nep-hea New Economics Papers
on Health Economics
Issue of 2019‒03‒04
fourteen papers chosen by
Nicolas R. Ziebarth
Cornell University

  1. Anticipation of deteriorating health and information avoidance By Schünemann, Johannes; Strulik, Holger; Trimborn, Timo
  2. Parental job loss and child human capital in the short and long run By Mörk, Eva; Sjögren, Anna; Svaleryd, Helena
  3. Using RCTs to Estimate Long-Run Impacts in Development Economics By Bougen, Adrien; Huang, Yue; Kremer, Michael; Miguel, Edward
  4. Impact of later retirement on mortality: Evidence from France By Antoine Bozio; Clémentine Garrouste; Elsa Perdrix
  5. WELL-BEING DURING THE TRANSITION FROM WORK TO RETIREMENT. By Lieze Sohiers; Luc Van Ootegem; Elsy Verhofstadt
  6. Health condition and job status interactions: econometric evidence of causality from a French longitudinal survey By Eric Delattre; Richard Moussa; Mareva Sabatier
  7. Local Economic Hardship and Its Role in Life Expectancy Trends By John Bound; Arline T. Geronimus; Timothy A. Waidmann; Javier M. Rodriguez
  8. Soda tax incidence and design under monopoly By Lozachmeur, Jean-Marie; Cremer, Helmuth; Goulão, Catarina
  9. Absenteeism on bridging days By René Böheim; Thomas Leoni
  10. Mentally Spent: Credit Conditions and Mental Health By Qing Hu; Ross Levine; Chen Lin; Mingzhu Tai
  11. "If You Were Me": Proxy Respondents' Biases in Population Health Surveys By Bérengère Davin; Xavier Joutard; Alain Paraponaris
  12. Short-Run Health Consequences of Retirement and Pension Benefits: Evidence from China By Nikolov, Plamen; Adelman, Alan
  13. In Search of China's Income-Health Gradient: A Biomarker-Based Analysis By Nie, Peng; Li, Qing; Sousa-Poza, Alfonso
  14. Sex and the Mission: The Conflicting Effects of Early Christian Investments on the HIV Epidemic in sub-Saharan Africa By Julia Cage; Valeria Rueda

  1. By: Schünemann, Johannes; Strulik, Holger; Trimborn, Timo
    Abstract: The anticipation of bad future events reduces currently experienced happiness and it may through this channel elicit detrimental behavioral responses. We explore this idea in the context of endogenous health and aging. We integrate physiological aging into a life-cycle model, calibrate it with data from gerontology, and analyze how the anticipation of a deteriorating state of health affects health spending, life expectancy, and the value of life. In counterfactual computational experiments we compare behavior and outcomes of anticipating and non-anticipating individuals and find that anticipation decreases lifetime utility, health investments, and longevity. We then use the model to contribute to the literature on information avoidance. We find that anticipation provides a strong motive to avoid medical testing even when the likelihood of developing a certain disease is high and the cost for the test is low.
    Keywords: Health,Anticipation,Longevity,Health Behavior,Value of Life,Information Avoidance
    JEL: D11 D91 I12 J17
    Date: 2019
  2. By: Mörk, Eva (Uppsala University); Sjögren, Anna (IFAU - Institute for Evaluation of Labour Market and Education Policy); Svaleryd, Helena (Uppsala University)
    Abstract: We study the effects of parental job loss on children’s health, educational achievement and labor market success as young adults. Past evidence shows mixed results which could be due to small sample sizes and that workers who suffer job loss are a selected group. Using Swedish register data, including more than 140,000 children whose parents were displaced due to workplace closures, and conditioning on a wide set of pretreatment outcomes of both parents and children, we find no effects of parental job loss on childhood health, school performance or outcomes as young adults although parents are negatively affected.
    Keywords: Parental unemployment; workplace closure; child health; human capital formation
    JEL: I12 J11
    Date: 2019–02–18
  3. By: Bougen, Adrien; Huang, Yue; Kremer, Michael; Miguel, Edward
    Abstract: We assess evidence from randomized control trials (RCTs) on long-run economic productivity and living standards in poor countries. We first document that several studies estimate large positive long-run impacts, but that relatively few existing RCTs have been evaluated over the long-run. We next present evidence from a systematic survey of existing RCTs, with a focus on cash transfer and child health programs, and show that a meaningful subset can realistically be evaluated for long-run effects. We discuss ways to bridge the gap between the burgeoning number of development RCTs and the limited number that have been followed up to date, including through new panel (longitudinal) data, improved participant tracking methods, alternative research designs, and access to administrative, remote sensing, and cell phone data. We conclude that the rise of development economics RCTs since roughly 2000 provides a novel opportunity to generate high-quality evidence on the long-run drivers of living standards.
    Keywords: cash transfers; child health; development economics; long-run impacts; panel (longitudinal) data; randomized controlled trials
    Date: 2019–01
  4. By: Antoine Bozio (PJSE - Paris Jourdan Sciences Economiques - UP1 - Université Panthéon-Sorbonne - ENS Paris - École normale supérieure - Paris - INRA - Institut National de la Recherche Agronomique - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique, PSE - Paris School of Economics, IPP - Institut des politiques publiques - PSE - Paris School of Economics); Clémentine Garrouste (LEDa - Laboratoire d'Economie de Dauphine - Université Paris-Dauphine, Legos - Laboratoire d'Economie et de Gestion des Organisations de Santé - Université Paris-Dauphine); Elsa Perdrix (PJSE - Paris Jourdan Sciences Economiques - UP1 - Université Panthéon-Sorbonne - ENS Paris - École normale supérieure - Paris - INRA - Institut National de la Recherche Agronomique - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique, PSE - Paris School of Economics)
    Abstract: This paper investigates the impact of delaying retirement on mortality among the French population. We take advantage of the 1993 pension reform in the private sector to identify the causal effect of an increase in claiming age on mortality. We use administrative data which provide detailed information on career characteristics, dates of birth and death. Our results, precisely estimated, show that an exogenous increase of the claiming age has no significant impact on the probability to die between age 65 and 72, conversely we find that an increase of the retirement age of one year leads to an increase of 0.004 in the death rate between age 72 and 77. This effect is qualitatively small, and we discuss more generally the ability to estimate small effects in rare event data using minimal detectable effect procedure.
    Keywords: pension reform,health,mortality
    Date: 2019–02
  5. By: Lieze Sohiers; Luc Van Ootegem; Elsy Verhofstadt (-)
    Abstract: We investigate the consequences of retirement from work for the overall well-being of individuals aged 50 and above. The overall well-being is approximated by two indicators: the life satisfaction indicator which is a cognitive reflection of the satisfaction with life and a multidimensional indicator about Control, Autonomy and Self-realizations (CAS). The latter indicator is related to the capabilities concept (specifically agency-freedom) of Sen (1985, 1999). It evaluates overall well-being by the level of agency or the ability of people to pursue the things they want to do and be the humans they want to be. Using the longitudinal Survey of Health, Ageing and Retirement in Europe (SHARE), we find that employed and recently retired respondents have no different level of life satisfaction. Older workers do report a higher level of agency-freedom when they retire. This paper additionally investigates several forms of heterogeneities in the transition from work to retirement. We consider partial, early and joint retirement, part-time and self-employment, and job quality. We also investigate whether the extra leisure time of retired respondents affects well-being. We find that there is no difference in overall well-being between being partially and fully retired, between being retired before or after the normal retirement age or between those who retire simultaneously with their partner and those who don’t. However, for some older workers, such as those employed with a low quality job, retirement can be a relief from their current employment status. Retired respondents have more care duties which affects their well-being negatively. Charity work and sport activities affect well-being positively.
    Keywords: retirement; life satisfaction; agency; CASP; aging; well-being
    Date: 2019–02
  6. By: Eric Delattre (THEMA - Théorie économique, modélisation et applications - UCP - Université de Cergy Pontoise - Université Paris-Seine - CNRS - Centre National de la Recherche Scientifique); Richard Moussa (ENSEA - Ecole nationale supérieure de statistique et d'économie appliquée [Abidjan]); Mareva Sabatier (IREGE - Institut de Recherche en Gestion et en Economie - USMB [Université de Savoie] [Université de Chambéry] - Université Savoie Mont Blanc)
    Abstract: This article investigates the causal links between health and employment status. To disentangle correlation from causality effects, the authors leverage a French panel survey to estimate a bivariate dynamic probit model that can account for the persistence effect, initial conditions, and unobserved heterogeneity. The results highlight the crucial role of all three components and reveal strong dual causality between health and employment status. The findings clearly support demands for better coordination between employment and health public policies.
    Keywords: C51,Health and job causality,Bivariate dynamic probit model,Gauss-Hermite quadrature
    Date: 2019
  7. By: John Bound (University of Michigan); Arline T. Geronimus (University of Michigan); Timothy A. Waidmann (Urban Institute); Javier M. Rodriguez (Claremount Graduate University)
    Abstract: Recent research has found, in some groups of Americans, dramatic increases in deaths due to drug overdose and suicide and an overall stagnation of trends toward increased longevity. This study examines the link between mortality of older working age (45 to 64) adults and local economic downturns in the U.S. to evaluate the role of economic shifts in various causes of death and their related mortality trends. Specifically, we estimate regression models to test the hypotheses that the longevity effects of poor economic prospects are reflected through (1) increased suicide, drug overdose, and other “deaths of despair” and (2) other causes of death linked to exposure to economic and social stress such as heart and cerebrovascular disease. To avoid the problem of endogeneity of local economic conditions to mortality conditions, we measure the local economic shock of lost employment with predicted employment based on baseline industrial composition and national trends in employment by industry. We find evidence consistent with prior research that among non-Hispanic white adults, midlife mortality has increased since 1990, particularly among those with low educational attainment. We also find that “deaths of despair” are important contributors to that trend. However, we find that while distress in local, area economies does predict increased mortality for chronic disease, it predicts decreased mortality from suicides, opioids, and other substance abuse. This finding suggests caution in the application of the construct of despair in explaining recent mortality patterns.
    Date: 2018–10
  8. By: Lozachmeur, Jean-Marie; Cremer, Helmuth; Goulão, Catarina
    Abstract: We consider an unhealthy good, such as a sugar-sweetened beverage, the health damages of which are misperceived by consumers. The sugar content is endogenous. We rst study the solution under \pseudo" perfect competition. In that case a simple Pigouvian tax levied per unit of output but proportional to the sugar content is sucient to achieve a rst best solution. Then we consider a monopoly. Market power aects both output and sugar content, possibly in opposite directions, and these eects have to be balanced against Pigouvian considerations. We show that, nevertheless, a tax per unit of output achieves an ecient solution, but it must be an ane function of the sugar content; taxing \grams of sugar" is no longer sucient. Interestingly, both the total tax as well as its sugar component can be positive as well as negative.
    Keywords: sin tax; tax incidence; misperception; monopoly
    JEL: H22 I12 D42
    Date: 2019–02
  9. By: René Böheim; Thomas Leoni
    Abstract: We estimate sickness absences on Mondays and Fridays which fall between a weekend and public holidays, so called “bridging days”. Many public holidays change their day of the week over the years. We find that sickness absences are considerably lower on bridging days than on regular Mondays and Fridays. Based on an investigation of diagnoses with unobservable symptoms, we do not find indications for changes in shirking behavior by workers.
    Keywords: sickness absence, moral hazard, bridging days
    JEL: J22
    Date: 2019–02
  10. By: Qing Hu; Ross Levine; Chen Lin; Mingzhu Tai
    Abstract: In light of the human suffering and economic costs associated with mental illness, we provide the first assessment of whether local credit conditions shape the incidence of mental depression. Using several empirical strategies, we discover that bank regulatory reforms that improved local credit conditions reduced mental depression among low-income households and the impact was largest in counties dominated by bank-dependent firms. On the mechanisms, we find that the regulatory reforms boosted employment, income, and mental health among low-income individuals in bank-dependent counties, but the regulatory reforms did not increase borrowing by these individuals.
    JEL: D14 G21 I1 R23
    Date: 2019–02
  11. By: Bérengère Davin (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD - Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale - IRD - Institut de Recherche pour le Développement - INSERM - Institut National de la Santé et de la Recherche Médicale - AMU - Aix Marseille Université, ORS PACA - Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille]); Xavier Joutard (LEST - Laboratoire d'économie et de sociologie du travail - AMU - Aix Marseille Université - CNRS - Centre National de la Recherche Scientifique, OFCE - Observatoire Français des Conjonctures économiques - Institut d'Études Politiques [IEP] - Paris - Fondation Nationale des Sciences Politiques [FNSP]); Alain Paraponaris (AMSE - Aix-Marseille Sciences Economiques - EHESS - École des hautes études en sciences sociales - AMU - Aix Marseille Université - ECM - Ecole Centrale de Marseille - CNRS - Centre National de la Recherche Scientifique, ORS PACA - Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille])
    Abstract: Proxy respondents are widely used in population health surveys to maximize response rates. When surveys target frail elderly, the measurement error is expected to be smaller than selection or participation biases. However, in the literature on elderly needs for care, proxy use is most often considered with a dummy variable in which endogeneity with subjects' health status is rarely scrutinised in a robust way. Pitfalls of this choice extend beyond methodological issues. Indeed, the mismeasurement of needs for care with daily activities might lead to irrelevant social policies or to private initiatives that try to address those needs. This paper proposes a comprehensive and tractable strategy supported by various robustness checks to cope with the suspected endogeneity of proxy use to the unobserved health status of subjects in reports of needs for care with activities of daily living. Proxy respondents' subjectivity is found to inflate the needs of the elderly who are replaced or assisted in answering the questionnaire and to deflate the probability of unmet or undermet needs.
    Keywords: needs for care,Copula,selection,proxy respondent,measurement bias,endogeneity,ADLs,IADLs
    Date: 2019–02–20
  12. By: Nikolov, Plamen; Adelman, Alan
    Abstract: This paper examines the impact of the New Rural Pension Scheme (NRPS) in China. Exploiting the staggered implementation of an NRPS policy expansion that began in 2009, we used a difference-in-difference approach to study the effects of the introduction of pension benefits on the health status, health behaviors, and healthcare utilization of rural Chinese adults age 60 and above. The results point to three main conclusions. First, in addition to improvements in self-reported health, older adults with access to the pension program experienced significant improvements in several important measures of health, including mobility, self-care, usual activities, and vision. Second, regarding the functional domains of mobility and self-care, we found that the females in the study group led in improvements over their male counterparts. Third, in our search for the mechanisms that drive positive retirement program results, we find evidence that changes in individual health behaviors, such as a reduction in drinking and smoking, and improved sleep habits, play an important role. Our findings point to the potential benefits of retirement programs resulting from social spillover effects. In addition, these programs may lessen the morbidity burden among the retired population.
    Keywords: life-cycle,retirement,pension,health,aging,developing countries,China
    JEL: H55 H75 I10 I12 I19 J26
    Date: 2019
  13. By: Nie, Peng (University of Hohenheim); Li, Qing (University of Sherbrooke); Sousa-Poza, Alfonso (University of Hohenheim)
    Abstract: Using data from the 2009 China Health and Nutrition Survey, this study investigates China's income-health gradient by analyzing the effect of both current and long-term household income on 22 blood-based biomarkers, 4 used as individual variables and all 22 assessed as a composite. After applying a two-step residual inclusion estimator, we find limited evidence of an income-health gradient irrespective of whether the income measure is current or long term. Because risky behavior may attenuate income's positive effects on health, we also analyze the association between income and such health-influencing factors as alcohol consumption, smoking, diet, physical activity, and dietary knowledge. Although we find that higher incomes go hand-in-hand with some of these factors (in particular, a higher number of cigarettes smoked per day), they also promote poorer diets (higher consumption of fats and calories). However, the fact that these effects are small, dependent on income measure, and susceptible to reporting biases makes it unlikely that they are attenuating income's potentially positive effects on health.
    Keywords: biomarkers, income-health gradient, China
    JEL: I12 I14 I15
    Date: 2019–02
  14. By: Julia Cage (Département d'économie); Valeria Rueda (Département d'économie)
    Abstract: This article investigates the long-term historical impact of missionary activity on the prevalence of HIV/AIDS in sub-Saharan Africa. On the one hand, missionaries were among the first to invest in modern medicine in a number of countries. On the other hand, Christianity influenced sexual beliefs and behaviors. We build a new geocoded dataset locating Protestant and Catholic missions in the early 20th century, as well as their health investments. Using a number of different empirical strategies to address selection in missionary locations and into health investments, we show that missionary presence has conflicting effects on HIV today. Regions close to historical mission stations exhibit higher HIV prevalence. This negative impact is robust to multiple specifications accounting for urbanization, and we provide evidence that it is specific to STDs. Less knowledge about condom use is a likely channel. On the contrary, among regions historically close to missionary settlements, proximity to a mission with a health investment is associated with lower HIV prevalence nowadays. Safer sexual behaviors around these missions are a possible explanatory channel.
    Keywords: Historical persistence; Missions; Health investments; HIV/AIDS; Sexual behavior
    JEL: D72 N37 N77 O33 Z12 Z13
    Date: 2017–07

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