nep-hea New Economics Papers
on Health Economics
Issue of 2020‒10‒12
thirty-two papers chosen by
Nicolas R. Ziebarth
Cornell University

  1. Scaring or scarring? Labour market effects of criminal victimisation By Anna Bindler; Nadine Ketel
  2. Are Older People Aware of Their Cognitive Decline? Misperception and Financial Decision Making By Mazzonna, Fabrizio; Peracchi, Franco
  3. The Peace Baby Boom: Evidence from Colombia's peace agreement with the FARC By Guerra-Cújar, María Elvira; Prem, Mounu; Rodríguez-Lesmes, Paul; Vargas, Juan F.
  4. Impact of State Children’s Health Insurance Program on Fertility of Immigrant Women By Kabir Dasgupta; Keshar Ghimire; Alexander Plum
  5. Work Disability after Motherhood and How Paternity Leave Can Help By Fontenay, Sébastien; Tojerow, Ilan
  6. Incorporating quality in the efficiency assessment of hospitals using a generalized directional distance function approach By Calogero Guccio; Domenico Lisi; Marco Ferdinando Martorana; Giacomo Pignataro
  7. Happy Pills? Mental Health Effects of the Dramatic Increase of Antidepressant Use By Masiero, Giuliano; Mazzonna, Fabrizio; Steinbach, Sandro
  8. Self-Selection in Physical and Mental Health among Older Intra-European Migrants By Amelie F. Constant; Nadja Milewski
  9. Healthy business? Managerial education and management in healthcare By Bloom, Nick; Lemos, Renato; Sadun, Raffaella; Van Reenen, John
  10. On Absolute Socioeconomic Health Inequality Comparisons By Mohamad Khaled; Paul Makdissi; Myra Yazbeck
  11. Selfitis and Motivation for Self-portrayal Among Young Nigerians By Olanrewaju O. Akinola; Akintayo A. Ogunsanya; Oluwakemi D. Okunade; Ibrahim A. Adekunle
  12. Understanding Alcohol Consumption across Countries By Clements, Ken; Lan, Yihui; Liu, Haiyan
  13. Does Health Reform Reduce Inequalities? Primary Healthcare of Young Children in Turkey By Asena Caner; Deniz Karaoglan; Gülbiye Yasar
  14. Revised Estimates of the Impact of Climate Change on Extreme Poverty by 2030 By Jafino,Bramka Arga; Walsh,Brian James; Rozenberg,Julie; Hallegatte,Stephane
  15. Act Early to Prevent Infections and Save Lives: Causal Impact of Diagnostic Efficiency on the COVID-19 Pandemic By Chen, Simiao; Jin, Zhangfeng; Bloom, David E.
  16. Investigating the Effect of Health Insurance in the COVID-19 Pandemic By Rajashri Chakrabarti; Lindsay Meyerson; William Nober; Maxim L. Pinkovskiy
  17. Lives Saved during Economic Downturns: Evidence from Australia By Atalay, Kadir; Edwards, Rebecca; Schurer, Stefanie; Ubilava, David
  18. Real Time Forecasting of Covid-19 Intensive Care Units demand By Berta, Paolo; Lovaglio, Pietro Giorgio; Paruolo, Paolo; Verzillo, Stefano
  19. Contraception, Intra-household Behaviour and Epidemic: Evidence from the Zika crisis in Colombia By Cortés, Darwin; Gamboa, Luis Fernando; Rodríguez-Lesmes, Paul
  20. Face Masks, Public Policies and Slowing the Spread of COVID-19: Evidence from Canada By Alexander Karaivanov; Hitoshi Shigeoka; Shih En Lu; Cong Chen; Stephanie Pamplona
  21. Slums and Pandemics By Luiz Brotherhood; Tiago Cavalcanti; Daniel da Mata; Cezar Santos
  22. Experts and Epidemics By Klaus Gründler; Niklas Potrafke
  23. An economic model of the Covid-19 pandemic with young and old agents: Behavior, testing and policies By Luiz Brotherhood; Philipp Kircher; Cezar Santos; Michèle Tertilt
  24. On Covid-19: New Implications of Job Task Requirements and Spouse's Occupational Sorting By Warn N. Lekfuangfu; Suphanit Piyapromdee; Ponpoje Porapakkarm; Nada Wasi
  25. Predictors of Social Distancing and Mask-Wearing Behavior: Panel Survey in Seven U.S. States By Nikolov, Plamen; Pape, Andreas; Tonguc, Ozlem; Williams, Charlotte
  26. Who’s In and Who’s Out under Workplace COVID Symptom Screening? By Krista Ruffini; Aaron Sojourner; Abigail Wozniak
  27. COVID-19 and social protection in South Asia: India By Fabianna Bacil; Gabriel Soyer
  28. How did the early stages of the COVID-19 pandemic affect teacher wellbeing? By Rebecca Allen; John Jerrim; Sam Sims
  29. COVerAGE-DB: a database of age-structured COVID-19 cases and deaths By Timothy Riffe; Enrique Acosta; José M. Aburto; Diego Alburez-Gutierrez; Ugofilippo Basellini; Anna Altová; Simona Bignami; Didier Breton; Eungang Choi; Jorge Cimentada; Gonzalo De Armas; Emanuele Del Fava; Alicia Delgado; Viorela Diaconu; Jessica Donzowa; Christian Dudel; Antonia Fröhlich; Alain Gagnon; Mariana Garcia Cristómo; Victor M. Garcia-Guerrero; Armando González-Díaz; Irwin Hecker; Dagnon Eric Koba; Marina Kolobova; Mine Kühn; Chia Liu; Andrea Lozer; Mădălina Manea; Muntasir Masum; Ryohei Mogi; Saskia Morwinsky; Ronald Musizvingoza; Mikko Myrskylä; Marilia R. Nepomuceno; Michelle Nickel; Natalie Nitsche; Anna Oksuzyan; Samuel Oladele; Emmanuel Olamijuwon; Oluwafunke Omodara; Soumaila Ouedraogo; Mariana Paredes; Marius Pascariu; Manuel Piriz; Raquel Pollero; Federico Rehermann; Filipe Ribeiro; Silvia Rizzi; Francisco Rowe; Isaac Sasson; Jiaxin Shi; Rafael Silva-Ramirez; Cosmo Strozza; Catalina Torres; Sergi Trias-Llimos; Fumiya Uchikoshi; Alyson A. van Raalte; Paola Vazquez-Castillo; Estevão Vilela; Iván Williams; Virginia Zarulli
  30. The gender gap in aversion to COVID-19 exposure: evidence from professional tennis By Piotr Lewandowski; Zuzanna Kowalik
  31. Framing the Predicted Impacts of COVID-19 Prophylactic Measures in Terms of Lives Saved Rather Than Deaths Is More Effective for Older People By Biroli, Pietro; Bosworth, Steven J.; Della Giusta, Marina; Di Girolamo, Amalia; Jaworska, Sylvia; Vollen, Jeremy
  32. COVID-19 Pandemic and Economic Scenarios for Ontario By Miguel Casares; Paul Gomme; Hashmat Khan

  1. By: Anna Bindler (University of Cologne and University of Gothenburg); Nadine Ketel (Vrije Universiteit Amsterdam)
    Abstract: Little is known about the costs of crime to victims. We use unique and detailed register data on victimisations and monthly labour market outcomes from the Netherlands and estimate event-study designs to assess short- and long-term effects of criminal victimisation. Across offences, both males and females experience significant decreases in earnings (up to -12.9%) and increases in benefit receipt (up to +6%) after victimisation. The negative labour market responses are lasting (up to four years) and accompanied by shorter-lived responses in health expenditure. Additional analyses suggest that the victimisation is a life-changing event leading to escalation points in victims’ lives.
    Keywords: Crime; victimisation; labour market outcomes; event-study design
    JEL: K4 J01 J12 I1
    Date: 2020–09
  2. By: Mazzonna, Fabrizio (USI Università della Svizzera Italiana); Peracchi, Franco (University of Rome Tor Vergata)
    Abstract: We investigate whether older people correctly perceive their own cognitive decline, and the potential financial consequences of misperception. First, we document the fact that older people tend to underestimate their cognitive decline. We then show that those who experienced a severe cognitive decline, but are unaware of it, are more likely to suffer wealth losses compared to those who are aware or did not experience a severe decline. These losses largely reflect decreases in financial wealth and are mainly experienced by wealthier people who were previously active on the stock market. Our findings support the view that financial losses among older people unaware of their cognitive decline are the result of bad financial decisions, not of rational disinvestment strategies.
    Keywords: aging, cognitive ability, household finance, HRS
    JEL: J14 J24 C23
    Date: 2020–09
  3. By: Guerra-Cújar, María Elvira; Prem, Mounu; Rodríguez-Lesmes, Paul; Vargas, Juan F.
    Abstract: Violent environments are known to affect household fertility choices, demand for health services and health outcomes of newborns. Using administrative data with a difference-in-differences (2011-2018 period), we study how the end of the 50 years old Colombian conflict with FARC modified such decisions and outcomes in traditionally affected areas of the country. Results indicate a reduction in fertility for municipalities traditionally affected by conflict because of the permanent ceasefire (2014). Total fertility rate observed a relative increase of 2.6% in the formerly conflict-affected areas. However, no impact was found for demand of health care services, neonatal and infant mortality rates, or birth outcomes such as the incidence of low weight at birth or the percentage of preterm births. Our evidence shows that municipalities with landmine victims and expelled population by forced displacement before the ceasefire have significantly higher total fertility rate in the four years following the ceasefire.
    Keywords: fertility; pregnancy; mortality; armed conflict; violence
    JEL: I12 I15
    Date: 2020–09
  4. By: Kabir Dasgupta (NZ Work Research Institute, Faculty of Business, Economics and Law at AUT University); Keshar Ghimire; Alexander Plum (NZ Work Research Institute, Faculty of Business, Economics and Law at AUT University)
    Abstract: Between 1997 and 2000, all states in the United States (US) enacted the State Children’s Health Insurance Program (SCHIP) to provide publicly funded health insurance coverage for children in low income families. However, only 15 states including the District of Columbia chose to provide coverage for children of newly arrived immigrants in their SCHIP. We exploite the resulting state and time variation in the implementation of the program in a difference-in-differences framework to estimate the effect of a publicly funded children’s health insurance benefit on immigrant women’s fertility. While estimates from full samples show that the net effect of the program was indistinguishable from zero, we find a significant positive effect on the fertility of unmarried immigrant women, both at extensive and at intensive margin. Our findings have important policy implications for societies experiencing a persistent decline in fertility.
    Keywords: State Children’s Health Insurance Program; Immigrant Fertility; Birth rate; Quantity-quality tradeoff
    JEL: I13 J13
    Date: 2020–08
  5. By: Fontenay, Sébastien (Free University of Brussels); Tojerow, Ilan (Free University of Brussels)
    Abstract: We study how childbirth increases the likelihood of young, working mothers to claim disability insurance and how paternity leave could ease this effect. Our event study analysis uses Belgian data to show that the incidence rate of disability across gender only diverges after first-time childbirth. This "other child penalty" can be reduced with the provision of paternity leave. Our regression discontinuity difference-in-differences design shows that mothers with partners eligible for a two-week-long paternity leave spent on average 21% fewer days on disability over twelve years. Moreover, we show links between this incidence of paternity leave and consequent birth-spacing decisions.
    Keywords: disability insurance, gender, child penalty, paternity leave, maternal health, birth spacing, natural experiment, regression discontinuity, event study
    JEL: J16 J13 I13 H55
    Date: 2020–09
  6. By: Calogero Guccio (Università di Catania); Domenico Lisi (Università di Catania e University of York); Marco Ferdinando Martorana (Università di Catania); Giacomo Pignataro (Università di Catania, University of York e Politecnico di Milano)
    Abstract: The increasing pressure to cost containment in the public sector and, specifically, in health care provision raises concern on the potential adverse effects on the hospital quality that would imply the existence of an efficiency-effectiveness trade-off. This hypothesis calls for taking into account explicitly the relationship between efficiency and quality when analyzing hospitals’ performance. This paper adopts a non-parametric approach to study the whole performance in the provision of hospital services in Italy. We employ a generalized directional distance function that allows incorporating both desirable outputs and undesirable outcomes (i.e. risk-adjusted mortality rates) in the estimation of efficiency, thus enabling for studying hospital performance thoroughly, and assess the impact of integrating quality in the efficiency assessment. We find that including quality does matter. In addition, considering that patients in the Italian National Health System do not directly pay for treatments and, thus, hospitals presumably compete on quality in a catchment area, we also study whether taking into account quality matters in studying spatial dependence in hospital performance.
    Keywords: hospital efficiency, directional distance function, undesirable outputs, tradeoff effectiveness-efficiency, spatial dependence
    JEL: I12 I18 H75 D22
    Date: 2020–09
  7. By: Masiero, Giuliano (USI Università della Svizzera Italiana); Mazzonna, Fabrizio (USI Università della Svizzera Italiana); Steinbach, Sandro (University of Connecticut)
    Abstract: Despite the growing skepticism regarding the efficacy of antidepressants, global consumption has increased at an unprecedented rate with unknown implications for society. We estimate the causal effect of this increase on mental health outcomes using an instrumental variable strategy that exploits pharmaceutical company local market power and the availability of detailed drug sales data from Switzerland between 2002 and 2014. Our main instrument, a modified version of the popular shift-share instrument, relies on the national growth in antidepressant sales for pharmaceutical companies (the shift) – mainly due to product innovation – and assigns it locally using regional non-antidepressant market shares. Our estimates show that an increase in antidepressant sales causes a sharp increase of hospital admissions related to depression symptoms. An alternative instrument, which exploits prescribing practice spillovers from neighboring countries, leads to very similar point estimates providing further evidence about the validity of our results.
    Keywords: depression, antidepressant treatment, suicides, mental health
    JEL: I12 I18
    Date: 2020–09
  8. By: Amelie F. Constant; Nadja Milewski
    Abstract: The Healthy Immigrant Paradox found in the literature by comparing the health of immigrants to that of natives in the host country, may suffer from serious cultural biases. Our study evades such biases by utilizing a destination-origin framework, in which we compare the health of emigrants to that of their compatriots who stay in the country of origin. Isolating cultural effects can best gauge self-selection and host country effects on the health of emigrants with longer time abroad. We study both the physical and mental dimensions of health among European-born emigrants over 50, who originate from seven European countries and now live elsewhere in Europe. We use the Survey of Health, Ageing and Retirement in Europe and apply multi-level modeling. Regarding the physical health we find positive self-selection, beneficial adaptation effects, and effects from other observables for some but not all countries. With the notable exception of the German émigrés, we cannot confirm selection in mental health, while additional years abroad have only weak effects. Overall, living abroad has some favorable effects on the health of older emigrants. The economic similarity of countries and the free intra-European mobility mitigate the need for initial self-selection in health and facilitate the migration experience abroad.
    Keywords: panel data, physical health, mental health, older population, emigrants, multi-level models, Europe
    JEL: C23 F22 J11 J14 J15 J61 I12 I14 O52
    Date: 2020
  9. By: Bloom, Nick; Lemos, Renato; Sadun, Raffaella; Van Reenen, John
    Abstract: We investigate the link between hospital performance and managerial education by collecting a large database of management practices and skills in hospitals across nine countries. We find that hospitals closer to universities offering both medical education and business education have lower mortality rates from acute myocardial infarction (heart attacks), better management practices, and more MBA-trained managers. This is true compared to the distance to universities that offer only business or medical education (or neither). We argue that supplying bundled medical and business education may be a channel through which universities improve management practices in hospitals and raise clinical performance.
    JEL: J50
    Date: 2019–06–26
  10. By: Mohamad Khaled (University of Queensland); Paul Makdissi (University of Ottowa); Myra Yazbeck (University of Ottawa)
    Abstract: This paper introduces a new graphical tool: the mean deviation concentration curve. Using a unified approach, we derive the associated dominance conditions that identify robust rankings of absolute socioeconomic health inequality for all indices obeying Bleichrodt and van Doorslaer's (2006) principle of income-related health transfer. We also derive dominance conditions that are compatible with other transfer principles available in the literature. In order to make the identification of all robust orderings implementable using survey data, we discuss statistical inference for these dominance tests. To illustrate the empirical relevance of the proposed approach, we compare joint distributions of income and health-related behavior in the United States.
    Keywords: mean deviation concentration curves, generalized health concentration curves, generalized health range curves, absolute socioeconomic health inequality, stochastic dominance, inference
    JEL: D63 I10
    Date: 2020–10
  11. By: Olanrewaju O. Akinola (Olabisi Onabanjo University, Ago-Iwoye, Nigeria); Akintayo A. Ogunsanya (North West University, South Africa); Oluwakemi D. Okunade (University of Ibadan, Nigeria); Ibrahim A. Adekunle (Olabisi Onabanjo University, Nigeria)
    Abstract: Since contemporary technological developments led to an explosion in different media of communication allowing individuals to actively create and publish whatever content they desire, scholars have been investigating trends, activities and implications thereof linked to this advancement. Whereas the literature on selfie is robust, little is known about motivations for taking selfies from a Nigerian perspective. Yet, the rate at which young Nigerians take and share selfies is both intense and passionate suggesting possible obsession, warranting the need to investigate if this critical segment of the national population is aware and mindful of mental illnesses associated with compulsive and excessive selfie-taking and sharing. Consequently, this study investigated motivations that drive young Nigerians\' selfie-taking and sharing habit, including gender disparity associated with the activity. A total of 487 questionnaires and 21 interviews, administered on young Nigerians between the ages of 16 and 24 from two tertiary institutions revealed that a substantial number of young Nigerians take, store and share selfies habitually. The study established that young female Nigerians take more selfie than their male counterparts while there is no gender disparity noticed in sharing. An overwhelming majority (85.7 percent) confessed to being obsessed with selfie-taking and sharing, while a corresponding percentage of respondents are not aware of the health-related dangers associated with the activity. In the light of these findings, coupled with the increasing rate of depression and suicide among young people, we conclude that the Selfitis disposition observed in a sizeable percentage of young Nigerians is ill-motivated and requires some urgent intervention.
    Keywords: Selfitis, Obsession, Selfie, Nigeria
    Date: 2020–01
  12. By: Clements, Ken; Lan, Yihui; Liu, Haiyan
    Abstract: Do drinkers respond to prices signals in the usual way by economising on beverages with higher prices and vice versa? Is the currency unit used in different countries irrelevant, or are drinkers subject to money illusion? Are the substitution effects of price changes symmetric? More fundamentally, can drinking patterns be adequately accounted for by the conventional utility-maximising approach? If so, how does consumption of beer, wine and spirits interact (if at all) in generating utility? According to the most recent data from the International Comparisons Program, on average, consumers in countries in the bottom quartile of the global income distribution devote something approaching one-half of all expenditures to food, while this falls to about 11% in the richest countries, in accordance with Engel’s law. The share for alcohol also drops, but much slower, so drinking rises noticeably relative to food as income increases. The within-alcohol distribution of spending (beer, wine and spirits) also changes quite dramatically. We use these cross-country data to address the above research questions. To visualise the data, we plot the budget shares for beer, wine and spirits in the form of a “drinking triangle”, which highlights the dominant beverage in each country. We also employ a Divisia-index-number approach to summarise the degree of price-quantity covariation. We cross-classify consumption and prices of beer, wine and spirits for nonparametric tests of the law of demand that higher prices lead to reduced consumption and vice versa. A system-wide model is estimated for the demand for beer, wine and spirits. As there is no unique way of ordering countries, a “levels version” of a differential system (similar to the Rotterdam model) is used. The system is used to test the hypotheses of homogeneity (the absence of money illusion) and symmetry of the substitution effects. For a substantial majority of countries, the Divisia price-quantity correlation is negative, which is suggestive evidence in favour of the economic approach to drinking. In the main, the results here support the law of demand. The hypotheses of homogeneity and symmetry cannot be rejected. Tests also reveal the coefficients are reasonable stable across countries, which sheds some light on the question of the similarity of tastes. Estimated price elasticities are tabulated for each beverage.
    Keywords: Food Consumption/Nutrition/Food Safety
    Date: 2020–09–16
  13. By: Asena Caner (TOBB University of Economics and Technology); Deniz Karaoglan (Gebze Technical University); Gülbiye Yasar (Ankara University)
    Abstract: Health service utilization in early childhood is crucial. It is often observed that children from low-resource households lack sufficient access to health services. We investigate whether the family medicine system introduced as part of the Turkish Health Transformation Program equalized utilization of health services between young children from low- and high-resource households. Using difference-in-differences analysis, we compare the change in service utilization over time between the two groups of children, using official nationally representative microdata from the Health Research Surveys in 2008, 2010, and 2012. We study a set of measures of service utilization and alternative indicators of household resources. Moreover, we test the common trends assumption. Overall, the effect of the reform depends on the measure of utilization. Considering ‘being taken to a health institution’ as the measure, we find no evidence for a positive differential effect on children from low-resource households. On the other hand, considering ‘being taken to a health institution when not sick’, the reform benefited children from lower-resource households more than it benefited better-off children. The evidence for having newborn screening is weak. Regarding the utilization of family health centers, we find no evidence for a positive differential effect for lower-resource households.
    Date: 2020–08–20
  14. By: Jafino,Bramka Arga; Walsh,Brian James; Rozenberg,Julie; Hallegatte,Stephane
    Abstract: Thousands of scenarios are used to provide updated estimates for the impacts of climate change on extreme poverty in 2030. The range of the number of people falling into poverty due to climate change is between 32 million and 132 million in most scenarios. These results are commensurate with available estimates for the global poverty increase due to COVID-19. Socioeconomic drivers play a major role: optimistic baseline scenarios (rapid and inclusive growth with universal access to basic services in 2030) halve poverty impacts compared with the pessimistic baselines. Health impacts (malaria, diarrhea, and stunting) and the effect of food prices are responsible for most of the impact. The effect of food prices is the most important factor in Sub-Saharan Africa, while health effects, natural disasters, and food prices are all important in South Asia. These results suggest that accelerated action to boost resilience is urgent, and the COVID-19 recovery packages offer opportunities to do so.
    Keywords: Inequality,Science of Climate Change,Climate Change and Health,Climate Change and Environment,Climate Change Impacts,Social Aspects of Climate Change,Health Care Services Industry
    Date: 2020–09–29
  15. By: Chen, Simiao (Harvard School of Public Health); Jin, Zhangfeng (affiliation not available); Bloom, David E. (Harvard University)
    Abstract: This paper examines the impact of diagnostic efficiency on the COVID-19 pandemic. Using an exogenous policy on diagnostic confirmation, we show that a one- day decrease in the time taken to confirm the first case in a city publicly led to 9.4% and 12.7% reductions in COVID-19 prevalence and mortality over the subsequent six months, respectively. The impact is larger for cities that are farther from the COVID-19 epicenter, are exposed to less migration, and have more responsive public health systems. Social distancing and a less burdened health system are likely the underlying mechanisms, while the latter also explains the more profound impact on reducing deaths than reducing infections.
    Keywords: diagnostic efficiency, information disclosure, social distancing, COVID-19, China, instrumental variable
    JEL: D83 H75 I12 I18 J61
    Date: 2020–09
  16. By: Rajashri Chakrabarti; Lindsay Meyerson; William Nober; Maxim L. Pinkovskiy
    Abstract: Does health insurance improve health? This question, while apparently a tautology, has been the subject of considerable economic debate. In light of the COVID-19 pandemic, it has acquired a greater urgency as the lack of universal health insurance has been cited as a cause of the profound racial gap in coronavirus cases, and as a cause of U.S. difficulties in managing the pandemic more generally. However, estimating the effect of health insurance is difficult because it is (generally) not assigned at random. In this post, we approach this question in a novel way by exploiting a natural experiment—the adoption of the Affordable Care Act (ACA) Medicaid expansion by some states but not others—to tease out the causal effect of a type of health insurance on COVID-19 intensity.
    Keywords: COVID-19; Affordable Care Act; regression discontinuity
    JEL: I18 I13
    Date: 2020–09–25
  17. By: Atalay, Kadir (University of Sydney); Edwards, Rebecca (University of Sydney); Schurer, Stefanie (University of Sydney); Ubilava, David (University of Sydney)
    Abstract: Worldwide, countries have been restricting work and social activities to counter an emerging public health crisis due to the coronavirus pandemic. These measures have caused dramatic increases in unemployment in the short run, with an expected deepening of the recession in the long run. Some commentators argue that the "draconian measures" will do more harm than good due to the economic contraction, despite a large literature that finds mortality rates decline during recessions. We estimate the relationship between unemployment, a widely accepted proxy for economic climate, and mortality in Australia, a country with universal health care. Using administrative time-series data on mortality that varies by state, age, sex, and cause of death collected for the years 1979-2017, we find no relationship between unemployment and mortality on average. However, we observe beneficial health effects in economic downturns for young men aged 25 to 34 associated with a reduction in vehicle transport accidents. Our estimates imply 425 fewer deaths if Reserve Bank of Australia expectations of a doubling of unemployment rates are realized by the end of 2020. For the early 1980s, we also find a procyclical pattern in the mortality rates of infants. However, this pattern disappears starting from the mid-1980s, coincident with the full implementation of universal health care in Australia in 1984. Our results suggest that universal health care may insulate individuals from the health effects of macroeconomic fluctuations. We conclude that the economic recession is an unlikely mediator for pandemic-related deaths in Australia.
    Keywords: mortality, health, recessions, unemployment, macroeconomic conditions, Australia, COVID-19, pandemic, universal health care
    JEL: I12 E32 E24
    Date: 2020–09
  18. By: Berta, Paolo (University of Milan-Bicocca); Lovaglio, Pietro Giorgio (University of Milan-Bicocca); Paruolo, Paolo (European Commission); Verzillo, Stefano (European Commission)
    Abstract: Response management to the SARS-CoV-2 outbreak requires to answer several forecasting tasks. For hospital managers, a major one is to anticipate the likely needs of beds in intensive care in a given catchment area one or two weeks ahead, starting as early as possible in the evolution of the epidemic. This paper proposes to use a bivariate Error Correction model to forecast the needs of beds in intensive care, jointly with the number of patients hospitalised with Covid-19 symptoms. Error Correction models are found to provide reliable forecasts that are tailored to the local characteristics both of epidemic dynamics and of hospital practice for various regions in Europe in Italy, France and Scotland, both at the onset and at later stages of the spread of the disease. This reasonable forecast performance suggests that the present approach may be useful also beyond the set of analysed regions.
    Keywords: SARS-CoV-2, Covid-19, Intensive Care Units, Cointegration, Error correction models, Health forecasting, Multivariate time series, Vector Autoregression Models
    JEL: C53 C32
    Date: 2020–09
  19. By: Cortés, Darwin; Gamboa, Luis Fernando; Rodríguez-Lesmes, Paul
    Abstract: We exploit the Zika outbreak in Colombia in 2015 to explore how a negative shock that puts at high risk the newborn's health affects female behaviours associated with fertility, according to their marital status. The potential endogeneity of behaviours and the outbreak onset is avoided by using instrumental variables strategies in the context of an intensity-of-treatment difference-in-differences at the municipality level. While single women reduce sexual activity (the extensive margin), married women do not; instead, married women increase contraception in both the extensive margin and the intensive margin (they substitute less effective methods for more effective ones). This result is in line with a moral hazard model of fertility decisions within the couple. According to the model, not having a child may aggrieve the husband, and he may, in turn, become a "difficult" husband. In such a model, the ZIKV epidemic increases the use of women's contraception and reduces the likelihood of men's retaliation. We find no significant effects on intra-household violence exerted by men (i.e. physical and psychological violence or forced sex) nor reductions in the proportion of expenditures made by women. We do find that husbands of older women are less likely to have other sexual partners. There are heterogeneous effects across age groups and education level.
    Keywords: Fertility; Intra-household allocation; Outbreaks; Intimate partner violence
    JEL: D13 I12 I15 J13
    Date: 2020–10
  20. By: Alexander Karaivanov (Simon Fraser University); Hitoshi Shigeoka (Simon Fraser University); Shih En Lu (Simon Fraser University); Cong Chen (Simon Fraser University); Stephanie Pamplona (Simon Fraser University)
    Abstract: We estimate the impact of mask mandates and other non-pharmaceutical interventions (NPI) on COVID-19 case growth in Canada, including regulations on businesses and gatherings, school closures, travel and self-isolation, and long-term care homes. We partially account for behavioral responses using Google mobility data. Our identification approach exploits variation in the timing of indoor face mask mandates staggered over two months in the 34 public health regions in Ontario, Canada's most populous province. We find that, in the first few weeks after implementation, mask mandates are associated with a reduction of 25 percent in the weekly number of new COVID-19 cases. Additional analysis with province-level data provides corroborating evidence. Counterfactual policy simulations suggest that mandating indoor masks nationwide in early July could have reduced the weekly number of new cases in Canada by 25 to 40 percent in mid-August, which translates into 700 to 1,100 fewer cases per week.
    Keywords: COVID-19, face mask mandates, non-pharmaceutical interventions, counterfactuals
    JEL: I18 I12 C23
    Date: 2020–09
  21. By: Luiz Brotherhood; Tiago Cavalcanti; Daniel da Mata; Cezar Santos
    Abstract: This paper studies the role of slums in shaping the economic and health dynamics of pandemics. Using data from millions of mobile phones in Brazil, an event-study analysis shows that residents of overcrowded slums engaged in less social distancing after the outbreak of Covid-19. We develop a choice-theoretic equilibrium model in which individuals are heterogeneous in income and some people live in high-density slums. The model is calibrated to Rio de Janeiro. Slum dwellers account for a disproportionately high number of infections and deaths. In a counterfactual scenario without slums, deaths increase in non-slum neighborhoods. Policy simulations indicate that: reallocating medical resources cuts deaths and raises output and the welfare of both groups; mild lockdowns favor slum individuals by mitigating the demand for hospital beds, whereas strict confinements mostly delay the evolution of the pandemic; and cash transfers benefit slum residents to the detriment of others, highlighting important distributional effects.
    JEL: C63 D62 E17 I10 I18 O18
    Date: 2020
  22. By: Klaus Gründler; Niklas Potrafke
    Abstract: Do experts adjust their policy recommendations when the facts change? We conduct a large-scale randomized experiment among 1,224 economic experts across 109 countries that includes two treatments. The first treatment is the geographic and temporal variation in the initial spread of Covid-19 during March 2020, which we use as a natural experiment. The second is a randomly assigned information treatment that informs experts about the past macroeconomic performance of their country. We find that greater exposure to Covid-19 decreases the probability to recommend contractionary fiscal policies. A better macroeconomic performance increases the probability to implement contractionary policies and reduces the exposure effect to Covid-19. While our results show that experts adjust their policy recommendations to changing environments, sentiment analyses of open-ended questions asked after the treatment suggest that these adjustments are caused by Bayesian information updating and not by a change in preferences.
    Keywords: epidemics, Covid-19, health, experts, fiscal preferences, randomized experiment
    JEL: A11 E62 H60 H63
    Date: 2020
  23. By: Luiz Brotherhood; Philipp Kircher; Cezar Santos; Michèle Tertilt
    Abstract: This paper investigates the importance of the age composition in the Covid-19 pandemic. We augment a standard SIR epidemiological model with individual choices on work and non-work social distancing. Infected individuals are initially uncertain unless they are tested. We find that older individuals socially distance themselves substantially in equilibrium. Confining the old even more reduces their welfare. Confining the young extends the duration of the epidemic, with negative consequences on the old if the epidemic cannot be controlled after confinement. Testing and quarantines save lives, even if conducted just on the young, as does separation of activities by age. Combining policies can increase the welfare of both the young and the old.
    JEL: C63 D62 E17 I10 I18
    Date: 2020
  24. By: Warn N. Lekfuangfu (Universidad Carlos III de Madrid); Suphanit Piyapromdee (University College London); Ponpoje Porapakkarm (National Graduate Institute for Policies Studies (GRIPS)); Nada Wasi (Puey Ungphakorn Institute for Economic Research, Bank of Thailand)
    Abstract: The Covid-19 pandemic has disrupted working life in many ways, the negative consequences of which may be distributed unevenly under lockdown regulations. In this paper, we construct a new set of pandemic-related indices from the Occupational Information Network (O*NET) using factor analysis. The indices capture two key dimensions of job task requirements: (i) the extent to which jobs can be adaptable to work from home; and (ii) the degree of infection risk at workplace. The interaction of these two dimensions help identify which groups of workers are more vulnerable to income losses, and which groups of occupations pose more risk to public health. This information is crucial for both designing appropriate supporting programs and finding a strategy to reopen the economy while controlling the spread of the virus. In our application, we map the indices to the labor force survey of a developing country, Thailand, to analyze these new labor market risks. We document differences in job characteristics across income groups, at both individual and household levels. First, low income individuals tend to work in occupations that require less physical interaction (lower risk of infection) but are less adaptable to work from home (higher risk of income/job loss) than high income people. Second, the positive occupational sorting among low-income couples amplifies these differences at the household level. Consequently, low-income families tend to face a disproportionately larger risk of income/job loss from lockdown measures. In addition, the different exposure to infection and income risks between income groups can play an important role in shaping up the timing and optimal strategies to unlock the economy.
    Keywords: Covid-19, Labor Market, Work-from-home, Physical proximity, Occupational sorting
    JEL: D10 E24 J12 J21
    Date: 2020–04
  25. By: Nikolov, Plamen (State University of New York); Pape, Andreas (State University of New York); Tonguc, Ozlem (State University of New York); Williams, Charlotte (State University of New York)
    Abstract: This paper presents preliminary summary results from a longitudinal study of participants in seven U.S. states during the COVID-19 pandemic. In addition to standard socio-economic characteristics, we collect data on various economic preference parameters: time, risk, and social preferences, and risk perception biases. We pay special attention to predictors that are both important drivers of social distancing and are potentially malleable and susceptible to policy levers. We note three important findings: (1) demographic characteristics exert the largest influence on social distancing measures and mask-wearing, (2) we show that individual risk perception and cognitive biases exert a critical role in influencing the decision to adopt social distancing measures, (3) we identify important demographic groups that are most susceptible to changing their social distancing behaviors. These findings can help inform the design of policy interventions regarding targeting specific demographic groups, which can help reduce the transmission speed of the COVID-19 virus.
    Keywords: COVID-19, social distancing, masks, mask-wearing, health markets, health economics, cognitive biases, exponential growth, behavioral economics
    JEL: I11 I12 I18 D81 D91 D62 D64
    Date: 2020–09
  26. By: Krista Ruffini; Aaron Sojourner; Abigail Wozniak
    Abstract: COVID symptom screening, a new workplace practice, is likely to affect many millions of American workers in the coming months. Eleven states already require and federal guidance recommends frequent screening of employees for infection symptoms. This paper provides some of the first empirical work exploring the tradeoffs employers face in using daily symptom screening. First, we find that common symptom checkers will likely screen out up to 7 percent of workers each day, depending on the measure used. Second, we find that the measures used will matter for three reasons: many respondents report any given symptom, survey design affects responses, and demographic groups report symptoms at different rates, even absent fluctuations in likely COVID exposure. This last pattern can potentially lead to disparate impacts, and is important from an equity standpoint.
    JEL: I1 J50 J70 K30 M50
    Date: 2020–09–01
  27. By: Fabianna Bacil (IPC-IG); Gabriel Soyer (IPC-IG)
    Abstract: COVID-19 is posing an unprecedented challenge to countries' social protection systems. Informal workers are particularly at risk, as they often represent the 'missing middle', covered by neither social assistance nor social insurance. In a recent policy brief, the IPC-IG and UNICEF ROSA analyse the economic fallout from the crisis and the policy measures taken in eight South Asian countries, and advocate for the inclusion of the missing middle in mainstream social protection. This One Pager summarises the study's findings for India.
    Keywords: social protection; COVID-19; emergency response; informal workers; India
    Date: 2020–09
  28. By: Rebecca Allen (Teacher Tapp); John Jerrim (Social Research Institute, UCL Institute of Education, University College London); Sam Sims (Centre for Education Policy and Equaliising Opportunities, UCL Institute of Education, University College London)
    Abstract: The COVID-19 pandemic has radically disrupted schooling, placing additional demands on teachers. This paper uses unique longitudinal survey data to track changes in teacher wellbeing as the virus hit the UK. It documents sharp spikes in teachers' anxiety as schools were locked down and as announcements around reopening were made. Teachers in fee-paying schools displayed higher levels of anxiety during the summer term when schools were closed, most likely because they delivered more `live' online lessons than state school teachers. Head teachers experienced particularly large increases in anxiety and reported that they were more likely to leave the profession as a result of the experience.
    Keywords: teachers, wellbeing, mental health, COVID-19
    JEL: I20
    Date: 2020–09
  29. By: Timothy Riffe (Max Planck Institute for Demographic Research, Rostock, Germany); Enrique Acosta (Max Planck Institute for Demographic Research, Rostock, Germany); José M. Aburto (Max Planck Institute for Demographic Research, Rostock, Germany); Diego Alburez-Gutierrez (Max Planck Institute for Demographic Research, Rostock, Germany); Ugofilippo Basellini (Max Planck Institute for Demographic Research, Rostock, Germany); Anna Altová; Simona Bignami; Didier Breton; Eungang Choi; Jorge Cimentada (Max Planck Institute for Demographic Research, Rostock, Germany); Gonzalo De Armas; Emanuele Del Fava (Max Planck Institute for Demographic Research, Rostock, Germany); Alicia Delgado; Viorela Diaconu (Max Planck Institute for Demographic Research, Rostock, Germany); Jessica Donzowa; Christian Dudel (Max Planck Institute for Demographic Research, Rostock, Germany); Antonia Fröhlich; Alain Gagnon (Max Planck Institute for Demographic Research, Rostock, Germany); Mariana Garcia Cristómo; Victor M. Garcia-Guerrero; Armando González-Díaz; Irwin Hecker; Dagnon Eric Koba; Marina Kolobova; Mine Kühn (Max Planck Institute for Demographic Research, Rostock, Germany); Chia Liu (Max Planck Institute for Demographic Research, Rostock, Germany); Andrea Lozer; Mădălina Manea; Muntasir Masum; Ryohei Mogi; Saskia Morwinsky; Ronald Musizvingoza; Mikko Myrskylä (Max Planck Institute for Demographic Research, Rostock, Germany); Marilia R. Nepomuceno (Max Planck Institute for Demographic Research, Rostock, Germany); Michelle Nickel; Natalie Nitsche (Max Planck Institute for Demographic Research, Rostock, Germany); Anna Oksuzyan (Max Planck Institute for Demographic Research, Rostock, Germany); Samuel Oladele; Emmanuel Olamijuwon; Oluwafunke Omodara; Soumaila Ouedraogo; Mariana Paredes; Marius Pascariu; Manuel Piriz; Raquel Pollero; Federico Rehermann; Filipe Ribeiro; Silvia Rizzi; Francisco Rowe; Isaac Sasson; Jiaxin Shi (Max Planck Institute for Demographic Research, Rostock, Germany); Rafael Silva-Ramirez; Cosmo Strozza (Max Planck Institute for Demographic Research, Rostock, Germany); Catalina Torres; Sergi Trias-Llimos; Fumiya Uchikoshi; Alyson A. van Raalte (Max Planck Institute for Demographic Research, Rostock, Germany); Paola Vazquez-Castillo; Estevão Vilela; Iván Williams (Max Planck Institute for Demographic Research, Rostock, Germany); Virginia Zarulli (Max Planck Institute for Demographic Research, Rostock, Germany)
    Abstract: COVerAGE-DB is an open access database including cumulative counts of confirmed COVID-19 cases, deaths, and tests by age and sex. Original data and sources are provided alongside data and measures in age-harmonized formats. The database is still in development, and at this writing, it includes 87 countries, and 195 subnational areas. Cumulative counts of COVID-19 cases, deaths, and tests are recorded daily (when possible) since January 2020. Many time series thus fully capture the first pandemic wave and the beginning of later waves. An international team, composed of more than 60 researchers, contributed to the collection of data and metadata in COVerAGE-DB from governmental institutions, as well as to the design and implementation of the data processing and validation pipeline. We encourage researchers interested in supporting this project to send a message to the email:
    Keywords: World, age-sex distribution, data collection, data comparability, epidemics, infectious diseases
    JEL: J1 Z0
    Date: 2020
  30. By: Piotr Lewandowski; Zuzanna Kowalik
    Abstract: We study the gender differences in aversion to COVID-19 exposure. We use a natural experiment of the 2020 US Open which was organised in the country with the highest number of COVID-19 cases and deaths and was the first major professional tennis tournament after the season was paused for six months. We analyse the gender gap in the propensity to voluntarily withdraw because of COVID-19 concerns among players who were eligible and fit to play. We find that female players are significantly more likely to withdraw from the 2020 US Open. While players from countries characterised by higher trust, higher patience, and lower risk taking are more likely to withdraw, female players exhibit significantly higher aversion to pandemic exposure also if cross-country differences in preferences are accounted for. About 15-20% of the probability to withdraw explained by our model can be attributed to gender.
    Keywords: COVID-19, exposure to disease, gender, aversion, tennis
    JEL: I12 J16 J44
    Date: 2020–09
  31. By: Biroli, Pietro (University of Zurich); Bosworth, Steven J. (University of Reading); Della Giusta, Marina (University of Reading); Di Girolamo, Amalia (University of Birmingham); Jaworska, Sylvia (University of Reading); Vollen, Jeremy (University of Zurich)
    Abstract: This paper contributes to the literature on public health communication by studying how the framing of a message relaying the forecast impact of COVID-19 prevention measures affects compliance behaviour amongst both the young and old. A representative sample of survey respondents in the UK and US, along with selected respondents in Italy, were presented with forecasts for the number of deaths from COVID-19 in their countries with and without public adherence to various preventive behaviours. We experimentally varied whether this information was presented in terms of likely deaths or lives saved. The lives saved frame increases reported protective behaviours, but only amongst older respondents. We present evidence consistent with the hypothesis that framing is likelier to affect decisions whose consequences are felt by oneself (i.e. protective behaviours by the elderly) rather than solely others (i.e. protective behaviours amongst the young).
    Keywords: framing, protective behaviours, cooperation, age, gender, COVID-19
    JEL: D03 D83 D84 D85 J16 J24
    Date: 2020–09
  32. By: Miguel Casares (Departamento de Economia - UPNA); Paul Gomme; Hashmat Khan
    Abstract: We propose the merge of an epidemiological Susceptible-Infected-Recovered (SIR) model with a macroeconomic model based on the optimizing behavior of representative agents. In the integrated model, the virus contagion depends on the endogenously determined number of daily interpersonal contacts of individuals. These contacts may occur during both economic activities (consumption, working) and social activities. The rational behavior of households to determine consumption and work hours are affected by the virus spread because of a ‘fear of contagion’ term in their utility function. Social contacts are also included in the utility function in this case providing a positive marginal satisfaction. Other key features of the model are (i) a time-varying contagion probability to capture variations in public health preventative actions, (ii) asymptomatic virus transmission, (iii) a quarantine index capturing the scale of testing and effectiveness of surveillance (e.g., tracing and tracking, the speed of the process), (iv) telework, and (v) business shutdowns in response to the evolution of the contagion curve. The model parameters are calibrated to Ontario data and we present quantitative analyses of a variety of pandemic and economic scenarios relevant for policy makers.
    Date: 2020

This nep-hea issue is ©2020 by Nicolas R. Ziebarth. It is provided as is without any express or implied warranty. It may be freely redistributed in whole or in part for any purpose. If distributed in part, please include this notice.
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