nep-hea New Economics Papers
on Health Economics
Issue of 2014‒10‒17
fourteen papers chosen by
Yong Yin
SUNY at Buffalo

  1. Addiction and Smoking Behaviour in Italy By Silvia TIEZZI
  2. Channels of impoverishment due to ill-health in rural Ethiopia By Debebe, Z.Y.; Mebratie, A.D.; Sparrow, R.A.; Dekker, M.; Alemu, G.; Bedi, A.S.
  3. A joint longitudinal and survival model with health care usage for insured elderly By Xavier Piulachs; Ramon Alemany; Montserrat Guillen
  4. Convergence or divergence? A longitudinal analysis of behaviour problems among disabled and non-disabled children aged 3 to 7 in England By Rebecca Fauth; Samantha Parsons; Lucinda Platt
  5. Exploiting externalities to estimate the long-term effects of early childhood deworming By Ozier, Owen
  6. Physical activity of adults: A survey of correlates, determinants, and effects By Cabane, Charlotte; Lechner, Michael
  7. Bending Canada's Healthcare Cost Curve: Watch Not What Governments Say, But What They Do By William B.P. Robson
  8. Health Financing Options for Samoa : Challenges and Opportunities By Ian Anderson
  9. Health Sector Planning: Modeling and Implications By Sardar Islam; Christine Mak
  10. Supplier Induced Demand (SID): Revising one of the by-ways of health economics Creation Date: 1995 By W.R. Cook
  11. The Impact of Cooking with Firewood on Respiratory Health: Evidence from Indonesia By Ani Rudra Silwal; Andy McKay
  12. We consider the effects of daytime fasting by pregnant women during the lunar month of Ramadan on their children's test scores at age seven. Using English register data, we find that scores are .05 to .08 standard deviations lower for Pakistani and Bangladeshi students exposed to Ramadan in early pregnancy. These estimates are downward biased to the extent that Ramadan is not universally observed. We conclude that the effects of prenatal investments on test scores are comparable to many conventional educational interventions but are likely to be more cost effective and less subject to "fade out". gains. By Douglas Almond; Bhashkar Mazumder; Reyn van Ewijk
  13. Obesity and Health-Related Decisions: An Empirical Model of the Determinants of Weight Status By Leonardo Fabio Morales; Penny Gordon-Larsen; David Guilkey
  14. Unhealthy Retirement? By Fabrizio Mazzonna; Franco Peracchi

  1. By: Silvia TIEZZI
  2. By: Debebe, Z.Y.; Mebratie, A.D.; Sparrow, R.A.; Dekker, M.; Alemu, G.; Bedi, A.S.
    Abstract: We analyse the effects of ill-health on household economic outcomes in Ethiopia, using three years of household panel data and event history interviews. We examine the immediate effects of a variety of ill-health measures on health expenditure and labour supply, the subsequent household coping responses, and finally the effect on household income and consumption. We find evidence of substantial economic risk in terms of increased health expenditure and reduced agricultural productivity. Households cope by resorting to intra-household labour substitution, hiring wage labour, borrowing and depleting assets. While households are able to maintain food consumption, we observe imperfect insurance of non-food consumption. This effect is larger for households with the lowest ability to self-insure. Maintaining current consumption through borrowing and depletion of assets and savings is unlikely to be sustainable and displays the need for interventions that work towards reducing the financial consequences of ill-health.
    Keywords: health shocks, ill-health, consumption insurance, health expenditure, labour supply, poverty dynamics, Ethiopia
    Date: 2014–09–30
  3. By: Xavier Piulachs (Department of Econometrics, Riskcenter-IREA, Universitat de Barcelona); Ramon Alemany (Department of Econometrics, Riskcenter-IREA, Universitat de Barcelona); Montserrat Guillen (Department of Econometrics, Riskcenter-IREA, Universitat de Barcelona)
    Abstract: We study longevity and usage of medical resources of a sample of individuals aged 65 years or more who are covered by a private insurance policy. A longitudinal analysis is presented, where the yearly cumulative number of medical coverage requests by each subject characterizes insurance intensity of care until death. We confirm that there is a significant correlation between the longitudinal data on usage level and the survival time processes. We obtain dynamic estimations of event probabilities and we exploit the potential of joint models for personalized survival curve adjustment.
    Keywords: joint modeling, health insurance, personalized survival probability, longitudinal data
    Date: 2014–08
  4. By: Rebecca Fauth (School of Arts and Sciences, Tufts University); Samantha Parsons (Department of Quantitative Social Science, Institute of Education); Lucinda Platt (Department of Social Policy, London School of Economics and Political Science)
    Abstract: This study sets out to identify the incidence and development of disabled children’s problem behaviours, including conduct, peer, hyperactivity and emotional problems during the early years using the Millennium Cohort Study, a large-scale, nationally representative UK study. We track the behaviour problems from age 3 to 7 to examine the emergence of problems and whether disabled girls’ and boys’ behaviour converges or diverges from non-disabled children over time. Childhood disability is assessed using three broad measures: developmental delay (DD), long standing limiting illness (LSLI), and special educational needs (SEN) to ascertain the implications of particular constructions of disability. Finally, we examine whether parenting and the home environment moderate any associations between disability and behaviour. Estimating linear growth models, we find that disabled children exhibit more behaviour problems than non-disabled children across disability measures. We find no evidence that trajectories converge for disabled and non-disabled children; rather, children with LSLI and SEN show a greater increase in peer problems, hyperactivity and emotional problems over time. We find little evidence that parenting moderates associations between disability and behaviour. The findings suggest that further in-school support for disabled children may be warranted given persistence in problem behaviour well after school entry.
    Keywords: Disabled children, behaviour, Millennium Cohort Study, SDQ, early years, growth curve models
    JEL: I3 I24 J13 J14
    Date: 2014–09–05
  5. By: Ozier, Owen
    Abstract: This paper investigates whether a large-scale deworming intervention aimed at primary school pupils in western Kenya had long-term effects on young children in the region. The paper exploits positive externalities from the program to estimate the impact on younger children who did not receive treatment directly. Ten years after the intervention, large cognitive effects are found -- comparable to between 0.5 and 0.8 years of schooling -- for children who were less than one year old when their communities received mass deworming treatment. Because mass deworming was administered through schools, effects are estimated among children who were likely to have older siblings in schools receiving the treatment directly; in this subpopulation, effects are nearly twice as large.
    Keywords: Disease Control&Prevention,Health Monitoring&Evaluation,Educational Sciences,Youth and Governance,School Health
    Date: 2014–10–01
  6. By: Cabane, Charlotte; Lechner, Michael
    Abstract: We survey the literature on the link of labour market related outcomes to individual physical activity and sports participation. The first part of the survey is devoted to the individual participation decision based and is based on papers from various disciplines. The second part summarizes parts of the epidemiological literature on health effects and the economic literature on the labour market effects as well as on the effects on well-being and social capital. Some¬what surprisingly, at least for studies in empirical economics, all the papers seem to agree that individual leisure sports participation and physical activity has positive effects for adults.
    Keywords: Physical activity, leisure time physical activity, sports participation, la¬bour market effects, unemployment, earnings
    JEL: I12 I18 J20 J30 J68 L83
    Date: 2014–08
  7. By: William B.P. Robson
    Abstract: Canadians should hold off on declaring a slowdown in government healthcare spending to sustainable growth rates, says a C.D. Howe Institute report released today. In “Bending Canada’s Healthcare Cost Curve: Watch Not What Governments Say, But What They Do,” author William B.P. Robson finds that reports of slower growth in healthcare spending have been repeatedly wrong-footed by chronic budget overshoots. So recent estimates that healthcare spending is no longer growing faster than the economy may also prove optimistic.
    Keywords: Economic Growth and Innovation, Social Policy, Health Policy
    JEL: I18 H61 H68
    Date: 2014–10
  8. By: Ian Anderson
    Abstract: Samoa currently faces two important public policy challenges in the health sector. One is to stem, and then reverse, the rapid rise of non-communicable diseases (NCDs). The second challenge is to put the country on a health-financing path that is effective, efficient, and financially affordable and sustainable. The two challenges are interconnected. This discussion paper examines eight options to address these challenges. The eight options are the following: (1) increasing government expenditure via higher general taxation; (2) increasing government expenditure via deficit financing; (3) increasing the share of government expenditure to health; (4) increasing external and donor financing; (5) increasing specific taxes; (6) mobilizing additional nongovernment resources via insurance (including social health insurance, and community and private insurance); (7) increasing cost-recovery measures; and (8) increasing efficiency. The paper concludes that the chief opportunity arises from more efficient use of resources already in the health system that are not presently used to maximum effect. Improving technical and allocative efficiency of the existing system has the potential to make a large difference and is technically feasible.
    Keywords: addiction, administrative costs, adolescents, alcohol consumption, allocation, allocation of resources, allocative efficiency, Annual Report, Antenatal care, Article, ... See More + budget documents, budget outlook, burden of disease, cancer patient, cancer patients, capital costs, cardiovascular diseases, central bank, child health, chlamydia, clinical services, clinics, communicable diseases, cost of services, cost of treatment, cost recovery, cost sharing, cost-effectiveness, cost-recovery, costs of health care, counseling, curative health care, deaths, debt, deficit financing, dental care, determinants of health, diabetes, diets, disasters, doctors, donor assistance, donor financing, economic downturns, economic growth, economic shocks, economies of scale, employment, essential drugs, essential health care, exchange rates, external shocks, families, family planning, Finance Ministry, financial barriers, financial cost, financial health, financial management, financial management systems, financial protection, financial resources, financial risk, financial risk protection, financial sector, financial statements, financial years, fiscal deficit, food security, foreign exchange, Foreign loans, gallstones, general taxation, girls' education, government expenditure, health behavior, health care, health care access, health care expenditure, health care providers, health care resources, health care system, health care­service delivery, health effects, health expenditure, health expenditure per capita, health expenditures, health facilities, HEALTH FINANCING, health funding, health information, health insurance, health interventions, Health Organization, health outcome, health outcomes, health plan, health professionals, health promotion, health resources, health sector, Health Service, health services, Health Specialist, health spending, health status, health system, HEALTH SYSTEMS, health workforce, health-care, health-care costs, HEALTH-FINANCING, health-financing system, high blood pressure, hospital admissions, hospital buildings, hospitals, household income, Human Development, human resources, hygiene, hypertension, illness, immunization, income, income countries, income distribution, income groups, income growth, infant mortality, infant mortality rate, infants, infectious diseases, inflation, Influenza, infrastructure projects, injuries, inpatient care, insurance, Life expectancy, Life expectancy at birth, living standards, local currency, low income, low-income countries, macroeconomic variables, marijuana, market failures, medical care, medical supplies, Medical Treatment, medicines, Medium-Term Expenditure, Medium-Term Expenditure Framework, Mental Health, midwifery, Ministry of Finance, monetary policies, mortality, national budgets, national health, National Health Service, National Health Services, natural disasters, Nurses, Nursing, Nutrition, Obesity, output levels, palliative care, patient, Patient treatment, patients, performance framework, pharmacy, physical activity, physicians, pocket payment, polio, postnatal care, price elasticities, private health insurance, private insurance, private pharmacies, private sector, programs, provider payment, public expenditure, Public Expenditure on Health, public health, public health care, public health interventions, public health services, public health system, public provision, public sector, quality of health, quality of services, reform agenda, rehabilitation, risk factors, sanitation, screening, sector policies, sexually transmitted infections, smoking, Social Development, social health insurance, STIs, structural reforms, suicide, surgery, Total expenditure, traditional health care, treatment, tuberculosis, uncertainty, under-five mortality, vaccination, vaccinations, wounds
    Date: 2013–08
  9. By: Sardar Islam; Christine Mak
  10. By: W.R. Cook
  11. By: Ani Rudra Silwal (Department of Economics, University of Sussex, Falmer, United Kingdom); Andy McKay (Department of Economics, University of Sussex, Falmer, United Kingdom)
    Abstract: The vast majority of households in low-income countries cook with firewood, which is known to produce various airborne toxins. We examine whether cooking with firewood results in poorer respiratory health by using a unique Indonesian household survey that collected direct measures of lung capacity. We find that individuals living in households that cook with firewood have 11.2 per cent lower lung capacity than those that cook with cleaner fuels. This impact is larger for women and children than for men. The results strongly support the international policy focus on encouraging households to switch to cooking with cleaner fuels.
    Keywords: Health production; Indoor air pollution; Household energy use
    JEL: I12 Q53 O13
    Date: 2014–09
  12. By: Douglas Almond (Columbia University); Bhashkar Mazumder (Federal Reserve Bank of Chicago); Reyn van Ewijk (Johannes Gutenberg-Universitaet Mainz, Germany)
    Keywords: ramadan, fasting, test scores, developmental origins
    Date: 2014–09–18
  13. By: Leonardo Fabio Morales; Penny Gordon-Larsen; David Guilkey
    Abstract: Using Add Health, a very comprehensive longitudinal data set of teenagers and young adults in the United States, we estimate a structural dynamic model of the determinants of obesity. In addition to including many of the well-recognized endogenous factors mentioned in the literature as obesity determinants, i.e., physical activity, smoking, a proxy for food consumption, and childbearing, we also model the residential location as a choice variable, relevant to the young-to middle-aged adult, as a major component. This allows us to control for an individual’s self-selection into communities which possess the types of amenities in the built environment which in turn affect their behaviors such as physical activity and fast food consumption. We specify reduced form equations for all these endogenous demand decisions, together with an obesity structural equation. The whole system of equations is jointly estimated by a semi-parametric full information log-likelihood method that allows for a general pattern of correlation in the errors across equations. Simulations are then used to allow us to quantify the effects of these endogenous factors on the probability of obesity. A key finding is that controlling for residential self-selection has important substantive implications. To our knowledge, this has not been yet documented within a full information maximum likelihood framework. Classification JEL: I12, I14, R52.
    Date: 2014–09
  14. By: Fabrizio Mazzonna (University of Lugano and MEA); Franco Peracchi (University of Rome "Tor Vergata" and EIEF)
    Abstract: We investigate the causal effect of retirement on health and cognitive abilities by exploiting the panel dimension of the first two waves of the Survey of Health Ageing and Retirement in Europe (SHARE) and the variation between and within European countries in old age retirement rules. We show evidence of substantial heterogeneity in the effect of retirement across occupational groups. In particular, we find that retirement increases the age-related decline of health and cognitive abilities for most workers. On the other hand, we find evidence of a positive immediate effect of retirement for those employed in highly physically demanding jobs.
    Date: 2014

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