts between drug-trafficking organisations by anxiety or even depression but also indirectly from less household income through less work which in turn has consequences for Mexico‘s social development and economic growth.
    Keywords: Mental health; labour supply; violent conflict; Mexico
    JEL: J22 I19 O12 D74
    Date: 2012–10
  7. By: Maren M. Michaelsen; Songül Tolan
    Abstract: This study investigates the effect of an economic shock due to crop loss on health outcomes of children in rural Mexico. Data from the Mexican Family Life Survey for the years 2002 and 2005 off er retrospective information on economic shocks since 1997 and height-for-age z-scores (HAZ) to measure long-term effects on child health. Since crop losses are exogenous to the children, simple OLS regressions are used to estimate the effect of crop loss overall and over time. Children who were hit by crop loss have on average 0.4 standard deviations smaller HAZ two and three years after the shock than other children. For boys and children aged 25 to 60 months being hit by crop loss also increases the probability of being stunted by 20 and 27 percentage points, respectively. The findings demonstrate that, albeit its large poverty reduction programs, Mexico has to invest more to combat poverty and provide mechanisms to help households to cope with sudden economic losses.
    Keywords: Economic shock; crop loss; child health; Mexico
    JEL: I15 J13 Q12
    Date: 2012–10
  8. By: Nina Boberg-Fazlic (University of Copenhagen, Department of Economics)
    Abstract: It is often conjectured that higher life expectancy leads to longer schooling. The reasoning behind this notion is that a longer lifespan increases the recovery period of human capital investment and thus, makes it more profitable to invest in education. This notion goes back to Ben-Porath (1967) and is therefore often termed the Ben-Porath mechanism. However, the original Ben-Porath mechanism concerns the length of economic life and not the length of life per se. This distinction is important in the presence of retirement and especially so as earlier retirement ages are observed in many western countries. This paper presents an overlapping generations model including both an educational and a retirement decision, thereby being able to test the Ben-Porath mechanism using the correct denition of length of working life. It is found that an increase in life expectancy does not necessarily increase the expected length of economic life as also early retirement can occur. Schooling still increases, however not due to the increase in the recovery horizon but due to an increase in the probability of surviving the recovery period.
    Keywords: longevity, human capital, retirement, overlapping generations
    JEL: D91 I20 J10 J26
    Date: 2012–09–01
  9. By: Staudigel, Matthias
    Abstract: This paper reviews the application of household production theory to health and nutrition and their determinants in the economics literature. We examine 17 recent studies applying this approach and analyse how they model utility functions, elementary goods, and production processes. Notwithstanding the valuable insights provided by these economic analyses into the phenomenon of obesity and health behaviour, the framework’s basic idea, the separation of utility generation and production technology, is not pursued consistently. The majority of the studies reviewed focus solely on health production, thereby neglecting important production processes for other elementary commodities and their related inputs and technologies. We advocate a broader application of the household production principle and discuss how such a view can guide theoretical and empirical analysis and may provide inspiration for data collection and policy design.
    Keywords: Household production theory, health, nutrition, obesity, economic analysis, Consumer/Household Economics,
    Date: 2012
  10. By: Conrad, Daren A.; Webb, Marquitta C.
    Abstract: Heart disease and Type 2 diabetes mellitus are among the two leading causes of death in the CARICOM member states with HIV/AIDS a distant sixth. Attention is now being paid to non-communicable diseases which have outpaced communicable diseases as the major cause of death. This paper investigated the link between the public medical cost of treating chronic non-communicable diseases, namely heart disease and diabetes, on national output in Barbados, Guyana, Jamaica, and Trinidad and Tobago. The results provide evidence that the public medical cost of treating chronic non-communicable diseases does have a statistically significant negative impact on national output.
    Keywords: Non-Communicable Diseases; Caribbean Development; Economic Growth
    JEL: H51
    Date: 2012–06–15

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