nep-hea New Economics Papers
on Health Economics
Issue of 2013‒04‒20
23 papers chosen by
Yong Yin
SUNY at Buffalo

  1. Health, Work Intensity, and Technological Innovations By Raouf Boucekkine; Natali Hritonenko; Yuri Yatsenko
  2. Home Heating and Asthma in New Zealand By Rachel Susan Webb; Andrea Menclova
  3. Does breastfeeding support at work help mothers and employers at the same time? By E. Del Bono; C. Pronzato
  4. Parental Health and Child Schooling By M. Bratti; M. Mendola
  5. Identifying Factors that Determine Bicyclist and Pedestrian-Involved Collision Rates and Bicyclist and Pedestrian Demand at Multi-Lane Roundabouts By Arnold, Lindsay S.; Flannery, Aimee; Ledbetter, Lauren; Bills, Tierra; Jones, Michael G.; Ragland, David R.; Spautz, Laura
  6. Expected health benefits of additional evidence: Principles, methods and applications By Karl Claxton; Susan Griffin; Hendrik Koffijberg; Claire McKenna
  7. Explaining the Sources of IncomeRelated Inequality in Health Care Utilization in Denmark By Gundgaard, Jens; Lauridsen, Jørgen
  8. How Does Unemployment Affect the Health-related Behavior of Japanese Men? A Panel Data Analysis By Kan, Mari
  9. Semiparametric duration analysis with an endogenous binary variable: An application to hospital stays By Masuhara, Hiroaki
  10. Physical Inactivity of Workers and its Relation to Uneven Allocation of Public Sports Facilities By Kumagai, Narimasa
  11. The Impact of Health Problems on Income of the Elderly in Japan By Hamaaki, Junya; Noguchi, Haruko
  12. What's an Apology Worth? Difference-in-Differences Analysis of State Apology Laws on Medical Malpractice Payouts By Benjamin Ho; Elaine Liu
  13. Endogenous altruism, redistribution, and long term care By Cremer, Helmuth; Gahvari, Firouz; Pestieau, Pierre
  14. Working time, health and safety a research synthesis paper By Tucker, Philip; Folkard, Simon
  15. The health of workers in selected sectors of the urban economy : challenges and perspectives By Comaru, Francisco; Werna, Edmundo
  16. Evidence on Individual Preferences for Longevity Risk By Delprat, Gaëtan; Leroux, Marie-Louise; Michaud, Pierre-Carl
  17. Health and Labour Income of Wage Earners and Self-Employed Workers in Cameroon By Fomba Kamga, Benjamin; Kengne Kamga, Arline; Audibert, Martine
  18. Education, Cognition, Health Knowledge, and Health Behavior By Naci Mocan; Duha T. Altindag
  19. Medicare Health Plans and Dually Eligible Beneficiaries: Industry Perspectives on the Current and Future Market. By Marsha Gold; Winnie Wang; Gretchen Jacobson
  20. Reducing Calories and Added Sugars by Improving Children's Beverage Choices. By Ronette R. Briefel; er Wilson; Charlotte Cabili; Allison Hedley Dodd
  21. Assessing the Usability of MAX 2008 Encounter Data for Comprehensive Managed Care. By Vivian L.H. Byrd; Allison Hedley Dodd
  22. Air Pollution and Procyclical Mortality By Heutel, Garth; Ruhm, Christopher J.
  23. Dynamic modelling of long-term care decisions By Michelle Sovinsky; Steven Stern

  1. By: Raouf Boucekkine (Aix-Marseille University (Aix-Marseille School of Economics, CNRS & EHESS, IRES and CORE, Université Catholique de Louvain.); Natali Hritonenko (Department of Mathematics, Prairie View A&M University); Yuri Yatsenko (Houston Baptist University)
    Abstract: Work significantly affects human life and health. Overworking may decrease the quality of life and cause direct economic losses. Technological innovations encourage modernization of firms’ capital and improve labor productivity in the workplace. The paper investigates the optimal individual choice of work intensity under improving technology embodied in new equipment leading to shorter lifetime of capital goods (obsolescence). The balanced growth trajectories are analyzed in this context to find out, in particular, how the optimal choice of work intensity is tied to the rate of embodied technological change. The impact of embodied technological advances on the work/life balance problem is discussed and their macroeconomic consequences are highlighted.
    Keywords: work-life balance, rational individual choice, technological development, vintage capital.
    JEL: D91 D92 O11 I10 C60
    Date: 2013–03
  2. By: Rachel Susan Webb; Andrea Menclova (University of Canterbury)
    Abstract: New Zealand has one of the highest asthma prevalence rates among developed coun¬tries and previous research attributes this partly to poor socioeconomic conditions in cer¬tain neighborhoods and to insufficient home heating in particular. International retro¬spect¬ive empirical studies suggest that home heating is associated with asthma rates. However, strong evid¬ence of causality is lacking. In this paper, we empirically investigate the link between home heating and hospital asthma admissions in New Zealand using panel data techniques and controlling for endogeneity. The hypothesis that higher electricity prices (via less ade¬quate heating) increase hospital asthma admissions is tested and receives strong empirical support across a number of model specifications and datasets used.
    Keywords: Asthma; Home heating; Electricity price
    JEL: I12
    Date: 2013–04–12
  3. By: E. Del Bono; C. Pronzato
    Abstract: This paper asks whether the availability of breastfeeding facilities at the workplace helps to reconcile breastfeeding and work commitments. Using data from the 2005 UK Infant Feeding Survey, we model the joint probability to return to work and breastfeeding and analyse its association with the availability of breastfeeding facilities. Our findings indicate that the availability of breastfeeding facilities is associated with a higher probability of breastfeeding and a higher probability to return to work by 4 and 6 months after the birth of the child. The latter effects are only found for women with higher levels of education.
    Keywords: breastfeeding, cognitive development, child outcomes
    JEL: J13 C26
    Date: 2012
  4. By: M. Bratti; M. Mendola
    Abstract: This paper provides new evidence on the impact of parental health shocks on investment in child education using detailed longitudinal data from Bosnia and Herzegovina. Our study controls for individual unobserved heterogeneity by using child fixed effects, and it accounts for potential health misreporting by employing several, more objective, health indicators. Our results show that children of ill mothers, but not of ill fathers, are significantly less likely to be enrolled in education at ages 15-24. Moreover, there is some evidence that mothers’ health shocks have more negative consequences on younger children and sons.
    Keywords: Human Capital, Intrahousehold allocation, Health shocks, Education, Bosnia and Herzegovina
    JEL: I21 O15
    Date: 2012
  5. By: Arnold, Lindsay S.; Flannery, Aimee; Ledbetter, Lauren; Bills, Tierra; Jones, Michael G.; Ragland, David R.; Spautz, Laura
    Abstract: This project examined the safety and demand issues for pedestrians and bicyclists at multi-lane roundabouts through a literature review, case studies, in-field counts and surveys, focus groups, and video analysis. This document presents research findings, synthesizes current information on best practices, and makes recommendations to assist local agencies planning and designing safer multi-lane roundabouts. These findings should help local agencies and Caltrans create roundabouts that better and more safely address the needs of bicyclists and pedestrians. The current literature is referred to throughout the document to augment the research team’s findings, especially for issues that were beyond the scope of this project. Key findings in the areas of pedestrian and bicyclist avoidance of, behavior around, and collisions at multi-lane roundabouts are presented along with recommendations for geometric design, design speed, sight distance, width of lanes, signage and pavement markings, and operational recommendations. 
    Keywords: Transportation and Highway Engineering
    Date: 2013–04–01
  6. By: Karl Claxton (Centre for Health Economics and Department of Economics and Related Studies,University of York, UK); Susan Griffin (Centre for Health Economics, University of York, UK); Hendrik Koffijberg (Julius Centre for Health Sciences and Primary Care, University Medical Centre, Utrecht, The Netherlands); Claire McKenna (Centre for Health Economics and Department of Economics & Related Studies, University of York, UK)
    Abstract: The purpose of this research is to illustrate: i) the principles of what assessments are required when considering the need for additional evidence and the priority of proposed research; and ii) how these assessments might be informed by quantitative analysis based on standard methods of systematic review and meta-analysis. We briefly outline the principles of what type of assessments are needed when considering research prioritization and commissioning. These are more fully examined through the integration of the principles of value of information analysis with the type of meta-analysis commonly conducted in systematic review and its application to four topics or case studies. The case studies were selected to cover a number of contexts in which these assessments are likely to be required and include: where the primary endpoint in existing studies capture key aspects of outcome; where it can be linked to other important aspects of outcome; when different ‘weights’ might be used to reflect the relevance and quality of different studies and when more than two alternative interventions need to be compared. Throughout, we distinguish the value of additional evidence and the value of implementing the findings from existing research. We also show how the value of additional evidence and the need for further research depends on the clinical difference in key aspects of outcome that would need to be demonstrated before clinical practice ‘should’ or is likely to change. We also consider whether the expected health benefits of additional evidence are sufficient to regard a particular research proposal as potentially worthwhile and whether it should it be prioritized over other research topics that could have been commissioned with the same resources. We also set out the implications of this type of analysis for research design, including whether randomised design is likely to be needed, the most appropriate scale of future research and the sequence in which different types of study might be undertaken. The report demonstrates how making best use of the results of standard meta-analysis can directly inform the questions posed in research prioritisation and commissioning. In principle, this type of analysis could become part of the routine reporting of the findings of systematic review. In addition, it is sufficiently general to be relevant across a range of different types of health care systems, whether or not formal cost effectiveness analysis is explicitly used as part of the decision making process.
    Date: 2013–04
  7. By: Gundgaard, Jens (Novo Nordisk A/S); Lauridsen, Jørgen (COHERE, Department of Budiness and Economics)
    Abstract: Objectives with the health care system often include equity considerations. One objective is equal treatment for equal need. In this paper we explain the sources of income-related inequality in utilization of health care services in Funen County, Denmark, by linking survey data to register based data. A decomposition of the concentration index was used to explain the sources of overall income-related inequality in utilization. The decomposition approach suggests that health care is in general equally distributed in Denmark when need based variables are controlled for. However, this overall result is a consequence of a number of off-setting effects from different types of health care and a complicated pattern of various explanatory variables.
    Keywords: health care; utilization; concentration index; inequality; decomposition
    JEL: D20 D31 I10 I12
    Date: 2013–04–01
  8. By: Kan, Mari
    Abstract: By using panel data, this study examines the effect of unemployment on various types of individual health-related behavior, namely physical exercise, dietary habits, smoking, drinking, and sleep duration among Japanese men aged 20 ?40 years. The results indicate that the effect of unemployment on health-related behavior varies. It is found that exercise habits and sleep duration are affected by unemployment, while there are no observed effects on dietary habits, smoking, and frequency of drinking. Being unemployed has positive effects on frequency of exercise and sleep duration. When an individual suffers from unemployment in two successive periods, he increases the frequency of exercise, while current unemployment directly affects sleep duration. The positive effects of unemployment on exercise and sleep are explained by the increased time in the health investment function.
    Keywords: health capital, unemployment, health-related behavior, exercise, smoking, drinking, sleep, panel data
    JEL: I12 I19 J22 J60
    Date: 2013–03
  9. By: Masuhara, Hiroaki
    Abstract: Background: In duration analysis, we find situations where covariates are simultaneously determined along with the duration variable. Moreover, although the models based on a hazard rate do not explicitly assume heterogeneity, in applied econometrics, the possibility of omitted variables is inevitable and controlling population heterogeneity alone is inadequate. It is important to consider both heterogeneity and endogeneity in duration analysis. Objectives and methods: Explicitly assuming semiparametric correlated heterogeneity, this paper proposes an alternative robust duration model with an endogenous binary variable that generalizes the heterogeneity of both duration and endogeneity using Hermite polynomials. Under these setups, we investigate the difference between the endogenous binary variable's coefficients of the parametric and semiparametric models using the Medical Expenditure Panel Survey (MEPS) data. Results: The parameter values of the endogenous binary variable (insurance choice) are statistically significant at the 1% level; however, the values differ among the parametric and semiparametric models and the any type of insurance choice increases the length of hospital stays by 104.010% in the censored parametric model, and 182.074% in the censored semiparametric model. Compared with the parametric model, the increase of hospital stays in the semiparametric model is large. Moreover, we find that the semiparametric model a twin-peak distribution and that the contour lines differ from the usual ellipsoids of the bivariate normal density. Conclusions: When applied to the duration of hospital stays of the MEPS data, the estimated results of the semiparametric model shows a good performance. The absolute values of the endogenous binary regressor coefficients of the semiparametric models are larger than that of the parametric model. The parametric model underestimates the effect of the individual's insurance choice in our example. Moreover, the estimated densities of the semiparametric models have twin peak distribution.
    Keywords: Endogenous switching, duration analysis, probit, semi-nonparametric model, heterogeneity
    JEL: C14 C31 C34
    Date: 2013–03
  10. By: Kumagai, Narimasa
    Abstract: Personal lifestyle choices such as leisure-time physical activity are major determinants of both the health and happiness of individuals. However, price discrimination exists between municipalities at almost public sports facilities. An economic intervention to change the cost of using public sports facilities could affect both the level of participation in sports and the health of the participants. Workers in rural areas have better access to public sports facilities, but lower income workers did not tend to engage in leisure-time physical activity. Using micro-data from nationwide surveys, we examined the effects of the policy to promote cross-border use of public sports facilities by workers in Japan, taking into account the endogeneity problem among physical activity, self-assessed health and happiness. We analyzed the relationship between physical inactivity and health using two latent dichotomous variables. As a proxy variable of the number of potential users of public sports facilities, the ratio of population to the number of public sports facilities was used. The seemingly unrelated bivariate probit model of latent physical inactivity and latent health provided the best specification. The ratio of population to the number of public sports facilities had two opposite effects. One was a negative effect on physical inactivity and the other was a positive effect on latent health. We concluded that abolishing price discrimination between municipalities to promote the cross-border use of public sports facilities would increase the health of the individuals. Since population has been decreasing in most municipalities in Japan, with the exception of several large cities, a policy which abolishes the price discrimination between municipalities would seem to be a good health policy.
    Keywords: Concentration Index, Perceived Happiness, Physical Inactivity, Public Sports Facilities, Self-Assessed Health
    Date: 2013–03
  11. By: Hamaaki, Junya; Noguchi, Haruko
    Abstract: The aim of this chapter is to empirically examine the impact of health problems of the elderly on their own and their household’s income. Using micro panel data from the “Survey on Health and Retirement” focusing on the elderly, we estimate the effect on an individual’s income and his household’s income of the number of illnesses respondents suffered in the three years preceding the survey, of suffering from a lifestyle disease, and of suffering from one of the three major “killer diseases” in Japan (cancer or malignant growth, heart disease, stroke or cerebrovascular disease). In order to deal with endogeneity in the health indicators, we employ survey respondents’ body mass index at age 30 and their parents’ medical history as instruments in the estimation and, when focusing on suffering from at least one of the three killer diseases, use respondents’ body height as an additional instrument. In the estimation, we focus on male survey participants. The results suggest that an additional illness in the preceding years on average significantly reduced individuals’ income. On the other hand, although the estimated coefficients on the effect of lifestyle diseases on individuals’ income or household income were as expected negative, they were insignificant in both cases. Furthermore, when dividing observations into two subsamples ? men under the age of 60 and age 60 and over ? we find that in the case of the under 60s, a deterioration in health on average has no significant effect either on the individuals’ own income or their household income. Likely reasons are that, if at all possible, such individuals will continue to work, or that any decline in income is offset by the spouse starting to work and/or the receipt of insurance payments. On the other hand, for men aged 60 and over, a deterioration in health has a significant impact on their own income, but that on household income is limited. That such individuals’ own income declines is likely due to the fact that they are much more likely to stop working as a result of health problems, while the limited effect on household income may be due to the fact that the share of such individuals’ income in total household income is relatively small.
    Date: 2013–03
  12. By: Benjamin Ho (Cornell University); Elaine Liu (University of Houston)
    Abstract: Past studies find that apologies affect the outcomes of medical malpractice litigation, but such studies have largely been limited to laboratory surveys or case studies. Following Ho and Liu (2010), we use the passage of state-level apology laws that exclude apologies from being used as evidence in medical malpractice cases, and estimate that apologizing to a patient in cases of medical malpractice litigation reduces the average payout by $32,000. This paper seeks to unpack the mechanism of apologies by examining the differential impact of apologies laws by various sub-samples. We find that apologies are most valuable for cases involving obstetrics and anesthesia, for cases involving infants, and for cases involving improper management by the physician and failures to diagnose.
    Keywords: I10
    Date: 2013–04–08
  13. By: Cremer, Helmuth (IDEI,TSE); Gahvari, Firouz (University Urbana); Pestieau, Pierre (CREPP, TSE, University of Liege)
    Abstract: This paper studies public provision of long term care insurance in a world in which family assistance is (i) uncertain and (ii) endogenous depending on the time parents spend raising their children. Public benefits will be paid in case of disability but cannot be combined with self-insurance or family aid. The benefits are provided equally to all recipients and financed by a proportional payroll tax. The paper shows that tax distortions imply that full insurance is undesirable. It characterizes the optimal tax and identifies the elements that determine its size. Of crucial importance are the extent of under-insurance, the effect of the tax on the probability of altruism, the distortionary effect of the tax, and, with wage heterogeneity, the covariance between the social mar- ginal utility of lifetime income and (i) earnings (positive effect) and (ii) the probability of altruism default (negative effect).
    Keywords: Long term care, uncertain altruism, endogenous probability, opting out,public insurance.
    JEL: H2 H5
    Date: 2013–03
  14. By: Tucker, Philip; Folkard, Simon
    Abstract: Outlines contemporary trends, developments and effects with regard to different aspects of working time, such as hours of work and work schedules. Examines the impact of modern working time arrangements on workers' health, well-being and workplace safety. Argues that while long daily hours tend to be associated with acute effects of fatigue, long weekly hours tend to be associated both with acute effects of fatigue as well as chronic fatigue, generating long-term negative health effects. Looks at newer forms of working time arrangements such as flexi-time arrangements, and concludes that providing employees with flexibility and control over their working time is associated with positive outcomes on workers' health and wellbeing, as well as positive organisational outcomes.
    Keywords: hours of work, flexible hours of work, arrangement of working time, occupational health, occupational safety, fatigue, developed countries, developing countries, durée du travail, horaire de travail variable, aménagement du temps de travail, santé au travail, sécurité du travail, fatigue, pays développés, pays en développement, horas de trabajo, horario de trabajo variable, ordenamiento del tiempo de trabajo, salud en el trabajo, seguridad en el trabajo, fatiga, países desarrollados, países en desarrollo
    Date: 2012
  15. By: Comaru, Francisco; Werna, Edmundo
    Abstract: Aims at analysing and systematizing the health challenges faced by the poorest strata of urban workers and to discuss solutions. Uses interviews carried out with ILO and WHO staff members from different departments and programmes, completed with interviews with professionals from other institutions, and focuses on five sectors of urban workers, namely: construction, waste picking and recycling, street trading, domestic work and agriculture.
    Keywords: occupational health, occupational safety, low income, capacity building, good practices, construction industry, waste recycling, street vendor, scavenger, domestic work, agriculture, child labour, urban area, Benin, Brazil, China, Colombia, Mexico, Sudan, Tanzania, Turkey, Uganda, ILO mentioned
    Date: 2013
  16. By: Delprat, Gaëtan (University of Québec at Montréal); Leroux, Marie-Louise (University of Québec at Montréal); Michaud, Pierre-Carl (University of Québec at Montréal)
    Abstract: The standard model of intertemporal choice assumes risk neutrality toward the length of life: due to additivity, agents are not sensitive to a mean preserving spread in the length of life. Using a survey fielded in the RAND American Life Panel (ALP), this paper provides empirical evidence on possible deviation from risk neutrality with respect to longevity in the U.S. population. The questions we ask allow to find the distribution as well as to quantify the degree of risk aversion with respect to the length of life in the population. We find evidence that roughly 75% of respondents were not neutral with respect to longevity risk. Higher income households are more likely to be risk averse. We do not find evidence that the degree of risk aversion varies with age or education.
    Keywords: risk aversion toward the length of life, intertemporal choice, stated-preference
    JEL: D12 D91 I10 J26
    Date: 2013–03
  17. By: Fomba Kamga, Benjamin (University of Yaounde II); Kengne Kamga, Arline (University of Yaounde II); Audibert, Martine (CERDI, University of Auvergne)
    Abstract: The objective of this paper is to assess the relationship between the health and the income from work of wage earners and self-employed workers in Cameroon. Health status is measured by a self-assessment of an individual's health; and income is measured by the monthly wage of the wage earners and monthly profits of the self-employed workers. This paper uses a simultaneous equation model to explore the relationship between health and income, allowing for the endogeneity of health, income, and selection into each employment status. The data used in this study is obtained from the 2007 Cameroon household consumption survey. Using OLS estimates, we find a positive and significant effect of health on labour incomes for self-employed workers. Using TSLS IV estimates, we find that health has a positive and significant effect on incomes for self-employed women, but not for men. We also undertake a reverse effect analysis from income to health, using the ordered probit estimation process. We find that, for men, the effect of income on health status is positive and significant for wage earners. For women, this effect is positive and significant for the self-employed.
    Keywords: health, labour income, wage earners, self-employed, Cameroon
    JEL: I12 J21 J31
    Date: 2013–03
  18. By: Naci Mocan (Louisiana State University, Department of Economics, National Bureau of Economic Research (NBER), and Institute for the Study of Labor (IZA)); Duha T. Altindag (Auburn University, Department of Economics)
    Abstract: Using data from NLSY97 we analyze the impact of education on health behavior. Controlling for health knowledge does not influence the impact of education on health behavior, supporting the productive efficiency hypothesis. Accounting for cognitive ability does not significantly alter the relationship between education and health behavior. Similarly, the impact of education on health behavior is the same between those with and without a learning disability, suggesting that cognition is not likely to be a significant factor in explaining the impact of education on health behavior.
    Keywords: Health inputs; Cognition; Learning; Productive efficiency.
    JEL: I12 I20
    Date: 2013–04
  19. By: Marsha Gold; Winnie Wang; Gretchen Jacobson
    Abstract: With federal and state governments pursuing efforts to better coordinate care and reduce costs for people dually eligible for both Medicare and Medicaid, this brief examines how insurers serving these markets view the opportunities and challenges. Based on interviews with senior executives at 13 large firms that contract with the Medicare and Medicaid programs, the brief finds almost all of the insurers expect dually eligible beneficiaries will become more important to their business over time.
    Keywords: Medicare, Dual Eligibiles, Health Plans, Health
    JEL: I
    Date: 2013–03–30
  20. By: Ronette R. Briefel; er Wilson; Charlotte Cabili; Allison Hedley Dodd
    Abstract: This study estimated the mean calories from added sugars saved by switching sugar-sweetened beverages (including soda, fruit-flavored drinks, and sport drinks) and flavored milks consumed to unflavored low-fat milk (less than 1 percent fat) at meals and water between meals. These changes, which were simulated to demonstrate the potential effects of improving school nutrition policies, translated to a mean of 205 calories or a 10 percent savings in energy intake across all students (8 percent among children in elementary school and 11 percent in middle and high schools).
    Keywords: Child Obesity, Sweetened beverages, Added Sugars, School Nutrition Policy; Home food environment
    JEL: I0 I1
    Date: 2013–02–28
  21. By: Vivian L.H. Byrd; Allison Hedley Dodd
    Keywords: Medicaid Managed Care, Managed Care Data, Encounter Data, MAX
    JEL: I
    Date: 2013–03–30
  22. By: Heutel, Garth (University of North Carolina at Greensboro, Department of Economics); Ruhm, Christopher J. (University of Virginia)
    Abstract: Prior research demonstrates that mortality rates increase during economic booms and decrease during economic busts, but little analysis has been conducted investigating the role of environmental risks as potential mechanisms for this relationship. We investigate the contribution of air pollution to the procyclicality of deaths by combining state-level data on overall, cause-specific, and age-specific mortality rates with state-level measures of ambient concentrations of three types of pollutants and the unemployment rate. After controlling for demographic variables and state and year fixed-effects, we find a significant positive correlation between carbon monoxide (CO) concentrations and mortality rates. Controlling for CO, particulate matter (PM10), and ozone (O3) attenuates the relationship between overall mortality and the unemployment rate by 30 percent. The attenuation is particularly large, although imprecisely measured, for fatalities from respiratory diseases and is frequently substantial for age groups unlikely to be involved in the labor market. Our results are consistent with those of other studies in the economics and public health literatures measuring the mortality effects of air pollution.
    Keywords: Pollution; Health; Mortality; Business Cycles
    JEL: E32 I10 Q53
    Date: 2013–04–16
  23. By: Michelle Sovinsky; Steven Stern
    Abstract: This paper describes and analyzes research on the dynamics of long-term care and suggests directions for the literature to make progress. We discuss sources and causes of dynamics including inertia/state dependence (confounded by unobserved heterogeneity); match-specific effects; and costs of changing caregivers. We comment on causes of dynamics including learning/human capital accumulation; burnout; and game-playing. We suggest how to deal with endogenous geography; dynamics in discrete and continuous choices; and equilibrium issues (multiple equilibria, dynamic equilibria). Next, we evaluate the advantages of different potential data sources (NLTCS, PSID, AHEAD/HRS, SHARE, ELSA) and identify first order data problems including noisy measures of wealth and family structure. We suggest some methods to handle econometric problems such as endogeneity (work, geography) and measurement error. Finally, we discuss potential policy implications of dynamics including the effect of dynamics on parameter estimates and direct policy implications of inertia (implications for family welfare, parent welfare, child welfare, and cost of government programs).
    Date: 2013–02

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