nep-hea New Economics Papers
on Health Economics
Issue of 2018‒11‒19
27 papers chosen by
Nicolas R. Ziebarth
Cornell University

  1. Equilibrium Labor Market Search and Health Insurance Reform, Third Version By Naoki Aizawa; Hanming Fang
  2. How Important Is Price Variation Between Health Insurers? By Stuart V. Craig; Keith Marzilli Ericson; Amanda Starc
  3. The Impact of Insurance Expansions on the Already Insured: The Affordable Care Act and Medicare By Colleen M. Carey; Sarah Miller; Laura R. Wherry
  4. Reducing Medical Spending of the Publicly Insured: The Case for a Cash-Out Option By Svetlana Pashchenko; Ponpoje Porapakkarm
  5. Parental Investments in Early Life and Child Outcomes. Evidence from Swedish Parental Leave Rules By Ginja, Rita; Jans, Jenny; Karimi, Arizo
  6. The causal effect of workload on the labour supply of older employees By Bratberg, Espen; Holmås, Tor Helge; Monstad, Karin
  7. The Effect of Working Hours on Health By Inés Berniell; Jan Bietenbeck
  8. Physical Disability and Labor Market Discrimination : Evidence from a Field Experiment By Charles Bellemare; Marion Goussé; Guy Lacroix; Steeve Marchand
  9. Long-term Care Risk Misperceptions By M. Martin Boyer; Claude Fluet; Marie-Louise Leroux; Pierre-Carl Michaud; Philippe De Donder
  10. A Canadian Parlor Room-Type Approach to the Long-Term Care Insurance Puzzle By M. Martin Boyer; Philippe De Donder; Claude Fluet; Marie-Louise Leroux; Pierre-Carl Michaud
  11. Measuring Physicians’ Response to Incentives: Evidence on Hours Worked and Multitasking By Bruce S. Shearer; Nibene Habib Somé; Bernard Fortin
  12. Effects of Market Structure and Patient Choice on Hospital Quality for Planned Patients By Giuseppe Moscelli; Hugh Gravelle; Luigi Siciliani
  13. Sex, Drugs, and Baby Booms: Can Behavior Overcome Biology? By Michele Baggio; Alberto Chong; David Simon
  14. You Are What Your Parents Think: Height and Local Reference Points By Jere R. Behrman; Flávio Cunha; Esteban Puentes; Fan Wang
  15. Have your cake and eat it too: real effort and risk aversion in schoolchildren By Della Giusta, Marina; Di Girolamo, Amalia
  16. Would you choose to be happy? Tradeoffs between happiness and the other dimensions of life in a large population survey By Adler, Matthew D.; Dolan, Paul; Kavetsos, Georgios
  17. Assessing the impact of More Doctors Program on health care indicators By Mattos, Enlinson; Mazetto, Débora
  18. Factors influencing the sleep behavior among the older adults in Macao: a qualitative approach By Cindy Sin U Leong
  19. Life cycles with Endogenous Time Allocation and Age-Dependent Mortality By Manuel Guerra; João Pereira; Miguel St. Aubyn
  20. The Effect of Education on Health: Evidence from National Compulsory Schooling Reforms By Raquel Fonseca Benito; Pierre-Carl Michaud; Yuhui Zheng
  21. The Great Recession and Children's Mental Health in Australia By Bubonya, Melisa; Cobb-Clark, Deborah A.; Christensen, Daniel; Johnson, Sarah E.; Zubrick, Stephen R.
  22. Does Disability Insurance Improve Health and Well-Being? By Börsch-Supan, Axel; Bucher-Koenen, Tabea; Hanemann, Felizia
  23. Comparing the Education Gradient in Chronic Disease Incidence Among the Elderly in Six OECD Countries By Aurélie Côté-Sergent; Raquel Fonseca Benito; Erin Strumpf
  24. Identifying the Effects of Migration on Parental Health: Evidence from Left-Behind Elders in China By Liu, C.; Yi, F.; Xu, Z.
  25. In Vaccines We Trust? The Effects of the CIA's Vaccine Ruse on Immunization in Pakistan By Monica Martinez-Bravo; Andreas Stegmann
  26. Remoteness, Urbanization and Child Nutrition in sub-Saharan Africa By Stifel, D.; Headey, D.; You, L.; Guo, Z.
  27. Height differentiated Wage Premium in West Bengal, India: An Empirical Study By Khasnobis, Poulomi; Dinda, Soumyananda

  1. By: Naoki Aizawa (Department of Economics, University of Wisconsin-Madison); Hanming Fang (Department of Economics, University of Pennsylvania)
    Abstract: We present and empirically implement an equilibrium labor market search model where risk averse workers facing medical expenditure shocks are matched with ï¬ rms making health insurance coverage decisions. Our model delivers a rich set of predictions that can account for a wide variety of phenomenon observed in the data including the correlations among ï¬ rm sizes, wages, employer-sponsored health insurance offering rates, turnover rates and workers’ health compositions. We estimate our model by Generalized Method of Moments using a combination of micro datasets including the Survey of Income and Program Participation, the Medical Expenditure Panel Survey and the Kaiser Family Employer Health Insurance Beneï¬ ts Survey. We use our estimated model to evaluate the equilibrium impact of the 2010 Affordable Care Act (ACA) and compare it with other health care reform proposals. We also use the estimates of the early impact of the ACA as a model validation. We ï¬ nd that the full implementation of the ACA would reduce the uninsured rate among the workers in our estimation sample from about 21.3% in the pre-ACA benchmark economy to 6.6%. We also ï¬ nd that income-based premium subsidies for health insurance purchases from the exchange play an important role for the sustainability of the ACA; without the premium subsidies, the uninsured rate would be around 15.8%. In contrast, as long as premium subsidies and health insurance exchanges with community ratings stay intact, ACA without the individual mandate, or without the employer mandate, or without both mandates, could still succeed in reducing the uninsured rates to 11.4%, 7.5% and 12.9% respectively.
    Keywords: Health, Health Insurance, Health Care Reform, Labor Market Equilibrium
    JEL: G22 I11 I13 J32
    Date: 2018–06–11
  2. By: Stuart V. Craig; Keith Marzilli Ericson; Amanda Starc
    Abstract: Prices negotiated between payers and providers affect a health insurance contract's value via enrollees' cost-sharing and self-insured employers' costs. However, price variation across payers is hard to observe. We measure negotiated prices for hospital-payer pairs in Massachusetts and characterize price variation. Between-payer price variation is similar in magnitude to between-hospital price variation. Administrative-services-only contracts, in which insurers do not bear risk, have higher prices. We model negotiation incentives and show that contractual form and demand responsiveness to negotiated prices are important determinants of negotiated prices.
    JEL: D4 I11 I13 L11 L4
    Date: 2018–10
  3. By: Colleen M. Carey; Sarah Miller; Laura R. Wherry
    Abstract: Some states that have not adopted the Affordable Care Act (ACA) Medicaid expansions have stated concerns that the expansions may impair access to care and utilization for those who are already insured. We investigate such negative spillovers using a large panel of Medicare beneficiaries. Across many subgroups and outcomes, we find no evidence that the expansions reduced utilization among Medicare beneficiaries, and can rule out all but very small changes in utilization or spending. These results suggest that the expansions in Medicaid did not impair access to care or utilization for the Medicare population.
    JEL: H51 I1 I11
    Date: 2018–10
  4. By: Svetlana Pashchenko (University of Georgia); Ponpoje Porapakkarm (National Graduate Institute for Policy Studies)
    Abstract: Individuals' medical spending has both necessary and discretionary components which are not, however, separately observable. This paper studies ways to improve upon existing public health insurance policies by using a framework where both the discretionary and necessary components of medical spending are explicitly modeled. First, using a simple theoretical framework the paper shows that the key to reducing discretionary medical spending is to introduce a trade-off between non-medical and medical consumption. Next, using a rich quantitative life-cycle model the paper shows that this trade-off can be successfully implemented by introducing an option to substitute public health insurance with cash transfers.
    Keywords: medical spending, health insurance, optimal taxation, life-cycle model, ex-post moral hazard
    JEL: D52 D91 E21 H53 I13 I18
    Date: 2018–11
  5. By: Ginja, Rita (University of Bergen, Department of Economics); Jans, Jenny (Department of Statistics, Uppsala University); Karimi, Arizo (Department of Economics, Uppsala University)
    Abstract: We study how parental resources early in life affect children’s health and education exploiting the so-called speed premium (SP) in the Swedish parental leave system. The SP grants mothers higher parental leave benefits for the subsequent child without re-establishing eligibility through pre-birth market work if the two births occur within a pre-specified interval. This allow us to use a Regression Discontinuity framework. We find that the SP improves the educational outcomes of the first-born child, but not of the second-born. Impacts are driven by a combination of a positive income shock, and substitution from informal care to maternal time.
    Keywords: Parental leave; earnings; time investments; child outcomes
    JEL: J13 J18 J22
    Date: 2017–10–29
  6. By: Bratberg, Espen (University of Bergen, Department of Economics); Holmås, Tor Helge (NORCE); Monstad, Karin (NORCE)
    Abstract: Several policies aim to keep older workers in the labour force, but little is known about their effects. We investigate the effects of a particular programme in Norway that reduces the workload of teachers at age 55 but maintains the same wage. Evaluation of this programme is well suited to a differencein-difference analysis, where the control group is teachers slightly too young to be eligible for the workload reduction. Using full population register data for the period 2005–2013, we analyse the effects of the programme on sickness absence, contracted hours, mental health, and musculoskeletal problems. We find that the programme reduces sickness absence and mental health problems for men, but not for women, and there is no effect on contracted hours. The results are robust to a number of checks.
    Keywords: workload; older workers; sickness absence; absenteeism; working hours; difference-in-difference; triple DD
    JEL: H55 I12 J32
    Date: 2017–12–18
  7. By: Inés Berniell (CEDLAS-FCE-UNLP); Jan Bietenbeck (Lund University and IZA)
    Abstract: Does working time affect workers' health? We study this question in the context of a French reform which reduced the standard workweek from 39 to 35 hours, at constant earnings. Our empirical analysis exploits variation in the reduction of working time across employers, which was driven by the institutional features of the reform and thus exogenous to workers' health. We find that longer working hours increase smoking and decrease self-reported health, and that these impacts are concentrated among bluecollar workers. In contrast, white-collar workers' body mass index increases with hours worked.
    JEL: I10 I12 J22
    Date: 2018–11
  8. By: Charles Bellemare; Marion Goussé; Guy Lacroix; Steeve Marchand
    Abstract: We investigate the determinants and extent of labor market discrimination to-ward people with physical disabilities using a large scale field experiment. Appli-cations were randomly sent to 1477 private firms advertising open positions. We find that average callback rates of disabled and non-disabled applicants are respec-tively 14.4% and 7.2%. We find this differential does not result from accessibility constraints related to firm infrastructures. We also find that mentioning eligibility to a government subsidy to cover the cost of workplace adaptation does not in-crease callback rates. Finally, we estimate that a lower bound of the proportion of discriminating firms is 49.7%.
    Keywords: Discrimination,Disabilities,Partial identification,
    JEL: J71 J68
    Date: 2018–04–27
  9. By: M. Martin Boyer; Claude Fluet; Marie-Louise Leroux; Pierre-Carl Michaud; Philippe De Donder
    Abstract: This paper reports survey evidence on long-term care (LTC) risk misperceptions and demand for long-term care insurance (LTCI) in Canada. LTC risk misperceptions is divided into three different risks: needing help for at least one activity of daily life, needing access to a nursing home, and living to be 85 years old. We contrast subjective (i.e. stated) probabilities with actual probabilities for these three dimensions. We first provide descriptive statistics of how objective and subjective probabilities differ and correlate to each other. Second, we study cross-correlations between different types of risks. We then study how risk misperceptions correlate with individual characteristics, and evaluate how misperceptions affect intentions and actual purchase of LTCI. Our conclusions are two-fold. First, we find that most subjects are not well informed about their individual LTC risks, making it difficult for them to take the correct LTCI decisions. Second, and even though misperceptions explain an individuals actual or his intentions to take-up LTCI, misperceptions are unlikely to explain the poor take-up rate of LTCI in our sample.
    Keywords: Long-term Care Insurance Puzzle,Disability,Misperceptions,Subjective Probability,
    JEL: D91 I13
    Date: 2018–05–31
  10. By: M. Martin Boyer; Philippe De Donder; Claude Fluet; Marie-Louise Leroux; Pierre-Carl Michaud
    Abstract: We examine the different hypotheses which have been put forward to explain the low demand for long-term care insurance using the results from a survey of 2000 Canadians that was conducted in the autumn of 2016. Defining the natural market of long-term care insurance buyers as the one catering to individuals aged between 50 and 70, we find that a remarkable proportion of this natural market has never been approached to purchase such protection. We estimate that approximately 60% of this natural market is currently under-served. After eliminating risk perception and demand side explanations for the low market penetration of long-term care insurance, we conclude that supply-side factors and the crowding-out by government programs are the most likely culprits in explaining the low proportion of Canadians that purchase LTC insurance from private providers.
    Keywords: Long-term Care Puzzle,Risk Perceptions,Supply and Demand of Insurance,Government Programs,
    JEL: G02 G12 C14
    Date: 2018–04–25
  11. By: Bruce S. Shearer; Nibene Habib Somé; Bernard Fortin
    Abstract: We measure the response of physicians to monetary incentives using matched administrative and time-use data on specialists from Québec (Canada). These physicians were paid fee-for-service contracts and supplied a number of different services. Our sample covers a period during which the Québec government changed the prices paid for clinical services. We apply these data to a multitasking model of physician labour supply, measuring two distinct responses. The first is the labour-supply response of physicians to broad-based fee increases. The second is the response to changes in the relative prices of individual services. Our results confirm that physicians respond to incentives in predictable ways. The own-price substitution effects of a relative price change are both economically and statistically significant. Income effects are present, but are overridden when prices are increased for individual services. They are more prominent in the presence of broad-based fee increases. In such cases, the income effect empirically dominates the substitution effet, which leads physicians to reduce their supply of clinical services.
    Keywords: Physician Labour Supply,Multitasking,Incentive Pay,
    JEL: I10 J22 J33 J44
    Date: 2018–05–31
  12. By: Giuseppe Moscelli (University of Surrey); Hugh Gravelle (University of York); Luigi Siciliani (University of York)
    Abstract: We investigate the change in the effect of market structure on planned hospital quality for three high-volume treatments, using a quasi difference-in-differences approach based on the relaxation of patient constraints on hospital choice in England. We employ control functions to allow for time-varying endogeneity from unobserved patient characteristics. We find that the choice reforms reduced quality for hip and knee replacement but not for coronary bypass, This is likely due to hospitals making a larger loss on hip and knee replacements, since robustness checks rule out changes in length of stay, new competitors’ entry and hospital-level mortality as possible confounders.
    JEL: H51 I11 I18 L32 L33
    Date: 2018–10
  13. By: Michele Baggio; Alberto Chong; David Simon
    Abstract: We study the behavioral changes due to marijuana consumption on fertility and its key mechanisms, as opposed to physiological changes. We can employ several large proprietary data sets, including the 1997 National Longitudinal Survey of Youth, Nielsen Retail Scanner database, as well as the Vital Statistics Natality files and apply a differences-in-differences approach by exploiting the timing of the introduction of medical marijuana laws among states. We first replicate the earlier literature by showing that marijuana use increases after the passage of medical marijuana laws. Our novel results reveal that birth rates increased after the passage of a law corresponding to increased frequency of sexual intercourse, decreased purchase of condoms and suggestive evidence on decreased condom use during sex. More sex and less contraceptive use may be attributed to behavioral responses such as increased attention to the immediate hedonic effects of sexual contact, delayed discounting and ignoring costs associated with risky sex. These findings are consistent with a large observational literature linking marijuana use with increased sexual activity and multiple partners. Our findings are robust to a broad set of tests.
    JEL: D90 I18 J13 K10 K29
    Date: 2018–11
  14. By: Jere R. Behrman (Department of Economics, University of Pennsylvania); Flávio Cunha (Department of Economics, University of Pennsylvania); Esteban Puentes (Department of Economics, Universidad de Chile); Fan Wang (Department of Economics, University of Houston)
    Abstract: Recent estimates are that about 170 million children under ï¬ ve years of age are stunted, with signiï¬ cant long-run negative consequences on their schooling, cognitive skills, health and economic productivity. Understanding what determines such growth retardation,therefore, is very important. We build a structural model for nutritional choices and height growth with reference–dependent preferences. Parents care about the relative height of their child compared to some reference population. In our empirical model, reference height is an equilibrium object determined by the parental nutritional choices for earlier cohorts in the same village. Taking advantage of a protein-supplementation experiment in Guatemala, we use exogenous variations in differential height growth paths between treated and control villages to estimate the model. We conduct a number of counterfactual policy simulations. First, we ï¬ nd that reference point changes account for up to 60% of the 1.7 cm in height difference between experimental and control villages at 24 months of age. Second,focusing on one-period effects, to obtain the same mean effects as an 1 cm increase in reference points would require a protein-price discount of 37 percent or an income increase of 60 percent. Third, endogenous reference points changes lead to signiï¬ cant policy spillovers: under poor-targeted subsidy policies, richer households over time gain up to 50 percent of the height gains of poorer households; under an universal subsidy policy, poorer households’ height gains increase from an initially low level by up to 4.8 times across periods as richer households,who also receive subsidies, help push up height reference points.
    JEL: I15 D8 D9 O15
    Date: 2018–04–22
  15. By: Della Giusta, Marina; Di Girolamo, Amalia
    Abstract: There is a large body of evidence documenting gender differences in preferences and their effects on a range of behaviours (including health and risky behaviours) and choices (including education, labour market, savings, marriage, and fertility). A key issue in order to mitigate some of the undesirable effects of these differences (the tendency for boys to engage in more risky behaviours or for girls to avoid choices that might instead benefit them) is establishing how soon such differences arise. Gender differences in competitiveness and risk aversion have been widely documented both in the lab and the field (Falk et al, 2015), and more recently adapting experiments normally performed with adults to children (Samak, 2013; Harbaugh et al., 2002). We advance this literature with a study of primary school children which consists of an innovative two-stage task game addressing both effort and risk: in the first stage a real effort task allows children to accumulate points playing a video game, and in the second they play a lottery game in which probabilities are presented visually. The two-stage task game is designed in order to avoid both the valuation and the probability problems that children normally face in such tasks. Our findings confirm the existence of gender differences in risk aversion once controlling for performance in a gender neutral task in schoolchildren, and contribute a visual way of using lotteries with children that yields results consistent with rational behaviour
    Keywords: Gender; Risk Aversion; Child Preferences; Artefactual Field Experiment
    JEL: C79 C90 D81 J70
    Date: 2018–07
  16. By: Adler, Matthew D.; Dolan, Paul; Kavetsos, Georgios
    Abstract: A large literature documents the determinants of happiness. But is happiness all that people want from life; and if so, what type of happiness matters to them? Or are they willing to sacrifice happiness (however it is defined) for other attributes in their lives? We show direct evidence that individuals trade-off levels of happiness with levels of income, physical health, family, career success and education in a large sample of UK and US individuals. On average, all types of happiness are preferred to other attributes except health. People prefer affective happiness (feeling good) over evaluative (life satisfaction) and eudaimonic (worthwhileness) components. This result is robust to methodological innovations, such as the use of vignettes and judgements of the lives described.
    Keywords: preference; subjective well-being; happiness
    JEL: D6 H00 I00 I31
    Date: 2017–07
  17. By: Mattos, Enlinson; Mazetto, Débora
    Abstract: This paper aims to assess the short run effects of the More Doctors Program, launched by the Brazilian federal government in 2013. Using differences-in-differences approach with municipal data collected between 2010 and 2015, we confirm that MDP has two correlated impacts. First, it has increased health service attendance on treated municipalities. We document that appointments, consults, referrals, and home visits have increased by 5.9%, 9.4%, 12.3%, and 29.7%. Second, we find a negative impact on hospitalization. We argue that intensification on health service access have reduced general hospitalization (4.6%). However, it does not seem to have been able to reduce mortality in the municipalities, in line with Carrilo and Feres (2018) and Fontes et al. (2017). We argue that increase in referrals and appointment with specialists can be interpreted as quality improvement, since a more precise diagnostic, can reduce hospitalization due to faster health recovery without an impact on mortality.
    Date: 2018–10
  18. By: Cindy Sin U Leong (Macao Polytechnic Institute)
    Abstract: The purpose of the study was to investigate the factors contributing to the sleep behavior among the older adults in Macao. As people become older, they may have a difficult time falling asleep and have a more trouble maintaining asleep in comparison to their younger age. Macao has an image of ?healthy city?, since the average life expectancy of people in Macao is 84-year-old for females and 81-year-old for males. From these figures, it may say the sleep behavior is not too bad for the general public, but is it correct? This research study used a qualitative approach to explore and understand the sleep patterns. There were total 60 older adults. All of these older adults lived with family members in the community. Most of them were from two elderly activity centers and society association. The information from the interviewees was transcribed verbatim to convey the interviewees? intended message as accurately as possible. One principal theme that emerged from the study was ?concerns about the living environment?. With better living environment, they had relatively proper sleep behavior. However, if their living environment was not reached the standard, they had quite ?poor? sleep behavior. Unless addressed successfully, this issue can compromise optimal older adults? health and increase the cost of health care sources. Being as health professionals and educators, there is a need to encourage the government to face and solve the problem.
    Keywords: sleep pattern, older adults, Macao
    Date: 2018–07
  19. By: Manuel Guerra; João Pereira; Miguel St. Aubyn
    Abstract: The negative effect of population aging on the economy can be mitigated by a behavioral effect of people as a reaction to a higher life expectancy. We analyze the optimal life-cycle of individuals that allocate time at the intensive margin between leisure, human capital accumulation, and labor supply while facing an age-dependent mortality. This allows to enhance effects of changes in life expectancy on labor supply and human capital accumulation and to uncover trade-offs between time allocations at different stages of the life-cycle. Our life-cycles are characterized by on the job training throughout all the working life with a possibility of a temporary exit from the labor market. We simulate the model numerically and nd that with a higher life expectancy, labor supply increases at the intensive margin and the individual invests more in human capital. We also nd a willingness to increase labor supply at the extensive margin.
    Keywords: Life-Cycle; Age-Dependent Mortality; Aging; Time Allocation
    JEL: J22 J24 H55
    Date: 2018–11
  20. By: Raquel Fonseca Benito; Pierre-Carl Michaud; Yuhui Zheng
    Abstract: This paper sheds light on the causal relationship between education and health outcomes. We combine three surveys (SHARE, HRS and ELSA) that include nationally representative samples of people aged 50 and over from fifteen OECD countries. We use variations in the timing of educational reforms across these countries as an instrument for education. Using IV-Probit models, we find causal evidence that more years of education lead to a lower probability of reporting poor health, less likely of having limitations in functional status (ADL and iADLs), and lower prevalence for diabetes. These effects are larger than those from the Probit that do not control for the endogeneity of education. The relationship between education and cancer is positive in both Probit and IV-Probit models. The causal impacts of education on other chronic conditions as well as functional status are not established using IV-Probit models.
    Keywords: Education,Health,Causality,Compulsory Schooling Laws,
    JEL: I1 I2
    Date: 2018–04–11
  21. By: Bubonya, Melisa (Melbourne Institute of Applied Economic and Social Research); Cobb-Clark, Deborah A. (University of Sydney); Christensen, Daniel (Telethon Kids Institute); Johnson, Sarah E. (Telethon Kids Institute); Zubrick, Stephen R. (Telethon Kids Institute)
    Abstract: This paper analyzes the effects of 'shocks' to community-level unemployment expectations, induced by the onset of the Great Recession, on children's mental well-being. The Australian experience of the Great Recession represents a unique case study as despite little change in actual unemployment rates, levels of economic uncertainty grew. This affords us the ability to examine the effects of shocks to economic expectations independent of any actual changes to economic conditions. We draw on and link data from multiple sources, including a longitudinal cohort study of children, a consumer sentiment survey and data on local economic conditions. Using our purpose-built data set, we estimate difference-in-differences models to identify plausibly causal effects. We find, for boys, there is no detectable effect of community-level unemployment expectations shocks on mental health. For girls, however, there are modest increases in mental health problems and externalizing behaviors, as measured by the Strengths and Difficulties Questionnaire. We additionally find no discernable change in mother's psychological distress as a result of expectations shocks. These results are stable after controlling for actual labor market conditions.
    Keywords: mental health, children, Great Recession, unemployment expectations, cohort studies
    JEL: I31 G01 D84
    Date: 2018–10
  22. By: Börsch-Supan, Axel; Bucher-Koenen, Tabea; Hanemann, Felizia (Munich Center for the Economics of Aging (MEA))
    Abstract: The purpose of disability insurance (DI) is to protect people with health problems that limit their ability to work. We evaluate the effectiveness of DI benefit programs in delivering this protection by following people’s health and financial well-being after the take-up of DI benefits. This paper takes advantage of internationally harmonized panel data and the differences across DI programs in Europe and the United States, as well as their changes over time. We use several econometric approaches to account for the potential endogeneity of DI enrollment and sample selectivity. We find that self-reported health stabilizes after DI benefit receipt. Mental health improves more for DI benefit recipients than non-recipients relative to the beginning of DI benefit receipt. This effect is stronger in countries with more generous DI systems. The effects on objective health measures are positive but largely insignificant.
    JEL: H55 J21 J26
    Date: 2017–12–18
  23. By: Aurélie Côté-Sergent; Raquel Fonseca Benito; Erin Strumpf
    Abstract: Inequalities in health by educational attainment are persistent both over time and across countries. However, their magnitudes, evolution, and main drivers are not necessarily consistent across jurisdictions. We examine the health-education gradient among older adults in the United States, Canada, France, the Netherlands, Spain and Italy, including how it changes over time between 2004 and 2010. Using longitudinal survey data, we assess how rates of incident poor health, incident difficulties with activities of daily living, and incident chronic conditions vary by educational attainment across countries. We also examine how potential confounders, including demographic characteristics, income, health care utilisation and health behaviours, affect the health-education gradient within countries over time. We find systematic differences in disease incidence, as well as in the health-education gradients, across countries. We also demonstrate that while adjusting for confounders generally diminishes the health-education gradient, the impacts of these variables vary somewhat across countries.
    Keywords: Disease incidence,Older ages,Education,
    JEL: I1 I2
    Date: 2018–04–12
  24. By: Liu, C.; Yi, F.; Xu, Z.
    Abstract: This study pioneers the application of the New Economics of Labor Migration theory to outline and estimate two opposite effects of labor loss driven by the migration and remittances of adult children on the health of left-behind elderly parents through the changing rural market constraints. We use China's rural household survey data and simultaneous equation econometric techniques to estimate the effects of migration on the physical and mental health of left-behind elders. Results indicate that the loss of labor to migration has a significantly negative effect on the health of left-behind elders, but remittances from migrants can compensate for the adverse effect. This study provides a comprehensive understanding that remittances from migration relax the constraints on household resource allocations in undeveloped rural areas with imperfect market conditions. Overall, left-behind elderly parents benefit from migrant children both physically and mentally. Acknowledgement : Authors gratefully acknowledge the financial support by National Science Foundation of China (Grants: 71673137), Nanjing Agricultural University (Grants: Y0201400037, SKCX2015004), Education department of Jiangsu province (Grant: 2014SJD069), Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD), China Center for Food Security Studies at Nanjing Agricultural University, Jiangsu Rural Development and Land Policy Research Institute, and Jiangsu Agriculture Modernization Decision Consulting Center. All remaining errors are ours.
    Keywords: Health Economics and Policy
    Date: 2018–07
  25. By: Monica Martinez-Bravo (CEMFI, Centro de Estudios Monetarios y Financieros); Andreas Stegmann (CEMFI, Centro de Estudios Monetarios y Financieros)
    Abstract: In July 2011, the Pakistani public unexpectedly learnt that the CIA had used a vaccination campaign as cover during the operations to locate and capture Osama Bin Laden. This episode lent credibility to conspiracy theories against vaccines that had been spread by the Taliban. We evaluate the effects of these events on immunization by implementing a Difference-in-Differences strategy across cohorts and regions. We find that vaccination rates declined 9 to 13% per standard deviation in Islamist parties' support. These results suggest that the disclosure of information discrediting vaccination campaigns can negatively affect trust in health services and demand for immunization.
    Keywords: Vaccines, demand, propaganda, trust, Pakistan.
    JEL: I15 D74 D83
    Date: 2017–09
  26. By: Stifel, D.; Headey, D.; You, L.; Guo, Z.
    Abstract: Reducing undernutrition requires improving access to goods and services from a wide range of economic and social sectors, including agriculture, education and health. Yet despite broad agreement on the multisectoral nature of the global burden of undernutrition, relatively little research has analyzed how different dimensions of accessibility, such as urbanization and travel times to urban centers, affect child nutrition and dietary outcomes. In this paper we study these relationships in sub-Saharan Africa, a highly rural continent still severely hindered by remoteness problems. We link spatial data on travel times to 20,000 person cities to survey data from 10,900 communities in 23 countries. We document strong negative associations between nutrition indicators and rural livelihoods, but only moderately strong associations with remoteness to cities. Moreover, the harmful effects of remoteness and rural living largely disappear once education, wealth, and social/infrastructural services indicators are added to the model. This implies that the key nutritional disadvantage of rural populations stems chiefly from social and economic poverty. Combating these problems requires either an acceleration of urbanization processes, or finding innovative cost-effective mechanisms for extending basic services to isolated rural communities. Acknowledgement : This paper was funded by The Bill and Melinda Gates Foundation under the project Advancing Research on Nutrition and Agriculture (ARENA), Phase II, as well as the CGIAR program on Agriculture for Nutrition and Health (A4NH). We thank Marie Ruel for comments and suggestions. The usual disclaimer applies.
    Keywords: Food Consumption/Nutrition/Food Safety
    Date: 2018–07
  27. By: Khasnobis, Poulomi; Dinda, Soumyananda
    Abstract: Recently literature focuses on health status and labour market outcomes highlighting the height premium or height differentiated wage earning in labour market. Body height and weight of a worker, normally, represents his/her health status which is the basis of efficiency of a worker and it determines his/her productivity too. Literature has considered height, weight, age, education and experience, etc. as wage determining factors. Literature suggests that taller earns more than short heighted labour. Now, question arises weather height differentiated wage is true for all jobs or sector specific jobs only. This study attempts to answer these questions. Using primary data of six different job sectors, this paper investigates the relationship between physical health status and wage earning in West Bengal, India. Primary observation shows that taller earns more compared to their counter parts. This paper provides evidence that height differentiates wage income is significant in hard job sectors while education differential wage earning in soft job sectors. Worker’s height is statistically significant and positively affect on wage earning in hard working sector. Here, taller is the gainer in wage income earning and the estimated height premium is around 2% - 4%. However, backward or lower caste workers lose their wage income even in hard job sectors due to physical inefficiency that arises because of malnutrition or insufficient nutritional intake in the childhood.
    Keywords: Height, Weight, Wage Earning, Wage Premium, Income, Short height, Taller, Reference Height, Labour’s Productivity, Health Policy, India, Nutritional Intake, Wage Determining Factor, West Bengal
    JEL: C21 I15 J13 J31 J78 Z13
    Date: 2017–02

This nep-hea issue is ©2018 by Nicolas R. Ziebarth. It is provided as is without any express or implied warranty. It may be freely redistributed in whole or in part for any purpose. If distributed in part, please include this notice.
General information on the NEP project can be found at For comments please write to the director of NEP, Marco Novarese at <>. Put “NEP” in the subject, otherwise your mail may be rejected.
NEP’s infrastructure is sponsored by the School of Economics and Finance of Massey University in New Zealand.