nep-hea New Economics Papers
on Health Economics
Issue of 2014‒08‒16
fourteen papers chosen by
Yong Yin
SUNY at Buffalo

  1. The Salience of Excise vs. Sales Taxes on Healthy Eating: An Experimental Study By Chen, Xiu; Kaiser, Harry M.; Rickard, Bradley J.
  2. Structural social capital and health in Italy By Damiano Fiorillo; Fabio Sabatini
  3. Smoking in top­â€grossing US movies 2013 By Polansky, Jonathan R.; Titus, Kori; Lanning, Natalie; Glantz, Stanton A.
  4. The sex differential in mortality: a historical comparison of the adult-age pattern of the ratio and the difference By Oliver Wisser; James W. Vaupel
  5. Access to Piped Water and Human Capital Formation - Evidence from Brazilian Primary Schools By Julia A. Barde; Juliana Walkiewicz
  6. Health, Work and Working Conditions: A Review of the European Economic Literature By Thomas Barnay
  7. Unsafe abortion still frequent across the world but less often fatal By Clémentine Rossier
  8. Combining Conditional Cash Transfers and Primary Health Care to Reduce Childhood Mortality in Brazil By Davide Rasella; Rômulo Paes-Sousa
  9. Health Behaviors and Education in Turkey By Aysit Tansel; Deniz Karaoglan
  10. Did the Affordable Care Act's Dependent Coverage Mandate Increase Premiums? By Briggs Depew; James Bailey
  11. The 9/11 Dust Cloud and Pregnancy Outcomes: A Reconsideration By Janet Currie; Hannes Schwandt
  12. Being Healthy, Wealthy, and Wise: Dynamics of Indonesian Subnational Growth and Poverty. By Sumarto, Sudarno; De Silva, Indunil
  13. Health shocks and coping strategies: State health insurance scheme of Andhra Pradesh, India By Dhanaraj, Sowmya
  14. Strengthening Malaria service delivery through supportive supervision and community mobilization in an endemic Indian setting : an evaluation of nested delivery models By Das, Ashis; Friedman, Jed; Kandpal, Eeshani; Ramana, GNV; Das Gupta, R K; Pradhan, Madan M; Govindaraj, Ramesh

  1. By: Chen, Xiu; Kaiser, Harry M.; Rickard, Bradley J.
    Keywords: Food Consumption/Nutrition/Food Safety, Production Economics,
    Date: 2014
  2. By: Damiano Fiorillo; Fabio Sabatini
    Abstract: This paper presents the first empirical assessment of the causal relationship between social capital and health in Italy. The analysis draws on the 2000 wave of the Multipurpose Survey on Household conducted by the Italian Institute of Statistics on a representative sample of the population (n = 46,868). Our measure of social capital is the frequency of meetings with friends. Based on IV and bivariate probit estimates, we find that individuals who meet friends every day or at least two times a week are approximately 11% to 16% more likely to report good health.
    Date: 2014–08
  3. By: Polansky, Jonathan R.; Titus, Kori; Lanning, Natalie; Glantz, Stanton A.
    Keywords: Education, Medicine and Health Sciences
    Date: 2014–06–12
  4. By: Oliver Wisser (Max Planck Institute for Demographic Research, Rostock, Germany); James W. Vaupel (Max Planck Institute for Demographic Research, Rostock, Germany)
    Abstract: The ratio (RMR) is the standard measure of sex differentials in mortality. It is commonly known that the RMR was historically small and increased throughout the 20th century. However, numerical properties might account for the trend in the RMR rather than sex differences in risk factors. In this study we examine the age pattern of the absolute difference in male to female mortality rates (DMR) as an alternative measure in a historical context and compare it to the RMR pattern. Whereas the RMR is close to one at every age in the 19th and early 20th century and increases until the present day, the adult age pattern of the DMR is relatively stable throughout the last 150 years. We also found that the DMR is approximately exponentially increasing from age 40 to 90, implying a universal biological force behind sex differentials in mortality. However, interactions between biology, behavior and environment are complicated and have to be considered when interpreting these findings. Moreover, between ages 15 and 40 the DMR declined in the second half of the 20th century, whereas the RMR increased. Hence, the trend in the latter measure is likely to be an artifact of very different mortality regimes between populations. Therefore, we argue that it is necessary to consider both measures when conducting comparative analyses and to be careful in interpreting their time, cross-cultural and age trends, since they can lead to different conclusion about sex specific underlying risk factors.
    Keywords: England, Europe, France, Sweden, adult mortality, historical analysis, sex differentials
    JEL: J1 Z0
    Date: 2014–06
  5. By: Julia A. Barde; Juliana Walkiewicz (Department of International Economic Policy, University of Freiburg)
    Abstract: This paper analyzes the impact of access to piped water on human capital formation as measured by test scores from standardized school exams in Brazilian primary schools. We find that children in urban areas with access to tap water at home perform signicantly better at school: They achieve test scores that are 14 percent of the standard deviation higher than the average test score without access. The effect is conditional on the education of the mother and turns out to be insignicant in rural areas. Our results capture the long term effect of the reduced incidence of water-related diseases for children with access to tap water. We exploit school-specic variation across years as well as a comprehensive vector of socioeconomic background variables to identify this effect.
    Keywords: Health, piped water, cognitive development, human capital formation
    JEL: I15 I25 H41
    Date: 2014–07
  6. By: Thomas Barnay (ERUDITE - Equipe de Recherche sur l'Utilisation des Données Individuelles Temporelles en Economie - Université Paris-Est Créteil Val-de-Marne (UPEC) : EA437 - Université Paris-Est Marne-la-Vallée (UPEMLV), TEPP - Travail, Emploi et Politiques Publiques - CNRS : FR3435 - Université Paris-Est Marne-la-Vallée (UPEMLV))
    Abstract: Economists have traditionally been very cautious when studying the interaction between employment and health because of the two-way causal relationship between these two variables: health status influences the probability of being employed and, at the same time, working affects the health status. Because these two variables are determined simultaneously, researchers control endogeneity skews (e.g., reverse causality, omitted variables) when conducting empirical analysis. With these caveats in mind, the literature finds that a favourable work environment and high job security lead to better health conditions. Being employed with appropriate working conditions plays a protective role on physical health and psychiatric disorders. By contrast, non-employment and retirement are generally worse for mental health than employment, and overemployment has a negative effect on health. These findings stress the importance of employment and of adequate working conditions for the health of workers. In this context, it is a concern that a significant proportion of European workers (29%) would like to work fewer hours because unwanted long hours are likely to signal a poor level of job satisfaction and inadequate working conditions, with detrimental effects on health. Thus, in Europe, labour-market policy has increasingly paid attention to job sustainability and job satisfaction. The literature clearly invites employers to take better account of the worker preferences when setting the number of hours worked. Overall, a specific "flexicurity" (combination of high employment protection, job satisfaction and active labour-market policies) is likely to have a positive effect on health.
    Keywords: work, health, working conditions, employment, causality, selection
    Date: 2014–07–24
  7. By: Clémentine Rossier (INED)
    Abstract: The frequency of induced abortions fell worldwide in the 1990s, from 35 abortions per 1,000 womenof childbearing age (15-44 years) in 1995 to 29 per 1,000 in 2003. But it stabilized in the 2000s (28per 1,000 in 2008) as the spread of contraceptive use slowed down in developing countries. Theproportion of unsafe abortions, defined by the WHO as abortions "performed by persons lackingthe necessary skills or in an environment not in conformity with minimal medical standards, or both,"did not fall, however, and still represents nearly halfof all elective terminations (49% in 2008). Paradoxically, abortion-related mortality has beenfalling steadily for two decades, from 60 maternal deaths per 100,000 live births in 1990 to 40 per100,000 in 2008. The drop has been particularly pronounced in Latin America, even though abortionis still strongly condemned there. This development is linked in part to the spread of medical abortion incountries where it nonetheless remains illegal. Today, illegal no longer systematically means unsafe.
    Date: 2014
  8. By: Davide Rasella (Instituto de Saúde Coletiva, Federal University of Bahia); Rômulo Paes-Sousa (World Centre for Sustainable Development, RIO+ Centre)
    Abstract: Combining Conditional Cash Transfers and Primary Health Care to Reduce Childhood Mortality in Brazil
    Keywords: Combining Conditional Cash Transfers and Primary Health Care to Reduce Childhood Mortality in Brazil
    Date: 2014–05
  9. By: Aysit Tansel (Department of Economics, Middle East Technical University, Institute for the Study of Labor (IZA) Bonn, Germany and Economic Research Forum (ERF) Cairo, Egypt); Deniz Karaoglan (Department of Economics, Middle East Technical University)
    Abstract: This is the first study which provides empirical analysis of the variation in health behaviors for adult men and women in Turkey which is a developing country. The health behaviors considered are smoking, drinking, fruit and vegetable consumption, exercise and body mass index (BMI). We find that in Turkey education is the most important factor that affects the health behaviors. The results indicate that smoking is positively associated with education at all levels with a decreasing effect with the level of education unlike in the developed countries. This result indicates that smoking is a serious public health problem in Turkey at all levels of education. Further, alcohol consumption and schooling are positively related and it increases by the level of education. Higher educated individuals clearly eat more fruits, vegetables and exercise more and their BMI levels are in the normal range compared to less educated and illiterate. We also highlight the importance of demographic factors, labor market status and household income. We use Health Survey of Turkish Statistical Institute (TURKSTAT) for years 2008, 2010 and 2012. This study will provide a baseline for further studies on the various aspects of health behaviors in Turkey.
    Keywords: Health Behaviors, Education, Demographic Factors, Turkey.
    JEL: I10 I12 I19
    Date: 2014–06
  10. By: Briggs Depew; James Bailey
    Abstract: We investigate the impact of the Affordable Care Act's dependent coverage mandate on insurance premiums. The expansion of dependent coverage under the ACA allows young adults to remain on their parent's private health insurance plans until the age of 26. We find that the mandate has led to a 2.5-2.8 percent increase in premiums for health insurance plans that cover children, relative to single-coverage plans. We find no evidence that the mandate caused an increase in the amount of the employee contribution for family plans.
  11. By: Janet Currie; Hannes Schwandt
    Abstract: The events of 9/11 released a million tons of toxic dust into lower Manhattan, an unparalleled environmental disaster. It is puzzling then that the literature has shown little effect of fetal exposure to the dust. However, inference is complicated by pre-existing differences between the affected mothers and other NYC mothers as well as heterogeneity in effects on boys and girls. Using all births in utero on 9/11 in NYC and comparing them to their siblings, we show that residence in the affected area increased prematurity, low birth weight, and admission to the NICU after birth, especially for boys.
    JEL: I1
    Date: 2014–08
  12. By: Sumarto, Sudarno; De Silva, Indunil
    Abstract: The aim of this study is twofold. First, despite the vast empirical literature on testing the neoclassical model of economic growth using cross-country data, very few studies exist at the subnational level. We attempted to fill this gap by using panel data for 2002–12, a modified neoclassical growth equation, and a dynamic-panel estimator to investigate the effect of both health and education capital on economic growth and poverty at the district level in Indonesia. Second, although most existing cross-country studies tend to concentrate only on education as a measure of human capital, we expanded the analysis and probed the effects of health capital as well. As far as we are aware, no study has done a direct and comprehensive examination of the impacts of health on growth and poverty at the subnational level. Thus, this study is the first at the subnational level, and our findings will be particularly relevant in understanding the role of both health and education capital in accelerating growth and poverty reduction efforts. The empirical findings are broadly encouraging. First, nullifying any doubts on the reliability of Indonesian subnational data, our results suggest that the neoclassical model augmented by both health and education capital provides a fairly good account of cross-district variation in economic growth and poverty in Indonesia. We found that the results on conditional convergence, physical capital investment rate, and population growth confirm the theoretical predictions of the augmented neoclassical model. We also found that both health and education capital had a relatively large and statistically significant positive effect on the growth rate of per capita income. Economic growth was found to play a vital role in educing Indonesian poverty, reinforcing the importance of attaining higher rates of economic growth. Findings from the poverty–human capital model showed that districts with low levels of education are characterized by higher levels of poverty. We found that regions with mediocre immunization coverage and greater than average prevalence of waterborne diseases had higher poverty rates and lower output per capita. Similarly, regions with higher numbers of births attended by a skilled birth attendant were associated with lower poverty rates and higher economic output. Our results in particular suggest that, in designing policies for growth, human development, and poverty reduction, it is necessary to broaden the concept of human capital to include health as well.
    Keywords: Neoclassical growth, poverty, human capital, health, education, dynamic panel
    JEL: I15 I18 I3 I31 O4
    Date: 2014–02–14
  13. By: Dhanaraj, Sowmya
    Abstract: The objectives of the study are three-fold: to investigate who are vulnerable to welfare loss from health shocks, what are the household responses to cope with the economic burden of health shocks and if policy responses like state health insurance scheme
    Keywords: health shocks, coping strategies, state health insurance scheme, three-level random intercept model
    Date: 2014
  14. By: Das, Ashis; Friedman, Jed; Kandpal, Eeshani; Ramana, GNV; Das Gupta, R K; Pradhan, Madan M; Govindaraj, Ramesh
    Abstract: Malaria continues to be a prominent global public health challenge, in part because of the slow population adoption of recommended preventive and curative behaviors. This paper tests the effectiveness of two service delivery models designed to promote recommended behaviors, including prompt treatment seeking for febrile illness, in Odisha India. The tested modules include supportive supervision of community health workers and community mobilization promoting appropriate health seeking. Program effects were identified through a randomized cluster trial comprising 120 villages from two purposively chosen malaria-endemic districts. Significant improvements were measured in the reported utilization of bed nets in both intervention arms vis-à-vis the control. Although overall rates of treatment seeking were equal across the study arms, treatment seeking from community health workers was higher in both intervention arms and care seeking from trained providers also increased with a substitution away from untrained providers. Further, fever cases in both treatments were more likely to have received timely medical treatment (within 24 hours) from a skilled provider. The study arm with supportive supervision was particularly effective in shifting care seeking to community health workers and ensuring prompt diagnosis and treatment. A community-based intervention combining the supportive supervision of community health workers with intensive community mobilization can be effective in shifting care seeking and increasing preventive behavior, and thus may be used to strengthen the national malaria control program.
    Keywords: Health Monitoring&Evaluation,Housing&Human Habitats,Disease Control&Prevention,Population Policies,Adolescent Health
    Date: 2014–06–01

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