nep-hea New Economics Papers
on Health Economics
Issue of 2015‒07‒25
thirteen papers chosen by
Yong Yin
SUNY at Buffalo

  1. How increasing tobacco prices affects the decision to start and quit smoking: evidence from Argentina By Martin Gonzalez-Rozada; Giselle Montamat
  2. Older people's experiences of dignity and nutrition during hospital stays: Secondary data analysis using the Adult Inpatient Survey By Tania Burchardt; Polly Vizard
  3. Employer downsizing and older workers’ health By Pierre-Carl Michaud; Italo A. Gutierrez
  4. Health Costs of Arsenic Contamination of Drinking Water in Assam, India By Jayashree Chowdhury; Ratul Mahanta; Hiranya K. Nath
  5. Application of Comprehensive Nursing Intervention to Improve Social Support Level on Breastfeeding Women in China By Dai Hong-Xia
  6. A study of Adolescents´ Mental Health: Gender Analysis By rekha sharma
  7. The Effects of Life-and-death Education on Nursing Students' Attitude By YAN WANG
  8. Comparing Distributions of Body Mass Index Categories By Fatiha Bennia; Nicolas Gravel; Brice Magdalou; Patrick Moyes
  9. Evaluating the Effectiveness and Efficiency of the Health System By Nazarov, Vladimir; Davis, Christopher Mark; Gerry, Christopher J.; Polyakova, Aleksandra; Sisigina, Natalia; Sokolov, D.
  10. The Effect of Post-and-Hold Laws on Alcohol Consumption By Henry Saffer; Markus Gehrsitz
  11. The Socio-Economic Impacts of Ebola in Liberia By Kristen Himelein; Jonathan G. Kastelic
  12. Shaping Healthier Societies and Building Higher Performing Health Systems in the GCC Countries By World Bank Group
  13. Zambias HIV Response By World Bank

  1. By: Martin Gonzalez-Rozada; Giselle Montamat
    Abstract: We study empirically the role of cigarettes’ prices on smoking onset and quitting in Argentina, using a continuous-time split population model. The findings in this paper suggest that increasing cigarettes’ prices, using taxes, has a larger effect on the starting age of smoking than on the quitting age. In particular, at the mean starting age of 15 years an increase of 20% in real cigarettes’ prices is expected to delay smoking onset by 3 years. On the other hand, the same policy is less effective to reduce the duration of the habit because, while negative, the relationship between the duration of the smoking habit and the real price of cigarettes is weak. A policy recommendation that emerges from this evidence is that for people with a developed addiction a combination of an increment in taxes and other public health policies, like cessation therapies, could be implemented to accelerate the time of quitting smoking.
    Keywords: smoking onset, quitting smoking, split population model, cigarettes’ prices and taxes, survival analysis
    JEL: I18 C41
    Date: 2015–06
  2. By: Tania Burchardt; Polly Vizard
    Abstract: The report uses the Adult Inpatient Survey 2012 to build up an in-depth quantitative evidence base on older people's experiences of dignity and nutrition during hospital stays in England. The survey covers adults aged 16 or above who stay in hospital for at least one night. The research has been funded by the Economic and Social Research Council, Research Grant ES/K004018/1.
    Keywords: dignity,nutrition,elderly,social care,health
    Date: 2015–07
  3. By: Pierre-Carl Michaud; Italo A. Gutierrez
    Abstract: We estimate the effects of employer downsizing on older workers’ health outcomes using different approaches to control for endogeneity and sample selection.  With the exception of the instrumental variables approach, which provides large imprecise estimates, our results suggest that employer downsizing increases the probability that older workers rate their health as fair or poor; increases the risk of showing symptoms of clinical depression; and increases the risk of being diagnosed with stroke, arthritis, and psychiatric or emotional problems. We find weaker evidence that downsizing increases the risk of showing high levels of C-reactive protein (CRP), a measure of general inflammation.  We find that downsizing affects health by increasing job insecurity and stress, but that its effects remain statistically significant after controlling for these pathways, suggesting that other mechanisms such as diminished morale and general demotivation also affect worker health. Our findings suggest that employers ought to consider actions to offset the detrimental health effects of reducing personnel on their remaining (older) workers.
    Keywords: Older workers, employer downsizing, health outcomes,
    JEL: I12 M51
    Date: 2015–07–15
  4. By: Jayashree Chowdhury (Department of Economics, Handique Girls’ College); Ratul Mahanta (Department of Economics, Gauhati University); Hiranya K. Nath (Department of Economics and International Business, Sam Houston State University)
    Abstract: This paper estimates the health costs of arsenic contamination of drinking water in Assam, India, where 0.72 million people are affected. Applying the Three Stage Least Square (3SLS) procedure to data collected through a primary survey of 355 households in 2013, it estimates three structural equations to determine health costs due to arsenic contamination. The estimates show that the annual health cost of a 1 microgram increase in arsenic concentration is about INR 4 per household. Furthermore, if the level of arsenic concentration is reduced to the safe limit of 50 microgram per liter, the annual welfare gain for a household is estimated to be INR 862 (USD 14). Projecting these figures to the entire arsenic-affected population of Assam, the annual health cost is estimated to be about INR 0.76 million (USD 0.01 million) and the welfare gain from reducing the level of arsenic concentration to the safe limit is estimated to be INR 153 million (USD 2.49 million).The results also indicate that these health costs and welfare gains vary significantly across different levels of arsenic concentration and across districts. Finally, the paper draws policy implications for providing safe drinking water in Assam.
    Date: 2015–07
  5. By: Dai Hong-Xia (School of Health Science, Macao Polytechnic Institute)
    Abstract: Objectives: To evaluate the effects of application of ‘comprehensive nursing intervention’ on social support in Chinese breastfeeding women. Methods: The study was a prospective clinical experimental research. 313 postnatal women were recruited from 3 hospitals in Guangzhou by using cluster sampling method. The control group received general care with verbal education about breastfeeding without handbook, standard breastfeeding instruction and telephone follow-up. The treatment group received ‘comprehensive nursing intervention’, which composed of a practical handbook on breastfeeding, instruction of breastfeeding skills through face-to-face and one-on-one methods at bed-side within 24 hours postpartum. The participants accepted twice telephone follow-ups related to breastfeeding at 5 and 11 weeks postpartum. They completed 3 questionnaires on infant feeding and Social Support Rating Scale (SSRS) in the hospital, at 6 weeks and 3 months postpartum.. The T test, X2 test and analysis of variance (ANOVA) were used to evaluate the effects of intervention by using SPSS 17.0 software.Results: At 3 days, 6 weeks and 3 months postpartum, the exclusive breastfeeding rates of the treatment group (31.5%, 52.7%, 59.4%) were higher than the control group respectively (20.9%, 29.7%, 29.1%), p values were 0.006, 0.034, <0.001 and <0.001 respectively; The mean score of total SSRS in the treatment group was 40.58±5.33, which was higher than that of the control group (36.61±6.01) at 6 weeks postpartum, p<0.001. The results of two-way ANOVA found significant effect on time, group, and interaction between group and time on SSRS score (p<0.001). The percentage of language support of breastfeeding in the treatment group was 86.1%, which was higher than that of the control group (64.9%) at 3 months postpartum, p<0.001. The percentage of action support of infant feeding in the treatment group was 75.2%, which was higher than that of the control group (54.7%) at 3 months postpartum, p<0.001.Conclusions: Comprehensive nursing intervention of exclusive breastfeeding improved exclusive breastfeeding rates at 3 days, 6 weeks and 3 months postpartum, improved mother’s social support level and this effect could be lasted until 6weeks postpartum.
    Keywords: Exclusive Breastfeeding, Nursing Intervention, Social Support, Chinese, Postpartum Women
    JEL: I10
  6. By: rekha sharma (,sirsa, India)
    Abstract: the present study investigated mental health of 260 adoescents.Mental Health battery in english by A.K. Singh was applied.Mental Health includes six areas--- emotional stability,adjustment,autonomy,security-insecurity, self concept and genearal intelligence. Obtained data was analysised by applying t-- test . Results found that male students were found to be more stable, having more clear self concept than females very significantly.Females were found to have more high level of general intelligence than males significantly..In case of Auotonomy and Insecurity-Security the two gender did not show any significant difference. results found better mental heath in both males as wellas female adolescents in this area of Haryana in India.
    Keywords: Mental Health , Emotional Stability, Over all Adjustment, Autonomy, Security-insecurity, Self concept & Intelligence.
    Abstract: AbstractAim and objectives:The aim of this study was to explore the effects of life-and-death education to the nursing students.Background: Caring the death and their families is the important duty of nurses. There was few special lessons for nursing students' preparation to care the death in Chinese community, and also life meaning was scarcely discussed in the nursing curriculum. Design: Qualitative method and quantitative method were combined in the study to explore the changes of nursing students' life-and-death attitude before and after the life-and-death education.Method: In a institute of Macao, by advertisements, students enrollingin the life-and-death education wereallocated into the experimental group, and the rest students were included into the control group. Forty-five hours of life-and-death education were given to the experimental group, and the control group accepted no interventions. Scale of Life Attitudewas used quantitatively to evaluate students' life-and-death attitude before and after the intervention. Purposive sampling, one-to-one in-depth semi-structured interviews were conducted qualitatively to evaluate the changes of students' life-and-death attitude after the intervention. Data from investigation were analyzed by t-test and general linear model univariate analysis. Data from interviews were analyzed by Colaizzi’s seven steps method of phenomenological enquiry.Results: There were 48 and 126 students in the experimental and control group respectively. After the life-and-death education, students in the experimental group showed more positive life-and-death attitude according to the score of Scale of Life Attitude. Data saturation was achieved after interviewing 13 students. Six themes were identified: the life-and-death education can help students
    Keywords: Life-and-death Education, Nursing students; Life-and-death Attitude
  8. By: Fatiha Bennia (Aix-Marseille Univ., Laboratoire de Santé Publique, Faculté de Médecine); Nicolas Gravel (Aix-Marseille Univ. (Aix-Marseille School of Economics), CNRS & EHESS); Brice Magdalou (Université de Montpellier 1 & LAMETA); Patrick Moyes (CNRS, GRETHA, Université Montesquieu (Bordeaux 4))
    Abstract: This paper compares distributions of Body Mass Index (BMI) among men and women in France, the US and the UK on the basis of a new normative criterion. Comparing distributions of BMI from a normative standpoint is conceptually challenging because of the ordinal nature of the variable. Our normative criterion is well-suited to handle this issue. It coincides with the possibility of moving from the dominated distribution to the dominating one by a finite sequence of Hammond transfers and/or elementary efficiency gains. An additional difficulty with BMI is that it is not monotonically increasing (or decreasing) with health or well-being. We therefore perform our analysis by considering all health-consistent rankings of BMI values. Our empirical results are striking. For a large class of these rankings of BMI values, it is shown that the distribution of BMI in France has worsened on the period 2008-2010 for both men and women according to first order dominance. It is also shown that for most welfare rankings of BMI values, the distribution of BMI is worse in every period in the female population than in the male one in all three countries.
    Keywords: body weight, equality, genders, categorical variables
    JEL: I14 I31 I32
    Date: 2015–05–28
  9. By: Nazarov, Vladimir (Russian Presidential Academy of National Economy and Public Administration (RANEPA)); Davis, Christopher Mark (Russian Presidential Academy of National Economy and Public Administration (RANEPA)); Gerry, Christopher J. (Russian Presidential Academy of National Economy and Public Administration (RANEPA)); Polyakova, Aleksandra (Russian Presidential Academy of National Economy and Public Administration (RANEPA)); Sisigina, Natalia (Russian Presidential Academy of National Economy and Public Administration (RANEPA)); Sokolov, D. (Russian Presidential Academy of National Economy and Public Administration (RANEPA))
    Abstract: Keeping pace of development of the Russian health care system requires improving the efficiency of spending. In developed countries, an important role in this task plays a multilevel system of evaluation and control of cost-effectiveness and results of operations of the health system and its individual members, supported by the use of evaluation findings in political and administrative decisions in the health sector, financial incentives and information support of participants in the evaluation. Effective today in Russia, the system for monitoring the effectiveness of the health system is largely a formality and does not meet modern political tasks. The most acute problems in assessing the effectiveness of the country include the lack of evaluation of individual elements, first of all, health technology assessment; the poor quality of data collected, the weak development of mechanisms for the implementation of evaluation results, in particular, the development of public policies promoting health care providers, informing the public about the quality of services provided. The aim of the present work is the development of basic mechanisms for assessing the efficiency and effectiveness of the Russian health care system, taking into account the best international and domestic experience.
    Keywords: health care system, Russia
    Date: 2015–05
  10. By: Henry Saffer; Markus Gehrsitz
    Abstract: This paper estimates the effects of post-and-hold laws on alcohol consumption and price. Post-and-hold laws require alcohol wholesalers to provide a list of prices to the state, which can be reviewed by retailers, competitors and the public. These laws were generally enacted at the end of prohibition with the intention of limiting alcohol consumption by raising prices. The laws may also have the unintended consequence of protecting small retailers. Recently, several large retailers have argued in court that these laws are counter to the Sherman Act, which limits anti-competitive behavior. This paper follows the recent paper by Cooper and Wright (2012) and adds new data and new statistical tests. Both difference-in–difference models and synthetic control models are employed. The estimation results provide no persuasive evidence of an effect of post-and-hold laws on the consumption of either beer, wine, or spirits. There is also no persuasive evidence that the laws increase the prices of these products. One possible explanation of this null effect is that the wholesale markets for alcohol are so highly regulated that post-and-hold laws have no discernable marginal effect. The empirical results presented in this paper do support alcohol excise taxes as effective means of reducing alcohol consumption.
    JEL: I18
    Date: 2015–07
  11. By: Kristen Himelein; Jonathan G. Kastelic
    Keywords: Poverty Reduction - Rural Poverty Reduction Poverty Reduction - Small Area Estimation Poverty Mapping Housing Human Habitats Food Beverage Industry Education - Primary Education Industry Communities and Human Settlements
    Date: 2015–04
  12. By: World Bank Group
    Keywords: Health, Nutrition and Population - Disease Control & Prevention Health, Nutrition and Population - Health Economics & Finance Health, Nutrition and Population - Health Monitoring & Evaluation Health, Nutrition and Population - Health Systems Development & Reform Health, Nutrition and Population - Population Policies
    Date: 2015–04
  13. By: World Bank
    Keywords: Health, Nutrition and Population - Population Policies Disease Control Prevention AIDS HIV Gender - Gender and Health Health Monitoring Evaluation
    Date: 2015–01

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