nep-hea New Economics Papers
on Health Economics
Issue of 2017‒06‒11
24 papers chosen by
Yong Yin
SUNY at Buffalo

  1. How Much Long-Term Care Do Adult Children Provide? By Gal Wettstein; Alice Zulkarnain
  2. The Hospital as a Multi-Product Firm: The Effect of Hospital Competition on Value-Added Indicators of Clinical Quality By Matthew Skellern
  3. Productivity of the English NHS: 2014/15 Update By Chris Bojke; Adriana Castelli; Katja Grasic; Daniel Howdon; Andrew Street
  4. Is housing a health insult? By Emma Baker; Andrew Beer; Laurence Lester; David Pevalin; Christine M E Whitehead; Rebecca Bentley
  5. Can HIV alter the quantity-quality switch and delay the fertility transition in Sub-Saharan Africa? By Gori, Luca; Lupi, Enrico; Manfredi, Piero; Sodini, Mauro
  6. Does neighbour’s grass matter? Exploring spatial dependent heterogeneity in technical efficiency of Italian hospitals By Cavalieri, M.; Di Caro, P.; Guccio, C.; Lisi, D.;
  7. The economic burden of chronic diseases: Estimates and projections for China, Japan, and South Korea By Bloom, David E.; Chen, Simiao; Kuhn, Michael; McGovern, Mark; Oxley, Les T.; Prettner, Klaus
  8. Health effects of instruction intensity: Evidence from a natural experiment in German high-schools By Quis, Johanna Sophie; Reif, Simon
  9. The Lasting Legacy of Seasonal Influenza: In-utero Exposure and Labor Market Outcomes By Schwandt, Hannes
  10. Risky consumption among adolescents: A survey for Spain By Ferrando, Sandra
  11. Smoking in top-grossing US movies 2016 By Polansky, Jonathan R; Titus, Kori; Atayeva, Renata; Glantz, Stanton A
  12. Exit, Voice or Loyalty? An Investigation into Mandated Portability of Front-Loaded Private Health Plans By Juan Pablo Atal; Hanming Fang; Martin Karlsson; Nicolas R. Ziebarth
  13. Did the Affordable Care Act Young Adult Provision Affect Labor Market Outcomes? Analysis Using Tax Data By Bradley Heim; Ithai Lurie; Kosali Simon
  14. Health consequences of sterilizations By Maëlys de La Rupelle; Christelle Dumas
  15. Access and Use of Contraception and Its Effects on Women’s Outcomes in the U.S. By Martha J. Bailey; Jason M. Lindo
  16. The Effect of Unpaid Overtime Hours on Health By Taisei Noda; Takaaki Ikeda
  17. The Discourse of Japanese Development Assistance and the Scaling-up of Community-based Health Planning and Services (CHPS) in Ghana By Ampiah, Kweku
  18. The Cost-Effectiveness of High-Risk Lung Cancer Screening and Drivers of Program Efficiency By Sonya Cressman; Stuart J. Peacock; Martin C. Tammemägi; William K. Evans; Natasha B. Leighl; John R. Goffin; Alain Tremblay; Geoffrey Liu; Daria Manos; Paul MacEachern; Rick Bhatia; Serge Puksa; Garth Nicholas; Annette McWilliams; John R. Mayo; John Yee; John C. English; Reka Pataky; Emily McPherson; Sukhinder Atkar-Khattra; Michael R. Johnston; Heidi Schmidt; Frances A. Shepherd; Kam Soghrati; Kayvan Amjadi; Paul Burrowes; Christian Couture; Harmanjatinder S. Sekhon; Kazuhiro Yasufuku; Glenwood Goss; Diana N. Ionescu; David M. Hwang; Simon Martel; Don D. Sin; Wan C. Tan; Stefan Urbanski; Zhaolin Xu; Ming-Sound Tsao; Stephen Lam
  19. Mortality and the Business Cycle: Evidence from Individual and Aggregated Data By van den Berg, Gerard J.; Gerdtham, Ulf-G.; von Hinke Kessler Scholder, Stephanie; Lindeboom, Maarten; Lissdaniels, Johannes; Sundquist, Jan; Sundquist, Kristina
  20. Body-Weight and Women's Hours of Work: More Evidence That Marriage Markets Matter By Grossbard, Shoshana; Mukhopadhyay, Sankar
  21. Health and Health Inequality during the Great Recession: Evidence from the PSID By Wang, Chenggang; Wang, Huixia; Halliday, Timothy J.
  22. Economic Conditions at Birth and Cardiovascular Disease Risk in Adulthood: Evidence from New Cohorts By Alessie, Rob; Angelini, Viola; van den Berg, Gerard J.; Mierau, Jochen O.; Viluma, Laura
  23. Long-Run Effects of Severe Economic Recessions on Male BMI Trajectories and Health Behaviors By Nizalova, Olena Y.; Norton, Edward C.
  24. Effect of Political Decentralization and Female Leadership on Institutional Births and Child Mortality in Rural Bihar, India By Kumar, Santosh; Prakash, Nishith

  1. By: Gal Wettstein; Alice Zulkarnain
    Abstract: As people age and their health starts to deteriorate, their need for help in daily life increases. Normal activities become more difficult as they lose the strength, flexibility, and agility required for basic routines such as dressing, buying groceries, and handling finances. To assist with such activities, one option is formal caregiving services. However, cost concerns and personal preferences lead many people to first turn to informal care from family members, particularly children. While formal care has a clear monetary cost, the burdens of informal care are harder to pin down. This brief uses the Health and Retirement Study (HRS) to estimate how many adult children provide care to their parents and the extent of their caregiving burden. The caregiving issue is becoming increasingly important. In the coming decade, baby boomers will begin reaching their 80s, an age when the need for care rises substantially. This cohort is larger than earlier generations, but also had fewer children per household. The resulting higher ratio of parents to children suggests a potentially bigger burden for the boomers’ children than for previous generations. To the extent that this burden is too much to handle, it will likely fall on formal care providers and insurers, particularly public programs like Medicaid. This brief proceeds as follows. The first section presents data on the need for care among the elderly and on how much care is provided by adult children. The second section synthesizes recent research on the burden of care provision borne by adult children. The final section concludes that while only a moderate share of adult children provide care for their parents, those who do so contribute a lot of time and effort. The provision of informal care, therefore, can have significant implications for the caregivers’ financial health and overall well-being.
    Date: 2017–06
  2. By: Matthew Skellern
    Abstract: There is increasing international interest in using Patient Reported Outcome Measures (PROMs) to assess health care provider performance. PROMs are a fundamental advance on existing indicators of health care quality in two respects: they equate outcomes with value added (i.e. health gain) from treatment rather than post-treatment health status, and they allow clinical quality to be measured at the level of the individual medical intervention to a far greater extent than existing failure-based indicators of quality such as mortality or readmissions. Most existing econometric studies of hospital competition and quality equate outcomes with post-treatment health status, and use mortality rates of various kinds as indicators of overall hospital performance, in spite of the fact that mortality is a relatively uncommon outcome in the spheres of hospital activity - such as elective surgery - in which competition for patients does occur. This paper contributes to the development of a value-added, multi-product conception of hospital quality by studying the impact of a major competition-promoting reform to the English NHS in 2006, in which patients were allowed to choose which hospital they attended for elective surgery, on PROMs of health gain from hip and knee replacement, groin hernia repair, and varicose vein surgery. In contrast to the existing literature, I find that the competition brought about by the introduction of patient choice of hospital may have had a negative effect on clinical quality. I put forward a theoretical framework that explains these findings, and conclude by arguing that future research should model the hospital as a multi-product firm, and capture clinical quality using value-added outcome measures.
    Keywords: health care, hospital competition, price regulation, prospective reimbursement, patient choice, health care quality, vertical product quality, performance measurement, multi-tasking, value added
    JEL: C21 D21 H42 I11 I18 L1 L15 L32 R12
    Date: 2017–05
  3. By: Chris Bojke (Centre for Health Economics, University of York, UK); Adriana Castelli (Centre for Health Economics, University of York, UK); Katja Grasic (Centre for Health Economics, University of York, UK); Daniel Howdon (Centre for Health Economics, University of York, UK); Andrew Street (Centre for Health Economics, University of York, UK)
    Abstract: This report updates the Centre for Health Economics’ time-series of National Health Service (NHS) productivity growth. The full productivity series runs from 1998/99, but this report updates the series to account for growth between 2013/14 and 2014/15, as well as looking at 10 year growth trends since 2004/05.
    Date: 2017–04
  4. By: Emma Baker; Andrew Beer; Laurence Lester; David Pevalin; Christine M E Whitehead; Rebecca Bentley
    Abstract: In seeking to understand the relationship between housing and health, research attention is often focussed on separate components of people’s whole housing ‘bundles’. We propose in this paper that such conceptual and methodological abstraction of elements of the housing and health relationship limits our ability to understand the scale of the accumulated effect of housing on health and thereby contributes to the under-recognition of adequate housing as a social policy tool and powerful health intervention. In this paper, we propose and describe an index to capture the means by which housing bundles influence health. We conceptualise the index as reflecting accumulated housing “insults to health”—an Index of Housing Insults (IHI). We apply the index to a sample of 1000 low-income households in Australia. The analysis shows a graded association between housing insults and health on all outcome measures. Further, after controlling for possible confounders, the IHI is shown to provide additional predictive power to the explanation of levels of mental health, general health and clinical depression beyond more traditional proxy measures. Overall, this paper reinforces the need to look not just at separate housing components but to embrace a broader understanding of the relationship between housing and health.
    Keywords: housing; health; index; longitudinal
    JEL: N0
    Date: 2017–05–26
  5. By: Gori, Luca; Lupi, Enrico; Manfredi, Piero; Sodini, Mauro
    Abstract: According to the conventional theory of the demographic transition, mortality decline has represented the major trigger for fertility decline and eventually sustained economic development. In Sub-Saharan Africa (SSA), the HIV/AIDS epidemic has had a devastating impact on mortality, by dramatically reversing, in high HIV-prevalence countries, the long-term positive trend in life expectancies. Despite the fact that SSA as a whole is suffering a delayed and slow fertility transition compared to other world’s regions, and despite evidence for halting or even reverting fertility decline in countries with severe HIV epidemics, there seems to be little concern amongst international policy makers, about the ultimate impact that HIV might have on SSA fertility. This work reports model-based evidence of the potential for a HIV-triggered reversal of fertility in high HIV-prevalent SSA countries induced by the fall in education and human capital investments following the drop in life expectancy for young adults. This eventually breaks down the virtuous circle promoting the switch quantity-to-quality of children. This result suggests that the current evidence on fertility halting and declining education in high HIV-prevalent SSA countries should be seriously taken into consideration to prioritise current international interventions.
    Keywords: Sub-Saharan Africa,fertility transition,quantity-quality switch,HIV/AIDS epidemics,human capital accumulation,fertility reversal
    JEL: J11 J13 O1 O41
    Date: 2017
  6. By: Cavalieri, M.; Di Caro, P.; Guccio, C.; Lisi, D.;
    Abstract: With respect to the other dimensions of hospital behaviour, studying the presence of interaction effects on efficiency involves the issue of which approach is most appropriate to incorporate the spatial dependence in the empirical efficiency model. Using a large sample of Italian hospitals, this paper explores the presence of spatial dependence in technical efficiency. To this purpose, we employ a Spatial Stochastic Frontier Analysis (SSFA) that allows us to robustly estimate the efficiency of each hospital while considering the presence of spatial dependence. Furthermore, we employ both standard spatial contiguity matrix and spatial matrixes exploring the idea of institutional contiguity. Overall, the results suggest an insignificant role for spatial dependence in the efficiency of Italian hospitals, regardless of the specific form of spatial dependence implicit in the weights matrix.
    Keywords: technical efficiency; hospitals; spatial dependence; SSFA;
    JEL: C21 I11 D61
    Date: 2017–06
  7. By: Bloom, David E.; Chen, Simiao; Kuhn, Michael; McGovern, Mark; Oxley, Les T.; Prettner, Klaus
    Abstract: We propose a novel framework to analyse the macroeconomic impact of noncommunicable diseases. We incorporate measures of disease prevalence into a human capital augmented production function, which enables us to determine the economic costs of chronic health conditions in terms of foregone gross domestic product (GDP). Unlike previously adopted frameworks, this approach allows us to account for i) variations in human capital for workers in different age groups, ii) mortality and morbidity effects of non-communicable diseases, and iii) the treatment costs of diseases. We apply our methodology to China, Japan, and South Korea, and estimate the economic burden of chronic conditions in five domains (cardiovascular diseases, cancer, respiratory diseases, diabetes, and mental health conditions). Overall, total losses associated with these non-communicable diseases over the period 2010-2030 are $16 trillion for China (measured in real USD with the base year 2010), $5.7 trillion for Japan, and $1.5 trillion for South Korea. Our results also highlight the limits of cost-effectiveness analysis by identifying some intervention strategies to reduce disease prevalence in China that are cost beneficial and therefore a rational use of resources, though they are not cost-effective as judged by conventional thresholds.
    Keywords: Non-communicable Diseases,Human Capital,Health Interventions,Aggregate Output,Ageing,East Asia
    JEL: H51 I15 I18 J24 O11
    Date: 2017
  8. By: Quis, Johanna Sophie; Reif, Simon
    Abstract: A large literature aims to establish a causal link between education and health using changes in compulsory schooling laws. It is however unclear how well more education is operationalized by marginal increases in school years. We shed a new light on this discussion by analyzing the health effects of a reform in Germany where total years of schooling for students in the academic track were reduced from nine to eight while keeping cumulative teaching hours constant by increasing instruction intensity. The sequential introduction of the reform allows us to implement a triple difference-in-differences estimation strategy with data from the German Socio-Economic Panel. We find that increased weekly instruction time has negative health effects for females while they are still in school. However, after graduation, females even seem to benefit from reduced school years. We find no effects on males' health.
    Keywords: education and health,instruction intensity,natural experiment,SOEP
    JEL: I19 I21 I28
    Date: 2017
  9. By: Schwandt, Hannes (Department of Business and Economics, and COHERE)
    Abstract: Pregnancy conditions have been shown to matter for later economic success, but many threats to fetal development that have been identified are difficult to prevent. In this paper I study seasonal influenza, a preventable illness that comes around every year and causes strong inflammatory responses in pregnant women. Using administrative data from Denmark, I identify the effects of maternal influenza on the exposed offspring via sibling comparison, exploiting both society-wide influenza spread and information on individual mothers who suffer strong infections during pregnancy. In the short term, maternal influenza leads to a doubling of prematurity and low birth weight, by triggering premature labor among women infected in the third trimester. Following exposed offspring into young adulthood, I observe a 9% earnings reduction and a 35% increase in welfare dependence. These long-term effects are strongest for influenza infections during the second trimester and they are partly explained by a decline in educational attainment, pointing to cognitive impairment. This effect pattern suggests that maternal influenza damages the fetus through multiple mechanisms, and much of the damage may not be visible at birth. Taken together, these results provide evidence that strong infections during pregnancy are an often overlooked prenatal threat with long-term consequences.
    Keywords: Fetal origins; seasonal influenza; labor market outcomes
    JEL: I10 J13 J24 J30
    Date: 2017–06–02
  10. By: Ferrando, Sandra
    Abstract: The purpose of this paper is to review the extensive literature on the abuse of drugs by minors in Spain. The most important evidence obtained so far for Spain is gathered in the following results. While it is true that the authors have identified the environment and the lack of information on the harmful effects of drug consumption as the primary determinant variables in drug use, they also show that, through information campaigns and reduction of drug use by both parents and friends, the rates of individual drug abuse would be reduced. It is important to invest money in information campaigns about the risks of drug use, because adolescents are the most vulnerable to substance abuse leading to dependency, to school failure, and consequently to a deterioration in the individual stocks of human capital - not to mention the effects on health.
    Keywords: Risky consumption, Adolescents, Spain
    JEL: D11 D12
    Date: 2017–05–31
  11. By: Polansky, Jonathan R; Titus, Kori; Atayeva, Renata; Glantz, Stanton A
    Keywords: Medicine and Health Sciences, Social and Behavioral Sciences
    Date: 2017–06–01
  12. By: Juan Pablo Atal; Hanming Fang; Martin Karlsson; Nicolas R. Ziebarth
    Abstract: We study theoretically and empirically how consumers in an individual private long-term health insurance market with front-loaded contracts respond to newly mandated portability requirements of their old-age provisions. To foster competition, effective 2009, German legislature made the portability of standardized old-age provisions mandatory. Our theoretical model predicts that the portability reform will increase internal plan switching. However, under plausible assumptions, it will not increase external insurer switching. Moreover, the portability reform will enable unhealthier enrollees to reoptimize their plans. We find confirmatory evidence for the theoretical predictions using claims panel data from a big private insurer.
    JEL: G22 I11 I18
    Date: 2017–06
  13. By: Bradley Heim; Ithai Lurie; Kosali Simon
    Abstract: We study the impact of the Affordable Care Act (ACA) young adult dependent coverage requirement on labor market-related outcomes, including measures of employment status, job characteristics, and post-secondary education, using a data set of U.S. tax records spanning 2008-2013. We find that the ACA provision did not result in substantial changes in labor market outcomes. Our results show that employment and self-employment were not statistically significantly affected. While we find some evidence of increased likelihood of young adults earning lower wages, not receiving fringe benefits, enrolling as full-time or graduate students, and young men being self-employed, the magnitudes imply extremely small impacts on these outcomes in absolute terms and when compared to other estimates in the literature. These results are consistent with health insurance being less salient to young adults when making labor market decisions compared to other populations.
    JEL: I13 J01
    Date: 2017–06
  14. By: Maëlys de La Rupelle; Christelle Dumas
    Abstract: One-third of married women are sterilized in India. This is largely due to family planning programs that put a strong emphasis on ‘permanent’ contraceptive methods rather than temporary ones. However, little is known about potential adverse effects on women’s wellbeing. We analyse the consequences of sterilization on maternal health. To do so, we take advantage of datasets that record information on various symptoms in the reproductive sphere or anthropometric and biological measurements. In order to deal with endogeneity issues, we exploit two features of the sterilization decision. First, households have a son preference and women are more likely to be sterilized when their first-born is male. Second, Indian households face different malaria prevalence. Being sterilized involves taking the risk of losing one child in infancy and not being able to replace him or her. As a consequence, women tend to postpone sterilization in areas with more malaria. We exploit the fact that the increase in sterilization associated with a male first-born decreases with malaria prevalence. We show that sterilization strongly increases the prevalence of various symptoms in the reproductive sphere (from +50 per cent for vaginal discharge to more than 100 per cent for pain or problems during sexual intercourse, for instance). However, we also find that sterilization leads to improvements in BMI and haemoglobin levels, likely from the avoidance of pregnancies.
    Date: 2017
  15. By: Martha J. Bailey; Jason M. Lindo
    Abstract: Changes in childbearing affect almost every aspect of human existence. Over the last fifty years, American women have experienced dramatic changes in the ease and convenience of timing and limiting childbearing, ranging from the introduction of the birth control pill and the legalization of abortion to more recent availability of long-acting reversible contraceptives (LARCs). This article chronicles these changes, provides descriptive evidence regarding trends in use, and reviews the literature linking them to changes in childbearing and women’s economic outcomes.
    JEL: I12 I13 I18 J1 J13 J18 N32
    Date: 2017–06
  16. By: Taisei Noda (Graduate School of Economics, Osaka University); Takaaki Ikeda (Graduate school of Economics, The University of Tokyo)
    Abstract: Do working overtime hours affect worker health? Does the effect depend on whether a worker receives overtime payment or not? In this paper, we examine the effect of overtime hours on health, paying attention to overtime payment. We use gPreference Parameters Study of Osaka University h from 2009 to 2013. The dataset enables us to control observable factors, for example: work environment, individual and household characteristics. Further, panel analysis is employed to remove unobservable heterogeneity. Our result shows a harmful effect of overtime hours to worker health. We also find that overtime hours deteriorate worker health only if the worker does not get paid for overtime.
    Keywords: working hours, overtime, reward, panel data analysis
    JEL: I12 J22 J81
    Date: 2017–05
  17. By: Ampiah, Kweku
    Abstract: The paper explores Japan’s contribution to the provision of primary healthcare in Ghana through the Community-based Health Planning and Service (CHPS) strategy. The discussion trawls the policy regarding the development of the CHPS and highlights the specific role of the Japan International Cooperation Agency (JICA) in the ‘Scaling up’ of the CHPS project in the Upper West Region (UWR) of Ghana. It is suggested in this analysis that through the application of Facilitative Supervision (FSV), a supportive approach to supervision, JICA aimed to review and fine-tune the administrative capacity of the relevant health administrators of the UWR with the primary objective to improve and enhance healthcare delivery in the region. The study proposes that in tune with Michel Foucault’s concept of ‘administrative control’ and ‘noso-politics’ the FSV initiative further essentialised the role of the state in healthcare delivery in the region.
    Keywords: Primary Healthcare,Ghana,Michel Foucault,Administrative Control,Japanese Aid
    Date: 2017–03
  18. By: Sonya Cressman; Stuart J. Peacock; Martin C. Tammemägi; William K. Evans; Natasha B. Leighl; John R. Goffin; Alain Tremblay; Geoffrey Liu; Daria Manos; Paul MacEachern; Rick Bhatia; Serge Puksa; Garth Nicholas; Annette McWilliams; John R. Mayo; John Yee; John C. English; Reka Pataky; Emily McPherson; Sukhinder Atkar-Khattra; Michael R. Johnston; Heidi Schmidt; Frances A. Shepherd; Kam Soghrati; Kayvan Amjadi; Paul Burrowes; Christian Couture; Harmanjatinder S. Sekhon; Kazuhiro Yasufuku; Glenwood Goss; Diana N. Ionescu; David M. Hwang; Simon Martel; Don D. Sin; Wan C. Tan; Stefan Urbanski; Zhaolin Xu; Ming-Sound Tsao; Stephen Lam
    Abstract: Lung cancer risk prediction models have the potential to make programs more affordable; however, the economic evidence is limited.
    Keywords: Cost-effectiveness , Lung cancer screening , Economics , Screening operations
    JEL: I
  19. By: van den Berg, Gerard J. (University of Bristol); Gerdtham, Ulf-G. (Lund University); von Hinke Kessler Scholder, Stephanie (University of Bristol); Lindeboom, Maarten (Vrije Universiteit Amsterdam); Lissdaniels, Johannes (Lund University); Sundquist, Jan (Lund University); Sundquist, Kristina (Lund University)
    Abstract: There has been much interest recently in the relationship between economic conditions and mortality, with some studies showing that mortality is pro-cyclical whereas others find the opposite. Some sug-gest that the aggregation level of analysis (e.g. individual vs. regional) matters. We use both individual and aggregated data on a sample of 20-64 year-old Swedish men from 1993 to 2007. Our results show that the association between the business cycle and mortality does not depend on the level of analysis: the sign and magnitude of the parameter estimates are similar at the individual level and the aggregate (county) level; both showing pro-cyclical mortality.
    Keywords: unemployment, health, recession, death, income, aggregation
    JEL: E3 I1 I12
    Date: 2017–05
  20. By: Grossbard, Shoshana (San Diego State University); Mukhopadhyay, Sankar (University of Nevada, Reno)
    Abstract: Higher body-weight (BMI) can affect labor supply via its effects on outcomes in both labor markets and marriage markets. To the extent that it is associated with lower prospects of being in couple and obtaining intra-couple transfers, we expect that higher BMI will increase willingness to supply labor in labor markets, especially for women. We use US panel data from the NLSY79 and NLSY97 to examine whether body weight influences hours of work in the labor market. We use sibling BMI as an instrument for own BMI to address potential endogeneity of BMI in hours worked. We find that White women with higher BMI work more. This is true for both single and married White women. Results for other groups of women and men produce mixed results. The extended analysis suggests that what drives the relationship between BMI and hours worked is not lower market wages earned by high-BMI women, but rather lower spousal transfers to married women or lower expected intra-marriage transfers to single women.
    Keywords: obesity, labor supply, marriage prospects, intra-household division of resources
    JEL: J22 I12 J12
    Date: 2017–05
  21. By: Wang, Chenggang (University of Hawaii at Manoa); Wang, Huixia (Hunan University); Halliday, Timothy J. (University of Hawaii at Manoa)
    Abstract: We estimate the impact of the Great Recession of 2007–2009 on health outcomes in the United States. We show that a one percentage point increase in the unemployment rate resulted in a 7.8–8.8 percent increase in reports of poor health. Mental health was also adversely impacted and reports of chronic drinking increased. These effects were concentrated among those with strong labor force attachments. Whites, the less educated, and women were the most impacted demographic groups.
    Keywords: Great Recession, health behaviors, health outcomes, inequality
    JEL: I0 I12 I14
    Date: 2017–05
  22. By: Alessie, Rob (University of Groningen); Angelini, Viola (University of Groningen); van den Berg, Gerard J. (University of Bristol); Mierau, Jochen O. (University of Groningen); Viluma, Laura (University of Groningen)
    Abstract: Most of the literature that exploits business cycle variation at birth to study long-run effects of eco-nomic conditions on health later in life is based on pre-1940 birth cohorts. They were born in times where social safety nets were largely absent and they grew up in societies with relatively low female labor force participation. We complement the evidence from this literature by exploiting post-1950 regional business cycle variations in the Netherlands to study effects on cardiovascular disease (CVD) risk in adulthood, by gender. We operationalize CVD risk by constructing the Systematic COronary Risk Evaluation (SCORE) index from an extensive set of biomarkers. The data are from a large cohort study covering socio-economic, biological and health data from over 75k individuals aged between 18 and 63. We conclude that women born in adverse economic conditions experience higher CVD risk.
    Keywords: early-life conditions, developmental origins, recession, health, unemployment, long-run effects, biomarkers
    JEL: I10 I15 J11
    Date: 2017–05
  23. By: Nizalova, Olena Y. (University of Kent); Norton, Edward C. (University of Michigan)
    Abstract: With periodic recessions and the rising costs of health care, it is important to know how labor market participation and insecurity affects health outcomes. Yet, this line of research faces a number of methodological challenges which this paper aims to address. We turn to Ukraine's experience after the col-lapse of the USSR to investigate how exogenous labor market shocks during severe recessions affect men's body mass index (BMI) and health-related behaviors. We use growth curve models to analyze BMI trajectories from 2003 to 2007 and find that past exogenous shocks (e.g., plant closings, bankruptcies, restructuring, and privatization) from 1986 to 2003 significantly change the BMI-age relationship for men. We also find a long-lasting effect on drinking behavior that is decreasing with age, while the effect on the probability of smoking is constant across all ages. At the same time, there is no effect on the probability of engaging in vigorous or moderate physical activity.
    Keywords: job loss, labour market exclusion, lay-offs, recession, BMI, growth curve, life course
    JEL: I12 J21 J65
    Date: 2017–05
  24. By: Kumar, Santosh (Sam Houston State University); Prakash, Nishith (University of Connecticut)
    Abstract: In this paper, we investigate the impacts of political decentralization and women reservation in local governance on institutional births and child mortality in the state of Bihar, India. Using the difference-in-differences methodology, we find a significant positive association between political decentralization and institutional births. We also find that the increased participation of women at local governance led to an increased survival rate of children belonging to richer households. We argue that our results are consistent with female leaders having policy preference for women and child well-being.
    Keywords: gender quota, political decentralization, institutional delivery, child, mortality, Bihar, India
    JEL: H41 I15 J16 O12
    Date: 2017–05

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