nep-hea New Economics Papers
on Health Economics
Issue of 2015‒09‒05
thirty papers chosen by
Yong Yin
SUNY at Buffalo

  1. The Earlier and the More, the Healthier? The Effects of Prenatal Care Utilization on Maternal Health and Health Behaviors By Ji Yan
  2. No Social Security COLA Causes Medicare Flap By Alicia H. Munnell; Anqi Chen
  3. Do More of Those in Misery Suffer from Poverty, Unemployment or Mental Illness? By Sarah Flèche; Richard Layard
  4. Long-Term Care Reform and the Labor Supply of Household Members: Evidence from a Quasi-Experiment By Johannes Geyer; Thorben Korfhage
  5. The rise of noncommunicable diseases in Latin America and the Caribbean: Challenges for public health policies. By Maria Victoria Anauati; Sebastian Galiani; Federico Weinschelbaum
  6. Second Trimester Sunlight and Asthma: Evidence from Two Indpendent Studies By Wernerfelt, Nancy; Slusky, David; Zeckhauser, Richard
  7. Macroeconomic impacts of Universal Health Coverage : Synthetic control evidence from Thailand By Rieger, M.; Wagner, N.; Bedi, A.S.
  8. Sanitation and health: Empirical evidence for Brazilian municipalities By MATTOS, Enlinson; PINTO, Cristine; TEIXEIRA, Lucas
  9. The impact of household health shocks on female time allocation and agricultural labor participation in rural Pakistan: By Gajate-Garrido, Gissele
  10. Corruption in the Health Sector: Evidence from Unofficial Consultation Fees in Bangladesh By Abdallah, Wahid; Chowdhury, Shyamal; Iqbal, Kazi
  11. Health Insurance Benefit Mandates and the Firm-Size Distribution By Bailey, James; Webber, Douglas A.
  12. Fighting Infectious Disease: Evidence from Sweden 1870-1940 By Lazuka, Volha; Quaranta, Luciana; Bengtsson, Tommy
  13. Small Businesses and Health Reform: Results from a Survey of Five States By Catherine McLaughlin Adam Swinburn
  14. Spotlight on Oregon By Mynti Hossain; Grace Anglin; Christal Ramos; Amanda Napoles; Amy Phillips
  15. Spotlight on Utah By Dana Petersen; Mynti Hossain; Veronica Barrios; Betsy Santos
  16. Spotlight on Illinois By Dana Petersen; Christal Ramos; Emily Lawton; Amanda Napoles
  17. Spotlight on Florida By Dana Petersen; Embry Howell; Christal Ramos; Emily Lawton; Amanda Napoles
  18. Spotlight on Wyoming By Grace Anglin; Adam Swinburn
  19. Health Information Technology in the United States: Progress and Challenges Ahead, 2014 (Executive Summary) By Catherine M. DesRoches; Michael W. Painter; Ashish K. Jha
  20. The Effects of Two Influential Early Childhood Interventions on Health and Healthy Behaviors By Gabriella Conti; James J. Heckman; Rodrigo Pinto
  21. The Effect of Hospital/Physician Integration on Hospital Choice By Laurence C. Baker; M. Kate Bundorf; Daniel P. Kessler
  22. Health Care Spending: Historical Trends and New Directions By Alice Chen; Dana Goldman
  23. The Value of Socialized Medicine: The Impact of Universal Primary Healthcare Provision on Birth and Mortality Rates in Turkey By Resul Cesur; Pınar Mine Güneş; Erdal Tekin; Aydogan Ulker
  24. Does Health Plan Generosity Enhance Hospital Market Power? By Laurence C. Baker; M. Kate Bundorf; Daniel P. Kessler
  25. Patient Mobility and Health Care Quality when Regions and Patients Differ in Income By Kurt R. Brekke; Rosella Levaggi; Luigi Siciliani; Odd Rune Straume
  26. Improving Customer Experience in Mental Health Service: A case Study of Ivy Willis House By Azeez, Waheed
  27. IQ and the Weight of Nations By Salahodjaev, Raufhon; Azam, Sardor
  28. Getting to the Roots of Long-Term Care Needs: A Regression Tree Analysis By Bassetti, Thomas; Rebba, Vincenzo
  29. Regional disparities in health outcome indicators : A study across Indian states By Mukhopadhyay, Debabrata
  30. Physical Activity, Present Bias, and Habit Formation: Theory and Evidence from Longitudinal Data By Humphreys, Brad; Ruseski, Jane; Zhou, Li

  1. By: Ji Yan
    Abstract: While many economic studies have explored the role of prenatal care in infant health production, the literature is quite sporadic about the effects of prenatal care on the mother. This research contributes to this understudied but important area using a unique large dataset of sibling newborns. We apply empirical models with mother fixed effects to find robust evidence that poor prenatal care utilization due to late onset of care, low frequency of care visits, or combinations of the two significantly increases the risks of maternal inadequate gestational weight gain, prenatal smoking, premature rupture of membranes, precipitous labor, no breastfeeding, postnatal underweight, and postpartum smoking. The magnitude of the estimates relative to the respective sample means of the outcome variables ranges from 3 to 33 percent. The results highlight the importance of receiving timely and sufficient prenatal care in improving maternal health and health behaviors during pregnancy as well as after childbirth. Moreover, we also find there is a high prevalence of underuse of prenatal care among pregnant women, which suggests potentially large scope for subsequent policy intervention. Key Words: Prenatal Care; Maternal Health; Gestational Weight Gain; Smoking; Breastfeeding; Unhealthy Body Weight
    JEL: I12 I18
    Date: 2015
  2. By: Alicia H. Munnell; Anqi Chen
    Abstract: The 2015 Social Security Trustees Report assumes that – for just the third time since the automatic adjustments were adopted in 1975 – Social Security recipients will not receive a cost-of-living-adjustment (COLA) in 2016. The reason is that the Consumer Price Index is not expected to increase in the base period used to determine the COLA. The anticipated lack of a Social Security COLA will cause a flap in the Medicare program because, by law, the cost of higher Medicare Part B premiums cannot be passed on to most beneficiaries when they do not get a raise in their Social Security benefits. This flap also highlights the complicated interaction between Medicare premiums, which are generally deducted automatically from Social Security benefits, and the net benefit – the money available for non-health care expenditures. Because, for a number of reasons, the COLA does not fully reflect the increase in health care costs faced by the elderly, the net Social Security benefit does not keep pace with inflation. This brief explores the interaction of inflation, Medicare premi­ums, and Social Security benefits. The discussion proceeds as follows. The first sec­tion describes Social Security’s COLA. The second section describes how Medicare premiums are calcu­lated and explains next year’s flap. The third reports that Medicare Part B premiums have increased more than twice as fast as the COLA and discusses three reasons why this differential matters for non-medical care spending. The final section concludes that, while the inflation adjustment in Social Security is extremely valuable, the rise in Medicare premiums undermines the ability of beneficiaries to maintain their purchasing power for non-health-care items.
    Date: 2015–08
  3. By: Sarah Flèche; Richard Layard
    Abstract: Studies of deprivation usually ignore mental illness. This paper uses household panel data from the USA, Australia, Britain and Germany to broaden the analysis. We ask first how many of those in the lowest levels of life-satisfaction suffer from unemployment, poverty, physical ill health, and mental illness. The largest proportion suffer from mental illness. Multiple regression shows that mental illness is not highly correlated with poverty or unemployment, and that it contributes more to explaining the presence of misery than is explained by either poverty or unemployment. This holds both with and without fixed effects.
    Keywords: Mental health, life-satisfaction, wellbeing, poverty, unemployment
    JEL: I1 I31 I32
    Date: 2015
  4. By: Johannes Geyer; Thorben Korfhage
    Abstract: Germany introduced a new mandatory insurance for long-term care in 1995 as part of its social security system. It replaced a system based on meanstested social welfare. Benefits from the long-term care insurance are not means tested and depend on the required level of care. The insurance provides both benefits in kind and cash benefits. The new scheme improved the situation for households to organize informal care at home. This was one goal of the reform since policymakers view informal care as a cost-saving alternative to formal care. This view however neglects possible opportunity costs of reduced labor supply of carers. We exploit this reform as a quasi-experiment and examine its effect on the labor supply of caregivers who live in the same household as the care recipient. We find strong negative labor market effects for men but not for women. We conduct a series of robustness tests and find results to be stable.
    Keywords: Labor supply, long-term care, long-term care insurance, natural experiment, quasi-experiment
    JEL: J22 H31 I13
    Date: 2015
  5. By: Maria Victoria Anauati (Universidad de San Andrés); Sebastian Galiani (University of Maryland); Federico Weinschelbaum (Universidad de San Andrés)
    Abstract: The health landscape in Latin America and the Caribbean is changing quickly. The region is undergoing a demographic and epidemiological transition in which health problems are highly concentrated on noncommunicable diseases (NCDs). In light of this, the region faces two main challenges: (1) develop cost-effective policies to prevent NCD risk factors, and (2) increase access to quality healthcare in a scenario in which a large share of the labor force is employed in the informal sector. This paper describes both alternative interventions to expand health insurance coverage and their tradeoff with labor informality and moral hazard problems. The paper also focuses on obesity as a case example of a NCD, and emphasizes how lack of knowledge along with self-control problems would lead people to make suboptimal decisions related to food consumption, which may later manifest in obesity problems.
    JEL: I12 I13 I18
    Date: 2015–07
  6. By: Wernerfelt, Nancy (MIT); Slusky, David (Princeton University and University of KS); Zeckhauser, Richard (Harvard University)
    Abstract: One in twelve Americans suffers from asthma and its annual costs are estimated to exceed $50 billion. Simultaneously, the root causes of the disease remain unknown. A recent hypothesis speculates that maternal vitamin D levels during pregnancy affect the probability the fetus later develops asthma. In two large-scale studies, we test this hypothesis using a natural experiment afforded by historical variation in sunlight, a major source of vitamin D. Specifically, holding the birth location and month fixed, we see how exogenous within-location variation in sunlight across birth years affects the probability of asthma onset. We show that this measurement of sunlight correlates with actual exposure, and consistent with pre-existing results from the fetal development literature, we find substantial and highly significant evidence in both datasets that increased sunlight during the second trimester lowers the subsequent probability of asthma. Our results suggest policies designed to augment vitamin D levels in pregnant women, the large majority of whom are vitamin D insufficient, could be very cost-effective.
    JEL: I12 I18 J13
    Date: 2014–10
  7. By: Rieger, M.; Wagner, N.; Bedi, A.S.
    Abstract: We study the impact of Universal Health Coverage (UHC) on various macroeconomic outcomes in Thailand using synthetic control methods. Thailand is compared to a weighted average of control countries in terms of aggregate health and economic performance over the period 1995 to 2012. Our results suggest that financial protection in Thailand has improved relative to its synthetic counterfactual. While out-of-pocket payments as a percentage of overall health expenditures decreased by 16.9 percentage points, annual government per capita health spending increased by $78. However, we detect no impact on total health spending per capita nor the share of the government budget allocated to health. We find positive health impacts as captured by reductions in infant and child mortality. The introduction of UHC has had no discernible impact on GDP per capita. Our results complement micro evidence based on within country variation. The counterfactual design implemented here may be used to inform other countries on the causal repercussions and benefits of UHC at the macroeconomic level.
    Keywords: macroeconomic impacts, synthetic control approach, Thailand
    Date: 2015–07–27
  8. By: MATTOS, Enlinson; PINTO, Cristine; TEIXEIRA, Lucas
    Abstract: The relationship between sanitation policies (access and quality) and health in Brazilian municipalities was estimated from 2003 to 2010 using a panel data model with corrections for missing data. The results suggest a limited effect of sanitation policy on health. Compared with results from the literature, we found that the worsening quality of water appears to be associated with increased rates of mortality and hospitalization for children up to one month of age. Improvements in sewage sanitation have reduced the mortality and morbidity rates in children aged one to four. Improved access to piped water is associated with decreased hospitalization related to dysentery and acute respiratory infections (ARI) and does not have an effect on child mortality. Finally, epidemiological transition is only supported by weak evidence, including a more intense effect of reduced access to sanitation in municipalities with the worst mortality and morbidity indicators. In most models, this theory has been rejected
    Date: 2015–06–15
  9. By: Gajate-Garrido, Gissele
    Abstract: There have been few empirical studies in the developing world and the agricultural sector, on the impact of negative health shocks on household well-being. Does the pervasive effect of a negative household-level health shock persist beyond its initial impact and indirectly affect long-run outcomes? What are the channels through which this impact affects household dynamics? To answer these questions this research paper measures the effect of household health shocks on female time allocation and agricultural labor participation in rural Pakistan. To deal with joint determination and measurement error issues, it uses a wide range of covariates found in the 2012 and 2013 Pakistan Rural Household Panel Surveys, including individual, year, and district fixed effects. This paper improves on previous research by providing evidence on the role of changes in female labor supply as an insurance mechanism and shedding light on the nonmonetary consequences of adverse health shocks. Increases in paid workload for women reduce time spent on household chores directly related to child quality. The paper shows how these changes in time allocation affect households’ overall well-being.
    Keywords: development, gender, women, division of labor, health shocks, agricultural productivity,
    Date: 2015
  10. By: Abdallah, Wahid (BRAC University); Chowdhury, Shyamal (University of Sydney); Iqbal, Kazi (Bangladesh Institute of Development Studies)
    Abstract: We study the incidence and extent of bribes paid to the doctors in the public health facilities which are cleverly identified using a nationally representative survey. The survey asks households about the fees paid to public doctors, not about the bribe, which makes it less prone to reporting bias. We find that though consultations are free in the public health facilities, 41% of the patients who visited them paid about US$2 as a consultation fee, which is about 16% of their total medical expenditure. Three interesting generalized results that we find on the determinants of incidence and extent of bribe payment are: First, bribe givers and non-givers are different in terms of observed characteristics. Second, the same doctors, when sit in a private facility, charge more, setting an upper limit of bribes at public facilities. Third, travel time of the service seekers is used as a price discriminating device by the public service providers. Results have important implications for combating corruption, especially in developing countries.
    Keywords: corruption, public health, price discrimination, Bangladesh
    JEL: D73 I18 L11
    Date: 2015–08
  11. By: Bailey, James (Creighton University); Webber, Douglas A. (Temple University)
    Abstract: By 2010, the average US state had passed 37 health insurance benefit mandates (laws requiring health insurance plans to cover certain additional services). Previous work has shown that these mandates likely increase health insurance premiums, which in turn could make it more costly for firms to compensate employees. Using 1996–2010 data from the Quarterly Census of Employment and Wages and a novel instrumental variables strategy, we show that there is limited evidence that mandates reduce employment. However, we find that mandates lead to a distortion in firm size, benefiting larger firms that are able to self-insure and thus exempt themselves from these state-level health insurance regulations. This distortion in firm size away from small businesses may lead to substantial decreases in productivity and economic growth.
    Keywords: health insurance, benefit mandates, self-insurance, interest groups, employment, firm size
    JEL: L51 I13 I18 J32
    Date: 2015–08
  12. By: Lazuka, Volha (Lund University); Quaranta, Luciana (Lund University); Bengtsson, Tommy (Lund University)
    Abstract: Fighting infectious disease in the past, much like today, focused on isolating the disease and thereby stopping its spread. New insights into the modes of transmission and the causal agents in the mid-nineteenth century, together with fear of new epidemic outbreaks, motivated public investments aimed at reducing mortality from infectious disease. Combining longitudinal individual-level data on 17,000 children in a rural/semi-urban region in southern Sweden with parish-level data on public health investment from local ledger registers, we explore the effects of public health initiatives, such as the establishment of isolation hospitals and improved midwifery, on infant and child mortality. Using a difference-in-differences approach, we find that the establishment of isolation hospitals in the mid-1890s had been efficient in reducing child mortality, while the reformation of the midwife system after 1900s led to the decline in infant mortality, both by a magnitude of more than 50 per cent.
    Keywords: public health investment, infectious diseases, mortality, children, Sweden
    JEL: I14 I18 H51 J18
    Date: 2015–08
  13. By: Catherine McLaughlin Adam Swinburn
    Abstract: This brief found that many proprietors of small businesses were unaware of ACA provisions designed to help small businesses offer health insurance to their employees, often by directly or indirectly reducing the costs of providing coverage. The findings highlight the importance of raising awareness of the potential benefits of health reform.
    Keywords: Small Businesses, Health Reform, Survey, Alabama, Colorado, Minnesota, New York, Oregon
    JEL: I
    Date: 2014–04–30
  14. By: Mynti Hossain; Grace Anglin; Christal Ramos; Amanda Napoles; Amy Phillips
    Abstract: This brief highlights the major strategies, lessons learned, and outcomes from Oregon’s experience during the first 5 years of the quality demonstration funded by the Centers for Medicare & Medicaid Services (CMS) through the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA).
    Keywords: Oregon, CHIPRA, Quality Demonstration Grant Program
    JEL: I
    Date: 2015–07–30
  15. By: Dana Petersen; Mynti Hossain; Veronica Barrios; Betsy Santos
    Abstract: This brief highlights the major strategies, lessons learned, and outcomes from Utah’s experience during the first 5 years of the quality demonstration funded by the Centers for Medicare & Medicaid Services (CMS) through the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA).
    Keywords: Utah, CHIPRA, Quality Demonstration Grant Program
    JEL: I
    Date: 2015–07–30
  16. By: Dana Petersen; Christal Ramos; Emily Lawton; Amanda Napoles
    Abstract: This brief highlights the major strategies, lessons learned, and outcomes from Illinois's experience in the first 5 years of the quality demonstration funded by the Centers for Medicare & Medicaid Services (CMS) through the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA).
    Keywords: Illinois, CHIPRA, Quality Demonstration Grant Program
    JEL: I
    Date: 2015–07–30
  17. By: Dana Petersen; Embry Howell; Christal Ramos; Emily Lawton; Amanda Napoles
    Abstract: This brief highlights the major strategies, lessons learned, and outcomes from Florida’s experience during the first 5 years of the quality demonstration funded by the Centers for Medicare Medicaid Services (CMS) through the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA).
    Keywords: Florida, CHIPRA, Quality Demonstration Grant Program
    JEL: I
    Date: 2015–07–30
  18. By: Grace Anglin; Adam Swinburn
    Abstract: This brief highlights the major strategies, lessons learned, and outcomes from Wyoming’s experience during the first 5 years of the quality demonstration funded by the Centers for Medicare & Medicaid Services (CMS) through the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA).
    Keywords: Wyoming, CHIPRA, Quality Demonstration Grant Program
    JEL: I
    Date: 2015–07–30
  19. By: Catherine M. DesRoches; Michael W. Painter; Ashish K. Jha
    Abstract: Adopting EHRs is the first step in a long and complex journey to an IT-enabled health care system in which technology is effectively leveraged to address ongoing cost and quality challenges.
    Keywords: Health Information Technology, HIT, Health
    JEL: I
    Date: 2014–08–07
  20. By: Gabriella Conti; James J. Heckman; Rodrigo Pinto
    Abstract: This paper examines the long-term impacts on health and healthy behaviors of two of the oldest and most widely cited U.S. early childhood interventions evaluated by the method of randomization with long-term follow-up: the Perry Preschool Project (PPP) and the Carolina Abecedarian Project (ABC). There are pronounced gender effects strongly favoring boys, although there are also effects for girls. Dynamic mediation analyses show a significant role played by improved childhood traits, above and beyond the effects of experimentally enhanced adult socioeconomic status. These results show the potential of early life interventions for promoting health.
    JEL: C12 C93 I12 I13 J13 J24
    Date: 2015–08
  21. By: Laurence C. Baker; M. Kate Bundorf; Daniel P. Kessler
    Abstract: In this paper, we estimate how hospital ownership of physicians’ practices affects their patients’ hospital choices. We match data on the hospital admissions of Medicare beneficiaries, including the identity of their admitting physician, with data on the identity of the owner of the admitting physician’s practice. We find that a hospital's ownership of an admitting physician’s practice dramatically increases the probability that the physician's patients will choose the owning hospital. We also find that patients are more likely to choose a high-cost, low-quality hospital when their admitting physician’s practice is owned by that hospital.
    JEL: I11
    Date: 2015–08
  22. By: Alice Chen; Dana Goldman
    Abstract: Over the last five decades, broad changes in the US health care system have dramatically influenced growth in health care expenditures. These structural changes have also influenced the trajectory of the health economics research. This paper reviews some of the seminal health economics papers (measured by citations) and identifies the salient factors driving the growth of medical expenditures. We find that the research identified – and was strongly influenced by – four eras of expenditure growth: (1) coverage expansion; (2) experimentation with financial incentives; (3) the managed care backlash; and (4) a golden era of declining expenditure growth. We conclude by discussing some themes from this research suggesting optimism that, going forward, we can curb excess expenditure growth above GDP growth without harming population health.
    JEL: I1 I11 I12 I13 I18
    Date: 2015–08
  23. By: Resul Cesur; Pınar Mine Güneş; Erdal Tekin; Aydogan Ulker
    Abstract: This paper examines the impact of universal, free, and easily accessible primary healthcare on population health as measured by age-specific birth and mortality rates, focusing on a nationwide socialized medicine program implemented in Turkey. The Family Medicine Program (FMP), launched in 2005, assigns each Turkish citizen to a specific state-employed family physician, who offers a wide range of primary healthcare services that are free-of-charge. Furthermore, these services are provided at family health centers, which operate on a walk-in basis and are located within the neighborhoods in close proximity to the patients. To identify the causal impact of the FMP, we exploit the variation in its introduction across provinces and over time. Our estimates indicate that the FMP caused large declines in mortality rates across all age groups with more pronounced impacts among infants and the elderly, and a moderate reduction in the birth rates, primarily among teenagers. Furthermore, the results are suggestive that the program has also contributed towards equalization in the mortality disparities across provinces. Our findings highlight the importance of a nationwide supply-side intervention on improving public health.
    JEL: I0 I1 I11 I13 I14 I18 J13 J14
    Date: 2015–08
  24. By: Laurence C. Baker; M. Kate Bundorf; Daniel P. Kessler
    Abstract: We test whether the generosity of employer-sponsored health insurance facilitates the exercise of market power by hospitals. We construct indices of health plan generosity and the price and volume of hospital services using data from Truven MarketScan for 601 counties from 2001-2007. We use variation in the industry and union status of covered workers within a county over time to identify the causal effects of generosity. Although OLS estimates fail to reject the hypothesis that generosity facilitates the exercise of hospital market power, IV estimates show a statistically significant and economically important positive effect of plan generosity on hospital prices in uncompetitive markets, but not in competitive markets. Our results suggest that most of the aggregate effect of hospital market structure on prices found in previous work may be coming from areas with generous plans.
    JEL: I11
    Date: 2015–08
  25. By: Kurt R. Brekke (Department of Economics, Norwegian School of Economics); Rosella Levaggi (Department of Economics, University of Brescia); Luigi Siciliani (Department of Economics and Related Studies, University of York); Odd Rune Straume (Universidade do Minho - NIPE)
    Abstract: This paper studies the effects of cross-border patient mobility on health care quality and welfare when income varies across and within regions. We use a Salop model with a high, middle and low income region, where, in each region, a policy maker chooses the level of health care quality that maximises welfare subject to costs being …financed by general taxation. In equilibrium, regions with higher income offer better quality, implying that the high (low) income region imports (exports) patients and the middle-income region both imports and exports patients. Assuming DRG-pricing, we …find that a reduction in mobility costs has generally heterogeneous effects on regional health care quality and welfare, with low and middle income regions being vulnerable to adverse effects of cross-border health care liberalisation. We also show that higher income inequality in a region might have negative spillover effects on quality provision in other regions because of cross-border patient mobility.
    Keywords: Patient mobility; Health care quality; Income inequalities; Regional welfare.
    JEL: H51 H73 I11 I18
    Date: 2015
  26. By: Azeez, Waheed
    Abstract: The negative effects of the current economic climate on mental health service providers under the NHS cannot be overemphasised. As the government is trying to cut its expenses and minimise wasteful activities and unnecessary spending within the NHS, every trust and every department or unit within the trust has now realised that it has to justify its existence and review its services to the public. More so, the on-going restructuring of the NHS has led to the closure of some hospitals and departments that are considered not fit for purpose. Meanwhile, the closure of certain hospitals or departments, especially the accident and emergency departments (A&E), have caused outrage among the general public who reside within the vicinities or catchment areas served by those departments. In some cases, this move is challenged in the courts of law forcing the government to rescind its decision and leave certain hospitals open after they have been marked for closure. The joint efforts of staff and patients of these hospitals and their determination to preserve these valuable institutions are paying off greatly. However, the same cannot be said about the mental health facilities within the NHS. This is probably because the services provided by mental health departments are not meant for every member of the public. The services are meant for those who have mental health issues. As a result of this, only those who are concerned with mental health issues advocate for their continuous existence and maintenance. The general public do not always speak out for them. The aim of this report is to look into the plight of these mental health institutions and the difficulties they are facing in terms of funding, staffing levels, public support, research and development, patient satisfaction among other things. We have chosen Ivy Willis House because of its achievement as one of the most successful mental health rehabilitation centres in the south-west area of London.
    Keywords: Customer Experience, Mental Health Service
    JEL: M31
    Date: 2015–01
  27. By: Salahodjaev, Raufhon; Azam, Sardor
    Abstract: The antecedents of the ‘weights of nations’ have been in the center of theoretical and empirical discussion over the past decades. In this research, we contribute to extant studies by investigating the effect of general intelligence, measured by nation IQ, on the Body Mass Indices (BMI) of male and female populations for 187 countries of the world. Our results suggest an inverted U-shaped link between intelligence and BMI. Even after controlling for an alternative set of control variables such as trade openness, urbanization and others, our results remain intact. This paper documents a turning point of 80.8 for female and 83.7 IQ score for male BMI. The results remain robust to a number of robustness checks.
    Keywords: IQ, health, obesity, BMI, globalization, trade openness
    JEL: I1 O1
    Date: 2015–08–07
  28. By: Bassetti, Thomas; Rebba, Vincenzo
    Abstract: This paper investigates the effects of individual and environmental determinants on physical and cognitive impairment of Europeans aged 50 and older using data drawn from the Survey of Health Aging and Retirement in Europe (SHARE). The aim is to understand the different paths that need-related determinants of long-term care might take across individuals. As dependent variables, we consider several measures of physical and cognitive disability which are regressed on a list of covariates which includes biological, health, behavioural, socio-demographic and early-life conditions of individuals. We adopt a methodology that combines the structure of random effects models for longitudinal data with the flexibility of a tree regression method. We show the existence of clusters in the main determinants of functional decline (physical and cognitive). Our findings are in line with the existing literature, but, at the same time, we further characterize previous evidence: 1) cognitive impairment, measured by the results of a memory test, strongly depends on educational attainments, age and respondents’ country of residence; 2) physical impairment, measured through the loss of handgrip strength, basic and instrumental activities of daily living (ADLs, IADLs) and mobility, strongly depends on health and behavioural factors.
    Keywords: Long-term care, physical impairment, cognitive impairment, health behaviour, early-life conditions, RE-EM tree analysis, SHARE.
    JEL: I12 J14 J26
    Date: 2015–08–18
  29. By: Mukhopadhyay, Debabrata
    Abstract: This paper focuses on the disparities that persist in India’s health sector across different states. Following the conventional measures of regional inequality such as standard deviation and coefficient of variation, we investigate the spatial variations across the Indian states in terms of three basic health indicators viz. infant mortality rate (IMR), under five mortality and maternal mortality rates. We analyzed the temporal variations of regional disparities of IMR for the period 1998 to 2012. A multiple cross regression of IMR on medical and non-medical conditions show the role of socio-economic and the health infrastructure as significant in determining health outcomes.
    Keywords: Health Outcome Indicators, Infant mortality rate, Under five mortality rate, maternal mortality rate Regional disparities
    JEL: I14
    Date: 2015–08–17
  30. By: Humphreys, Brad (West Virginia University, Department of Economics); Ruseski, Jane (West Virginia University, Department of Economics); Zhou, Li (University of Alberta, Department of Economics)
    Abstract: We investigate temporal decisions to participate in exercise in a dynamic model featuring present bias and habit formation. The model highlights naivete about present bias and projection bias about habit formation/decay and implies that promoting participation in physical activity must both encourage the inactive to start and discourage the active from quitting as behavioral biases apply to both. Our empirical analysis using data from the British Household Panel Survey (BHPS) develops evidence consistent with predictions about present bias and habit formation/decay and an interesting asymmetry between starting and quitting that furthers understanding of existing empirical evidence.
    Keywords: present-bias; physical activity; habit formation; habit decay; projection bias
    JEL: D10 I12 L83
    Date: 2015–08–01

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