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on Health Economics |
| By: | Conti, Gabriella (University College London); Hanson, Mark (University of Southampton); Inskip, Hazel (University of Southampton); Crozier, Sarah (University of Southampton); Cooper, Cyrus (University of Southampton); Godfrey, Keith (University of Southampton) |
| Abstract: | Birth weight is the most widely used indicator of neonatal health, mainly because it is routinely recorded in birth registries. But are better measures available? We use unique data including fetal ultrasounds to show that more specific measures of the fetus and of the newborn are more informative about the prenatal environment and more predictive of child health and development, beyond birth weight. Our results are robust to correcting for measurement error and accounting for child- and mother-specific unobserved heterogeneity. Our analysis rationalizes a common finding in the early origins literature, that prenatal events can influence postnatal development without aecting birth outcomes. |
| Keywords: | birth weight, fetal development, child health, developmental origins, measurement |
| JEL: | I12 J13 J24 |
| Date: | 2020–05 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp13296&r=all |
| By: | Peter Savelyev (The College of William & Mary); Benjamin Ward; Bob Krueger (University of Minnesota); Matthew McGue (University of Minnesota) |
| Abstract: | We analyze data from the Minnesota Twin Registry (MTR), combined with the Socioeconomic Survey of Twins (SST), and new mortality data, and contribute to two bodies of literature. First, we demonstrate a beneficial casual effect of education on health and longevity in contrast to other twin-based studies of the US population, which show little or no effect of education on health. Second, we present evidence that parents compensate for differences in their children’s health endowments through education, but find no evidence that parents reinforce differences in skill endowments. We argue that there is a bias towards detecting reinforcement both in this paper and in the literature. Our compensation result for health endowment holds, as it is obtained despite the bias. We account for observed and unobserved confounding factors, sample selection bias, and measurement error in education. |
| Keywords: | skill endowment, intrafamily resource allocation, education, longevity, twin study |
| JEL: | I12 I14 I24 J13 J24 |
| Date: | 2020–05 |
| URL: | http://d.repec.org/n?u=RePEc:hka:wpaper:2020-040&r=all |
| By: | Agar Brugiavini (Department of Economics, University Of Venice Cà Foscari); Raluca Elena Buia (Department of Economics, University Of Venice Cà Foscari); Matija Kovacic (European Commission, Joint Research Centre (JRC); Department of Economics, University Of Venice Cà Foscari); Cristina Elisa Orso (Department of Economics, University Of Verona) |
| Abstract: | In this paper we investigate whether exposure to adverse experiences during childhood such as physical and emotional abuse affects the likelihood of unhealthy habits and separately the insurgency of chronic diseases and disabilities later in life. The novelty of our approach consists in exploiting the recently published data on adverse childhood experiences for 19 SHARE countries, which enables us to account for country-specific heterogeneity and investigate the long-run effects of exposure to adverse early-life circumstances on risk behaviour such as smoking, drinking, overweight and obesity. Our results highlight a significant positive effect of exposure to adverse childhood experiences (ACEs) on the probability of unhealthy lifestyles as well as on the insurgency of chronic diseases and disabilities in the long run. |
| Keywords: | Adverse Childhood Experiences, Smoking Behaviour, Heavy drinking, Obesity |
| JEL: | H4 I12 |
| Date: | 2020 |
| URL: | http://d.repec.org/n?u=RePEc:ven:wpaper:2020:08&r=all |
| By: | Manuel Flores Mallo; Barbara L. Wolfe |
| Abstract: | We expand on earlier studies investigating the links between early health and later health by including different dimensions of early-life health and multiple life course outcomes consisting of the age of onset of serious cardiovascular diseases (CVDs) and multiple job-related health outcomes. The four dimensions of childhood health are mental, physical, self-rated general health and severe headaches or migraines. The data set we use includes 21 countries from the Survey of Health, Ageing and Retirement in Europe. We find that the different dimensions of childhood health have unique ties to later outcomes. For men, early mental health problems play a stronger role for life course job-related health outcomes, but early poor or fair general health is more strongly linked to the spike in onset of CVDs in their late 40s. For women, these links between childhood health dimensions and life course outcomes are less clear-cut than for men. The spike in onset of CVDs in their late 40s is driven by those with severe headaches or migraines while those with early physical health problems generally do better as captured by job-related outcomes. We also explore and control for possible mediating factors and assess the importance of omitted variables using a test proposed by Oster (2019). |
| JEL: | D1 I10 I14 J0 |
| Date: | 2020–05 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:27174&r=all |
| By: | Martin Gaynor; Nirav Mehta; Seth Richards-Shubik |
| Abstract: | We study physician agency and optimal payment policy in the context of an expensive medication used in dialysis care. Using Medicare claims data we estimate a structural model of treatment decisions, in which physicians differ in their altruism and marginal costs, and this heterogeneity is unobservable to the government. In a novel application of nonlinear pricing methods, we theoretically characterize the optimal unrestricted contract in this screening environment with multidimensional heterogeneity. We combine these results with the estimated model to construct the optimal contract and simulate counterfactual outcomes. The optimal contract is a flexible fee-for-service contract, which pays for reported treatments but uses variable marginal payments instead of constant reimbursement rates, resulting in substantial health improvements and reductions in costs. Our structural approach also yields important qualitative findings, such as rejecting the optimality of any linear contract, and may be employed more broadly to analyze a variety of applications. |
| JEL: | D86 H51 I11 I13 I18 L14 |
| Date: | 2020–05 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:27172&r=all |
| By: | Karine Lamiraud (Essec Business School); Pierre Stadelmann |
| Abstract: | Our article deals with pricing strategies in Swiss health insurance markets and focuses on the relationship between basic and supplementary insurance. We analyzed how firms' pricing strategies (i.e., pricing of basic and supplementary products) can create switching costs in basic health insurance markets, thereby preventing competition in basic insurance from working properly. More specifically, using unique market and survey data, we investigated whether firms use bundling strategies or supplementary products as low-price products to attract and retain basic insurance consumers. To our knowledge, this is the first paper to analyze these pricing strategies in the context of insurance/health insurance. We found no evidence of bundling in the Swiss setting. We did however observe that firms used low-price supplementary products that contributed to lock in consumers. A majority of firms offered at least one of such product at a low price. None offered low-price products in both basic and supplementary markets. Low-price insurance products differed across firms. When buying a lowprice supplementary product, consumers always bought their basic contract from the same firm. Furthermore, those who opted for low-price supplementary products were less likely to declare an intention to switch basic insurance firms in the near future. This result was true for all risk category levels. |
| Keywords: | Managed Competition,Swiss Health Care Systems,Pricing,Consumer Inertia,Switching Costs,Supplementary Insurance,low-price supplementary product,Bundling |
| Date: | 2020–05–13 |
| URL: | http://d.repec.org/n?u=RePEc:hal:wpaper:hal-02635107&r=all |
| By: | Kim, Seonghoon (Singapore Management University); Koh, Kanghyock (Korea University) |
| Abstract: | We examine the health impacts of early access to public pension wealth by exploiting a unique policy in Singapore allowing individuals to withdraw a proportion of their pension savings after their 55th birthday. For the identification, we employ a regression discontinuity design by comparing individuals before and after their 55th birthday. To address anticipated and lagged health impacts, we adopt the donut regression discontinuity approach. Using nationally representative monthly panel data, we find that early access to pension wealth improves self-reported overall health. |
| Keywords: | regression discontinuity design, early access to pension wealth, health |
| JEL: | I10 H55 |
| Date: | 2020–04 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp13184&r=all |
| By: | Folke, Olle; Rickne, Johanna |
| Abstract: | This paper offers a comprehensive empirical analysis of sexual harassment in the Swedish labor market. First, we use nationally representative survey data linked with employer-employee data to describe rates of self-reported sexual harassment across occupations and workplaces. The risk of 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 hypothetical job-choice experiment with vignettes for sexual harassment to measure the disutility of sexual harassment risks. Both men and women have an equally high willingness to pay for avoiding workplaces where sexual harassment has occurred. But the willingness to pay is conditional on the sex of the fictional harassment victim. People reject workplaces where the victim is the same sex as themselves, but not where the victim is of the opposite sex. We return to the administrative data to study employer compensation for the disutility of sexual harassment risks. Within workplaces, a high risk is associated with lower, not higher wages. People who self-report sexual harassment 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 harassment should be conceptualized as gender discrimination in workplace amenities, and that this discrimination 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 |
| URL: | http://d.repec.org/n?u=RePEc:cpr:ceprdp:14737&r=all |
| By: | Yann Algan (Département d'économie); Fabrice Murtin (Economics department); Elizabeth Beasley; Kazuhito Higad (Organisation de Coopération et de Développement Économiques (OCDE)); Claudia Senik (Paris-Jourdan Sciences Economiques) |
| Abstract: | We build models to estimate well-being in the United States based on changes in the volume of internet searches for different words, obtained from the Google Trends website. The estimated well-being series are weighted combinations of word groups that are endogenously identified to fit the weekly subjective well-being measures collected by Gallup Analytics for the United States or the biannual measures for the 50 states. Our approach combines theoretical underpinnings and statistical analysis, and the model we construct successfully estimates the out-of-sample evolution of most subjective well-being measures at a one-year horizon. Our analysis suggests that internet search data can be a complement to traditional survey data to measure and analyze the well-being of a population at high frequency and local geographic levels. We highlight some factors that are important for well-being, as we find that internet searches associated with job search, civic participation, and healthy habits consistently predict well-being across several models, datasets and use cases during the period studied. |
| Date: | 2019–01 |
| URL: | http://d.repec.org/n?u=RePEc:spo:wpmain:info:hdl:2441/63csdfkqvu9nfanvuffe3qk8r6&r=all |
| By: | Dolan, Paul; Lordan, Grace |
| Abstract: | We examine how intergenerational mobility impacts on subjective wellbeing (SWB) drawing on data from the British Cohort Study. Our SWB measures encapsulate both life satisfaction and mental health, and we consider both relative and absolute movements in income. We find that relative income mobility is a significant predictor of life satisfaction and mental health, whether people move upward or downward. For absolute income, mobility is only a consistent predictor of SWB and mental health outcomes if the person moves downwards, and in this case the impact is far larger than relative mobility. For both relative and income mobility, downward movements impact SWB to a greater extent than upward movements, consistent with exhibiting loss aversion. Notably, we find that social class mobility does not affect SWB. We present evidence that the significant relative and absolute mobility effects we find operate partially through financial perceptions and consumption changes which can occur because of income mobility. |
| Keywords: | income mobility; life satisfaction; mental health; social class mobility; subjective wellbeing |
| JEL: | D31 D63 J60 |
| Date: | 2020–05–14 |
| URL: | http://d.repec.org/n?u=RePEc:ehl:lserod:104059&r=all |
| By: | Jaime Ruiz-Tagle; Ignacio Urria |
| Abstract: | It has been widely documented that household overcrowding over time negatively affects mental health. However, scant evidence documents this dynamic relationship in the low- and middle- income countries of Latin America, where housing issues remain a relevant policy issue. Employing a nationally representative panel dataset of 10,024 Chilean households, we examine whether variation in household overcrowding levels between 2006 and 2009 is associated with the prevalence of depressive symptoms in 2009. We find that an increase in household overcrowding levels (due to a reduction in the number of bedrooms) is associated with an increase in depressive symptoms, while a constant or decreasing trajectory of household overcrowding over time is not associated with changes in depressive symptoms. These results suggest an asymmetric relationship between household density and mental health over a three-year window and support the implementation of preventive rather than corrective housing policies to address overcrowding. |
| Date: | 2020–05 |
| URL: | http://d.repec.org/n?u=RePEc:udc:wpaper:wp494&r=all |
| By: | Smriti Sharma; Saurabh Singhal; Finn Tarp |
| Abstract: | While there is substantial corruption in developing countries, the costs imposed by corruption on individuals and households are little understood. This study examines the relationship between exposure to local corruption and mental health, as measured by depressive symptoms. We use two large data sets - one cross-sectional and one panel - collected across rural Vietnam. After controlling for individual and regional characteristics, we find strong and consistent evidence that day-to-day petty corruption is positively associated with psychological distress. Our results are robust to a variety of specification checks. Further, we find that the relationship between corruption and mental health is stronger for women, and that there are no heterogeneous effects by poverty status. Finally, using a difference-in-difference estimation strategy, we provide suggestive evidence that a recent highly proled anti-corruption campaign had significant positive effects on mental health. Overall, our findings suggest that there may be substantial psychosocial and mental health benefits from efforts to reduce corruption and improve rural governance structures. |
| Keywords: | Corruption, mental health, depression, Vietnam |
| JEL: | I3 I15 O12 D73 P3 |
| Date: | 2020 |
| URL: | http://d.repec.org/n?u=RePEc:lan:wpaper:296967914&r=all |
| By: | Eva M. Berger (Johannes Gutenberg University); Ernst Fehr (University of Zurich); Henning Hermes (Norwegian School of Economics); Daniel Schunk (Johannes Gutenberg University); Kirsten Winkel (Johannes Gutenberg University) |
| Abstract: | Working memory capacity is thought to play an important role for a wide range of cognitive and noncognitive skills such as fluid intelligence, math, reading, the inhibition of pre-potent impulses or more general self-regulation abilities. Because these abilities substantially affect individuals’ life trajectories in terms of health, education, and earnings, the question of whether working memory (WM) training can improve them is of considerable importance. However, whether WM training leads to improvements in these far-transfer skills is contested. Here, we examine the causal impact of WM training embedded in regular school teaching by a randomized educational intervention involving a sample of 6–7 years old first graders. We find substantial immediate and lasting gains in working memory capacity. In addition, we document relatively large positive effects on geometry skills, reading skills, Raven’s fluid IQ measure, the ability to inhibit pre-potent impulses and self-regulation abilities. Moreover, these far-transfer effects emerge over time and only become fully visible after 12- 13 months. Finally, we document that 3–4 years after the intervention, the children who received training have a roughly 16 percentage points higher probability of entering the academic track in secondary school. |
| Date: | 2020–06–04 |
| URL: | http://d.repec.org/n?u=RePEc:jgu:wpaper:2015&r=all |
| By: | Carozzi, Felipe (London School of Economics); Roth, Sefi (London School of Economics) |
| Abstract: | In this paper we study the effect of urban density on the exposure of city dwellers to air pollution using data from the United States urban system. Exploiting geological features to instrument for density, we find an economically and statistically significant pollution-density elasticity of 0.13. We also assess the health implications of these estimates and find that doubling density in an average city increases annual mortality costs by $630 per capita. Our findings highlight the possible trade-off between reducing global greenhouse gas emissions, which is associated with denser cities according to prior research, and preserving local air quality and human health within cities. |
| Keywords: | air pollution, cities, density, health |
| JEL: | Q53 R11 I10 |
| Date: | 2020–04 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp13191&r=all |
| By: | Basu, Arnab K. (Cornell University); Byambasuren, Tsenguunjav (Cornell University); Chau, Nancy H. (Cornell University); Khanna, Neha (University of Birmingham) |
| Abstract: | Indoor air pollution (IAP)–predominantly from the use of solid fuel for cooking–is a global health threat, particularly for women and young children, and one of the leading causes of infant deaths worldwide in developing countries. We estimate the causal effect of cooking fuel choice on infant mortality in India, focusing on children under five years of age using pooled cross-sectional data from the National Family Health Survey (NFHS) over the period 1992–2016. To address the potential endogeneity in the relationship between fuel choice and mortality, we instrument for cooking fuel choice using a speed of change in forest cover and ownership status of agricultural land, which induce significant variations in fuel type. We find that cooking fuel choice has a statistically significant impact on under-five and neonatal mortality, raising the mortality risk by 4.9 percent. We also find that the past literature has overestimated the association between under-five mortality and polluting fuel use by about 0.6 percentage points or equivalently, 152,000 deaths per year nationally. Our result is robust to a set of alternative specifications with the inclusion of various controls and different estimation strategies. |
| Keywords: | cooking fuel, indoor air pollution, infant mortality, India |
| JEL: | I18 N35 Q53 |
| Date: | 2020–05 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp13295&r=all |
| By: | Ding, Lanlin; Jones, Andrew M. (University of York); Nie, Peng (Xi’an Jiaotong University) |
| Abstract: | We present a comprehensive analysis of ex ante inequality of opportunity (IOp) in health among Chinese adults aged 60+ and decompose the contributions of different sets of circumstances. Data are drawn from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study (CHARLS) linked with the 2014 CHARLS Life History Survey. We use a range of blood-based biomarkers, and apply a re-centered influence function (RIF) approach and a Shapley-Shorrocks decomposition to partition the contribution of circumstances across different quantiles of the biomarker distributions. We find that IOp accounts for between 3.75% and 29.57% of total health inequality in old age across the range of biomarkers. Shapley-Shorrocks decompositions show that spatial circumstances such as urban/rural residence and province of residence are the dominant determinants of IOp for most of the biomarkers. Distributional decompositions further reveal that the relative contributions to IOp in health of household socioeconomic status and health and nutrition conditions in childhood increase towards the right tails of the distribution for most of the biomarkers, where the clinical risk is focused. |
| Keywords: | biomarkers, CHARLS, China, inequality of opportunity, Shapley-Shorrocks decomposition, unconditional quantile regressions |
| JEL: | D63 I12 I14 |
| Date: | 2020–05 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp13292&r=all |
| By: | Arthur Attema (Erasmus School of Health Policy and Management |Rotterdam]); Han Bleichrodt (Erasmus School of Health Policy and Management |Rotterdam]); Olivier L’haridon (CREM - Centre de recherche en économie et management - UNICAEN - Université de Caen Normandie - NU - Normandie Université - UR1 - Université de Rennes 1 - UNIV-RENNES - Université de Rennes - CNRS - Centre National de la Recherche Scientifique); Stefan Lipman (Erasmus School of Health Policy and Management |Rotterdam]) |
| Abstract: | Quality-Adjusted Life-Years (QALYs) are typically derived from individual preferences over health episodes. This paper reports the first experimental investigation into the effects of collective decision making on health valuations, using both time trade-off (TTO) and standard gamble (SG) tasks. We investigated collective decision making in dyads, by means of a mixed-subjects design where we control for learning effects. Our data suggest that collective decision making has little effect on decision quality, as no effects were observed on decision consistency and monotonicity for both methods. Furthermore, QALY weights remained similar between individual and collective decisions, and the typical difference in elicited weights between TTO and SG was not affected. These findings suggest that consulting with others has little effect on health state valuation, although learning may have. Additionally, our findings add to the literature of the effect of collective decision making, suggesting that no such effect occurs for TTO and SG. |
| Keywords: | Health state valuation,collective decision making,standard gamble,time trade-off |
| Date: | 2020–01–04 |
| URL: | http://d.repec.org/n?u=RePEc:hal:journl:halshs-02435045&r=all |
| By: | Luisa Corrado (University of Rome Tor Vergata, Italy); Roberta Distante (University of Copenhagen & Nordea, Denmark); Majlinda Joxhe (CREA, Université du Luxembourg) |
| Abstract: | We apply a dynamic linear-in-means model to analyze the importance of social ties for the body-weight-related behavior of US youth. Our methodology shows how to estimate peer effects free of the “reflection problem” in a dynamic context where individual- and group-specific unobservable effects are controlled for. Our results show that the main drivers for the body-weight-related behavior are past and peer effects. For individuals who were normal-weight or obese during adolescence, past and peer effects are shown to be both relevant. Peer effects, instead, explain more the variation in the BMI for individuals who were over-weight during adolescence, showing in this way the importance of social interactions for body-weight-related behavior. |
| Keywords: | Over-weight, Obesity, Peer Effects, Social Networks, Personal History, Dynamic Linear-in-means Model |
| JEL: | C01 D10 D71 I19 J11 Z13 |
| Date: | 2019 |
| URL: | http://d.repec.org/n?u=RePEc:luc:wpaper:19-06&r=all |
| By: | Pierre Dubois (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); Paulo Albuquerque (INSEAD - Institut Européen d'administration des Affaires); Oliver Allais (INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement); Céline Bonnet (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); Patrice Bertail (MODAL'X - Modélisation aléatoire de Paris X - UPN - Université Paris Nanterre); Pierre Combris (INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement); Saadi Lahlou (LSE - London School of Economics and Political Science); Nathalie Rigal (UPN - Université Paris Nanterre); Bernard Ruffieux (INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement); Pierre Chandon (INSEAD - Institut Européen d'administration des Affaires) |
| Abstract: | To examine whether four pre-selected front-of-pack nutrition labels improve food purchases in real-life grocery shopping settings, we put 1.9 million labels on 1,266 food products in four categories in 60 supermarkets and analyzed the nutritional quality of 1,668,301 purchases using the FSA nutrient profiling score. Effect sizes were 17 times smaller on average than those found in comparable laboratory studies. The most effective nutrition label, Nutri-Score, increased the purchases of foods in the top third of their category nutrition-wise by 14%, but had no impact on the purchases of foods with medium, low, or unlabeled nutrition quality. Therefore, Nutri-Score only improved the nutritional quality of the basket of labeled foods purchased by 2.5% (-0.142 FSA points). Nutri-Score's performance improved with the variance (but not the mean) of the nutritional quality of the category. In-store surveys suggest that Nutri-Score's ability to attract attention and help shoppers rank products by nutritional quality may explain its performance. |
| Date: | 2020–04 |
| URL: | http://d.repec.org/n?u=RePEc:hal:journl:hal-02562456&r=all |
| By: | Paolo BRUNORI,; Caterina Francesca GUIDI; Alain Trannoy |
| Abstract: | We offer a flexible latent type approach to rank populations according to unequal health opportunities. Building upon the latent-class method proposed by Li Donni et al. (2015), our contribution is to let the number of types vary to obtain an opportunity-inequality curve for a population that gives how the between-type inequality varies with the number of types. A population A is said to have less inequality of opportunity than population B if its curve is statistically below that of population B. This version of the latent class approach allows for a robust ranking of 31 European countries regarding inequality of opportunity in health. |
| Keywords: | Inequality of opportunity, health inequality, latent class, opportunity-inequality curve, self-assessed health |
| JEL: | I14 D63 |
| Date: | 2020 |
| URL: | http://d.repec.org/n?u=RePEc:frz:wpaper:wp2020_01.rdf&r=all |
| By: | Andrew Goodman-Bacon; Jan Marcus |
| Abstract: | Policymakers have implemented a wide range of non-pharmaceutical interventions to fight the spread of COVID-19. Variation in policies across jurisdictions and over time strongly suggests a difference-in-differences (DD) research design to estimate causal effects of counter-COVID measures. We discuss threats to the validity of these DD designs and make recommendations about how researchers can avoid bias, interpret results accurately, and provide sound guidance to policymakers seeking to protect public health and facilitate an eventual economic recovery. |
| Keywords: | Difference-in-differences, non-pharmaceutical interventions, COVID-19, causal inference |
| JEL: | C1 I18 |
| Date: | 2020 |
| URL: | http://d.repec.org/n?u=RePEc:diw:diwwpp:dp1870&r=all |
| By: | Adam S. Posen (Peterson Institute for International Economics); Maurice Obstfeld (Peterson Institute for International Economics) |
| Abstract: | The world's leading economic powers must cooperate more to combat the health and economic shocks resulting from the COVID-19 pandemic. In a new PIIE Briefing, Peterson Institute experts outline how collective action by the Group of Twenty (G20) nations can make a difference. The PIIE agenda includes removal of trade barriers impeding the flow of medical supplies and food, and more money for research, testing, and disease control, especially for debt-burdened low-income countries. The World Bank and the World Health Organization need more resources to relieve suffering, and the International Monetary Fund must step up to stabilize the world financial system. |
| Date: | 2020–04 |
| URL: | http://d.repec.org/n?u=RePEc:iie:piiebs:piieb20-1&r=all |
| By: | Luiz Brotherhood; Philipp Kircher; Cezar Santos; Michéle Tertilt |
| Abstract: | This paper investigates the role of testing and age-composition in the Covid-19 epidemic. We augment a standard SIR epidemiological model with individual choices regarding how much time to spend working and consuming outside the house, both of which increase the risk of transmission. Individuals who have flu symptoms are unsure whether they caught Covid-19 or simply a common cold. Testing reduces the time of uncertainty. Individuals are heterogeneous with respect to age. Younger people are less likely to die, exacerbating their willingness to take risks and to impose externalities on the old. We explore heterogeneous policy responses in terms of testing, confinements, and selective mixing by age group. |
| Keywords: | Covid-19, testing, social distancing, age-specific policies |
| JEL: | E17 C63 D62 I10 I18 |
| Date: | 2020–05 |
| URL: | http://d.repec.org/n?u=RePEc:bon:boncrc:crctr224_2020_175&r=all |
| By: | Andy Glover (Federal Reserve Bank of Kansas City); Jonathan Heathcote (Federal Reserve Bank of Minneapolis); Dirk Krueger (University of Pennsylvania); Jose Victor Rios-Rull (University of Minnesota) |
| Abstract: | To slow the spread of COVID-19, many countries are shutting down non-essential 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 the fall. People prefer deeper and longer shutdowns if a vaccine is imminent, especially the elderly. |
| Keywords: | COVID-19, economic policy, redistribution |
| JEL: | I14 I18 J14 J17 |
| Date: | 2020–05 |
| URL: | http://d.repec.org/n?u=RePEc:hka:wpaper:2020-038&r=all |
| By: | Colvin, Christopher L.; McLaughlin, Eoin |
| Abstract: | Using the Irish experience of the Spanish flu, we demonstrate that pandemic mortality statistics are sensitive to the demographic composition of a country. We build a new demographic database for Ireland's 32 counties with vital statistics on births, ageing, migration and deaths. We then show how age-at-death statistics in 1918 and 1919 should be reinterpreted in light of these data. Our new estimates suggest the very young were most impacted by the flu. New studies of the economic impact of Influenza-18 must better control for demographic factors if they are to yield useful policy-relevant results. Covid-19 mortality statistics must go through a similar procedure so policymakers can better target their public health interventions. |
| Keywords: | demographic economics,pandemics,age-adjusted mortality,Spanish flu,Ireland |
| JEL: | N34 I18 Q54 |
| Date: | 2020 |
| URL: | http://d.repec.org/n?u=RePEc:zbw:qucehw:202004&r=all |
| By: | Mario F. Carillo (Università di Napoli Federico II and CSEF); Tullio Jappelli (Università di Napoli Federico II, CSEF and CEPR) |
| Abstract: | We investigate the link between the 1918 Great Influenza and regional economic growth in Italy, a country in which the measures implemented by public authorities to contain the contagion were limited or ineffective. The pandemic caused about 600,000 deaths in Italy, a death rate of about 1.2%. We find evidence of a strong and significant adverse effect of the pandemic on regional growth. In particular, going from regions with the lowest mortality to those with the highest mortality is associated to a decline in per capita GDP growth of about 6.5%, which dissipated within three years. In line with this finding, we also estimate a small and transitory negative effect of the influenza on industrialization. Our estimates provide an upper bound of the adverse effect of pandemics on local economic growth in the absence of non-pharmaceutical public-health interventions. |
| Keywords: | Great Influenza; regional growth; mortality and growth |
| Date: | 2020–06–04 |
| URL: | http://d.repec.org/n?u=RePEc:sef:csefwp:568&r=all |
| By: | Aguirregabiria, Victor; Gu, Jiaying; Luo, Yao; Mira, Pedro Solbes |
| Abstract: | This paper presents a dynamic structural model to evaluate economic and public health effects of the diffusion of COVID-19, as well as the impact of factual and counterfactual public policies. Our framework combines a SIR epidemiological model of virus diffusion with a structural game of network production and social interactions. The economy comprises three types of geographic locations: homes, workplaces, and consumption places. Each individual has her own set of locations where she develops her life. The combination of these sets for all the individuals determines the economy's production and social network. Every day, individuals choose to work and consume either outside (with physical interaction with other people) or remotely (from home, without physical interactions). Working (and consuming) outside is more productive and generates stronger complementarities (positive externality). However, in the presence of a virus, working outside facilitates infection and the diffusion of the virus (negative externality). Individuals are forward-looking. We characterize an equilibrium of the dynamic network game and present an algorithm for its computation. We describe the estimation of the parameters of the model combining several sources of data on COVID-19 in Ontario, Canada: daily epidemiological data; hourly electricity consumption data; and daily cell phone data on individuals' mobility. We use the model to evaluate the health and economic impact of several counterfactual public policies: subsidies for working at home; testing policies; herd immunity; and changes in the network structure. These policies generate substantial differences in the propagation of the virus and its economic impact. |
| Keywords: | COVID-19; Disease-Specific Public Health Interventions; dynamics; Production and social networks; Production externalities; Virus diffusion |
| JEL: | C57 C73 I18 L14 L23 |
| Date: | 2020–05 |
| URL: | http://d.repec.org/n?u=RePEc:cpr:ceprdp:14750&r=all |
| By: | Andrew W. Lo; Kien Wei Siah; Chi Heem Wong |
| Abstract: | A key driver in biopharmaceutical investment decisions is the probability of success of a drug development program. We estimate the probabilities of success (PoSs) of clinical trials for vaccines and other anti-infective therapeutics using 43,414 unique triplets of clinical trial, drug, and disease between January 1, 2000, and January 7, 2020, yielding 2,544 vaccine programs and 6,829 nonvaccine programs targeting infectious diseases. The overall estimated PoS for an industry-sponsored vaccine program is 39.6%, and 16.3% for an industry-sponsored anti-infective therapeutic. Among industry-sponsored vaccines programs, only 12 out of 27 disease categories have seen at least one approval, with the most successful being against monkeypox (100%), rotavirus (78.7%), and Japanese encephalitis (67.6%). The three infectious diseases with the highest PoSs for industry-sponsored nonvaccine therapeutics are smallpox (100%), cytomegalovirus (CMV) infection (31.8%), and onychomycosis (29.8%). Non-industry-sponsored vaccine and nonvaccine development programs have lower overall PoSs: 6.8% and 8.2%, respectively. Viruses involved in recent outbreaks—Middle East respiratory syndrome (MERS), severe acute respiratory syndrome (SARS), Ebola, and Zika—have had a combined total of only 45 nonvaccine development programs initiated over the past two decades, and no approved therapy to date. These estimates offer guidance both to biopharma investors as well as to policymakers seeking to identify areas most likely to be underserved by private sector engagement and in need of public sector support. |
| JEL: | C01 C13 I1 I11 I13 I15 I18 L65 |
| Date: | 2020–05 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:27176&r=all |
| By: | Viet Phuong La; Thanh-Hang Pham; Manh Toan Ho; Minh Hoang Nguyen; Khanh Linh K.L.P. Nguyen; Thu Trang Vuong; Hong Kong To Nguyen; Trung Tran; Quy Khuc; Manh Tung Ho; Quan-Hoang Vuong |
| Abstract: | Having geographical proximity and a high volume of trade with China, the first country to record an outbreak of the new Coronavirus disease (COVID-19), Vietnam was expected to have a high risk of transmission. However, as of 4 April 2020, in comparison to attempts to containing the disease around the world, responses from Vietnam are seen as prompt and effective in protecting the interests of its citizens, with 239 confirmed cases and no fatalities. This study analyzes the situation in terms of Vietnam's policy response, social media and science journalism. A self-made web crawl engine was used to scan and collect official media news related to COVID-19 between the beginning of January and April 4, yielding a comprehensive dataset of 14,952 news items. The findings shed light on how Vietnam-despite being under-resourced-has demonstrated political readiness to combat the emerging pandemic since the earliest days. Timely communication on any developments of the outbreak from the government and the media, combined with up-to-date research on the new virus by the Vietnamese science community, have altogether provided reliable sources of information. By emphasizing the need for immediate and genuine cooperation between government, civil society and private individuals, the case study offers valuable lessons for other nations concerning not only the concurrent fight against the COVID-19 pandemic but also the overall responses to a public health crisis. |
| Keywords: | Coronavirus; COVID-19; Pandemic; Policy response; Public health system; SARS-CoV-2; Science journalism; Social media; Vietnam |
| Date: | 2020–04 |
| URL: | http://d.repec.org/n?u=RePEc:ulb:ulbeco:2013/307409&r=all |
| By: | Andersson, Tommy (Department of Economics, Lund University); Erlanson , Albin (Department of Economics, University of Essex); Spiro, Daniel (Department of Economics, Uppsala University); Östling, Robert (Department of Economics, Stockholm School of Economics) |
| Abstract: | Abstract: This paper considers a simple model where a social planner can influence the spread-intensity of an infection wave, and, consequently, also the economic activity and population health, through a single parameter. Population health is assumed to only be negatively affected when the number of simultaneously infected exceeds health care capacity. The main finding is that if (i) the planner attaches a positive weight on economic activity and (ii) it is more harmful for the economy to be locked down for longer than shorter time periods, then the optimal policy is to (weakly) exceed health care capacity at some time. |
| Keywords: | Covid-19 pandemic; SI-model; economic activity; health; optimal policy |
| JEL: | E23 E27 E60 E65 |
| Date: | 2020–05–15 |
| URL: | http://d.repec.org/n?u=RePEc:hhs:lunewp:2020_008&r=all |
| By: | Shomesh Chaudhuri; Andrew W. Lo; Danying Xiao; Qingyang Xu |
| Abstract: | In the midst of epidemics such as COVID-19, therapeutic candidates are unlikely to be able to complete the usual multiyear clinical trial and regulatory approval process within the course of an outbreak. We apply a Bayesian adaptive patient-centered model—which minimizes the expected harm of false positives and false negatives—to optimize the clinical trial development path during such outbreaks. When the epidemic is more infectious and fatal, the Bayesian-optimal sample size in the clinical trial is lower and the optimal statistical significance level is higher. For COVID-19 (assuming a static R 0 – 2 and initial infection percentage of 0.1%), the optimal significance level is 7.1% for a clinical trial of a nonvaccine anti-infective therapeutic and 13.6% for that of a vaccine. For a dynamic R 0 decreasing from 3 to 1.5, the corresponding values are 14.4% and 26.4%, respectively. Our results illustrate the importance of adapting the clinical trial design and the regulatory approval process to the specific parameters and stage of the epidemic. |
| JEL: | C11 C12 C44 C54 C9 C93 H12 H51 I1 I11 I12 I15 I18 |
| Date: | 2020–05 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:27175&r=all |
| By: | Quaas, Georg |
| Abstract: | The Robert Koch Institute (RKI) has the goal of „protecting the population from disease and improving their state of health“ (RKI 2017). To this end, it develops research-based concrete recommendations for policy and makes data available to the expert public. Since the April 3, 2020, it has been publishing daily the numbers of corona infections reported by the health authorities, since the April 9, 2020, also the number of deaths from this infection and since April 25, 2020, the estimated number of convalescents. The so-called reproduction number reported since April 7, 2020, have largely superseded all other criteria by which the public health policy is guided. This article shows that the calculation of this figure by the RKI is neither theory-based nor particularly reliable. Nevertheless, there is a simple way to determine this number in the framework of the classic epidemic model (CEM). This study makes explicit important parts of the theoretical background of the CEM with the goal to underline that the method of determining the reproduction number empirically is a theoretically defined matter and cannot be replaced by a phenomenological method. |
| Keywords: | Classic epidemic model, reproduction number, economic cost of health policy |
| JEL: | C32 C61 I18 |
| Date: | 2020–05–30 |
| URL: | http://d.repec.org/n?u=RePEc:pra:mprapa:100780&r=all |
| By: | Baskozos, Giorgos (University of Oxford); Galanis, Giorgos (Goldsmiths, University of London, UK; and Centre for Applied Macroeconomic Analysis, Australian National University; and CRETA, University of Warwick); Di Guilmi, Corrado (University of Technology Sydney, Australia; and Centre for Applied Macroeconomic Analysis, Australian National University) |
| Abstract: | The paper proposes a behavioural-compartmental-epidemiological model with heterogenous agents who choose whether to enact physical distancing practices. Motivated by the evidence on individual physical distancing behaviour during the COVID-19 outbreak, our model extends the standard compartmental-epidemiological models by including endogenous physical distancing behaviour, drawing on discrete choice theory. This approach can account for two important factors : (i) the limited information about the contagion dynamics available for individuals and (ii) the heterogeneity in the individual ability and preferences concerning physical distancing. Despite its simplicity, the model provides policy indications about the timing and size of mitigating policies and the level and quality of information available for the public. |
| Date: | 2020 |
| URL: | http://d.repec.org/n?u=RePEc:wrk:wcreta:58&r=all |
| By: | Eiji Yamamura.; Yoshiro Tsutsui |
| Abstract: | During the COVID-19 epidemic in Japan between March and April 2020, Internet surveys were conducted to construct panel data to investigate changes at the individual level regarding preventive behaviors and mental conditions by surveying the same respondents at different times. Specifically, the difference-in-difference (DID) method was used to explore the impact of the COVID-19 state of emergency declared by the government. Key findings were: (1) the declaration led people to stay home, while also generating anger, fear, and anxiety. (2) The effect of the declaration on the promotion of preventive behaviors was larger than the detrimental effect on mental conditions. (3) Overall, the effect on women was larger than that on men. |
| Date: | 2020–05 |
| URL: | http://d.repec.org/n?u=RePEc:arx:papers:2005.13008&r=all |
| By: | Martin Forster; Emanuela Randon |
| Abstract: | We present a model of infectious disease control which incorporates uncertainty and information. A policy-maker possesses beliefs about the value of a key parameter - we choose the level of herd immunity in the population - and seeks the welfare-maximising level of intervention, accounting for both the public health benefit and economic cost. An approximation to the optimal rule shows that it accounts for interactions between beliefs, the policy-maker's attitude to risk, the production technology and costs, and the weights in the welfare function. We consider the role of information, in the form of expert opinion and scientific advice, in influencing the policy-maker's beliefs and the optimal policy. We assess the framework's potential for advancing the economic modelling of epidemic control. |
| Keywords: | Economics; Epidemics; COVID-19 |
| JEL: | I18 H12 H51 |
| Date: | 2020–05 |
| URL: | http://d.repec.org/n?u=RePEc:yor:yorken:20/05&r=all |
| By: | Gründl, Helmut; Regele, Fabian |
| Abstract: | This Policy Letter outlines a pandemic insurance solution through a pandemic-related 'Insurance Linked Bond'. It would be originated by governments, with a principal amount to cover significant costs resulting from a pandemic. These bonds, which would be traded on a secondary market, generate a risk-adequate return for private and institutional investors that is financed through the insurance premiums paid by the public domain. In case of a pre-defined pandemic trigger event, the principal of the bond becomes available for the originating governments to cover pandemic-related costs. Through this approach, governments can insure themselves against future pandemic-related risks, while funding comes primarily from private and institutional investors. |
| Keywords: | Covid-19-Crisis,catastrophe bond,public private partnership,pandemic insurance |
| Date: | 2020 |
| URL: | http://d.repec.org/n?u=RePEc:zbw:safepl:86&r=all |
| By: | Kim De Boeck; Catherine Decouttere; Jónas Oddur Jónasson; nico Vandaele |
| Abstract: | Immunization is widely recognized as one of the most successful and cost-effective health interventions, preventing two to three million deaths from vaccine-preventable diseases each year. Although progress has been made in recent years, substantial operational challenges persist in resource-limited settings with frequent stock-outs contributing to sub-optimal immunization coverage and inequality in vaccine access. In this paper, we investigate the role of rainy season induced supply chain disruptions on vaccination coverage and inequalities. We develop a modeling framework combining spatial modeling--to predict flood disruptions in road networks--and a discrete-event simulation of a multi-tiered vaccine supply chain (VSC). Our models are fitted and validated using data from the Malagasy VSC network. Our baseline simulation predicts the national vaccination coverage with good accuracy and suggests that 67% of regions with low reported immunization coverage are affected by rainy season disruptions or operational inefficiencies, causing significant geographical inequalities in vaccine access. We investigate various mitigation strategies to increase the resiliency of VSCs and find that by strategically placing buffer inventory at targeted facilities prior to the rainy season the proportion of children receiving all basic vaccines in these areas is increased by 7% and the geographical inequality in vaccination coverage is reduced by 11%. By also increasing the replenishment frequency from every third month to every month, the national vaccination coverage improves by 37%. Our results contribute to achieving the UN Sustainable Development Goals (SDGs) by providing actionable insights for improving vaccination coverage (SDG 3) and investigating the resiliency of the VSC to increased flooding due to climate change (SDG 13). |
| Date: | 2020 |
| URL: | http://d.repec.org/n?u=RePEc:ete:kbiper:654662&r=all |
| By: | FitzRoy, Felix (University of St. Andrews); Spencer, David (University of Leeds) |
| Abstract: | This review of UK economic policy responses to the Covid-19 crisis identifies serious problems with existing measures. We describe alternative policies which could alleviate hardship, protect business from destruction in the growing depression, facilitate recovery with full employment in a Green New Deal, and redistribute income and power with economic democracy in the workplace. Only such policies can ensure high quality work for all, the natural rights of self-determination at work, and equitable sharing of the surplus that is produced by all employees as intentional agents. The proposed reforms are opposed by the strong vested interests which currently hold most power, so mobilising popular support and achieving real change will require a long struggle, just as attaining political democracy a century ago did. |
| Keywords: | COVID-19, policy response, better recovery, economic democracy |
| JEL: | H J L |
| Date: | 2020–06 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izapps:pp160&r=all |
| By: | M. Keith Chen; Yilin Zhuo; Malena de la Fuente; Ryne Rohla; Elisa F. Long |
| Abstract: | Accurately estimating the effectiveness of stay-at-home orders (SHOs) on reducing social contact and disease spread is crucial for mitigating pandemics. Leveraging individual-level location data for 10 million smartphones, we observe that by April 30th---when nine in ten Americans were under a SHO---daily movement had fallen 70% from pre-COVID levels. One-quarter of this decline is causally attributable to SHOs, with wide demographic differences in compliance, most notably by political affiliation. Likely Trump voters reduce movement by 9% following a local SHO, compared to a 21% reduction among their Clinton-voting neighbors, who face similar exposure risks and identical government orders. Linking social distancing behavior with an epidemic model, we estimate that reductions in movement have causally reduced SARS-CoV-2 transmission rates by 49%. |
| Date: | 2020–05 |
| URL: | http://d.repec.org/n?u=RePEc:arx:papers:2005.05469&r=all |
| By: | Alexandre Boumezoued (R&D, Milliman, Paris - Milliman); Amal Elfassihi (R&D, Milliman, Paris - Milliman) |
| Abstract: | Since the conjecture of Richards (2008), the work by Cairns et al. (2016) and subsequent developments by Boumezoued (2016), Boumezoued et al. (2018) and Boumezoued et al. (2019), it has been acknowledged that observations from censuses have led to major problems of reliability in estimates of general population mortality rates as implemented in practice. These issues led to misinterpretation of some key mortality characteristics in the past decades, including "false cohort effects". To overcome these issues, the exposure estimates for a given country can be corrected by using monthly fertility records. However, in the absence of birth-by-month data, the recent developments are not applicable. Therefore, this paper explores new solutions regarding the construction of mortality tables in this context, based on machine learning techniques. As a main result, it is demonstrated that the new exposure models proposed in this paper allow to provide correction with high quality and to improve the fitting of stochastic mortality models without cohort component, as it is the case for the existing correction method based on monthly fertility data. |
| Keywords: | Human Mortality Database,cohort effect,anomalous mortality data,stochastic mortality models,machine learning,neural network |
| Date: | 2020–05–27 |
| URL: | http://d.repec.org/n?u=RePEc:hal:wpaper:hal-02634631&r=all |
| By: | John Gibson (University of Waikato) |
| Abstract: | The New Zealand policy response to Coronavirus (Covid-19) was the most stringent in the world during the Level 4 lockdown. At least ten billion New Zealand dollars of output (around 3.3% of GDP) were lost then, compared to staying at Level 2. For lockdown to be optimal requires large health benefits to offset these output losses. Forecast deaths from epidemiological models are not valid counterfactuals, due to poor identification. Instead, I use empirical data, based on variation amongst United States counties, over one-fifth of which just had social distancing rather than lockdown. Political drivers of lockdown provide identification. Lockdowns do not reduce Covid-19 deaths. This pattern is visible on each date that key lockdown decisions were made in New Zealand. The ineffectiveness of lockdowns implies New Zealand suffered large economic costs for little benefit in terms of lives saved. |
| Keywords: | Covid-19; deaths; impact evaluation; lockdown; response stringency; New Zealand |
| JEL: | C21 I18 |
| Date: | 2020–06–03 |
| URL: | http://d.repec.org/n?u=RePEc:wai:econwp:20/06&r=all |
| By: | Finn E. Kydland; Enrique Martínez-García |
| Abstract: | This paper examines the impact of the behavioral changes and governments' responses to the spread of the COVID-19 pandemic using a unique dataset of daily private forecasters' expectations on a sample of 32 emerging and advanced economies from January 1 till April 13, 2020. We document three important lessons from the data: First, there is evidence of a relation between the stringency of the policy interventions and the health outcomes consistent with slowing down the spread of the pandemic. Second, we find robust evidence that private forecasters have come to anticipate a sizeable contraction in economic activity followed by a check mark recovery as a result of the governments' increasingly stringent response. The evidence suggests also that workplace restrictions have further contributed to the downturn and to the subsequent sluggish recovery—opening up the question about the costs of tighter work restrictions. Finally, we argue inflation expectations have not changed significantly so far. Through the lens of the neoclassical growth model, these changes in macro expectations can result from the resulting work disruptions and the potential productivity slowdown from the gradual de-escalation of the confinement. |
| Keywords: | COVID-19; Macro Expectations; Flattening the Curve; Policy Response Stringency; Google Mobility |
| JEL: | I18 F62 E30 C23 C83 |
| Date: | 2020–05–12 |
| URL: | http://d.repec.org/n?u=RePEc:fip:feddgw:87966&r=all |
| By: | Serra Garcia, Marta; Szech, Nora |
| Abstract: | We study individual demand for COVID-19 antibody tests in an incentivized study on a representative sample of the US population. Almost 2,000 participants trade off obtaining an athome test kit against money. At prices close to zero, 80 percent of individuals want the test. However, this broad support of testing falls sharply with price. Demand decreases by 19 percentage points per $10 price increase. Demand for testing increases with factors related to its potential value, such as age, increased length and strength of protective immunity from antibodies, and greater uncertainty about having had the virus. Willingness to pay for antibody tests also depends on income, ethnicity and political views. Black respondents show significantly lower demand than white and Hispanic respondents, and Trump-supporters demonstrate significantly lower demand for testing. The results suggest that charging even moderate prices for antibody tests could widen health inequalities. |
| Keywords: | Coronavirus,COVID-19,Antibody Tests,Information Preferences,Beliefs,Uncertainty |
| JEL: | D81 D91 I12 I18 |
| Date: | 2020 |
| URL: | http://d.repec.org/n?u=RePEc:zbw:kitwps:140&r=all |