nep-hea New Economics Papers
on Health Economics
Issue of 2020‒09‒07
sixty-five papers chosen by
Nicolas R. Ziebarth
Cornell University

  1. Positive Health Externalities of Mandating Paid Sick Leave By Pichler, Stefan; Wen, Katherine; Ziebarth, Nicolas R.
  2. Sunlight and Protection Against Influenza By Slusky, David; Zeckhauser, Richard J.
  3. Workplace Presenteeism, Job Substitutability and Gender Inequality By Azmat, Ghazala; Hensvik, Lena; Rosenqvist, Olof
  4. Loss of Life and Labour Productivity: The Canadian Opioid Crisis By Cheung, Alexander P.; Marchand, Joseph; Mark, Paddy
  5. The Drug Crisis and the Living Arrangements of Children By Kasey Buckles; William N. Evans; Ethan M.J. Lieber
  6. Missing a Nurse Visit By Hirani, Jonas Lau-Jensen; Sievertsen, Hans Henrik; Wüst, Miriam
  7. Technology Adoption in Primary Health Care By Iversen, Tor; Ching-to , Albert Ma
  8. Insurance Design and Pharmaceutical Innovation By Leila Agha; Soomi Kim; Danielle Li
  9. Government Advertising in Market-Based Public Programs: Evidence from the Health Insurance Marketplace By Naoki Aizawa; You Suk Kim
  10. Relabeling, Retirement and Regret By Jonathan Gruber; Ohto Kanninen; Terhi Ravaska
  11. Examining the Effects of Intimate Partner Violence on Psychological Distress Between Genders By Jade Turner; Chloe Johnson; Peter Gleason
  12. As If It Weren't Hard Enough Already: Breaking down Hiring Discrimination Following Burnout By Sterkens, Philippe; Baert, Stijn; Rooman, Claudia; Derous, Eva
  13. Encouraging parents to invest: A randomized trial with two simple interventions in early childhood By Ebert, Cara; Heesemann, Esther Luise; Vollmer, Sebastian
  14. Sustainability of Social Security in the Aging Economy from the Perspective of Improving Health By Tomoaki Kotera
  15. Should Early Health Investments Work? Evidence from an RCT of a Home Visiting Programme By Deirdre Coy; Orla Doyle
  16. Legal and Ethical Concerns Regarding Gene Editing By Stefania Andra Stanciu
  17. Impact of expenditures with human and non-human resources on medical efficiency indicators By ROTEA, Cătălin Ștefan; PLOSCARU, Claudia Cristina
  18. Are Mental Health and Neurodevelopmental Conditions Barriers to Postsecondary Access? By Arim, Rubab; Frenette, Marc
  20. The Effect of Hosting 3.4 Million Refugees on the Health System in Turkey and Infant, Child, and Elderly Mortality among Natives By Aysun Aygun; Murat Guray Kirdar; Berna Tuncay
  21. Why Are So Many Children Stunted in the Philippines ? By Capanzana,Mario V.; Demombynes,Gabriel; Gubbins,Paul Michael
  22. Selective Mortality and Malnutrition in India By Panda, Pallavi
  23. Childhood Circumstances and Health Inequality in Old Age: Comparative Evidence from China and the United States By Chen, Xi; Yan, Binjian; Gill, Thomas M.
  24. The Effect of Birth Order on Educational Attainment among the Baby Boom Generation By Handy, Christopher; Shester, Katharine
  25. Equity in Intra-State Distribution of Public Spending on Health: The Case of Bihar and Tamil Nadu. By Choudhury, Mita; Dubey, Jay Dev
  26. Data and Policy Decisions: Experimental Evidence from Pakistan By Michael Callen; Saad Gulzar; Syed Ali Hasanain; Muhammad Yasir Khan; Arman B. Rezaee
  27. Expanding Access to Clean Water for the Rural Poor: Experimental Evidence from Malawi By Pascaline Dupas; Basimenye Nhlema; Zachary Wagner; Aaron Wolf; Emily Wroe
  28. In between the market and public health insurance: a place for occupational welfare in Europe? By Thomas Houssoy; Marion del Sol; Philippe Martin
  29. The Value of Health - Empirical Issues when Estimating the Monetary Value of a QALY Based on Well-Being By Sebastian Himmler; Jannis Stöckel; Job van Exel; Werner Brouwer
  30. Enforcing Payment for Water and Sanitation Services in Nairobi’s Slums By Aidan Coville; Sebastian Galiani; Paul Gertler; Susumu Yoshida
  31. The economics of low emission zones By Börjesson, Maria; Bastian, Anne; Eliasson, Jonas
  32. Practical Lessons for Phone-Based Assessments of Learning By Noam Angrist; Peter Bergman; David K. Evans; Susannah Hares; Matthew C. H. Jukes; Thato Letsomo
  33. Comorbidity Factors Influence COVID-19 Mortality Much More than Age By Steven Gjerstad; Andrea Molle
  34. Effects of State COVID-19 Closure Policy on NON-COVID-19 Health Care Utilization By Engy Ziedan; Kosali I. Simon; Coady Wing
  35. Does BMI Predict the Early Spatial Variation and Intensity of COVID-19 in Developing Countries? Evidence from India By Menon, Nidhiya
  36. The enduring influence of institutions on universal health coverage: an empirical investigation of 62 former colonies By Miller, Michael; Toffolutti, Veronica; Reeves, Aaron
  37. Adaptive Control of COVID-19 Outbreaks in India: Local, Gradual, and Trigger-based Exit Paths from Lockdown By Anup Malani; Satej Soman; Sam Asher; Paul Novosad; Clement Imbert; Vaidehi Tandel; Anish Agarwal; Abdullah Alomar; Arnab Sarker; Devavrat Shah; Dennis Shen; Jonathan Gruber; Stuti Sachdeva; David Kaiser; Luis M.A. Bettencourt
  38. On the Management of Population Immunity By Toxvaerd, F.; Rowthorn, R.
  39. COVID-19 and Mental Health Deterioration among BAME Groups in the UK By Proto, Eugenio; Quintana-Domeque, Climent
  40. On Plague and Ebola in a Time of COVID-19 By Cormac Ó Gráda
  41. Inequality and the Coronavirus: Socioeconomic Covariates of Behavioral Responses and Viral Outcomes Across US Counties By Caitlin S. Brown; Martin Ravallion
  42. Internal migration and the spread of Covid-19 By Michele Valsecchi; Ruben Durante
  43. First-Generation Students’ Experiences During the COVID-19 Pandemic By Soria, Krista M; Horgos, Bonnie; Chirikov, Igor; Jones-White, Daniel
  44. Tracking the Spread of COVID-19 in the Region By Jaison R. Abel; Jason Bram; Richard Deitz; Jonathan Hastings
  45. Furloughing By Adams-Prassl, A.; Boneva, T.; Golin, M; Rauh, C.
  46. Mass Outdoor Events and the Spread of an Airborne Virus: English Football and Covid-19 By Matthew Olczak; J. James Reade; Matthew Yeo
  47. Good use of big data: building a home for everyone By Moustafa, Khaled
  48. Racial and Ethnic Disparities in COVID-19: Evidence from Six Large Cities By Benitez, Joseph; Courtemanche, Charles; Yelowitz, Aaron
  49. Preparing for Future Pandemics: Stress Tests and Wargames By Frank Milne; David Longworth
  50. Four Stylized Facts about COVID-19 By Andrew Atkeson; Karen A. Kopecky; Tao Zha
  51. Pandemic Control in ECON-EPI Networks By Marina Azzimonti-Renzo; Alessandra Fogli; Fabrizio Perri; Mark Ponder
  52. The Disproportionate Effects of COVID-19 on Households with Children By Olivier Armantier; Gizem Koşar; Rachel Pomerantz; Wilbert Van der Klaauw
  53. Exploring the Relationship between Care Homes and Excess Deaths in the COVID-19 Pandemic: Evidence from Italy By Alacevich, Caterina; Cavalli, Nicolò; Giuntella, Osea; Lagravinese, Raffaele; Moscone, Francesco; Nicodemo, Catia
  54. COVID-19, Race, and Redlining By Bertocchi, Graziella; Dimico, Arcangelo
  55. Does Holding Elections during a Covid-19 Pandemic Put the Lives of Politicians at Risk? By Laurent Bach; Arthur Guillouzouic; Clément Malgouyres
  56. COVID-19 Age-Mortality Curves Are Flatter in Developing Countries By Demombynes,Gabriel
  57. Collaborating During Coronavirus: The Impact of COVID-19 on the Nature of Work By Evan DeFilippis; Stephen Michael Impink; Madison Singell; Jeffrey T. Polzer; Raffaella Sadun
  58. Work-Related and Personal Predictors of COVID-19 Transmission By Anand, Paul; Allen, Heidi; Ferrer, Robert; Gold, Natalie; Gonzales Martinez, Rolando; Kontopantelis, Evan; Krause, Melanie; Vergunst, Francis
  59. Predicted COVID-19 Fatality Rates Based on Age, Sex, Comorbidities, and Health System Capacity By Selene Ghisolfi; Ingvild Almås; Justin Sandefur; Tillmann von Carnap; Jesse Heitner; Tessa Bold
  60. A Spatial Stochastic SIR Model for Transmission Networks with Application to COVID-19 Epidemic in China By Tatsushi Oka; Wei Wei; Dan Zhu
  61. The DEI: tracking economic activity daily during the lockdown By António Rua; Nuno Lourenço
  62. Compliance with Social Distancing: Theory and Empirical Evidence from Ontario during COVID-19 By Anastasios Papanastasiou; Bradley J. Ruffle; Angela L. Zheng
  63. Modern Pandemics: Recession and Recovery By Chang Ma; John H. Rogers; Sili Zhou
  64. Gender Inequality in COVID-19 Times: Evidence from UK Prolific Participants By Oreffice, Sonia; Quintana-Domeque, Climent
  65. Measuring the labor market at the onset of the COVID-19 crisis By Alexander W. Bartik; Marianne Bertrand; Feng Lin; Jesse Rothstein; Matt Unrath

  1. By: Pichler, Stefan (ETH Zurich); Wen, Katherine (Cornell University); Ziebarth, Nicolas R. (Cornell University)
    Abstract: A growing economic literature studies the optimal design of social insurance systems and the empirical identification of welfare-relevant externalities. In this paper, we test whether mandating employee access to paid sick leave has reduced influenza-like-illness (ILI) transmission rates as well as pneumonia and influenza (P&I) mortality rates in the United States. Using uniquely compiled data from administrative sources at the state-week level from 2010 to 2018 along with difference-in-differences methods, we present quasi-experimental evidence that sick pay mandates have causally reduced doctor-certified ILI rates at the population level. On average, ILI rates fell by about 11 percent or 290 ILI cases per 100,000 patients per week in the first year.
    Keywords: sick pay mandates, population health, flu infection, negative externalities
    JEL: H23 H75 I12 I14 I18 J22 J38 J58
    Date: 2020–07
  2. By: Slusky, David (University of Kansas); Zeckhauser, Richard J. (Harvard University)
    Abstract: Recent medical literature suggests that vitamin D supplementation protects against acute respiratory tract infection. Humans exposed to sunlight produce vitamin D directly. This paper investigates how differences in sunlight, as measured over several years across states and during the same calendar week, affect influenza incidence. We find that sunlight strongly protects against getting influenza. This relationship is driven almost entirely by the severe H1N1 epidemic in fall 2009. A 10% increase in relative sunlight decreases the influenza index in September or October by 1.1 points on a 10-point scale. A second, complementary study employs a separate data set to study flu incidence in counties in New York State. The results are strongly in accord.
    Keywords: Seasonal Influenza, sunlight, vitamin d, natural experiment, H1N1
    JEL: I10 I12 I18 Q5 N32
    Date: 2020–07
  3. By: Azmat, Ghazala (Sciences Po, Paris); Hensvik, Lena (IFAU); Rosenqvist, Olof (Uppsala University)
    Abstract: Following the arrival of the first child, women's absence rates soar and become less predictable due to the greater frequency of their own sickness and the need to care for sick children. In this paper, we argue that this fall in presenteeism in the workplace hurts women's wages, not only indirectly and gradually, through a slower accumulation of human capital, but also immediately, through a direct negative effect on productivity in unique jobs (i.e., jobs with low substitutability). Although both presenteeism and job uniqueness are highly rewarded, we document that women's likelihood of holding jobs with low substitutability decreases substantially relative to men's after the arrival of the first child. This gap persists over time, with important long-run wage implications. We highlight that the parenthood wage penalty for women could be reduced by organizing work in such a way that more employees have tasks that, at least in the short run, can be performed satisfactorily by other employees in the workplace.
    Keywords: work absence, job substitutability, gender wage inequality
    JEL: J16 J22
    Date: 2020–07
  4. By: Cheung, Alexander P. (University of Alberta, Department of Economics); Marchand, Joseph (University of Alberta, Department of Economics); Mark, Paddy (Nanaimo Regional General Hospital)
    Abstract: The purpose of this study is to measure and quantify the losses in labour productivity due to the Canadian opioid crisis. Since 2016, over 15,393 Canadians have lost their lives due to opioid overdose. It is estimated that 10,775 of these overdose victims were employed in the 5 years prior to their death. This study applies public data to a human capital (HC) model to estimate the total lost productivity to the Canadian economy. The HC model mathematically projects forward the future economic output of an individual overdose victim given their occupation and age (at time of death) until retirement. The total estimated productivity loss is at least $5.71 billion dollars. Given this, the opioid crisis has affected a whole working cross-section of society causing irreversible damage to the Canadian economy in addition to an immeasurable human cost. A multidisciplinary review of the literature regarding opioid use disorder was also undertaken to enhance understanding into the nature of the Canadian opioid crisis in relation to premature deaths and the subsequent losses in labor productivity.
    Keywords: opioid crisis; labour productivity; health economics
    JEL: E24 I10 J17 J24 O47
    Date: 2020–08–27
  5. By: Kasey Buckles; William N. Evans; Ethan M.J. Lieber
    Abstract: We examine the impact of the drug crisis that has unfolded over the last three decades in the United States on children’s living arrangements and environments. Because the current living arrangement could be a result of events that occurred at any point in a child’s life, we measure children’s exposure to the crisis with the cumulative drug-related mortality of likely parents. A potential omitted variables bias complicates the analysis, as the factors that may have led parents to abuse drugs could also have altered the living arrangements of their children. Within a 2SLS framework, we instrument for the cumulative mortality of likely parents with a child’s years of exposure to a non-triplicate prescription pad environment. Previous work by Alpert et al. (2019) demonstrates that pharmaceutical advertising was much more extensive in non-triplicate states and fostered the development of the drug crisis. Our results indicate that OLS and 2SLS estimates are nearly identical and the crisis increased both the fraction of children living away from a parent and in a household headed by a grandparent. We estimate that if drug abuse had remained at 1996 levels, 1.5 million fewer children aged 0-16 would have lived away from a parent in 2015.
    JEL: I1 J12
    Date: 2020–07
  6. By: Hirani, Jonas Lau-Jensen (VIVE - The Danish Centre for Applied Social Science); Sievertsen, Hans Henrik (University of Bristol); Wüst, Miriam (University of Copenhagen)
    Abstract: While a large literature studies the impact of exposure to early-life investment policies, this paper examines the impact of changes within a program, the Danish nurse home visiting program, on child and maternal health. We exploit variation induced by a nurse strike, which resulted in families missing one of the four universally-provided nurse visit. Using variation in children's age at strike start, we show that early, but not later, strike exposure increases child and mother contacts to health professionals in the first four years after birth. Forgoing an early nurse visit also increases the probability of maternal contacts to mental health specialists in the first four years after childbirth. We highlight two potential channels for these results: screening and information provision. We show that–in non-strike years–nurses perform well in detecting maternal mental health risks during early visits, and that effects of early strike exposure are strongest for families that we expect to benefit most from information provided by nurses shortly after birth. A stylized calculation confirms that short-run health benefits from early universal home visiting outweigh costs.
    Keywords: early-life health, early interventions, nurse home visiting, parental investments
    JEL: I11 I12 I14 I18 I21
    Date: 2020–07
  7. By: Iversen, Tor (Department of Health Management and Health Economics, University of Oslo); Ching-to , Albert Ma (Department of Economics, Boston University)
    Abstract: We study primary care physicians’ prevention and monitoring technology adoption. Physicians are assumed to decide to adopt based on benefits and costs, which depend on payment incentives, educational assistance, and market characteristics. The empirical study uses national Norwegian register and physician claims data between 2009 and 2014. In 2006, a new annual comprehensive checkup for Type 2 diabetic patients was introduced. A physician collects a fee for each checkup. In 2013, an education assistance program was introduced in two Norwegian counties. We estimate adoption decisions by two-part and fixed-effect regressions, and hazard models. We use a difference-in-difference model to estimate the education program impact. Adoptions are positively associated with a physician’s number of diabetic patients, and the fraction of physician-adopters in the same market. Fixed-effect estimations and separate analyses of physicians who have moved between municipalities causally support a peer effect. The education program has a strongly positive effect.
    Keywords: primary care; technology; monitoring; incentives; education program
    JEL: I11 I18 O31
    Date: 2020–08–27
  8. By: Leila Agha; Soomi Kim; Danielle Li
    Abstract: This paper studies how insurance coverage policies affect incentives for pharmaceutical innovation. In the United States, the majority of drugs are sold to Pharmacy Benefit Managers (PBMs), which administer prescription drug plans on behalf of insurers. Beginning in 2012, PBMs began adopting “closed formularies”, excluding coverage for certain drugs, including many newly approved drugs, when adequate substitutes were available. We show that this policy reshaped upstream R&D activity and led pharmaceutical firms to shift investment away from therapeutic classes at greater risk of facing coverage exclusions. This move translated into a relative decline in the number of drug candidates that appear more incremental in their therapeutic contribution: that is, those in drug classes with more pre-existing therapies and less scientifically novel research.
    JEL: I11 O31 O32 O33 O38
    Date: 2020–07
  9. By: Naoki Aizawa; You Suk Kim
    Abstract: This paper studies government and private marketing activities in the context of the Affordable Care Act health insurance marketplace. Using detailed TV advertising data, we present evidence that government and private advertising are targeted to different geographical areas and provide different messaging content. Then, we estimate the impacts of government and private advertising on consumer demand by exploiting discontinuities in advertising along the borders of local TV markets. We find that government advertising has a market-expansion effect and enhances welfare. We also find that private advertising is not more effective than government advertising in increasing total program enrollment. Although private advertising is still effective in increasing insurer’s own enrollment, it does not have positive spillovers to other insurers but has a modest business-stealing effect. We then develop and estimate an equilibrium model of marketplaces to illustrate mechanisms through which government advertising affects the market equilibrium. Our simulation suggests that government advertising can simultaneously increase total program enrollment and reduce excessive advertising spending among private insurers.
    JEL: G2 I1 I3 L1 M3
    Date: 2020–08
  10. By: Jonathan Gruber; Ohto Kanninen; Terhi Ravaska
    Abstract: Focal retirement ages are a central feature of Social Security programs around the world, and provide a potentially powerful tool for policy makers who are interested in reforming retirement systems to address the growing funding shortfalls. But these tools often come hand in hand with significant changes in the financial structure of Social Security that can have independent, and potentially deleterious, impacts on retirees. In this paper, we use a major reformulation of the retirement system in Finland, featuring a relabeling of retirement ages with modest and continuous changes in financial incentives allows us to separately estimate the impact of relabeling from financial incentives in driving retirement decisions. We find that relabeling is particularly powerful as a determinant of date of retirement. Both graphical evidence and estimated hazard models reveal an enormous change in retirement when individuals face a newly defined “normal retirement” age. We also present a new approach to assessing the welfare implications of induced earlier retirement: looking at the impact on return to work. We show that the marginal workers induced to retire by relabeling are much more likely to return to work over the next three years than is the typical worker. This suggests that there is a marginal increase in regret among those who respond to this change in retirement ages.
    JEL: H55 J26
    Date: 2020–07
  11. By: Jade Turner (Walla Walla University, United States); Chloe Johnson (Walla Walla University, United States); Peter Gleason (Walla Walla University, United States)
    Abstract: The purpose of this project is to evaluate the association of intimate partner violence (IPV) on psychological variables including feelings of hopelessness, suicidal ideation, suicide planning, and past suicide attempts. Research on adult populations suggests a positive correlation between IPV and psychological distress; however, adolescent IPV and its relation to psychological distress remain an understudied correlation. Using the 2017 CDC Youth Risk Behavior Survey data analyses was conducted on responses obtained from anonymous questionnaires from a sample of adolescents ages 12-18 (n=14,765). Analysis of victims of IPV showed that males were more likely to report planned suicide and suicide attempts, while a higher percentage of females than males were more likely to report feeling sad or hopeless and suicidal ideation. Our findings confirm the inverse relationship between intimate partner violence and psychological distress. There is a surprising connection between IPV and psychological distress in men. Future research is needed to clarify the nature of these associations.
    Keywords: mental health, intimate partner violence, psychological distress, adolescent
    Date: 2020–06
  12. By: Sterkens, Philippe (Ghent University); Baert, Stijn (Ghent University); Rooman, Claudia (Ghent University); Derous, Eva (Ghent University)
    Abstract: Hiring discrimination towards (former) burnout patients has been extensively documented in the literature. To tackle this problem, it is important to understand the underlying mechanisms of such discrimination. Therefore, we conducted a vignette experiment with 425 genuine recruiters and jointly tested the potential stigma against job candidates with a history of burnout that were mentioned earlier in the literature. We found candidates revealing a history of burnout elicit perceptions of requiring work adaptations, likely having more unpleasant collaborations with others as well as diminished health, autonomy, ability to work under pressure, leadership capacity, manageability, and learning ability, when compared to candidates with a comparable gap in working history due to physical injury. Led by perceptions of a reduced ability to work under pressure, the tested perceptions jointly explained over 90% of the effect of revealing burnout on the probability of being invited to a job interview. In addition, the negative effect on interview probability of revealing burnout was stronger when the job vacancy required higher stress tolerance. In contrast, the negative impact of revealing burnout on interview probability appeared weaker when recruiters were women and when recruiters had previously had personal encounters with burnout.
    Keywords: hiring discrimination, burnout, statistical discrimination, taste-based discrimination
    JEL: J71 I14 C83 C91
    Date: 2020–07
  13. By: Ebert, Cara; Heesemann, Esther Luise; Vollmer, Sebastian
    Abstract: The lottery of birth draws some children into deprived environments and others into environments where they thrive. In a field experiment in rural India with 10-20 months old children we test two scalable interventions to reduce early disadvantages in health and mental development. We distribute a durable device for home iron fortification of meals, called the Lucky Iron Leaf, and picture books together with a training for caregivers in dialogic reading. We find no significant average impact of either intervention on anemia or mental development. However, we find a cross-productivity of children's baseline health and the interventions' effectiveness. Children, who are non-anemic at baseline, improve in receptive language skills by half a standard deviation one year after implementation.
    Keywords: early childhood,parental investment,nutrition,health behavior,human capital
    JEL: D04 I12 I15 J13
    Date: 2020
  14. By: Tomoaki Kotera (Economist, Institute for Monetary and Economic Studies, Bank of Japan (currently, Assistant Professor, Graduate School of Economics and Management, Tohoku University, E-mail:
    Abstract: An aging economy is widely believed to increase the recipients of Social Security and thus increase the fiscal burden. However, since the health condition of the elderly today is better than before and may continue to improve in the future, the number of elderly workers may increase. This paper studies the quantitative role of old workers in the sustainability of Social Security in an aging economy by developing a computable overlapping generations model with heterogeneous agents in a general equilibrium framework. The distinctive feature of the model is the incorporation of health status linked to survival probability, medical expenditures, and disutility of labor. The model simulation shows that old workers play a significant role in mitigating the fiscal cost and the effect remains pronounced when Social Security reform is implemented. It also highlights the crucial role of the projected future health status of the population in quantifying the fiscal cost.
    Keywords: Elderly Workers, Health, Social Security Reform, Benefit Claim, Overlapping Generations
    JEL: H55 I13 J22
    Date: 2020–08
  15. By: Deirdre Coy; Orla Doyle
    Abstract: Evidence for the short-term impact of early intervention on childhood health is weak and inconsistent. Using rigorous methods, careful hypothesis setting, and socioeconomic contextualisation, we examine the impact of an Irish home visiting programme on child health. The treatment provides mentoring visits from pregnancy until school entry to improve child outcomes through positively affecting parenting. In a context where socioeconomic inequalities in health have yet to emerge, modest effects by age four are found, driven by reduced hospital attendance. Conflicting reports in the literature may thus arise from an over-expectation of hypothesized effects and failure to account for social contexts.
    Keywords: Home visiting programme; Randomised controlled trial; Child health; Health inequality; Human capital formation
    JEL: I14 I12 J13
    Date: 2020–07
  16. By: Stefania Andra Stanciu (Bucharest City Police, Romania)
    Abstract: The field of genetics has given rise to technology that will revolutionize the biological sciences: the powerful gene-editing tool known as CRISPR-Cas9. Between medical progress, ultimate new age cure for diseases and the risk of altering human DNA in an irreversible way, the legal challenges of applying CRISPR in the health context, along with the regulatory and ethical issues that might arise must be approached with increased responsibility. A main goal or a variety of purposes? Enhancement or gene editing to improve normal human traits, changes from edited genomes that might be inherited - repercussions of the new gene-editing technology could result in altering human DNA. Current international legislation and interpretation, global consensus worth pursuing on this subject and future regulations required.
    Keywords: CRISPR technology, designer babies, gene editing, moral vs. medical benefits, ethical vs. law
    Date: 2020–04
  17. By: ROTEA, Cătălin Ștefan; PLOSCARU, Claudia Cristina
    Abstract: The most valuable resource of an organization is the human resource, especially in the area of health care. The specific problem of the public medical systems is that some managers of hospital institutions do not have strategies for employees’ compensation. In this paper, we propose to evaluate the impact of significant changes in the levels and the structure of budgetary allocation on the medical efficiency indicators of a public hospital from Romania, as well as the effects of changing reward policies on the hospital efficiency indicators. The paper provides a useful tool for hospital managers, which allows them to assess the impact of budgetary allocations for human and non-human resources (HNHR) on medical efficiency indicators of a public hospital.
    Keywords: budget allocations; payments for personnel; payments for goods and services; medical efficiency indicators; case mix index
    JEL: I10 O15
    Date: 2020–02
  18. By: Arim, Rubab; Frenette, Marc
    Abstract: The Canadian literature on postsecondary access has identified many of its key determinants including parental education and income, academic performance, and sex. However, relatively little work has investigated the independent role of disability in postsecondary enrollment. This study fills that gap by estimating the relationship between mental health and neurodevelopmental conditions diagnosed in childhood (available from the National Longitudinal Survey of Children and Youth [NLSCY]) and postsecondary enrollment during early adulthood (available from the tax credits on the T1 Family File [T1FF]).
    Keywords: Postsecondary education, Disabilities, Access to education
    Date: 2019–02–09
  19. By: Dharna Sharma
    Abstract: Various researches have been carried out optimism as a psychological phenomenon. Optimists are people who anticipate future outcomes to be positive. Conversely, pessimistic people are those who display more negative anticipations for the future. Positive and negative expectations regarding the future play an important role in understanding the vulnerability to psychological disorders and physical illness as well. A significant positive connection arises between optimism and coping strategies emphasized on social support and insistence on positive facets of stressful events. By employing of specific strategies, optimism also influences quality of life indirectly. Many researchers also confirmed that the optimistic people showed a higher level of life as compared to those with low levels of optimism. Optimism may also significantly impacts physical and mental wellbeing of individuals by the promotion of a healthy life style patterns and also by adaptive behaviours linked with greater decision making, flexible approach and problem solving capability. This paper focuses on optimism and its important constructs. This paper is also an attempt to explore the relationship of optimism with physical health, mental health, coping, quality of life and adaptation to purpose, healthy life style and risk perception. Key Words: Optimism, physical health, mental health, coping strategies. Policy
    Date: 2020–06
  20. By: Aysun Aygun (Istanbul Technical University, Department of Economics); Murat Guray Kirdar (Bogazici University, Department of Economics); Berna Tuncay (Koç University, Department of Economics)
    Abstract: As of the end of 2017, 3.4 million Syrian refugees lived in Turkey. These refugees left a country where the health system was completely broken. Several studies report that Syrian refugees faced numerous diseases during their exodus, brought certain infectious diseases to the hosting communities, and have a high incidence of health care utilization. Moreover, they have much higher fertility rates than natives (5.3 to 2.3). We examine the effect of Syrian refugees on the health infrastructure in Turkey and on natives’ mortality—with a focus on infant, child, and elderly mortality. Our OLS results yield suggestive evidence of a negative effect of the refugee shock on infant and child mortality. However, we find that this is a result of endogenous settlement patterns of refugees. Once we account for the endogeneity using a plausibly exogenous instrument, we find no evidence of an effect on native mortality for any age group. We also analyze the pressure that the refugees put on the health care services in Turkey, as well as the government’s response, to understand our findings on mortality outcomes.
    Keywords: refugees; health care infrastructure; native mortality; infant; child; elderly; instrumental variables.
    JEL: H51 I18 J13 J15 O15
    Date: 2020–09
  21. By: Capanzana,Mario V.; Demombynes,Gabriel; Gubbins,Paul Michael
    Abstract: Nearly one in three children under age five in the Philippines is stunted, a key marker of undernutrition. This rate is high for the country's level of income. This paper provides the first detailed multivariate analysis of potential drivers of stunting in the Philippines, using data from the 2015 National Nutrition Survey. Potential drivers are analyzed individually and grouped in major categories. The analysis finds that stunting between 24-60 months is principally associated with suboptimal prenatal conditions and inadequate food security and diversity. If the results are given a causal interpretation, they imply that if all Filipino newborns had adequate prenatal conditions, the fraction stunted at age 24-60 months would fall by 20 percent. Similarly, providing adequate food security and diversity to all Filipino children would reduce stunting by 22 percent. Other factors -- including access to water, sanitation, and environmental conditions -- have less strong associations with stunting. The results point to a series of policy priorities to reduce stunting: supporting the nutrition and health of expectant mothers, ensuring access to contraception to reduce adolescent pregnancy, and ensuring that children consume a variety of healthy foods, including protein-dense foods such as milk, meat, and eggs.
    Keywords: Reproductive Health,Early Child and Children's Health,Nutrition,Health Care Services Industry,Educational Sciences,Hydrology
    Date: 2020–06–23
  22. By: Panda, Pallavi
    Abstract: India presents itself as a paradox with low infant mortality and high malnutrition. This paper provides survival bias as an explanation of the paradox. Using pooled health surveys from 1993 to 2005 and a pseudo-panel selection model, this study finds that the change in Height-for-Age Z-Scores (HAZ scores) can be explained by mortality selection. Specifically, children with sample average characteristics that survive have 17.4% less HAZ scores than a child randomly drawn from the population indicating an overestimation of malnutrition in India. This is consistent with the hypothesis of weaker children surviving due to skilled delivery which pulls down the overall HAZ scores. The results are robust to controls for unobservable characteristics of groups of women. Son preference is also apparent in the results. The selection is more evident among male children and in the states where sex selection is historically seen as a problem in India.
    Keywords: Infant Mortality, Child Health, Malnutrition, Son Preference, India
    JEL: I15 J11 J13 O12
    Date: 2019–11–29
  23. By: Chen, Xi (Yale University); Yan, Binjian (Nanjing University); Gill, Thomas M. (Yale University)
    Abstract: This paper estimates the extent to which childhood circumstances contribute to health inequality in old age and evaluates the importance of major domains of childhood circumstances to health inequalities in the USA and China. We link two waves of the China Health and Retirement Longitudinal Study (CHARLS) in 2013 and 2015 with the newly released 2014 Life History Survey (LHS), and two waves of the Health and Retirement Study (HRS) in 2014 and 2016 with the newly released 2015 Life History Mail Survey (LHMS) in the USA, to quantify health inequality due to childhood circumstances for which they have little control. Using the Shapley value decomposition approach, we show that childhood circumstances may explain 7-16 percent and 14-30 percent of health inequality in old age in China and the USA, respectively. Specifically, the contribution of childhood circumstances to health inequality is larger in the USA than in China for self-rated health, mental health, and physical health. Examining domains of childhood circumstance, regional and rural/urban status contribute more to health inequality in China, while family socioeconomic status (SES) contributes more to health inequality in the USA. Our findings support the value of a life course approach in identifying the key determinants of health in old age. Distinguishing sources of health inequality and rectifying inequality due to early childhood circumstances should be the basis of policy promoting health equity.
    Keywords: life course approach, inequality of opportunity, self-rated health, mental health, frailty, childhood circumstances
    JEL: I14 J13 J14 O57
    Date: 2020–07
  24. By: Handy, Christopher; Shester, Katharine
    Abstract: We show that changes in birth order during the baby boom can explain a substantial share of the stagnation and recovery in educational attainment among cohorts born between 1946 and 1974. Combining birth order effects estimated using the Health and Retirement Survey and birth order data from Vital Statistics, we estimate that changes in birth order can explain more than 20 percent of the decline in white male college completion rates among the 1946–1960 cohorts, and more than one third of the rebound among the 1960–1974 cohorts. We also revisit the role of cohort size, finding smaller effects than previously reported.
    Keywords: baby boom, birth order, educational attainment, cohort size
    JEL: I20 J13 N32
    Date: 2020–08
  25. By: Choudhury, Mita (National Institute of Public Finance and Policy); Dubey, Jay Dev (National Institute of Public Finance and Policy)
    Abstract: Equitable distribution of public spending has been argued to be an effective tool for enhancing access to health care and moving towards Universal Health Coverage. In India, much of the existing evidence on equity in public spending has been confined to state-level aggregates, and intra-state distribution of public spending has received limited attention. This paper focuses on the distribution of public spending on health within two Indian States (Bihar and Tamil Nadu) to provide insights on differential access to health care within each state. The analysis suggests that public spending on health is pro-rich in Bihar, and plays a relatively weak redistributive role. In contrast, the distribution of public spending on health in Tamil Nadu is strikingly pro-poor, particularly at lower levels of care. In both horizontal and vertical dimensions (across districts and levels of health care), inequity in public spending is significantly higher in Bihar than in Tamil Nadu.
    Date: 2020–07
  26. By: Michael Callen; Saad Gulzar; Syed Ali Hasanain; Muhammad Yasir Khan; Arman B. Rezaee
    Abstract: We evaluate a program in Pakistan that equips government health inspectors with a smartphone app which channels data on rural clinics to senior policy makers. The system led to rural clinics being inspected 104% more often after 6 months, but only 43.8% more often after a year, with the latter estimate not attaining significance at conventional levels. There is also no clear evidence that the increase in inspections led to increases in general staff attendance. In addition, we test whether senior officials act on the information provided by the system. Focusing only on districts where the app is deployed, we find that highlighting poorly performing facilities on a dashboard viewed by supervisors raises doctor attendance by 75%. Our results indicate that technology may be able to mobilize data to useful effect, even in low capacity settings
    JEL: C93 D02 D73 K42 O17
    Date: 2020–08
  27. By: Pascaline Dupas; Basimenye Nhlema; Zachary Wagner; Aaron Wolf; Emily Wroe
    Abstract: Using data from an 18-month randomized trial, we estimate large and sustained impacts on water purification and child health of a program providing monthly coupons for free water treatment solution (diluted chlorine) to households with young children. The program is more effective and much more cost-effective than asking Community Health Workers (CHWs) to distribute free chlorine to households during routine monthly visits. That is because only 40% of households make use of free chlorine, targeting through CHWs is worse than self-targeting through coupon redemption, and water treatment promotion by CHWs does not increase chlorine use among free chlorine beneficiaries. Non- use of free chlorine is driven by households who have a protected water source and those who report that chlorine makes water taste bad.
    JEL: D10 D12 I11 I12
    Date: 2020–07
  28. By: Thomas Houssoy; Marion del Sol (IODE - Institut de l'Ouest : Droit et Europe - UR1 - Université de Rennes 1 - UNIV-RENNES - Université de Rennes - CNRS - Centre National de la Recherche Scientifique); Philippe Martin (COMPTRASEC - Centre de droit comparé du travail et de la sécurité sociale - CNRS - Centre National de la Recherche Scientifique - UB - Université de Bordeaux)
    Abstract: There is a growing body of studies emphasising the multi-pillar configuration of protection against social risk in Europe, particularly in pension reform. In this chapter, we try to expand on this literature to find applicability beyond the sole case of pensions by looking at the case of occupational health insurance in France. In order to do so, we present a restatement of the pillar/provision perspective in order to apply it to a broader range of cases. We argue it is a powerful analytical tool provided it is complemented with a (non-exhaustive) list of perspectives widely used in studies on social policy and does not blunder into the pitfall of functionalism. The chapter focuses on crossing the pillar perspective with a finance and also a regime perspective. Following the seminal intuition of R. Titmuss, an important result yielded is that the overall structure of resources distribution of the whole welfare system can become highly anti-redistributive once occupational schemes and fiscal incentives are included in the analysis.
    Date: 2020
  29. By: Sebastian Himmler; Jannis Stöckel; Job van Exel; Werner Brouwer
    Abstract: Cost-utility analysis compares the monetary cost of health interventions to the associated health consequences expressed using quality-adjusted life years (QALYs). At whichthreshold the ratio of both is still acceptable is a highly contested issue. Obtaining societal valuations of the monetary value of a QALY can help in setting such threshold values but it remains methodologically challenging. A recent study applied the well-being valuation approach to calculate such a monetary value using a compensating income variation approach. We explore the feasibility of this approach in a different context, using large-scale panel data from Germany. We investigate several important empirical and conceptual challenges such as the appropriate functional specification of income and the health state dependence of consumption utility. The estimated monetary values range from e20,000-60,000 with certain specifications leading to considerable deviations, underlining persistent practical challenges when applying the well-being valuation methodology to QALYs. Recommendations for future applications are formulated.
    Keywords: Quality-adjusted life years, health valuation, well-being valuation, panel data,instrumental variable regression, piecewise regression
    JEL: D61 I18 I31 C33 C36
    Date: 2020
  30. By: Aidan Coville; Sebastian Galiani; Paul Gertler; Susumu Yoshida
    Abstract: Most of the recent focus in the delivery of public utility services has been on last mile connections to water, sewerage and electricity grids. However, the high frequency of nonpayment for services associated with this expansion has created a fiscal crisis for public utilities and has forced utilities to ration services. Public utilities afraid that service disconnections will have political consequences are reluctant to enforce payment with service cutoff. We test this hypothesis using a field experiment in the slums of Nairobi with two interventions intended to improve repayment for water and sewage services: a soft encouragement that informs tenants about landlord’s payment delinquency and, second, a hard threat of disconnection for nonpayment with enforcement if landlords do not pay. While we find no effect of the soft encouragement intervention, we find very large effects of the disconnection intervention on repayment. Moreover, there seems to be no effect on landlord and tenant perceptions of utility fairness or quality of service delivery, on community activism, on the relationships of tenants with their landlords, or on child health. To counterbalance the effective increase in utility fees paid, landlords increase their rental income by both renting out additional space in their compounds and by marginally increasing tenant rents. These results suggest that strict enforcement through disconnections increases payment and the financial position of the utility without incurring political costs.
    JEL: C93 D04 O18
    Date: 2020–07
  31. By: Börjesson, Maria (Swedish National Road & Transport Research Institute (VTI)); Bastian, Anne (City of Stockholm); Eliasson, Jonas (Linköping University)
    Abstract: This paper provides two micro-economic models that derive the social cost of a low emission zone (LEZ) for light vehicles. We apply the models to a proposed LEZ for light vehicles in Stockholm, which would prohibit diesel cars of Euro 5 or lower and gasoline cars of Euro 4 or lower in the inner city (25 km2 ). The first model is based on how an increase in user cost impacts traffic volumes in the inner city. This rather conventional user cost calculation of drivers’ loss requires however some strong assumptions. The second model shows that drivers’ losses can be calculated based on price changes observed on the used car market. Our empirical results indicate that the second model yields a twice as large welfare loss as the first. The forecasted benefits of the LEZ consist primarily of air quality improvements leading to health benefits. The empirical results must be interpreted with caution, but we find that the social benefit of air quality improvements is less than a tenth of the social cost.
    Keywords: Dieselgate; Low emission zones; Environmental zones; Cost-benefit analysis; Car market
    JEL: D61 H54 R41 R48
    Date: 2020–08–28
  32. By: Noam Angrist (Young 1ove; Oxford University); Peter Bergman (Teachers College, Columbia University); David K. Evans (Center for Global Development); Susannah Hares (Center for Global Development); Matthew C. H. Jukes (RTI International); Thato Letsomo (Young 1ove)
    Abstract: School closures affecting more than 1.5 billion children are designed to prevent the spread of current public health risks from the COVID-19 pandemic, but they simultaneously introduce new short- and long-term health risks through lost education. Measuring these effects in real-time is critical to inform effective public health responses, and remote phone-based approaches are one of the only viable options with extreme social distancing in place. However, both the health and education literature are sparse on guidance for phone-based assessments. In this article, we draw on our pilot testing of phone-based assessments in Botswana, along with the existing literature on oral testing of reading and mathematics, to propose a series of preliminary practical lessons to guide researchers and service providers as they try phone-based learning assessments. We provide preliminary evidence that phone-based assessments can accurately capture basic numeracy skills. We provide guidance to help teams (1) ensure that children are not put at risk, (2) test the reliability and validity of phone-based measures, (3) use simple instructions and practice items to ensure the assessment is focused on the target skill, not general language and test-taking skills, (4) adapt the items from oral assessments that will be most effective in phone-based assessments, (5) keep assessments brief while still gathering meaningful learning data, (6) use effective strategies to encourage respondents to pick up the phone, (7) build rapport with adult caregivers and youth respondents, (8) choose the most cost-effective medium, and (9) account for potential bias in samples.
    Keywords: education, assessment, learning, mobile technology, COVID-19
    JEL: I21 I25 O15
    Date: 2020–05–28
  33. By: Steven Gjerstad (Chapman University); Andrea Molle (Chapman University)
    Abstract: This paper demonstrates that once we control for comorbidity factors, age has a minor effect on COVID-19 mortality. This has implications for the treatment of current and recovered COVID-19 patients, including health screenings of recovered COVID-19 patients, triage decisions for patients in critical care, and prioritization of vaccinations when one is developed. The coronavirus epidemic in Italy has strained hospital resources, including ICU beds and ventilators for those experiencing acute respiratory failure. Studies of COVID-19 in China [1], Italy [2], and the United States [3] show that fatality rates increase rapidly with age, especially beyond age 60. The same studies and others also show that fatalities increase substantially with comorbidity factors, such as heart disease, hypertension, diabetes, stroke, and liver disease [1, 4, 5]. These morbidity factors are known to increase rapidly with age [6, 7, 8]. Among the elderly the higher incidence of heart disease, diabetes, hypertension, and other comorbidity factors lead to their increased mortality from COVID-19. If it is primarily comorbidity factors that lead to death with COVID-19 patients and not age, then patient treatment will be more effective if physicians are aware that these factors lead to much greater risk than age does.
    Date: 2020
  34. By: Engy Ziedan; Kosali I. Simon; Coady Wing
    Abstract: The U.S. health care system has experienced great pressure since early March 2020 as it pivoted to providing necessary care for COVID-19 patients. But there are signs that non-COVID-19 care use declined during this time period. We examine near real time data from a nationwide electronic healthcare records system that covers over 35 million patients to provide new evidence of how non-COVID-19 acute care and preventive/primary care have been affected during the epidemic. Using event study and difference-in-difference models we find that state closure policies (stay-at-home or non-essential business closures) are associated with large declines in ambulatory visits, with effects differing by type of care. State closure policies reduced overall outpatient visits by about 15-16 percent within two weeks. Outpatient visits for health check-ups and well care experience very large declines during the epidemic, with substantial effects from state closure policies. In contrast, mental health outpatient visits declined less than other care, and appear less affected by state closure policies. We find substitution to telehealth modalities may have played an important role in mitigating the decline in mental health care utilization. Aggregate trends in outpatient visits show a 40% decline after the first week of March 2020, only a portion of which is attributed to state policy. A rebound starts around mid April that does not appear to be explained by state reopening policy. Despite this rebound, care visits still remain below the pre-epidemic levels in most cases.
    JEL: H0
    Date: 2020–07
  35. By: Menon, Nidhiya (Brandeis University)
    Abstract: This paper studies BMI as a correlate of the early spatial distribution and intensity of Covid-19 across the districts of India and finds that conditional on a range of individual, household, and regional characteristics, adult BMI significantly predicts the likelihood that the district is a hotspot, the natural log of the confirmed number of cases, the case fatality rate, and the propensity that the district is a red zone. Controlling for air-pollution, rainfall, temperature, demographic factors that measure population density, the proportion of the elderly, and health infrastructure including per capita health spending, the proportion of respiratory cases, and the number of viral disease outbreaks in the recent past, does not diminish the predictive power of BMI in influencing the spatial incidence and spread of the virus. The association between adult BMI and measures of spatial outcomes is especially pronounced among educated populations in urban settings, and impervious to conditioning on differences in testing rates across states. We find that among women, BMI proxies for a range of comorbidities (hemoglobin, high blood pressure and high glucose levels) that affects the severity of the virus while among men, these health indicators are less important and exposure to risk of contracting the virus as measured by work propensities is explanatory. We conduct heterogeneity and sensitivity checks and control for differences that may arise due to variations in timing of onset. Our results provide a readily available health marker that may be used to identify especially at-risk populations in developing countries like India.
    Keywords: BMI, COVID-19, spatial variation, intensity, India
    JEL: I15 I18 O12 D83
    Date: 2020–07
  36. By: Miller, Michael; Toffolutti, Veronica; Reeves, Aaron
    Abstract: In this paper, we argue that particular institutional arrangements partly explain the large and persistent differences in health systems and health outcomes observed in former colonies. Drawing on data from the World Health Organization for 62 countries, covering the period 2000–2014, we explore whether economic (risk of expropriation) and health (complete cause of death registries) institutions explain mortality rates and access to healthcare. To identify this relationship, we use settler mortality and the distance of the capital from the nearest major port – factors associated with institutional arrangements – to explain cross-national variation in health outcomes and the universality of health systems. We find that inclusive institutions arrangements – that protect and acknowledge the rights of citizens – are associated with better health outcomes (e.g. lower infant mortality and lower maternal mortality) as well as with better health systems (e.g. more skilled birth attendance and greater immunization). Inclusive institutions not only foster economic growth but improve health and well-being too.
    Keywords: Institutions; Health coverage; Instrumental variables; 313590-HRES
    JEL: I10 P16 P51
    Date: 2018–11–01
  37. By: Anup Malani; Satej Soman; Sam Asher; Paul Novosad; Clement Imbert; Vaidehi Tandel; Anish Agarwal; Abdullah Alomar; Arnab Sarker; Devavrat Shah; Dennis Shen; Jonathan Gruber; Stuti Sachdeva; David Kaiser; Luis M.A. Bettencourt
    Abstract: Managing the outbreak of COVID-19 in India constitutes an unprecedented health emergency in one of the largest and most diverse nations in the world. On May 4, 2020, India started the process of releasing its population from a national lockdown during which extreme social distancing was implemented. We describe and simulate an adaptive control approach to exit this situation, while maintaining the epidemic under control. Adaptive control is a flexible counter-cyclical policy approach, whereby different areas release from lockdown in potentially different gradual ways, dependent on the local progression of the dis- ease. Because of these features, adaptive control requires the ability to decrease or increase social distancing in response to observed and projected dynamics of the disease outbreak. We show via simulation of a stochastic Susceptible-Infected-Recovered (SIR) model and of a synthetic intervention (SI) model that adaptive control performs at least as well as immediate and full release from lockdown starting May 4 and as full release from lockdown after a month (i.e., after May 31). The key insight is that adaptive response provides the option to increase or decrease socioeconomic activity depending on how it affects disease progression and this freedom allows it to do at least as well as most other policy alternatives. We also discuss the central challenge to any nuanced release policy, including adaptive control, specifically learning how specific policies translate into changes in contact rates and thus COVID-19's reproductive rate in real time.
    JEL: I1
    Date: 2020–07
  38. By: Toxvaerd, F.; Rowthorn, R.
    Abstract: This paper considers a susceptible-infected-recovered type model of infectious diseases, such as COVID-19 or swine flu, in which costly treatment or vaccination confers immunity on recovered individuals. Once immune, individuals indirectly protect the remaining susceptibles, who benefit from a measure of herd immunity. Treatment and vaccination directly induce such herd immunity, which builds up over time. Optimal treatment is shown to involve intervention at early stages of the epidemic, while optimal vaccination defers intervention to later stages. Thus, while treatment and vaccination have superficial similarities, their effects and desirability at different stages of the epidemic are radically different. Equilibrium vaccination is qualitatively similar to socially optimal vaccination, while equilibrium treatment differs in nature from socially optimal treatment. The optimal policies are compared to traditional non-economic public health interventions which rely on herd immunity thresholds.
    Keywords: Economic epidemiology, herd immunity, treatment, vaccination, externalities
    JEL: C73 I18
    Date: 2020–08–19
  39. By: Proto, Eugenio (University of Glasgow); Quintana-Domeque, Climent (University of Exeter)
    Abstract: We use the UK Household Longitudinal Study and compare pre- (2017-2019) and post-COVID-19 data (April 2020) for the same group of individuals to assess and quantify changes in mental health among ethnic groups in the UK. We confirm the previously documented average deterioration in mental health for the whole sample of individuals interviewed pre- and post-COVID-19, and uncover four new facts. First, ethnicity predicts mental health deterioration when interacted with gender. Among men, BAME individuals experience a higher deterioration in mental health compared to British White individuals. However, among women, the deterioration in mental health is similar for both BAME and British White individuals. Second, the gender gap in mental health deterioration is only present among British White individuals and not among BAME individuals. Third, the drop in mental health among women and BAME men is very similar. Finally, there is substantial heterogeneity across BAME groups. The BAME group of Bangladeshi, Indian and Pakistani appears to be driving the difference in the gender gap in mental health deterioration between British White and BAME individuals. We call for additional research on the effects of the COVID-19 pandemic across different ethnic groups, and urge both policy makers and researchers to allocate resources to collect larger sample sizes of minority ethnic groups.
    Keywords: GHQ-12, wellbeing, mental health, mental distress, ethnicity, gender, COVID-19
    JEL: I1 J1 J15
    Date: 2020–07
  40. By: Cormac Ó Gráda
    Abstract: The global COVID-19 pandemic recalls the Ebola epidemic of 2014-15 and earlier much more lethal plague epidemics. All share several characteristics, even though the second and third plague epidemics dwarfed the both the 2014-15 Ebola outbreak and COVID-19 in terms of mortality. This essay reviews the mortality due to Ebola and plague and their lethality; the spatial and socioeconomic dimensions of plague mortality; the role of public action in containing the two diseases; and their economic impact.
    Keywords: Plague; Mortality; Health; Economic history
    JEL: I1 N
    Date: 2020–08
  41. By: Caitlin S. Brown; Martin Ravallion
    Abstract: Not much is obvious about how socioeconomic inequalities impact the spread of infectious diseases once one considers behavioral responses, correlations among multiple covariates and the likely non-linearities and dynamics involved. Social distancing responses to the threat of catching COVID-19 and outcomes for infections and deaths are modelled across US counties, augmenting epidemiological and health covariates with within-county median incomes, poverty and income inequality, and age and racial composition. Systematic socioeconomic effects on social distancing and infections emerge, and most effects do not fade as the virus spreads. Deaths, once infected, are less responsive to socioeconomic covariates. Richer counties tend to see greater gains in social distancing and lower infection rates, controlling for more standard epidemiological factors. Income poverty and inequality tend to increase the infection rate, but these effects are largely accountable to their correlation with racial composition. A more elderly population increases deaths conditional on infections, but has an offsetting effect on the infection rate, consistent with the behavioral responses we find through social distancing.
    JEL: I12 I14 I32
    Date: 2020–07
  42. By: Michele Valsecchi (New Economic School); Ruben Durante (Barcelona School of Economics and CEPR)
    Abstract: How does internal migration affect the spread of a pandemic? Looking at the case of Italy and using data on the province of origin of migrants located in outbreak areas, we document that provinces more exposed to the virus experience higher mortality in post-outbreak weeks, even when comparing provinces within the same region. We calculate that, had all non-outbreak provinces been as exposed as the one at the lowest decile of the exposure distribution, they would have experienced 60% fewer COVID-19 deaths. Additional evidence from phone records data confirms that the effect is mainly driven by increased mobility from outbreak areas.
    Keywords: internal migration, mobility, health, epidemic, Covid-19
    JEL: J61 R23 H12 I10
    Date: 2020–08
  43. By: Soria, Krista M; Horgos, Bonnie; Chirikov, Igor; Jones-White, Daniel
    Abstract: The COVID-19 pandemic has negative impacts on first-generation students enrolled at large public research universities, according to the Student Experience in the Research University (SERU) Consortium survey of 28,198 undergraduate students conducted May through July 2020 at nine universities. In the survey, 26% of respondents (n = 7,233) identified as first-generation students (those whose parents have not earned a bachelor’s degree). First-generation students were more likely than continuing-generation students to experience financial hardships during the pandemic, including lost wages from family members, lost wages from on- or off-campus employment, and increased living and technology expenses. Compared to continuing-generation students, first-generation students are nearly twice as likely to be concerned about paying for their education in fall 2020. Furthermore, first-generation students were also less likely to live in safe environments free from abuse (physical, emotional, drug, or alcohol) and more likely to experience food and housing insecurity. First-generation students also experienced higher rates of mental health disorders compared to their peers. The results of our study suggest that first-generation students experienced more challenges adapting to online instruction compared to continuing-generation students, including encountering obstacles related to lack of adequate study spaces and lack of technology necessary to complete online learning. Compared to continuing-generation students, first-generation students were also less likely to be able to meet during scheduled virtual class times. As institutional leaders look forward to the fall 2020 semester, we encourage them to consider the impact different instructional modalities may have in perpetuating existing disparities for first-generation students.
    Keywords: Education, Social and Behavioral Sciences, First-generation students, COVID-19, remote learning, mental health
    Date: 2020–08–10
  44. By: Jaison R. Abel; Jason Bram; Richard Deitz; Jonathan Hastings
    Abstract: The New York Fed today unveiled a set of charts that track COVID-19 cases in the Federal Reserve’s Second District, which includes New York, Northern New Jersey, Fairfield County Connecticut, Puerto Rico, and the U.S. Virgin Islands. These charts, available in the Indicators section of our Regional Economy webpage, are updated daily with the latest data on confirmed COVID-19 cases from The New York Times, which compiles information from state and local health agencies. Case counts are measured as the seven-day average of new reported daily cases and are presented on a per capita basis to allow comparisons to the nation and between communities in the region. Recent data indicate that after spiking to extraordinary levels in April, new cases have remained relatively low and stable in and around New York City. Cases didn’t reach nearly as high in upstate New York, and have held fairly low in recent weeks. By contrast, cases have been trending higher in Puerto Rico and the U.S. Virgin Islands since mid-July.
    Keywords: COVID-19; pandemic; cases
    JEL: R10
    Date: 2020–08–27
  45. By: Adams-Prassl, A.; Boneva, T.; Golin, M; Rauh, C.
    Abstract: Over 9 million jobs were furloughed in the UK during the Coronavirus pandemic. Using real time survey evidence from the UK in April and May, we document which workers were most likely to be furloughed and analyze variation in the terms on which they furloughed. We find that women were significantly more likely to be furloughed. Inequality in care responsibilities seem to have played a key role: mothers were 10 percentage points more likely than fathers to initiate the decision to be furloughed (as opposed to it being fully or mostly the employer’s decision) but we find no such gender gap amongst childless workers. The prohibition of working whilst furloughed was routinely ignored, especially by men who can do a large percentage of their work tasks from home. Women were less likely to have their salary topped up beyond the 80% subsidy paid for by the government. Considering the future, furloughed workers without employer-provided sick pay have a lower willingness to pay to return to work, as do those in sales and food preparation occupations. Compared to non-furloughed employees, furloughed workers are more pessimistic about keeping their job in the short to medium run and are more likely to be actively searching for a new job even when controlling for detailed job characteristics. These results have important implications for the design of short-time work schemes and the strategy for effectively reopening the economy.
    Keywords: Covid-19, Coronavirus, crisis, recession, short-time work, furlough, inequality
    JEL: J21 J22 J24 J33 J63
    Date: 2020–08–18
  46. By: Matthew Olczak (Aston Business School, Aston University); J. James Reade (Department of Economics, University of Reading); Matthew Yeo (Department of Economics, University of Reading)
    Abstract: Mass attendance events are a mainstay of economic and social activity. Such events have public health consequences, facilitating the spreading of disease, with attendant economic consequences. There is uncertainty over the impact such events can have on the spread of disease. We investigate the impact of regular mass outdoor meetings on the spread of a virus by considering football matches in England in February and March 2020 and the spread of Covid-19 into April 2020. There were 340 league and cup football matches with a combined attendance of 1.625m people in March, taking place over 188 of 313 local areas. We look at the occurrence and attendance at matches, and how full the stadia were, and how these variables are related to the spread of Covid-19 in April. We evaluate Covid-19 cases, deaths and excess deaths, all as rates of 100,000 people in an area. We find evidence that mass outdoor events were consistent with more cases and deaths, even after controlling for measurable characteristics of local areas. We find that a football match is consistent with around six additional Covid-19 cases per 100,000 people, two additional Covid-19 deaths per 100,000 people, and three additional excess deaths per 100,000 people. This effect is slightly stronger for the areas of away teams in March, and slightly weaker for matches in February. These results suggest caution in returning to unrestricted spectator attendance at matches. We caveat our analysis though by noting that stadium access and egress routes can be adapted such that some of the opportunities for the spread of an airborne virus could be mitigated. We recommend that the relevant authorities conduct pilot events before determining to what extent fans can return to mass outdoor events.
    Keywords: Social distancing, mass outdoor gatherings, Covid-19
    JEL: I18 H12 I10
    Date: 2020–09–03
  47. By: Moustafa, Khaled
    Abstract: The ongoing COVID-19 pandemic should teach us some lessons at health, environmental and human levels toward more fairness, human cohesion and environmental sustainability. At a health level, the pandemic raises the importance of housing for everyone particularly vulnerable and homeless people to protect them from the disease and other similar airborne pandemics. Here, I propose to make good use of big data along with 3D construction printers to solve major and pressing needs of housing worldwide. Big data can be used to calculate how many people do need accommodations and 3D construction printers to build houses accordingly and swiftly. The combination of such facilities- big data and 3D printers- can help solve global housing crises more efficiently than traditional and unguided construction plans. This is particularly urgent under environmental and major health crises where health and housing are tightly interrelated.
    Date: 2020–08–26
  48. By: Benitez, Joseph (University of Kentucky); Courtemanche, Charles (Georgia State University); Yelowitz, Aaron (University of Kentucky)
    Abstract: As of June 2020, the coronavirus pandemic has led to more than 2.3 million confirmed infections and 121 thousand fatalities in the United States, with starkly different incidence by race and ethnicity. Our study examines racial and ethnic disparities in confirmed COVID-19 cases across six diverse cities – Atlanta, Baltimore, Chicago, New York City, San Diego, and St. Louis – at the ZIP code level (covering 436 "neighborhoods" with a population of 17.7 million). Our analysis links these outcomes to six separate data sources to control for demographics; housing; socioeconomic status; occupation; transportation modes; health care access; long-run opportunity, as measured by income mobility and incarceration rates; human mobility; and underlying population health. We find that the proportions of black and Hispanic residents in a ZIP code are both positively and statistically significantly associated with COVID-19 cases per capita. The magnitudes are sizeable for both black and Hispanic, but even larger for Hispanic. Although some of these disparities can be explained by differences in long-run opportunity, human mobility, and demographics, most of the disparities remain unexplained even after including an extensive list of covariates related to possible mechanisms. For two cities – Chicago and New York – we also examine COVID-19 fatalities, finding that differences in confirmed COVID-19 cases explain the majority of the observed disparities in fatalities. In other words, the higher death toll of COVID-19 in predominantly black and Hispanic communities mostly reflects higher case rates, rather than higher fatality rates for confirmed cases.
    Keywords: COVID-19, coronavirus, racial disparities, ethnic disparities, health disparities
    JEL: I14
    Date: 2020–07
  49. By: Frank Milne (Queen's University); David Longworth
    Abstract: There is an important interdependence between economic, financial and health policy actions. The recent Covid-19 crisis has demonstrated that, apart from the direct economic consequences from illness and death from the virus, the main economic and financial costs have been due to the varying degrees of preventative measures taken by the public, firms, and governments that directly impacted economic and financial activity. This paper proposes the use of regular, combined medical, economic and financial stress tests and wargames in preparing for future pandemics and other major environmental shocks.
    Keywords: Covid-19, Government Policy, Wargames, Stress Tests, Banking, Monetary Policy
    JEL: I18 H12 H51 H84 G21
    Date: 2020–08
  50. By: Andrew Atkeson; Karen A. Kopecky; Tao Zha
    Abstract: We document four facts about the COVID-19 pandemic worldwide relevant for those studying the impact of non-pharmaceutical interventions (NPIs) on COVID-19 transmission. First: across all countries and U.S. states that we study, the growth rates of daily deaths from COVID-19 fell from a wide range of initially high levels to levels close to zero within 20-30 days after each region experienced 25 cumulative deaths. Second: after this initial period, growth rates of daily deaths have hovered around zero or below everywhere in the world. Third: the cross section standard deviation of growth rates of daily deaths across locations fell very rapidly in the first 10 days of the epidemic and has remained at a relatively low level since then. Fourth: when interpreted through a range of epidemiological models, these first three facts about the growth rate of COVID deaths imply that both the effective reproduction numbers and transmission rates of COVID-19 fell from widely dispersed initial levels and the effective reproduction number has hovered around one after the first 30 days of the epidemic virtually everywhere in the world. We argue that failing to account for these four stylized facts may result in overstating the importance of policy mandated NPIs for shaping the progression of this deadly pandemic.
    Keywords: COVID-19; Epidemic; Non-pharmaceutical intervention
    JEL: C01 I0
    Date: 2020–08–21
  51. By: Marina Azzimonti-Renzo; Alessandra Fogli; Fabrizio Perri; Mark Ponder
    Abstract: We develop an ECON-EPI network model to evaluate policies designed to improve health and economic outcomes during a pandemic. Relative to the standard epidemiological SIR set-up, we explicitly model social contacts among individuals and allow for heterogeneity in their number and stability. In addition, we embed the network in a structural economic model describing how contacts generate economic activity. We calibrate it to the New York metro area during the 2020 COVID-19 crisis and show three main results. First, the ECON-EPI network implies patterns of infections that better match the data compared to the standard SIR. The switching during the early phase of the pandemic from unstable to stable contacts is crucial for this result. Second, the model suggests the design of smart policies that reduce infections and at the same time boost economic activity. Third, the model shows that reopening sectors characterized by numerous and unstable contacts (such as large events or schools) too early leads to fast growth of infections.
    Keywords: Complex networks; COVID-19; Epidemiology; Social distance; SIR
    JEL: D85 E23 E65 I18
    Date: 2020–08–19
  52. By: Olivier Armantier; Gizem Koşar; Rachel Pomerantz; Wilbert Van der Klaauw
    Abstract: A growing body of evidence points to large negative economic and health impacts of the COVID-19 pandemic on low-income, Black, and Hispanic Americans (see this LSE post and reports by Pew Research and Harvard). Beyond the consequences of school cancellations and lost social interactions, there exists considerable concern about the long-lasting effects of economic hardship on children. In this post, we assess the extent of the underlying economic and financial strain faced by households with children living at home, using newly collected data from the monthly Survey of Consumer Expectations (SCE).
    Keywords: economic hardship; pandemic; COVID-19; households
    JEL: D14 I18
    Date: 2020–08–13
  53. By: Alacevich, Caterina (Pompeu Fabra University); Cavalli, Nicolò (Bocconi University); Giuntella, Osea (University of Pittsburgh); Lagravinese, Raffaele (University of Bari); Moscone, Francesco (Brunel University); Nicodemo, Catia (University of Oxford)
    Abstract: We explore the relationship between the spatial distributions of excess deaths and care home facilities during the COVID-19 outbreak in Italy. Using registry-based mortality data (January 1st- March 31st, 2015-2020) for Lombardy, one of the areas hit most severely, we estimate that municipalities with care homes present significantly higher excess death rates among the elderly (+41%). We find that this effect is not driven by the size of care homes and of the vulnerable population that they host. Rather, our results suggest that the excess deaths did not occur only within care homes and these facilities acted as one of the possible catalysts in the diffusion of COVID-19 in the whole elderly population of their surrounding territory.
    Keywords: care homes, COVID-19, excess mortality
    JEL: I10 I18 I30
    Date: 2020–07
  54. By: Bertocchi, Graziella (University of Modena and Reggio Emilia); Dimico, Arcangelo (Queen's University Belfast)
    Abstract: Discussion on the disproportionate impact of COVID-19 on African Americans has been at center stage since the outbreak of the epidemic in the United States. To present day, however, lack of race-disaggregated individual data has prevented a rigorous assessment of the extent of this phenomenon and the reasons why blacks may be particularly vulnerable to the disease. Using individual and georeferenced death data collected daily by the Cook County Medical Examiner, we provide first evidence that race does affect COVID-19 outcomes. The data confirm that in Cook County blacks are overrepresented in terms of COVID-19 related deaths since – as of June 16, 2020 – they constitute 35 percent of the dead, so that they are dying at a rate 1.3 times higher than their population share. Furthermore, by combining the spatial distribution of mortality with the 1930s redlining maps for the Chicago area, we obtain a block group level panel dataset of weekly deaths over the period January 1, 2020-June 16, 2020, over which we establish that, after the outbreak of the epidemic, historically lower-graded neighborhoods display a sharper increase in mortality, driven by blacks, while no pre-treatment differences are detected. Thus, we uncover a persistence influence of the racial segregation induced by the discriminatory lending practices of the 1930s, by way of a diminished resilience of the black population to the shock represented by the COVID-19 outbreak. A heterogeneity analysis reveals that the main channels of transmission are socioeconomic status and household composition, whose influence is magnified in combination with a higher black share.
    Keywords: COVID-19, deaths, blacks, redlining, vulnerability, Cook County, Chicago
    JEL: I14 J15 N32 N92 R38
    Date: 2020–07
  55. By: Laurent Bach (ESSEC Business School - Essec Business School, IPP - Institut des politiques publiques); Arthur Guillouzouic (IPP - Institut des politiques publiques, PSE - Paris School of Economics, Institut d'Études Politiques [IEP] - Paris); Clément Malgouyres (IPP - Institut des politiques publiques, PSE - Paris School of Economics)
    Abstract: We estimate the impact of French town hall elections held in mid-March 2020 on the mortality of 170,000 male candidates aged above 60. Their excess mortality during March and April was similar to the general population. We compare candidates in cities with two candidate lists to those in cities with only one list, as elections are more intense in contacts in the former group. We also use a regression discontinuity design and investigate mortality in 2020 depending on how candidates fared in the 2014 election. We cannot detect any causal effect of active participation in the 2020 elections on mortality.
    Keywords: Covid-19 pandemic,French elections,individual-level data,regression discontinuity design
    Date: 2020–07
  56. By: Demombynes,Gabriel
    Abstract: A greater share of reported COVID-19 deaths occur at younger ages in low- and middle-income countries (LMICs) compared to high-income countries (HICs). Based on data from 26 countries, people age 70 and older constitute 37 percent of deaths attributed to COVID-19 in LMICs on average, versus 87 percent in HICs. Only part of this difference is accounted for by differences in population age structure. In this paper, COVID-19 mortality rates are calculated for each age group by dividing the number of COVID-19 deaths by the underlying population. The resulting age-mortality curves are flatter in countries with lower incomes. In HICs, the COVID-19 mortality rate for those ages 70-79 is 12.6 times the rate for those ages 50-59. In LMICs, that ratio is just 3.5. With each year of age, the age-specific mortality rate increases by an average of 12.6 percent in HICs versus 7.1 percent in LMICs. This pattern holds overall and separately for men's and women's mortality rates. It reflects some combination of variation across countries in age patterns of infection rates, fatality rates among those infected, and under-attribution of deaths to COVID-19. The findings highlight that experiences with COVID-19 in wealthy countries may not be generalizable to developing countries.
    Date: 2020–07–01
  57. By: Evan DeFilippis; Stephen Michael Impink; Madison Singell; Jeffrey T. Polzer; Raffaella Sadun
    Abstract: We explore the impact of COVID-19 on employee's digital communication patterns through an event study of lockdowns in 16 large metropolitan areas in North America, Europe and the Middle East. Using de- identified, aggregated meeting and email meta-data from 3,143,270 users, we find, compared to pre- pandemic levels, increases in the number of meetings per person (+12.9 percent) and the number of attendees per meeting (+13.5 percent), but decreases in the average length of meetings (-20.1 percent). Collectively, the net effect is that people spent less time in meetings per day (-11.5 percent) in the post- lockdown period. We also find significant and durable increases in length of the average workday (+8.2 percent, or +48.5 minutes), along with short-term increases in email activity. These findings provide insight from a novel dataset into how the nature of work has changed for a large sample of knowledge workers. We discuss these changes in light of the ongoing challenges faced by organizations and workers struggling to adapt and perform in the face of a global pandemic.
    JEL: L2 L23 M0
    Date: 2020–07
  58. By: Anand, Paul (The Open University); Allen, Heidi (Columbia University); Ferrer, Robert (University of Texas at Dallas); Gold, Natalie (University of Oxford); Gonzales Martinez, Rolando (Agder University College); Kontopantelis, Evan (University of Manchester); Krause, Melanie (University College London); Vergunst, Francis (University of Montreal)
    Abstract: The paper provides new evidence from a survey of 2000 individuals in the US and UK related to predictors of Covid-19 transmission. Specifically, it investigates work and personal predictors of transmission experience reported by respondents using regression models to better understand possible transmission pathways and mechanisms in the community. Three themes emerge from the analysis. Firstly, transport roles and travelling practices are significant predictors of infection. Secondly, evidence from the US especially shows union membership, consultation over safety measures and the need to use public transport to get to work are also significant predictors. This is interpreted as evidence of the role of deprivation and of reactive workplace consultations. Thirdly and finally, there is some, often weaker, evidence that income, car-owership, use of a shared kitchen, university degree type, riskaversion, extraversion and height are predictors of transmission. The comparative nature of the evidence indicates that the less uniformly stringent nature of the US lockdown provides more information about both structural and individual factors that predict transmission. The evidence about height is discussed in the context of the aerosol transmission debate. The paper concludes that both structural and individual factors must be taken into account when predicting transmission or designing effective public health measures and messages to prevent or contain transmission.
    Keywords: COVID-19, transmission, predictors, transport, workplace, deprivation, risk preference, extraversion, height, US, UK
    JEL: I1 I12 I14 I18
    Date: 2020–07
  59. By: Selene Ghisolfi (Institute for International Economic Studies, Stockholm University; LEAP, Bocconi University); Ingvild Almås (Institute for International Economic Studies, Stockholm University); Justin Sandefur (Center for Global Development); Tillmann von Carnap (Institute for International Economic Studies, Stockholm University); Jesse Heitner (Aceso Global); Tessa Bold (Institute for International Economic Studies, Stockholm University)
    Abstract: Early reports suggest the fatality rate from COVID-19 varies greatly across countries, but non-random testing and incomplete vital registration systems render it impossible to directly estimate the infection fatality rate (IFR) in many low- and middle-income countries. To fill this gap, we estimate the adjustments required to extrapolate estimates of the IFR from high- to lower-income regions. Accounting for differences in the distribution of age, sex, and relevant comorbidities yields substantial differences in the predicted IFR across 21 world regions, ranging from 0.11% in Western Sub-Saharan Africa to 1.07% for High Income Asia Pacific. However, these predictions must be treated as lower bounds, as they are grounded in fatality rates from countries with advanced health systems. In order to adjust for health system capacity, we incorporate regional differences in the relative odds of infection fatality from childhood influenza. This adjustment greatly diminishes, but does not entirely erase, the demography-based advantage predicted in the lowest income settings, with regional estimates of the predicted COVID-19 IFR ranging from 0.43% in Western Sub-Saharan Africa to 1.83% for Eastern Europe.
    Keywords: COVID-19
    Date: 2020–06–12
  60. By: Tatsushi Oka; Wei Wei; Dan Zhu
    Abstract: Governments around the world have implemented preventive measures against the spread of the coronavirus disease (COVID-19). In this study, we consider a multivariate discrete-time Markov model to analyze the propagation of COVID-19 across 33 provincial regions in China. This approach enables us to evaluate the effect of mobility restriction policies on the spread of the disease. We use data on daily human mobility across regions and apply the Bayesian framework to estimate the proposed model. The results show that the spread of the disease in China was predominately driven by community transmission within regions and the lockdown policy introduced by local governments curbed the spread of the pandemic. Further, we document that Hubei was only the epicenter of the early epidemic stage. Secondary epicenters, such as Beijing and Guangdong, had already become established by late January 2020, and the disease spread out to connected regions. The transmission from these epicenters substantially declined following the introduction of human mobility restrictions across regions.
    Date: 2020–08
  61. By: António Rua; Nuno Lourenço
    Abstract: The SARS-CoV-2 outbreak has spread worldwide causing unprecedented disruptions in the economies. These unparalleled changes in economic conditions made clear the urgent need to depart from traditional statistics to inform policy responses. Hence, the interest in tracking economic activity in a timely manner has led economic agents to rely on high-frequency data as traditional statistics are released with a lag and available at a lower frequency. Naturally, taking on board such a novel data involves addressing some of the complexities of highfrequency data (e.g. marked seasonal patterns or calendar effects). Herein, we propose a daily economic indicator (DEI), which can be used to assess the behavior of economic activity during the lockdown period in Portugal. The indicator points to a sudden and sharp drop of economic activity around mid-March 2020, when the highest level of alert due to the COVID-19 pandemic was declared in March 12. It declined further after the declaration of the State of Emergency in the entire Portuguese territory in March 18, reflecting the lockdown of several economic activities. The DEI also points to an unprecedented decline of economic activity in the first half of April, with some very mild signs of recovery at the end of the month.
    JEL: C22 C38 E32
    Date: 2020
  62. By: Anastasios Papanastasiou (Department of Economics, McMaster University, Canada); Bradley J. Ruffle (Department of Economics, McMaster University, Canada; Rimini Centre for Economic Analysis); Angela L. Zheng (Department of Economics, McMaster University, Canada)
    Abstract: We study the factors associated with compliance with social-distancing regulations using a unique dataset on the behaviour of Ontarians during the COVID-19 pandemic. To start, we build a simple theoretical model of social distancing in order to understand how some individual and community-level factors influence compliance. We test our model’s predictions by designing and conducting a survey on Ontarians in which we elicit their degree of compliance with current distancing regulations as well as proposed regulations that impose different fine levels on violators or grant wage subsidies to encourage staying at home. In line with the model’s predictions, we show that variables related to one’s risk of infection (e.g., health status, age, necessity of working outside the home, regional COVID-19 cases) are significant predictors of compliance as are gender, political beliefs, risk and time preferences. Furthermore, we demonstrate that fines and wage subsidies can be powerful policy tools for promoting full compliance with regulations.
    Keywords: COVID-19, physical distancing, non-compliance fines, wage subsidies, risk of infection
    JEL: I12 I18 J38
    Date: 2020–08
  63. By: Chang Ma; John H. Rogers; Sili Zhou
    Abstract: We examine the immediate effects and bounce-back from six modern health crises: 1968 Flu, SARS (2003), H1N1 (2009), MERS (2012), Ebola (2014), and Zika (2016). Time-series models for a large cross-section of countries indicate that real GDP growth falls by around three percentage points in affected countries relative to unaffected countries in the year of the outbreak. Bounce-back in GDP growth is rapid, but output is still below pre-shock level five years later. Unemployment for less educated workers is higher and exhibits more persistence, and there is significantly greater persistence in female unemployment than male. The negative effects on GDP and unemployment are felt less in countries with larger first-year responses in government spending, especially on health care. Affected countries' consumption declines, investment drops sharply, and international trade plummets. Bounce-back in these expenditure categories is also rapid but not by enough to restore pre-shock trends. Furthermore, indirect effects on own-country GDP from affected trading partners are significant for both the initial GDP decline and the positive bounce back. We discuss why our estimates are a lower bound for the global economic effects of COVID-19 and compare contours of the current pandemic to the historical episodes.
    Keywords: Fiscal policy; Health crises; Unemployment; COVID-19; Trade network; Output loss
    JEL: I10 E60 F40
    Date: 2020–08–07
  64. By: Oreffice, Sonia; Quintana-Domeque, Climent (University of Exeter)
    Abstract: We investigate gender differences across socioeconomic and wellbeing dimensions after three months of lockdown in the UK, using an online sample of approximately 1,500 respondents in Prolific, representative of the UK population with regards to age, sex and ethnicity. We find that women's mental health is worse than men's along the four metrics we collected data on, that women are more concerned about getting and spreading the virus, and that women perceive the virus as more prevalent and lethal than men do. Women are also more likely to expect a new lockdown or virus outbreak by the end of 2020, and are more pessimistic about the current and future state of the UK economy, as measured by their forecasted present and future unemployment rates. Consistent with their more pessimistic views about the economy, women choose to donate more to food banks. Women are more likely to have lost their job because of the pandemic, and working women are more likely to hold more coronavirus-risky jobs than men. We also find that between February and June 2020 women have decreased their work hours, but increased housework and childcare much more than men. These gender inequalities are not driven by differences in age, ethnicity, education, family structure, income in 2019, current employment status, place of residence or living in rural/urban areas.
    Keywords: Coronavirus, sex, inequity, wellbeing, health, employment, perceptions, donations, COVID-19
    JEL: H1 J1 J16
    Date: 2020–07
  65. By: Alexander W. Bartik; Marianne Bertrand; Feng Lin; Jesse Rothstein; Matt Unrath
    Abstract: We use traditional and non-traditional data to measure the collapse and partial recovery of the U.S. labor market from March to early July, contrast this downturn to previous recessions, and provide preliminary evidence on the effects of the policy response. For hourly workers at both small and large businesses, nearly all of the decline in employment occurred between March 14 and 28. It was driven by low-wage services, particularly the retail and leisure and hospitality sectors. A large share of the job losses in small businesses reflected firms that closed entirely, though many subsequently reopened. Firms that were already unhealthy were more likely to close and less likely to reopen, and disadvantaged workers were more likely to be laid off and less likely to return. Most laid off workers expected to be recalled, and this was predictive of rehiring. Shelter-in-place orders drove only a small share of job losses. Last, states that received more small business loans from the Paycheck Protection Program and states with more generous unemployment insurance benefits had milder declines and faster recoveries. We find no evidence that high UI replacement rates drove job losses or slowed rehiring.
    JEL: E24 E32 J2 J63
    Date: 2020–07

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