nep-hea New Economics Papers
on Health Economics
Issue of 2020‒06‒08
fifty-one papers chosen by
Nicolas R. Ziebarth
Cornell University

  1. Optimal Regulation of E-cigarettes: Theory and Evidence By Hunt Allcott; Charlie Rafkin
  2. Double trouble: The burden of child rearing and working on maternal mortality By Bucher-Koenen, Tabea; Farbmacher, Helmut; Guber, Raphael; Vikström, Johan
  3. The Value of Health Insurance during a Crisis: Effects of Medicaid Implementation on Pandemic Influenza Mortality By Clay, Karen; Lewis, Joshua; Severnini, Edson R.; Wang, Xiao
  4. The Impact of Childhood Health Shocks on Parental Labor Supply By Tine L. Mundbjerg Eriksen; Amanda Gaulke; Niels Skipper; Jannet Svensson
  5. 'More Than One Red Herring'? Heterogeneous Effects of Ageing on Healthcare Utilisation By Costa-Font, Joan; Vilaplana-Prieto, Cristina
  6. Investigating the Genetic Architecture of Non-Cognitive Skills Using GWAS-By-Subtraction By Demange, Perline A.; Malanchini, Margherita; Mallard, Travis T.; Biroli, Pietro
  7. Presenteeism in the UK: Effects of physical and mental health on worker productivity By Mark L. Bryan; Andrew M. Bryce; Jennifer Roberts
  8. The Long-Run Effects of Peers on Mental Health By Lukas Kiessling; Jonathan Norris
  9. The Perceived Well-Being and Health Costs of Exiting Self-Employment By Nikolova, Milena; Nikolaev, Boris; Popova, Olga
  10. Prices and market power in mental health care: Evidence from a major policy change in the Netherlands By Rudy Douven; Chiara Brouns; Ron Kemp
  11. Health Shocks under Hospital Capacity Constraint: Evidence from Air Pollution in Sao Paulo, Brazil By Guidetti, Bruna; Pereda, Paula; Severnini, Edson R.
  12. Traffic Congestion, Transportation Policies, and the Performance of First Responders By Daniel A. Brent; Louis-Philippe Beland
  13. The Effect of Inpatient User Charges on Inpatient Care By Jana Votapkova
  14. Drinking is Different! Examining the Role of Locus of Control for Alcohol Consumption By Marco Caliendo; Juliane Hennecke
  15. The effect of pollen exposure on economic activity:Evidence from home scanner data By Yuta Kuroda
  16. Sleep Restriction Increases Coordination Failure By Castillo, Marco; Dickinson, David L.
  17. Retirement, Intergenerational Time Transfers, and Fertility By Peter Eibich; Thomas Siedler
  18. International Cost-Effectiveness Thresholds and Modifiers for HTA Decision Making By Zhang, K.; Garau, M.
  19. Risk attitude and air pollution: Evidence from chess* By Joris Klingen; Jos van Ommeren
  20. Working Paper 315 - Temperature and Children’s Nutrition: Evidence from West Africa By Sylvia Blom; Ariel Ortiz-Bobea; John Hoddinott
  21. Sexual Harassment and Gender Inequality in the Labor Market By Folke, Olle; Rickne, Johanna
  22. Economic Downturns and Mental Wellbeing By Daniel Avdic; Sonja C. de New; Daniel A. Kamhöfer
  23. Age, Death Risk, and the Design of an Exit Strategy: A Guide for Policymakers and for Citizens Who Want to Stay Alive By Oswald, Andrew J.; Powdthavee, Nattavudh
  24. Teaching the effect of COVID-19 with a manageable model By Sébastien Charles; Thomas Dallery; Jonathan Marie
  25. Occupational Exposure to Contagion and the Spread of COVID-19 in Europe By Lewandowski, Piotr
  26. Socioeconomic Factors influencing the Spatial Spread of COVID-19 in the United States By Christopher F Baum; Miguel Henry
  27. Corruption in the Times of Pandemia By Gallego, Jorge; Prem, Mounu; Vargas, Juan F.
  28. A Predator-Prey Model of Unemployment and W-shaped Recession in the COVID-19 Pandemic By Maria Cristina Barbieri Góes; Ettore Gallo
  29. Non-Pharmaceutical Interventions and Mortality in U.S. Cities during the Great Influenza Pandemic, 1918-1919 By Robert J. Barro
  30. "Contagion": The determinants of governments' public health responses to COVID-19 all around the world By Simon Porcher
  31. Trust and Compliance to Public Health Policies in Times of COVID-19 By Bargain, Olivier; Aminjonov, Ulugbek
  32. Optimal epidemic suppression under an ICU constraint * By Laurent Miclo; Daniel Spiro; Jörgen Weibull
  33. Health versus Wealth: On the Distributional Effects of Controlling a Pandemic By Andrew Glover; Jonathan Heathcote; Dirk Krueger; Jose-Victor Rios-Rull
  34. Staggered Release Policies for COVID-19 Control: Costs and Benefits of Sequentially Relaxing Restrictions by Age By Henry Zhao; Zhilan Feng; Carlos Castillo-Chavez; Simon A. Levin
  35. Designing Reopening Strategies in the Aftermath of COVID-19 Lockdowns: Some Principles with an Application to Denmark By Andersen, Torben M.; Schröder, Philipp J. H.; Svarer, Michael
  36. Deregulation in a Time of Pandemic: Does Pollution Increase Coronavirus Cases or Deaths? By Persico, Claudia; Johnson, Kathryn R.
  37. The relationship between air quality, wealth, and COVID-19 diffusion and mortality across countries By Roberto Antonietti; Paolo Falbo; Fulvio Fontini
  38. Health vs. Wealth? Public Health Policies and the Economy During Covid-19 By Zhixian Lin; Christopher M. Meissner
  39. COVID-19, Lockdowns and Well-Being: Evidence from Google Trends By Brodeur, Abel; Clark, Andrew E.; Flèche, Sarah; Powdthavee, Nattavudh
  40. The Short-Term Economic Consequences of COVID-19: Occupation Tasks and Mental Health in Canada By Louis-Philippe Beland; Abel Brodeur; Derek Mikola; Taylor Wright
  41. Life Dissatisfaction and Anxiety in COVID-19 pandemic By Pablo de Pedraza; Martin Guzi; Kea Tijdens
  42. The COVID-19 pandemic and its impact on inequality of opportunity in psychological distress in the UK By Davillas, Apostolos; Jones, Andrew M.
  43. Disparities and Mitigation Behavior during COVID-19 By Abigail Wozniak
  44. Lives or Livelihoods? Perceived Tradeoffs and Public Demand for Non-Pharmaceutical Interventions By Sonja Settele; Cortnie Shupe
  45. Pandemic, Shutdown and Consumer Spending: Lessons from Scandinavian Policy Responses to COVID-19 By Asger Lau Andersen; Emil Toft Hansen; Niels Johannesen; Adam Sheridan
  46. Stay-At-Home Orders, Social Distancing and Trust By Brodeur, Abel; Grigoryeva, Idaliya; Kattan, Lamis
  47. A novel dataset of governments' responses to COVID-19 all around the world By Simon Porcher
  48. Following Doctors’ Advice: Explaining the Issuance of Stay-at-Home Orders Related to the Coronavirus Disease 2019 (COVID-19) by U.S. Governors By Murray, Gregg R.; Murray, Susan M.
  49. Impact of virus testing on COVID-19 case fatality rate: estimate using a fixed-effects model By Anthony Terriau; Arthur Poirier; Julien Albertini; Quentin Le Bastard
  50. Socioeconomic Determinants of COVID-19 Infections and Mortality: Evidence from England and Wales By Sa, Filipa
  51. Coronavirus-Lockdowns, Secondary Effects and Sustainable Exit-Strategies for Sub-Saharan Africa By Raymond Boadi Frempong; David Stadelmann; Frederik Wild

  1. By: Hunt Allcott; Charlie Rafkin
    Abstract: We model optimal e-cigarette regulation and estimate key sufficient statistics. Using tax changes and scanner data, we estimate relatively elastic demand and limited substitution between e-cigarettes and combustible cigarettes. In sample surveys, historical smoking declines for high- and low-vaping demographics were unchanged after e-cigarettes were introduced; this demographic shift-share identification also suggests limited substitution. We field a new survey of experts, who report that vaping is almost as harmful as smoking cigarettes. In our model, these results imply that current e-cigarette taxes are far below the social optimum, but Monte Carlo simulations highlight substantial uncertainty.
    JEL: D12 D18 D61 H21 H23 I12 I18
    Date: 2020–04
  2. By: Bucher-Koenen, Tabea (Munich Center for the Economics of Aging); Farbmacher, Helmut (Munich Center for the Economics of Aging); Guber, Raphael (Munich Center for the Economics of Aging); Vikström, Johan (IFAU - Institute for Evaluation of Labour Market and Education Policy)
    Abstract: We document increased old-age mortality rates among Swedish twin mothers compared to non-twin mothers. Results are based on administrative data on mortality for the years 1990 to 2010. We argue that twins are an unplanned shock to fertility in the cohorts of older women considered. Deaths due to lung cancer, chronic obstructive pulmonary disease and heart attacks, which are associated with stress during life, are significantly increased. Stratifying the sample by education and pension income shows the highest increase in mortality rates among highly educated mothers and those with above-median pension income. These results are consistent with the existence of a double burden from child rearing and working on mothers’ health.
    Keywords: Mortality; maternal health; fertility; twins
    JEL: I10 J13 J20
    Date: 2020–05–19
  3. By: Clay, Karen (Carnegie Mellon University); Lewis, Joshua (University of Montreal); Severnini, Edson R. (Carnegie Mellon University); Wang, Xiao (Carnegie Mellon University)
    Abstract: This paper studies how better access to public health insurance affects infant mortality during pandemics. Our analysis combines cross-state variation in mandated eligibility for Medicaid with two influenza pandemics — the 1957-58 "Asian Flu" pandemic and the 1968-69 "Hong Kong Flu" — that arrived shortly before and after the program's introduction. Exploiting heterogeneity in the underlying severity of these two shocks across counties, we find no relationship between Medicaid eligibility and pandemic infant mortality during the 1957-58 outbreak. After Medicaid implementation, we find that better access to insurance in high-eligibility states substantially reduced infant mortality during the 1968-69 pandemic. The reductions in pandemic infant mortality are too large to be attributable solely to new Medicaid recipients, suggesting that the expansion in health insurance coverage mitigated disease transmission among the broader population.
    Keywords: public health insurance, medicaid, influenza pandemics
    JEL: I13 I18 N32 N52
    Date: 2020–04
  4. By: Tine L. Mundbjerg Eriksen (VIVE, The Danish Center for Social Science Research, Aarhus, Denmark); Amanda Gaulke (Department of Economics, Kansas State University, Manhattan, Kansas); Niels Skipper (Department of Economics and Business Economics, Aarhus University); Jannet Svensson (Copenhagen University Hospital, Copenhagen, Denmark)
    Abstract: Causal estimates of the effects of child health shocks on parental labor market outcomes are important for making efficient child disability insurance policy. We leverage the onset of type 1 diabetes (T1D) in childhood to investigate the link between child’s health and parental labor supply. We argue that T1D hits children as-if randomly because the exact cause is unknown, and it has low inheritability. T1D is characterized by a sudden, unpredictable onset, and receiving treatment is crucial to even short-term survival. Using Danish administrative registry data with quasi-experimental methods we show that mothers adjust their labor supply on the intensive margin and experience a 4-5% decrease in wage income that extends at least ten years after diagnosis. This reduction in wage income is similar in magnitude and duration to the motherhood penalty in Denmark. Maternal wage income and labor supply effects are smaller than previous estimates using disabilities that qualify for welfare, emphasizing the importance of not confounding welfare with child health. Fathers do not experience any long-term reduction in wage income.
    Keywords: Parental labor supply, chronic disease, health shocks
    JEL: J22 I12 I14
    Date: 2020–03–10
  5. By: Costa-Font, Joan (London School of Economics); Vilaplana-Prieto, Cristina (Universidad de Murcia)
    Abstract: We study the effect of ageing, defined an extra year of life, on health care utilisation. We disentangle the direct effect of ageing, from other alternative explanations such as the presence of comorbidities and endogenous time to death (TTD) that are argued to absorb the effect of ageing ( so-called 'red herring' hypothesis). We exploit individual level end of life data from several European countries that record the use of medicine, outpatient and inpatient care as well as long-term care. Consistently with a 'red herring hypothesis', we find that corrected TTD estimates are significantly different from uncorrected ones, and its effect size exceeds that of an extra year of life, which in turn is moderated by individual comorbidities. Corrected estimates suggest an overall attenuated effect of ageing, which does not influence outpatient care utilisation. These results suggest the presence of 'more than one red herring' depending on the type of health care examined.
    Keywords: endogeneous time to death (TTD), home help use and comorbidity, medicines use, hospital care, health care utilization, ageing, time to death, comorbidities
    JEL: I18 J13 H75
    Date: 2020–05
  6. By: Demange, Perline A. (Vrije Universiteit Amsterdam); Malanchini, Margherita (Queen Mary, University of London); Mallard, Travis T. (University of Texas at Austin); Biroli, Pietro (University of Zurich)
    Abstract: Educational attainment (EA) is influenced by characteristics other than cognitive ability, but little is known about the genetic architecture of these "non-cognitive" contributions to EA. Here, we use Genomic Structural Equation Modelling and prior genome-wide association studies (GWASs) of EA (N = 1,131,881) and cognitive test performance (N = 257,841) to estimate SNP associations with EA variation that is independent of cognitive ability. We identified 157 genome-wide significant loci and a polygenic architecture accounting for 57% of genetic variance in EA. Non-cognitive genetics were as strongly related to socioeconomic success and longevity as genetic variants associated with cognitive performance. Noncognitive genetics were further related to openness to experience and other personality traits, less risky behavior, and increased risk for psychiatric disorders. Non-cognitive genetics were enriched in the same brain tissues and cell types as cognitive performance, but showed different associations with gray-matter brain volumes. By conducting a GWAS of a phenotype that was not directly measured, we offer a first view of genetic architecture of non-cognitive skills influencing educational success.
    Keywords: genetics, noncognitive skills, education
    JEL: J24 I24 E24 I14
    Date: 2020–05
  7. By: Mark L. Bryan (Department of Economics, University of Sheffield, UK); Andrew M. Bryce (Department of Economics, University of Sheffield, UK); Jennifer Roberts (Department of Economics, University of Sheffield, UK)
    Abstract: Poor health in the workforce is costly to employers and the economy. This is partly due to health problems causing people to spend less time at work but is also due to people being less productive while at work. In this paper, we investigate the causes of presenteeism, defined as reduced productivity at work due to health problems. This is the first study to estimate the extent of presenteeism in the UK workforce as a whole. We assess the extent to which physical and mental health affect people’s ability to do their job effectively and seek to expose some of the ‘hidden’ costs of ill health on the UK economy. We find that both physical and mental health significantly predict the probability of presenteeism. These effects persist in a longitudinal framework, such that a worsening of health over time significantly increases the probability of presenteeism; and the effects of mental health problems seem to be worse than physical health. In comparison, changes to other characteristics, such as work circumstances, have little or no effect on presenteeism, with the exception of perceived job security. However, being in part time work and having autonomy over work tasks both significantly reduce the effect of mental health on presenteeism, suggesting that conducive working conditions can help to mitigate the negative impact of health on productivity.
    Keywords: international migration; migration choice; government ideology; OECD countries
    JEL: I14 J24
    Date: 2020–05
  8. By: Lukas Kiessling (Max Planck Institute for Research on Collective Goods, Bonn); Jonathan Norris (University of Strathclyde)
    Abstract: This paper studies how peers in school affect students’ mental health. Guided by a theoretical framework, we find that increasing students’ relative ranks in their cohorts by one standard deviation improves their mental health by 6% of a standard deviation conditional on own ability. These effects are more pronounced for low-ability students, persistent for at least 14 years, and carry over to economic long-run outcomes. Moreover, we document a strong asymmetry: Students who receive negative rather than positive shocks react more strongly. Our findings therefore provide evidence on how the school environment can have long-lasting consequences for the well-being of individuals.
    Keywords: Peer Effects, Mental Health, Depression, Rank Effects
    JEL: I21 I14 J24
    Date: 2020–06
  9. By: Nikolova, Milena (University of Groningen); Nikolaev, Boris (Emory University); Popova, Olga (Leibniz Institute for East and Southeast European Studies (IOS))
    Abstract: We explore how involuntary and voluntary exits from self-employment affect life and health satisfaction. To that end, we use rich longitudinal data from the German Socio-Economic Panel from 1985 to 2017 and a difference-in-differences estimation. Our findings suggest that while transitioning from self-employment to salaried employment (i.e., a voluntary self-employment exit) brings small improvements in health and life satisfaction, the negative psychological costs of business failure (i.e., switching from self-employment to unemployment) are substantial and exceed the costs of involuntarily losing a salaried job (i.e., switching from salaried employment to unemployment). Meanwhile, leaving self-employment has no consequences for selfreported physical health and behaviors such as smoking and drinking, implying that the costs of losing self-employment are largely psychological. Moreover, former business owners fail to adapt to an involuntary self-employment exit even two or more years after this traumatic event. Our findings imply that policies encouraging entrepreneurship should also carefully consider the costs of business failure.
    Keywords: entrepreneurship, self-employment, health, well-being, unemployment, job switches
    JEL: E24 I10 I31 J28 L26
    Date: 2020–04
  10. By: Rudy Douven (CPB Netherlands Bureau for Economic Policy Analysis); Chiara Brouns (Menzis); Ron Kemp (ACM, EUR)
    Abstract: In the Dutch health care system of managed competition, insurers and mental health providers negotiate on prices for mental health services. Contract prices are capped by a regulator who sets a maximum price for each mental health service. In 2013, the majority of the contract prices equaled these maximum prices. We study price setting after a major policy change in 2014.
    JEL: I11 I18 L11
    Date: 2020–05
  11. By: Guidetti, Bruna (University of Michigan); Pereda, Paula (University of Sao Paulo); Severnini, Edson R. (Carnegie Mellon University)
    Abstract: When a health shock hits a location, the healthcare infrastructure needs to be adjusted to meet the increased demand. This may be a challenge in developing countries because of limited hospital capacity. In this study, we examine the consequences of health shocks induced by air pollution in a megacity in the developing world: Sao Paulo, Brazil. Using daily data from 2015-2017, and an instrumental variable approach based on wind speed, we provide evidence that exposure to particulate matter (PM10) causes an increase in pediatric hospitalizations for respiratory diseases, which in turn leads to a decrease in hospital admissions for elective care – phimosis surgery and epilepsy-related procedures such as video-EEG (electroencephalograph) monitoring. Importantly, emergency procedures such as appendectomy and bone fracture repair are not affected. While strained Sao Paulo hospitals seem to absorb the increased demand induced by poor air quality, our results imply that the common practice of using health outcomes unrelated to pollution as "placebo tests" in studies on the effects of air pollution might be inadequate in settings with limited healthcare infrastructure. This is often the case in developing countries, where severe pollution is also ubiquitous, but also happens in deprived areas in the developed world.
    Keywords: air pollution, health outcomes, hospitalization for respiratory diseases and other causes, healthcare infrastructure, hospital capacity constraint
    JEL: I15 Q53 Q56 O13
    Date: 2020–05
  12. By: Daniel A. Brent (Department of Agricultural Economics, Sociology, and Education, Pennsylvania State University); Louis-Philippe Beland (Department of Economics, Carleton University)
    Abstract: Traffic congestion is a growing problem in urbanizing economies that results in lost time, health problems from pollution, and contributes to the accumulation of greenhouse gas emissions. We examine a new external cost of traffic by estimating the relationship between traffic congestion and emergency response times. Matching traffic data at a fine spatial and temporal scale to incident report data from fire departments in California allows us to assign traffic immediately preceding an emergency. Our results show that traffic slows down fire trucks arriving at the scene of an emergency and increases the average monetary damages from fires. The effects are highly nonlinear; increases in response time are primarily due to traffic in the right tail of the traffic distribution. We document an additional externality of traffic congestion and highlight the negative effect of traffic on a critical public good.
    Keywords: Traffic, Public Goods, Externalities, Emergency Response Times
    JEL: R41 R42 R48 H41 Q50
    Date: 2020–05–20
  13. By: Jana Votapkova (Institute of Economic Studies, Faculty of Social Sciences, Charles University Opletalova 26, 110 00, Prague, Czech Republic)
    Abstract: The essay assesses the infuence of inpatient user charges in the Czech Republic on the amount of inpatient hospital care provided, namely the number of patient days. We apply the difference-indifferences approach on a panel of 76 general hospitals in 2008-2009. The introduction and subsequent partial reimbursement of user fees charged on an inpatient day in the Czech Republic satisfies the criteria of a natural experiment - the decision to reimburse patients for user charges applied to hospitals under the control of the Social Democratic (ÄŒSSD) regional governments in the year 2009, and was unrelated to other hospital characteristic. Our treatment group comprises hospitals where patients could ask for reimbursement, i.e. user charges were effectively abolished. The control group covers hospitals where it was not possible to get reimbursement. The base year is 2008 when user charges were introduced. The observed effect of user-charge abolition was small and marginally significant (between 2.7 % and 4.1 %) having controlled for exogenous hospital and regional characteristics.
    Keywords: Cost-sharing, inpatient care, difference-in-difference, Czech Republic
    JEL: I12 I18
    Date: 2020–05
  14. By: Marco Caliendo (University of Potsdam, IZA Bonn, DIW Berlin, IAB Nuremberg); Juliane Hennecke (Auckland University of Technology, IZA Bonn)
    Abstract: Unhealthy behavior can be extremely costly from a micro- and macroeconomic perspective and exploring the determinants of such behavior is highly important from an economist’s point of view. We examine whether locus of control (LOC) can explain alcohol consumption as an important domain of health behavior. LOC measures how much an individual believes that she is in control of the consequences of her own actions for her life’s future outcomes. While earlier literature showed that an increasing internal LOC is associated with increased health-conscious behavior in domains such as smoking, exercise or diets, we find that drinking seems to be different. Using German panel data from the Socio-Economic Panel (SOEP) we find a significant positive effect of having an internal LOC on the probability of moderate and regular drinking. We suggest and discuss two likely mechanisms for this relationship and find interesting gender differences. While social investments play an important role for both men and women, risk perceptions are especially relevant for men.
    Keywords: locus of control, alcohol consumption, health behavior, risk perception, social investment
    JEL: I12 D91
    Date: 2020–05
  15. By: Yuta Kuroda
    Abstract: Although seasonal allergies caused by airborne pollen are detrimental to physical and mental health and impair daily activity, discussion on their social cost is scarce in the economics literature. Large amounts of airborne pollen can not only increase health care costs and reduce worker productivity, but also cause people to stay at home, thereby stagnating economic activity. This study uses daily purchase records from scanner data to investigate the effect of pollen exposure on consumption behavior. Exploiting the daily variation in the pollen counts at 120 observation stations in Japan, I find that consumption expenditure decreases by about 2% on days when airborne pollen is unusually high. A reduction in consumption due to pollen exposure is also observed in estimates using weekly and monthly panel data. This finding suggests that exposure to pollen may reduce total expenditure as opposed to delay spending. The results highlight the overlooked economic burden of pollen and seasonal allergies. Hence, they underline the importance of urban planning to reduce airborne pollen and health policy to deal with seasonal allergies.
    Date: 2020–05
  16. By: Castillo, Marco (Texas A&M University); Dickinson, David L. (Appalachian State University)
    Abstract: When group outcomes depend on minimal effort (e.g., disease containment, work teams, or indigenous hunt success), a classic coordination problem exists. Using a well-established paradigm, we examine how a common cognitive state (insufficient sleep) impacts coordination outcomes. Our data indicate that insufficient sleep increases coordination failure costs, which suggests that the sleep or, more generally, cognitive composition of a group might determine its ability to escape from a trap of costly miscoordination and wasted cooperative efforts. These findings are first evidence of the potentially large externality of a commonly experienced biological state (insufficient sleep) that has infiltrated many societies.
    Keywords: coordination games, sleep, cooperative dilemma
    JEL: C91 D91
    Date: 2020–05
  17. By: Peter Eibich; Thomas Siedler
    Abstract: Retired parents might invest time into their adult children by providing childcare. Such intergenerational time transfers can have important implications for family decisions. This paper estimates the effects of parental retirement on adult children’s fertility. We use representative panel data from Germany to link observations on parents and adult children. We exploit eligibility ages for early retirement for identification in a regression discontinuity design. The results show that parent’s early retirement significantly increases the probability of childbirth for adult children. However, parental retirement affects only the timing of adult children’s fertility, without having an effect on total fertility.
    Keywords: Retirement, fertility, intergenerational transfer, time use
    JEL: J13 J14 J22 J26
    Date: 2020
  18. By: Zhang, K.; Garau, M.
    Abstract: OHE presents an overview on the use of cost-effectiveness thresholds (CETs) in a number of selected countries in their decision-making process for health technology assessments. In addition to the different levels of CETs in these countries, this review examines whether an explicit or implicit CET is used, and the additional considerations (here termed 'modifiers') that are incorporated when funding and reimbursement decisions are made.
    Keywords: Economics of Health Technology Assessment; Value, Affordability, and Decision Making
    JEL: I1
    Date: 2020–05–01
  19. By: Joris Klingen (Vrije Universiteit Amsterdam); Jos van Ommeren (Vrije Universiteit Amsterdam)
    Abstract: Medical research suggests that particulate matter (PM) increases stress hormones, therefore increasing the feeling of stress, which has been hypothesised to induce individuals to take less risk. To examine this, we study whether PM increases the probability of drawing in chess games using information from the Dutch club competition. We provide evidence of a reasonably strong effect: A 10μg increase in PM10 (33.6% of mean concentration) leads to a 5.8% increase in draws. Our results demonstrate that air pollution causes individuals to take less risk.
    Keywords: air pollution, particulate matter, cognitive ability, risk taking
    JEL: Q53 D81 I18
    Date: 2020–05–24
  20. By: Sylvia Blom (Charles H. Dyson School of Applied Economics and Management, Cornell University); Ariel Ortiz-Bobea (Charles H. Dyson School of Applied Economics and Management, Cornell University); John Hoddinott (Charles H. Dyson School of Applied Economics and Management, Cornell University)
    Abstract: Wasting and stunting rates have been falling in Sub-Saharan Africa since 2000 due to concerted efforts to improve children’s nutrition. However, this progress is at risk of faltering due to rising temperatures across the continent. High temperatures can affect children’s nutrition through heat stress, decreased agricultural production, and increased disease. In this paper, we test the hypothesis that temperatures above 30oC negatively affect children’s nutritional status as measured by standardized anthropometric measures. To do so, we merge anthropometric data from the publicly available Demographic and Health Survey (DHS) data with weather data from the Global Meteorological Forcing Dataset. Exploiting spatial and temporal variation in temperature, we find evidence that high temperatures decrease both weight-for-height z scores (WHZ) and height-forage z scores (HAZ) in nutritionally meaningful orders of magnitude: for an increase of 470 hours above 30oC in a three-month period (the mean exposure), WHZ decrease by 0.16SD and HAZ decrease by 0.14SD. This equates to a 3% increase in the wasting rate and a 6% increase in the stunting rate. Children are most vulnerable to temperature shocks at 12 months of age and we find preliminary evidence that these shocks have permanent effects as evidenced by low HAZ at later ages.
    Keywords: Temperature, children nutrition, West Africa
    Date: 2019–08–20
  21. By: Folke, Olle (Uppsala University); Rickne, Johanna (Swedish Institute for Social Research, Stockholm University)
    Abstract: This paper offers a comprehensive empirical analysis of sexual harassment in the Swedish labormarket. First, we use nationally representative survey data linked with employer-employee datato describe rates of self-reported sexual harassment across occupations and workplaces. The riskof sexual harassment is clearly imbalanced across the sex segregated labor market. In gender-mixed and male-dominated occupations and workplaces, women have a higher risk than men,and men have a higher risk than women in female-dominated contexts. We use a hypotheticaljob-choice experiment with vignettes for sexual harassment to measure the disutility of sexualharassment risks. Both men and women have an equally high willingness to pay for avoidingworkplaces where sexual harassment has occurred. But the willingness to pay is conditional onthe sex of the fictional harassment victim. People reject workplaces where the victim is the samesex as themselves, but not where the victim is of the opposite sex. We return to the administrativedata to study employer compensation for the disutility of sexual harassment risks. Withinworkplaces, a high risk is associated with lower, not higher wages. People who self-report sexualharassment also have higher job dissatisfaction, more quit intentions, and more actual quits.Both these patterns indicate a lack of full compensation. We conclude that sexual harassmentshould be conceptualized as gender discrimination in workplace amenities, and that thisdiscrimination reinforces sex segregation and pay-inequalities in the labor market.
    Keywords: Gender Inequality; occupational gender segregation; Sexual harassment; workplace amenities
    JEL: J16 J24 J81
    Date: 2020–05–12
  22. By: Daniel Avdic; Sonja C. de New; Daniel A. Kamhöfer
    Abstract: We study the impact of the business cycle on mental wellbeing by linking rich German survey data to over a decade of detailed gross domestic product information. Endogeneity concerns are tackled using a shift-share instrumental variables approach in which exposure to macroeconomic fluctuations is estimated from regional variations in historical industry sector composition. Estimation results reveal strong negative effects of economic downturns on both life satisfaction and a multidimensional measure of mental health. We provide evidence that these effects are mediated by fear of job loss and income reductions, while actual unemployment effects are negligible. A case study of the impact of the global financial crisis reveals that adverse effects on mental wellbeing are persistent and remained even after the economy recovered.
    Keywords: Business cycle, mental health, life satisfaction, global financial crisis, shift-share instrument
    JEL: C36 E32 I15
    Date: 2020
  23. By: Oswald, Andrew J. (University of Warwick); Powdthavee, Nattavudh (University of Warwick)
    Abstract: Some commentators argue for a fairly general release from COVID-19 lockdown. That has a troubling flaw. It ignores the fatality risks that will then be faced by citizens in midlife and older. This paper provides information on the strong age-pattern in the risk of death from three countries (China, Italy, the UK). If politicians want an imminent removal of the lockdown, the safest approach in our judgment would be a rolling age-release strategy combined with the current principle of social distancing. But even if that is not the policy adopted, citizens need to be shown graphs of the kind in this paper. Honest guidance ought to be given to those in midlife and beyond. Governments have to allow people to understand their personal risk after any release from lockdown.
    Keywords: coronavirus, labor market, recession, COVID-19
    JEL: I18 J13 H75
    Date: 2020–05
  24. By: Sébastien Charles (LED - Laboratoire d'Economie Dionysien - UP8 - Université Paris 8 Vincennes-Saint-Denis); Thomas Dallery (CLERSE - Centre Lillois d’Études et de Recherches Sociologiques et Économiques - UMR 8019 - Université de Lille - ULCO - Université du Littoral Côte d'Opale - CNRS - Centre National de la Recherche Scientifique); Jonathan Marie (CEPN - Centre d'Economie de l'Université Paris Nord - UP13 - Université Paris 13 - USPC - Université Sorbonne Paris Cité - CNRS - Centre National de la Recherche Scientifique)
    Abstract: This note has one main ambition. It seeks to provide a very simple macroeconomic framework to explain the economic impact of the COVID-19 pandemic. The explanation for the unprecedented magnitude of the recession over a short span of time is to be found in the peculiar form of the shock due to the various lockdowns involving two recessive shocks simultaneously. Besides, this model is original in that although it is driven by demand it is capable of dealing with supply issues without entailing any additional technical difficulties.
    Keywords: COVID-19,lockdown,recession,simultaneous shocks
    Date: 2020–05–17
  25. By: Lewandowski, Piotr (Institute for Structural Research (IBS))
    Abstract: Social contacts are a key transmission channel of infectious diseases spread by the respiratory or close-contact route, such as COVID-19. There is no evidence, however, on the question of whether the nature and the organisation of work affect the spread of COVID-19 in different countries. I have developed a methodology to measure country-specific levels of occupational exposure to contagion driven by social contacts. I combined six indicators based on Occupation Information Network (O*NET) and the European Working Condition Survey (EWCS) data. I then applied them to 26 European countries, and found substantial cross-country differences in levels of exposure to contagion in comparable occupations. The resulting country-level measures of levels of exposure to contagion (excluding health professions) predict the growth in COVID-19 cases, and the number of deaths from COVID-19 in the early stage of pandemic (up to four weeks after the 100th case). The relationship between levels of occupational exposure to contagion and the spread of COVID-19 is particularly strong for workers aged 45-64. I found that 20-25% of the cross-country variance in numbers of COVID-19 cases and deaths can be attributed to cross-country differences in levels of occupational exposure to contagion in European countries. My findings are robust to controlling for the stringency of containment policies, such as lockdowns and school closures. They are also driven by country-specific patterns of social contacts at work, rather than by occupational structures. Thus, I conclude that measuring workplace interactions may help to predict the next waves of the COVID-19 pandemic.
    Keywords: COVID-19, contagion, exposure to disease, occupations, organisation of work
    JEL: J01 I10 J44
    Date: 2020–05
  26. By: Christopher F Baum (Boston College; DIW Berlin); Miguel Henry (Greylock McKinnon Associates)
    Abstract: As the COVID-19 pandemic has progressed in the U.S., "hotspots" have been shifting geographically over time to suburban and rural counties showing a high prevalence of the disease. We analyze daily U.S. county-level variations in COVID-19 confirmed case counts to evaluate the spatial dependence between neighboring counties. We find strong evidence of county-level socioeconomic factors influencing the spatial spread. We show the potential of combining spatial econometric techniques and socioeconomic factors in assessing the spatial effects of COVID-19 among neighboring counties.
    Keywords: COVID-19, coronavirus, socioeconomic factors, spillover effects, spatial econometrics
    JEL: C13 C21 R15 R23
    Date: 2020–05–29
  27. By: Gallego, Jorge; Prem, Mounu; Vargas, Juan F.
    Abstract: The public health crisis caused by the COVID-19 pandemic, coupled with the subsequent economic emergency and social turmoil, has pushed governments to substantially and swiftly increase spending. Because of the pressing nature of the crisis, public procurement rules and procedures have been relaxed in many places in order to expedite transactions. However, this may also create opportunities for corruption. Using contract-level information on public spending from Colombia's e-procurement platform, and a difference-in-differences identification strategy, we find that municipalities classified by a machine learning algorithm as traditionally more prone to corruption react to the pandemic-led spending surge by using a larger proportion of discretionary non-competitive contracts and increasing their average value. This is especially so in the case of contracts to procure crisis-related goods and services. Our evidence suggests that large negative shocks that require fast and massive spending may increase corruption, thus at least partially offsetting the mitigating effects of this fiscal instrument.
    Keywords: DiCorruption; COVID-19; Public procurement; Machine learning
    JEL: H57 D73 I18 H75
    Date: 2020–05
  28. By: Maria Cristina Barbieri Góes (Department of Economics, Università degli Studi Roma Tre); Ettore Gallo (Department of Economics, New School for Social Research)
    Abstract: The paper presents a predator-prey model which captures the interactions between unemployment rate and COVID-19 infection rate. The model shows that lockdown measures can effectively reduce the infection rate, but at the cost of higher unemployment rate. The solution of the system makes the case for an endemic equilibrium of COVID-19 infections, hence producing waves in the unemployment rate in the absence of widespread immunity and/or vaccination. Furthermore, we simulate the model, calibrating it for the US. The simulation shows the dramatic effects on unemployment and on overall economic activity produced by potential recurrent waves of COVID-19, leading to a series of W-shaped recessions that - in absence of adequate policy response - jeopardize the coming back to the normal trend in the medium run.
    Keywords: COVID-19, unemployment rate, jobless recovery, W-shaped recession
    JEL: E24 E60 H51 I18
    Date: 2020–05
  29. By: Robert J. Barro
    Abstract: Non-pharmaceutical interventions (NPIs) were measured by Markel, et al. (2007) for U.S. cities during the second wave of the Great Influenza Pandemic, September 1918-February 1919. The NPIs were in three categories: school closings, prohibitions on public gatherings, and quarantine/isolation. An increase in NPIs sharply reduced the ratio of peak to average deaths, with a larger effect when NPIs were treated as endogenous. However, the estimated effect on overall deaths was small and statistically insignificant. The likely reason that the NPIs were not more successful in curtailing mortality is that the interventions had a mean duration of only around one month.
    Date: 2020
  30. By: Simon Porcher (IAE - Institut d'Administration des Entreprises)
    Abstract: To respond to the COVID-19 outbreak, governments all around the world have implemented public health measures that have resulted in different policies to contain the spread of the virus and to support the economy. These measures include travel restrictions, bans on mass gatherings, school closures and domestic lockdowns, among others. This paper presents a unique dataset of governments' responses to COVID-19. The dataset codes the policy interventions with their dates at the country level for more than 180 countries. To facilitate crosscountry and cross-time comparisons, the paper builds on different measures to create an index of the rigidity of governments' responses to COVID-19. The index shows that responses to the pandemic vary across countries and across time. The paper also investigates the determinants of governments' public health responses by focusing on the timing of contamination, the health risk of the population and health quality.
    Keywords: COVID-19,public health,comparative public administration,quality of government
    Date: 2020–05–07
  31. By: Bargain, Olivier (University of Aix-Marseille II); Aminjonov, Ulugbek (University of Bordeaux)
    Abstract: While degraded trust and cohesion within a country are often shown to have large socioeconomic impacts, they can also have dramatic consequences when compliance is required for collective survival. We illustrate this point in the context of the COVID-19 crisis. Policy responses all over the world aim to reduce social interaction and limit contagion. Using data on human mobility and political trust at regional level in Europe, we examine whether the compliance to these containment policies depends on the level of trust in policy makers prior to the crisis. Using a double difference approach around the time of lockdown announcements, we find that high-trust regions decrease their mobility related to non-necessary activities significantly more than low-trust regions. We also exploit country and time variation in treatment using the daily strictness of national policies. The efficiency of policy stringency in terms of mobility reduction significantly increases with trust. The trust effect is nonlinear and increases with the degree of stringency. We assess how the impact of trust on mobility potentially translates in terms of mortality growth rate.
    Keywords: COVID-19, political trust, policy stringency
    JEL: H12 I12 I18 Z18
    Date: 2020–05
  32. By: Laurent Miclo (IMT - Institut de Mathématiques de Toulouse UMR5219 - UT1 - Université Toulouse 1 Capitole - INSA Toulouse - Institut National des Sciences Appliquées - Toulouse - INSA - Institut National des Sciences Appliquées - UT2J - Université Toulouse - Jean Jaurès - UT3 - Université Toulouse III - Paul Sabatier - Université Fédérale Toulouse Midi-Pyrénées - CNRS - Centre National de la Recherche Scientifique, TSE - Toulouse School of Economics - EHESS - École des hautes études en sciences sociales - CNRS - Centre National de la Recherche Scientifique - UT1 - Université Toulouse 1 Capitole - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement); Daniel Spiro (Department of Economics, Uppsala University.); Jörgen Weibull (X-DEP-ECO - Département d'Économie de l'École Polytechnique - X - École polytechnique, SSE/ECON - Department of Economics, Stockholm School of Economics - SSE - Stockholm School of Economics)
    Abstract: How much and when should we limit economic and social activity to ensure that the health-care system is not overwhelmed during an epidemic? We study a setting where ICU resources are constrained while suppression is costly (e.g., limiting economic interaction). Providing a fully analytical solution we show that the common wisdom of "flattening the curve", where suppression measures are continuously taken to hold down the spread throughout the epidemic, is suboptimal. Instead, the optimal suppression is discountinuous. The epidemic should be left unregulated in a first phase and when the ICU constraint is approaching society should quickly lock down (a discontinuity). After the lockdown regulation should gradually be lifted, holding the rate of infected constant thus respecting the ICU resources while not unnecessarily limiting economic activity. In a final phase, regulation is lifted. We call this strategy "filling the box". * We wish to thank Tommy Andersson, Hannes Malmberg and Robert Östling for valuable comments.
    Date: 2020–05–05
  33. By: Andrew Glover; Jonathan Heathcote; Dirk Krueger; Jose-Victor Rios-Rull
    Abstract: To slow the spread of COVID-19, many countries are shutting down nonessential sectors of the economy. Older individuals have the most to gain from slowing virus diffusion. Younger workers in sectors that are shuttered have the most to lose. In this paper, we build a model in which economic activity and disease progression are jointly determined. Individuals differ by age (young and retired), by sector (basic and luxury), and by health status. Disease transmission occurs in the workplace, in consumption activities, at home, and in hospitals. We study the optimal economic mitigation policy of a utilitarian government that can redistribute across individuals, but where such redistribution is costly. We show that optimal redistribution and mitigation policies interact, and reflect a compromise between the strongly diverging preferred policy paths of different subgroups of the population. We find that the shutdown in place on April 12 is too extensive, but that a partial shutdown should remain in place through July. People prefer deeper and longer shutdowns if a vaccine is imminent, especially the elderly.
    Keywords: Redistribution; COVID-19; Economic policy; Pandemic; Shutdowns
    JEL: J08 J23 J63 J78
    Date: 2020–05–10
  34. By: Henry Zhao; Zhilan Feng; Carlos Castillo-Chavez; Simon A. Levin
    Abstract: Strong social distancing restrictions have been crucial to controlling the COVID-19 outbreak thus far, and the next question is when and how to relax these restrictions. A sequential timing of relaxing restrictions across groups is explored in order to identify policies that simultaneously reduce health risks and economic stagnation relative to current policies. The goal will be to mitigate health risks, particularly among the most fragile sub-populations, while also managing the deleterious effect of restrictions on economic activity. The results of this paper show that a properly constructed sequential release of age-defined subgroups from strict social distancing protocols can lead to lower overall fatality rates than the simultaneous release of all individuals after a lockdown. The optimal release policy, in terms of minimizing overall death rate, must be sequential in nature, and it is important to properly time each step of the staggered release. This model allows for testing of various timing choices for staggered release policies, which can provide insights that may be helpful in the design, testing, and planning of disease management policies for the ongoing COVID-19 pandemic and future outbreaks.
    Date: 2020–05
  35. By: Andersen, Torben M. (Aarhus University); Schröder, Philipp J. H. (Aarhus University); Svarer, Michael (Aarhus University)
    Abstract: Governments across the globe have responded to the threat of the Covid-19 virus by imposing substantial lockdown measures largely guided by epidemiological concerns. These lockdowns come at significant economic costs with increased risk of e.g. mass unemployment. Recently, debates have emerged on how to design reopening strategies that achieve the largest possible economic gains while constraining the spread of the virus. The present paper identifies five central challenges economists face in delineating the trade-off between containing the virus from spreading and the economic consequences and costs of lockdown measures. While the principle of tradeoffs is at the core of economics, the road to actually operationalizing this perspective on Covid-19-related lockdown measures is still unpaved. We present several workarounds to the identified challenges based on a recently prepared economic expert assessment commissioned by the Danish government. A reduced form indicator for virus spread pressure is developed and mapped against economic indicators. The resulting tool captures the trade-off between health and economic concerns and can guide the design of reopening strategies.
    Keywords: COVID-19, reopening strategies, fiscal response
    JEL: A1 H3
    Date: 2020–05
  36. By: Persico, Claudia (American University); Johnson, Kathryn R. (American University)
    Abstract: The COVID-19 virus, also known as the coronavirus, is currently spreading around the world. While a growing literature suggests that exposure to pollution can cause respiratory illness and increase deaths among the elderly, little is known about whether increases in pollution could cause additional or more severe infections from COVID-19, which typically manifests as a respiratory infection. Using variation in pollution induced by a rollback of enforcement of environmental regulations by the Environmental Protection Agency (EPA) and a difference in differences design, we estimate the effects of increased pollution on county-level COVID-19 deaths and cases. Despite popular media coverage to the contrary, we find that counties with more Toxic Release Inventory (TRI) sites saw increases in pollution following the EPA's rollback of enforcement, while counties with fewer sites saw a smaller increase in pollution. We find that increases in pollution are associated with increases in cases and deaths from COVID-19.
    Keywords: pollution, COVID-19, coronavirus, health, mortality
    JEL: Q53 I10 I14
    Date: 2020–05
  37. By: Roberto Antonietti (“Marco Fanno” Department of Economics and Management, University of Padova, Italy); Paolo Falbo (Department of Economics, University of Brescia, Italy); Fulvio Fontini (“Marco Fanno” Department of Economics and Management, University of Padova, Italy)
    Abstract: This study concerns the relationship between economic wealth, air quality and COVID-19 diffusion and mortality around the world. We show that the level of air quality, in terms of particulate (PM 2.5) concentrations, does not significantly contribute to explaining the diffusion of COVID-19 and the related mortality after accounting for socioeconomic factors, especially per capita GDP. This latter variable significantly correlates with the diffusion of COVID-10 and related mortality, and the result holds for different times when COVID-19 infections and deaths are counted. When we cluster countries by level of wealth, economic openness, macroeconomic structure, CO2 emissions, and climate conditions, we find that higher concentrations of PM 2.5 coincide with more infections and deaths, but only holds in high-income countries.
    Keywords: COVID-19, pollution, PM2.5, wealth, cross-country analysis
    JEL: I10 Q50 Q53
    Date: 2020–05
  38. By: Zhixian Lin; Christopher M. Meissner
    Abstract: We study the impact of non-pharmaceutical policy interventions (NPIs) like “stay-at-home” orders on the spread of infectious disease. NPIs are associated with slower growth of Covid-19 cases. NPIs “spillover” into other jurisdictions. NPIs are not associated with significantly worse economic outcomes measured by job losses. Job losses have been no higher in US states that implemented “stay-at-home” during the Covid-19 pandemic than in states that did not have “stay-at-home”. All of these results demonstrate that the Covid-19 pandemic is a common economic and public health shock. The tradeoff between the economy and public health today depends strongly on what is happening elsewhere. This underscores the importance of coordinated economic and public health responses.
    JEL: E24 E3 Z18
    Date: 2020–05
  39. By: Brodeur, Abel (University of Ottawa); Clark, Andrew E. (Paris School of Economics); Flèche, Sarah (Aix-Marseille University); Powdthavee, Nattavudh (University of Warwick)
    Abstract: The COVID-19 pandemic has led many governments to implement lockdowns. While lockdowns may help to contain the spread of the virus, they may result in substantial damage to population well-being. We use Google Trends data to test whether the lockdowns implemented in Europe and America led to changes in well-being related topic search terms. Using differences-in-differences and a regression discontinuity design to evaluate the causal effects of lockdown, we find a substantial increase in the search intensity for boredom in Europe and the US. We also found a significant increase in searches for loneliness, worry and sadness, while searches for stress, suicide and divorce on the contrary fell. Our results suggest that people's mental health may have been severely affected by the lockdown.
    Keywords: boredom, COVID-19, loneliness, well-being
    JEL: I12 I31 J22
    Date: 2020–05
  40. By: Louis-Philippe Beland (Department of Economics, Carleton University); Abel Brodeur (Department of Economics, University of Ottawa); Derek Mikola (Department of Economics, Carleton University); Taylor Wright (Department of Economics, University of Ottawa)
    Abstract: In this paper, we document the short-term impact of COVID-19 on labour market outcomes in Canada. Following a pre-analysis plan, we investigate the negative impact of the pandemic on unemployment, labour force participation, hours and wages in Canada. We find that COVID-19 had drastic negative effects on labour market outcomes, with the largest effects for younger, not married, and less educated workers. We investigate whether the economic consequences of this pandemic were larger for certain occupations. We then built indices for whether (1) workers are relatively more exposed to disease, (2) work with proximity to coworkers, (3) are essential workers, and (4) can easily work remotely. Our estimates suggest that the impact of the pandemic was significantly more severe for workers more exposed to disease and workers that work in proximity to coworkers, while the effects are significantly less severe for essential workers and workers that can work remotely. Last, we rely on a unique survey, the Canadian Perspective Survey, and show that reported mental health is significantly lower among the most affected workers during the pandemic. We also find that those who were absent form work because of COVID-19 are more concerned with meeting their financial obligations and with losing their job than those who remain working outside of home, while those who transition from working outside the home to from home are not as concerned with job loss.
    Keywords: COVID-19; unemployment; wages; remote work; essential workers; exposure to disease
    JEL: I15 I18 J21
    Date: 2020–05–12
  41. By: Pablo de Pedraza (JRC European Commission and GLO); Martin Guzi (Masaryk University, CELSI, IZA and GLO); Kea Tijdens (AIAS University of Amsterdam and GLO)
    Abstract: The rising numbers of COVID-19 cases and deaths, prolonged lockdowns, substantial restrictions on public life and an economic downturn negatively affect personal well-being. In this paper, we explore COVID-19-related determinants of life dissatisfaction and feelings of anxiety using data collected from March 23 to April 30 2020 in 25 advanced and developing countries from four continents. We find that persons with better general health, with a paid job, living with a partner, daily exercising and those avoiding loneliness report less dissatisfaction and less anxiety. The presence of children and a pet in the household has no effect. Women report anxiety feelings more often than men. Older people report lower dissatisfaction and anxiety, remarkable given that the older population is among the most vulnerable in the current pandemic. Job-related changes due to COVID-19 such as income reduction and increase or decrease of workload are associated with more dissatisfaction and more anxiety. In reaction to the pandemic governments have adopted a range of measures. We show that restrictions on mobility and requirements to wear protective gear in public increase dissatisfaction and that the state-imposed emergency increase feelings of anxiety. We find that a growing number of confirmed COVID-19 cases increases dissatisfaction and anxiety but that this effect levels off with a higher number of cases. Our findings support targeted government policies to preserve economic security, and increase stability of employment.
    Keywords: Covid-19; life dissatisfaction; anxiety; public policy
    JEL: I31 I38 P51 D6
    Date: 2020–05
  42. By: Davillas, Apostolos; Jones, Andrew M.
    Abstract: We use data from Wave 9 of UK Household Longitudinal Study (UKHLS) and the April 2020 Wave of the UKHLS COVID-19 survey to compare measures of ex ante inequality of opportunity (IOp) in psychological distress, as measured by the General Health Questionnaire (GHQ), before (Wave 9) and at the initial peak (April 2020) of the pandemic. Based on a Caseness measure, the prevalence of psychological distress increases from 18.3% to 28.3% between Wave 9 and April 2020. Also, there is a systematic increase in total inequality in the Likert GHQ-12 score. However, measures of IOp have not increased. Specifically, the proportion of total inequality attributed to circumstances has declined, consistent with the notion that the pandemic is, to some extent, a leveller as far as psychological distress is considered. A Shapley-Shorrocks decomposition analysis shows that in the pre-COVID-19 period the largest contributors to IOp were financial strain, employment status and housing conditions. In contrast, in April 2020, these factors decline in their shares and age and gender now account for a larger share. The contribution of working in an industry related to the COVID-19 response plays a small role at Wave 9, but more than triples its share in April 2020. Household composition and parental occupation also increase their shares during the pandemic.
    Date: 2020–06–02
  43. By: Abigail Wozniak
    Abstract: This paper uses a unique large-scale survey administered in April 2020 to assess disparities on several dimensions of wellbeing under rising COVID-19 infections and mitigation restrictions in the US. The survey includes three modules designed to assess different dimensions of well-being in parallel: physical health, mental and social health, and economic and financial security. The survey is unique among early COVID-19 data efforts in that provides insight on diverse dimensions of wellbeing and for subnational geographies. I find dramatic declines in wellbeing from pre-COVID baseline measures across both people and places. Place-level variation is not well explained by local characteristics that either precede or coincide with the pandemic. Analysis by demographic groups also shows large and unequal declines in wellbeing in the COVID era. Hispanic, younger, and lower-earning individuals all faced disproportionately worsening economic conditions, as did those with school-aged children. I conclude that place-based relief policies are unlikely to be efficient relative to support targeted to the neediest individuals. I also find that individual COVID-19 exposure and risk show concerning relationships with employment, protective behavior, and mental health. Those with direct COVID-19 exposure through their households face significantly greater employment loss, but those with recent fever symptoms or elevated risk for COVID complications are not reducing their work hours or taking additional precautions, despite negative mental health status changes indicating concern. These findings suggest that some support policies might be directly targeted to households with confirmed infections.
    Keywords: COVID-19; coronavirus
    JEL: I1 I15 I18 J10 J15 J38
    Date: 2020–05–13
  44. By: Sonja Settele (CEBI, Department of Economics, University of Copenhagen); Cortnie Shupe (CEBI, Department of Economics, University of Copenhagen)
    Abstract: We study the role of cost-benefit considerations in driving public acceptance of non-pharmaceutical interventions (NPIs) during the Covid-19 pandemic. In a large-scale online survey experiment with a representative sample of the US population, we introduce exogenous variation in the perceived economic costs and health benefits of shutdown measures by informing a random half of our sample about relevant research evidence. We find that a one standard deviation decrease in perceived economic costs (increase in perceived health benefits) of shutdown measures increases the preferred shutdown length by 13 (11) days. These effects are substantial, corresponding to two times the effect of having a Covid at-risk condition and to approximately half of the Democrat-Republican difference in the support of NPIs. Individuals with an acute and immediate personal exposure to the crisis, either in the form of health at-risk conditions or job loss, however, are less responsive to cost-benefit considerations. Our results provide insights into the mechanisms determining public acceptance of pandemic response measures.
    Keywords: COVID-19, non-pharmaceutical interventions, beliefs, tradeoffs
    JEL: C91 D01 D9 H12
    Date: 2020–05–25
  45. By: Asger Lau Andersen; Emil Toft Hansen; Niels Johannesen; Adam Sheridan
    Abstract: This paper uses transaction data from a large bank in Scandinavia to estimate the effect of social distancing laws on consumer spending in the COVID-19 pandemic. The analysis exploits a natural experiment to disentangle the effects of the virus and the laws aiming to contain it: Denmark and Sweden were similarly exposed to the pandemic but only Denmark imposed significant restrictions on social and economic activities. We estimate that aggregate spending dropped by around 25 percent in Sweden and, as a result of the shutdown, by 4 additional percentage points in Denmark. This implies that most of the economic contraction is caused by the virus itself and occurs regardless of social distancing laws. The age gradient in the estimates suggest that social distancing reinforces the virus-induced drop in spending for low health-risk individuals but attenuates it for high-risk individuals by lowering the overall prevalence of the virus in the society.
    Date: 2020–05
  46. By: Brodeur, Abel (University of Ottawa); Grigoryeva, Idaliya (Stanford University); Kattan, Lamis (University of Ottawa)
    Abstract: Better understanding whether and how communities respond to government decisions is crucial for policy makers and health officials in response to the COVID-19 pandemic. In this study, we document the socioeconomic determinants of COVID-19 stay-at-home orders' compliance in the U.S. Using cell phone data measuring changes in average distance traveled and non-essential visitation, we find that: stay-at-home orders reduce mobility by about 8­–10 percentage points; high-trust counties decrease their mobility significantly more than low-trust counties post-lockdown; and counties with relatively more self-declared democrats decrease significantly more their mobility. We also provide evidence that the estimated eeffct on compliance post-lockdown is especially large for trust in the press, and relatively smaller for trust in science, medicine or government.
    Keywords: COVID-19, stay-at-home orders, social distancing, trust
    JEL: H12 I12 I18
    Date: 2020–05
  47. By: Simon Porcher (IAE - Institut d'Administration des Entreprises)
    Abstract: Following the COVID-19 outbreak, governments all around the world have implemented public health and economic measures to contain the spread of the virus and to support the economy. Public health measures include domestic lockdown, school closures and bans on mass gatherings among others. Economic measures cover wage support, cash transfers, interest rates cuts, tax cuts and delays, and support to exporters or importers. This paper presents a unique living dataset of governments' responses to COVID-19. The dataset codes the various policy interventions with their dates at the country-level for more than 200 countries in the first quarter of 2020. The generation of detailed data on the measures taken by governments can help generate robust evidence to support public health and economic decision making.
    Date: 2020–05–07
  48. By: Murray, Gregg R. (Augusta University); Murray, Susan M. (Augusta University)
    Abstract: Public health experts widely and strongly advocate for aggressive social distancing to slow the spread of serious infectious diseases. While government mandates to social distance protect public health, they can also impose substantial social and economic costs on those subject to them. As a result, government leaders may be reluctant to issue such mandates. The objective of this study is to identify political, social, economic, and scientific factors that influence governors of U.S. states to issue stay-at-home orders (SAHOs) or not to slow the spread of coronavirus disease 2019 (COVID-19). It uses event history analysis to investigate the issuance of COVID-19-related gubernatorial SAHOs in the 50 U.S. states from March 1, 2020, the day after the first reported COVID-19-related death in the U.S., to April 10, 2020, several days after the last SAHO was issued. During this 41-day period, 42 of the 50 governors issued such orders affecting more than 90 percent of the country’s residents. The results indicate that scientific factors alone did not inform governors’ decisions. While public health factors related to the spread of the disease informed these decisions, political factors related to the partisanship of the governor and economic factors related to the health of the economy also informed them. The results also provide mixed support for scientific factors related to state healthcare capacity and external factors related to geographic diffusion.
    Date: 2020–05–05
  49. By: Anthony Terriau (GAINS - Groupe d'Analyse des Itinéraires et des Niveaux Salariaux - UM - Le Mans Université); Arthur Poirier (GAINS - Groupe d'Analyse des Itinéraires et des Niveaux Salariaux - UM - Le Mans Université); Julien Albertini (GATE Lyon Saint-Étienne - Groupe d'analyse et de théorie économique - ENS Lyon - École normale supérieure - Lyon - UL2 - Université Lumière - Lyon 2 - UCBL - Université Claude Bernard Lyon 1 - Université de Lyon - UJM - Université Jean Monnet [Saint-Étienne] - Université de Lyon - CNRS - Centre National de la Recherche Scientifique); Quentin Le Bastard (MiHAR - Microbiotes, Hôtes, Antibiotiques et Résistances bactériennes (MiHAR) - UFR MEDECINE - Université de Nantes - UFR de Médecine et des Techniques Médicales - UN - Université de Nantes)
    Abstract: In response to the coronavirus disease (COVID-19) pandemic, governments have adopted a variety of public health measures. In this study, we aimed to evaluate the impact of testing on the fatality rate. We use data on inpatients across French geographic areas and propose a novel methodology that exploits policy discontinuities at region borders to estimate the effect of testing symptomatic individuals on the case-fatality rate in France. Our identification strategy is based on the fact that, in France, testing policies are determined regionally by the Regional Public Health Agencies. We compare all contiguous department pairs located on the opposite sides of a region border. Department pairs have different testing rates but share similar health trends. The heterogeneity in testing rate between department pairs together with the similarities in other dimensions allow us to mimic the existence of treatment and control groups and to identify the impact of testing on the mortality rate. We find that in France, the increase of one percentage point in the test rate is associated with a decrease of 0.001 percentage point in the death rate. Putting this number into perspective involves that for each additional 1000 tests, one person would have remained alive.
    Keywords: tests,Covid-19,Case-fatality rate,Fixed-effects model
    Date: 2020
  50. By: Sa, Filipa (King's College London)
    Abstract: I use simple correlations and regression analysis to study how the number of confirmed Covid-19 cases and the number of deaths with Covid-19 per 100,000 people is related with the socioeconomic characteristics of local areas in England and Wales. I find that local areas that have larger households, worse levels of self-reported health and a larger fraction of people using public transport have more Covid-19 infections per 100,000 people. For mortality, household size and use of public transport are less important, but there is a clear relation with age, ethnicity and self-reported health. Local areas with an older population, a larger share of black or Asian population and worse levels of self-reported health have more Covid-19 deaths per 100,000 people. To prevent the spread of infection and reduce mortality, policymakers should introduce measures to improve housing conditions and improve the health of the population. Also, as many countries now begin to relax lockdown measures, they should pay particular attention to reducing the risk of infection in public transport.
    Keywords: COVID-19
    JEL: I1
    Date: 2020–05
  51. By: Raymond Boadi Frempong; David Stadelmann; Frederik Wild
    Abstract: Pandemics and the reactions to pandemics increase the general problem of scarcity. Scarcity induced trade-offs are particularly relevant for countries in Sub-Saharan Africa as (1) the region suffers from numerous other diseases whose death toll may increase substantially due to lockdowns, (2) economic effects of lockdowns affect the region more negatively because citizens in Sub-Saharan Africa have limited economic resources compared to more developed economies, and (3) weak institutions may increase the adverse societal impacts of the pandemic.
    Keywords: Pandemics; General health; Economic effects; Institutions; Sustainability
    JEL: I10 O10
    Date: 2020–06

This nep-hea issue is ©2020 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.