nep-hea New Economics Papers
on Health Economics
Issue of 2020‒10‒26
33 papers chosen by
Nicolas R. Ziebarth
Cornell University

  1. The Effects of the Affordable Care Act on the Near-Elderly: Evidence for Health Insurance Coverage and Labor Market Outcomes By Mark Duggan; Gopi Shah Goda; Gina Li
  2. Side Effects of Labor Market Policies By Marco Caliendo; Robert Mahlstedt; Gerard J. van den Berg; Johan Vikström
  3. Health of Elderly Parents, their Children's Labor Supply, and the Role of Migrant Care Workers By Wolfgang Frimmel; Martin Halla; Joerg Paetzold; Julia Schmieder
  4. Quality and Efficiency Between Public and Private Firms: Evidence From the Ambulance Services By Knutsson, Daniel; Tyrefors, Björn
  5. Noise-Induced Randomization in Regression Discontinuity Designs By Dean Eckles; Nikolaos Ignatiadis; Stefan Wager; Han Wu
  6. Medical Research and Health Care Finance: Evidence from Academic Medical Centers By Pierre Azoulay; Misty L. Heggeness; Jennifer L. Kao
  7. Teenage Driving, Mortality, and Risky Behaviors By Jason U. Huh; Julian Reif
  8. How do we Measure the "Value" in Value-Based care? By McKenna, Ian
  9. Opportunities to Increase Efficiency in Healthcare By Errea, M.; Skedgel, C.; Zamora, B.; G, Hampson; R, Althin; Hofmarcher, T.; Lindgren, P.; Cookson, G.
  10. Pricing and waiting time decisions in a health care market with private and public provision By Alves, Vasco
  11. The Five-item Self-efficacy Scale for Support of Those Returning to Work (RTW) After Sick Leave (F-SES): Development, Reliability, and Validity By Kiuchi, Keita; Ozeki, Michiyo
  12. Catastrophic health expenditure and inequalities -- a district level study of West Bengal By Pijush Kanti Das
  13. Worker productivity during lockdown and working from home: evidence from self-reports By Etheridge, Ben; Wang, Yikai; Tang, Li
  14. A Natural Experiment on the Effect of Instruction Time and Quality: Lessons for the Covid-19 Outbreak By Ismael Sanz; J .D. Tenaa
  15. Covid-19 across European Regions: the Role of Border Controls By Eckardt, Matthias; Kappner, Kalle; Wolf, Nikolaus
  16. The Consequences of the COVID-19 Job Losses: Who Will Suffer Most and by How Much? By Yasemin Özdemir
  17. The income gradient in mortality during the Covid-19 crisis: evidence from Belgium By André Decoster; Thomas Minten; Johannes Spinnewijn
  18. Modeling optimal quarantines under infectious disease related mortality By Aditya Goenka; Lin Liu; Manh-Hung Nguyen
  19. COVID-19 Pounds: Quarantine and Weight Gain By Hasanzadeh, Samira; Alishahi, Modjgan
  20. COVID-19 Mortality and Contemporaneous Air Pollution By Wes Austin; Stefano Carattini; John Gomez Mahecha; Michael Pesko
  21. Modeling the effects of contact-tracing apps on the spread of the coronavirus disease: mechanisms, conditions, and efficiency By Chiba, Asako
  22. Black-White Disparities During an Epidemic: Life Expectancy and Lifespan Disparity in the US, 1980-2000 By Aburto, Jose Manuel; Kristensen, Frederikke Frehr; Sharp, Paul
  23. The Geography of COVID-19 in Sweden By Florida, Richard; Mellander , Charlotta
  24. Social Distancing and the Economic Impact of COVID-19 in the United States By Constantin Bürgi; Nisan Gorgulu
  25. Persistent patterns of behavior: Two infectious disease outbreaks 350 years apart By Dasgupta, Utteeyo; Jha, Chandan Kumar; Sarangi, Sudipta
  26. Real-time tracking of the economic impact of COVID-19: insights from the first wave of the pandemic across Europe By Carlo Fezzi; Valeria Fanghella
  27. The early impact of COVID-19 on local commerce: changes in spend across neighborhoods and online By Relihan, Lindsay; Ward, Marvin; Wheat, Chris W.; Farrell, Diana
  28. Between Lives and Economy: Optimal COVID-19 Containment Policy in Open Economies By Hsu, Wen-Tai; Lin, Hsuan-Chih (Luke); Yang, Han
  29. COVID-19 and the U.S. Economy: Progress on Health and Incomes By James B. Bullard
  30. Are People Overconfident about Avoiding COVID-19? By Rawley Heimer; Haoyang Liu; Xiaohan Zhang
  31. Most Fatal Pandemic COVID-19 Outbreak: An Analysis of Economic Consequences By Mohajan, Haradhan
  32. Substitution of social concerns under the Covid-19 pandemic By Esther Blanco; Alexandra Baier; Felix Holzmeister; Tarek Jaber-Lopez; Natalie Struwe
  33. How to remove the testing bias in CoV-2 statistics By Klaus Wälde

  1. By: Mark Duggan; Gopi Shah Goda; Gina Li
    Abstract: The Affordable Care Act (ACA) not only changed the landscape of health insurance coverage in the United States, but also affected the relationship between working decisions and health insurance. In this paper, we estimate the impact of the ACA on the near-elderly (ages 60-64) in the five years after the implementation of its key provisions in early 2014. We exploit variation across geographic areas in the pre-existing level of uninsurance and use 65-69 year olds, whose insurance coverage was unaffected by the ACA, as a within-region control group. Our findings indicate that the ACA increased health insurance coverage among the near elderly by approximately 4.5 percentage points and reduced their labor force participation rate by approximately 0.6 percentage points.
    JEL: H2 H31 H51 H75 I13 J14 J21 J26
    Date: 2020–10
  2. By: Marco Caliendo (University of Potsdam, IZA Bonn, DIW Berlin, IAB Nuremberg); Robert Mahlstedt (University of Copenhagen, IZA Bonn); Gerard J. van den Berg (University of Bristol, University of Groningen, IFAU Uppsala, IZA Bonn, ZEW, CEPR, CESifo, UCLS); Johan Vikström (IFAU Uppsala, Uppsala University, UCLS)
    Abstract: Labor market policy tools such as training and sanctions are commonly used to help bring workers back to work. By analogy to medical treatments, the individual exposure to these tools may have side effects. We study effects on health using individual-level population registers on labor market events outcomes, drug prescriptions and sickness absence, comparing outcomes before and after exposure to training and sanctions. We find that training improves cardiovascular and mental health and lowers sickness absence. The results suggest that this is not due to improved employment prospects but rather to instantaneous features of participation such as, perhaps, the adoption of a more rigorous daily routine. Unemployment benefits sanctions cause a short-run deterioration of mental health, possibly due higher stress levels, but this tapers out quickly.
    Keywords: unemployment, health, sickness, prescriptions, mental health, drugs, training, depression, cardiovascular disease, sanctions
    JEL: J68 I12 I18 H51
    Date: 2020–10
  3. By: Wolfgang Frimmel; Martin Halla; Joerg Paetzold (Universität Salzburg); Julia Schmieder
    Abstract: We estimate the impact of parental health on adult children’s labor market outcomes. We focus on health shocks which increase care dependency abruptly. Our estimation strategy exploits the variation in the timing of shocks across treated families. Empirical results based on Austrian administrative data show a significant negative impact on labor market activities of children. This effect is more pronounced for daughters and for children who live close to their parents. Further analyses suggest informal caregiving as the most likely mechanism. The effect is muted after a liberalization of the formal care market, which sharply increased the supply of foreign care workers.
    Keywords: Informal care, formal care, aging, health, labor supply, labor migration.
    JEL: J14 J22 I11 I18 R23
    Date: 2020–10
  4. By: Knutsson, Daniel (Research Institute of Industrial Economics (IFN)); Tyrefors, Björn (Research Institute of Industrial Economics (IFN))
    Abstract: Economic theory predicts that outsourcing public services to private firms will reduce costs, but the effect on quality is ambiguous. We explore quality differences between publicly and privately owned ambulances in a setting where patients are as good as randomly assigned to ambulances of different ownership statuses. We find that privately owned ambulances are better at responding to contracted quality measures but perform worse on noncontracted measures, such as mortality. In fact, a randomly allocated patient has a significantly higher risk of death if a private ambulance is dispatched. We also present suggestive evidence on the mechanism, supporting that private firms cost innovate at the expense of ambulance staff quality.
    Keywords: Public outsourcing; Pre-hospital care; Healthcare quality; Health
    JEL: D22 D44 H44 I11 L33 P48
    Date: 2020–10–10
  5. By: Dean Eckles; Nikolaos Ignatiadis; Stefan Wager; Han Wu
    Abstract: Regression discontinuity designs are used to estimate causal effects in settings where treatment is determined by whether an observed running variable crosses a pre-specified threshold. While the resulting sampling design is sometimes described as akin to a locally randomized experiment in a neighborhood of the threshold, standard formal analyses do not make reference to probabilistic treatment assignment and instead identify treatment effects via continuity arguments. Here we propose a new approach to identification, estimation, and inference in regression discontinuity designs that exploits measurement error in the running variable. Under an assumption that the measurement error is exogenous, we show how to consistently estimate causal effects using a class of linear estimators that weight treated and control units so as to balance a latent variable of which the running variable is a noisy measure. We find this approach to facilitate identification of both familiar estimands from the literature, as well as policy-relevant estimands that correspond to the effects of realistic changes to the existing treatment assignment rule. We demonstrate the method with a study of retention of HIV patients and evaluate its performance using simulated data and a regression discontinuity design artificially constructed from test scores in early childhood.
    Date: 2020–04
  6. By: Pierre Azoulay; Misty L. Heggeness; Jennifer L. Kao
    Abstract: Academic Medical Centers (AMCs)—comprising medical schools, teaching hospitals, and research laboratories)—play an important role in US biomedical innovation. The Balanced Budget Act of 1997 (BBA) changed the formula used to reimburse Medicare inpatient claims and subsidies for medical residents. We study the effect of changes in the generosity of clinical care reimbursements on the rate and direction of research performed within these institutions. We compare AMCs’ relative exposure to the reform and how these differences affect their researchers’ ability to attract NIH grant funding, as well as the quantity, impact, and content of their publications. We find that in response to the BBA, research activity increased by 10% among the average teaching hospital and 20% among major teaching hospitals, with larger effects observed for “translational” and clinical research. We find little evidence of concurrent changes in clinical outcomes.
    JEL: I13 I18 I23 O30
    Date: 2020–10
  7. By: Jason U. Huh; Julian Reif
    Abstract: We investigate the effect of teenage driving on mortality and risky behaviors in the United States using a regression discontinuity design. We estimate that motor vehicle fatalities rise by 40% at the minimum legal driving age cutoff, implying a mortality risk per additional mile driven 6-9 times higher than the risk faced by adult drivers. We also find a stark 80% increase in female deaths from drug overdoses and carbon monoxide poisoning at the cutoff, caused by changes in both suicides and accidental deaths. Our analysis suggests driving regulations could be an effective tool to improve teenage health.
    JEL: H75 I1 R4
    Date: 2020–10
  8. By: McKenna, Ian
    Abstract: Determining and defining value in health care is a persistent challenge in every country. To some extent, what constitutes value depends on perspective, e.g. a pharmaceutical company may view value somewhat differently than a doctor or a hospital administrator. Appropriate measurement, essential to understanding value, thus requires that the right things be targeted using the right measures. A critical issue is ensuring that, as much as possible, measures allow valid comparisons across diseases. This seminar includes discussion of that, with examples of what works and what does not. It also provides examples of an approach, which focuses on the patient's needs, including how disease may affect identity and the ability to function day to day.
    JEL: I1
    Date: 2020–10–01
  9. By: Errea, M.; Skedgel, C.; Zamora, B.; G, Hampson; R, Althin; Hofmarcher, T.; Lindgren, P.; Cookson, G.
    Abstract: Substantial economic resources are devoted to healthcare across Europe, but there is evidence that a large proportion of these resources are of limited benefit to patients and society. Around 10% of European Gross Domestic Product (GDP) is spent on healthcare and estimates suggest that as much as one-fifth of this amount (2% of GDP) is spent on interventions that make no meaningful contribution to health outcomes. In economic terms, these resources are used inefficiently. The objective of this report was to identify examples of efficient practice in healthcare and quantify their potential efficiency gains across the EU and UK.
    JEL: I1
    Date: 2020–10–01
  10. By: Alves, Vasco
    Abstract: This paper describes a duopoly market for healthcare where one of the two providers is publicly owned and charges a price of zero, while the other sets a price so as to maximize its profit. Both providers are subject to congestion in the form of an M/M/1 queue, and they serve patient-consumers who have randomly distributed unit costs of time. Consumer demand (as market share) for both providers is obtained and described. The private provider’s pricing decision is explored, equilibrium existence is proven, and conditions for uniqueness presented. Comparative statics for demand are presented. Social welfare functions are described and the welfare maximizing condition obtained. More detailed results are then obtained for cases when costs follow uniform and Kumaraswamy distributions. Numerical simulations are then performed for these distributions, employing several parameter values, demonstrating the private provider’s pricing decision and its relationship with social welfare.
    Keywords: Waiting times; queueing; private health care; competition
    JEL: D43 I11 L13
    Date: 2019–04–08
  11. By: Kiuchi, Keita (National Institute of Occupational Safety and Health, Japan); Ozeki, Michiyo
    Abstract: Objectives: The purpose of the current study was to develop a psychological scale, the Five-item Self-Efficacy Scale for the support of those returning to work (RTW) after sick leave (F-SES) in light of the absence of mental health problems (MHPs). Methods: Twenty-two items about difficulties with RTW support were created and administered with a 5-point Likert scale: this was given to 302 Japanese employees who have work experience with demographics that are able to evaluate the validity of the scale. Results: Five items with appropriate internal consistency were extracted as the F-SES; this showed a positive correlation with self-evaluated support capability measured by a one-item scale, sex (male), full-time/self-employed, professional/technical occupations, current RTW support experience, and their own RTW experience, and a negative correlation with the 12-item General Health Questionnaire (GHQ-12), and clerical/sales occupations. The interaction effect of RTW support and the GHQ-12 on F-SES were observed, suggesting that mental health might moderate RTW’s ability to promote self-efficacy, or that the experience of RTW support might moderate the effect of mental health to promote self-efficacy. Conclusions: Although these variables pose some challenges for continuous validity examination, F-SES appears to have appropriate reliability and validity and was therefore suggested to promote practice and research in support of RTW.
    Date: 2020–10–07
  12. By: Pijush Kanti Das
    Abstract: In this study, I aimed to estimate the incidence of catastrophic health expenditure and analyze the extent of inequalities in out-of-pocket health expenditure and its decomposition according to gender, sector, religion and social groups of the households across Districts of West Bengal. I analysed health spending in West Bengal, using National Sample Survey 71st round pooled data suitably represented to estimate up to district level. We measured CHE at different thresholds when OOP in health expenditure. Gini Coefficients and its decomposition techniques were applied to assess the degree of inequality in OOP health expenditures and between different socio geographic factors across districts. The incidence of catastrophic payments varies considerably across districts. Only 14.1 percent population of West Bengal was covered under health coverage in 2014. The inequality in OOP health expenditure for West Bengal has been observed with gini coefficient of 0.67. Based on the findings from this analysis, more attention is needed on effective financial protection for people of West Bengal to promote fairness, with special focus on the districts with higher inequality. This study only provides the extent of CHE and inequality across Districts of West Bengal but the causality may be taken in future scope of study.
    Date: 2020–10
  13. By: Etheridge, Ben; Wang, Yikai; Tang, Li
    Abstract: We examine self-reported productivity of home workers during lockdown using survey data from the UK. On average, workers report being as productive as at the beginning of the year, before the pandemic. However, this average masks substantial differences across sectors, by working from home intensities, and by worker characteristics. Workers in industries and occupations characterized as being suitable for home work according to objective measures report higher productivity on average. Workers who have increased their intensity of working from home substantially report productivity increases, while those who previously always worked from home report productivity declines. Notable groups suffering the worst average declines in productivity include women and those in low-paying jobs. Declines in productivity are strongly associated with declines in mental well-being. Using stated reasons for productivity declines, we provide evidence of a causal effect from productivity to well-being.
    Date: 2020–10–06
  14. By: Ismael Sanz; J .D. Tenaa
    Abstract: Exploring the impact of reducing instruction time has become a fundamental topic in education, particularly following the covid-19 outbreak. In this paper we consider an unexpected regulation change affecting the academic calendar of non-fee paying schools in the Madrid region (Spain) during the 2017-2018 school year. The availability of standard cognitive tests allows us to estimate the impact of this measure on academic performance by means of a difference in difference regression. Although this regulation change affected just two weeks of the school calendar, we found that it contributed to a significant deterioration of academic performance which was particularly evident in Spanish and English. We further explore nonlinear (quantile) effects across the distribution of scores in the standardized exam finding that the disruption of the new normative affected more to students in the upper quartile of the distribution. Overall, we found a reduction of the gap across students in non-fee schools together with an increase of the gap between non-fee and fee paying schools. We discuss the implications of these results for a better understanding of the impact of school closures due to covid-19.
    Keywords: Instruction time, difference in difference, quantile regression, academic performance
    Date: 2020–10
  15. By: Eckardt, Matthias (Humboldt University Berlin); Kappner, Kalle (Humboldt University Berlin); Wolf, Nikolaus (Humboldt University Berlin and CEPR)
    Abstract: Attempts to constrain the spread of Covid-19 included the temporal reintroduction of travel restrictions and border controls within the Schengen area. While such restrictions clearly involve costs, their benefits have been disputed. We use a new set of daily regional data of confirmed Covid19 cases from the respective statistical agencies of 18 Western European countries. Our data starts with calendar week 10 (starting 2nd March 2020) and extends to calendar week 17 (ending 26th April 2020), which allows us to test for treatment effects of border controls. Based on PPML methods and a Bayesian INLA approach we find that border controls had a significant effect to limit the pandemic.
    Keywords: Covid-19, border effects, INLA JEL Classification: C33, I18, R23
    Date: 2020
  16. By: Yasemin Özdemir
    Abstract: This paper investigates whether and how parents adjust their parenting behavior in response to their children's peers. In particular, I analyze whether changes in cognitive and non-cognitive skills of children's friends lead parents to adjust their investment and parenting style such, as monitoring and quality time spend with their children. Data from Add Health allow me to follow five cohorts of teenagers from grades 7 to 12 with repeated information on individual friendship networks. Combining the empirical strategy of overlapping peer groups and first-differencing, I estimate a simultaneous system of skill and investment equations. First, I show that parental monitoring increases as the level of cognitive skills among peers decreases. Also, mothers compensate decreases in cognitive skills of their child's peers by increasing verbal investment, while fathers reinforce higher non-cognitive skills of their child's peers with joint activities. Second, I document gender differences in monitoring, where cognitive skills of sons' peers are compensated but non-cognitive skills of daughters' peers are reinforced. Overall, effects in time investment are driven by parents with high educational expectations of their child, and parents that have no close relationship with peer-parents. Third, parental response to peers is not limited to peer skills, the composition of peers as measured by their characteristics also leads to an adjustment in the parenting behavior.
    Keywords: Child Development, Family Investment, Peers, Skills, Non-Cognitive Skills
    JEL: J13 J24 D13
    Date: 2020–09
  17. By: André Decoster; Thomas Minten; Johannes Spinnewijn
    Abstract: We use population-wide data from linked administrative registers to study the distributional pattern of mortality before and during the Covid-19 pandemic in Belgium. Excess mortality is only found among those aged 65 and over. For this group, we find a significant negative income gradient in excess mortality, with excess deaths in the bottom income decile more than twice as high as in the top income decile for both men and women. However, given the high inequality in mortality in normal times, the income gradient in all-cause mortality is only marginally steeper during the peak of the health crisis when expressed in relative terms. Leveraging our individual-level data, we gauge the robustness of our results for other socioeconomic factors and find that conclusions about the income gradient in excess mortality based on aggregate data can be misguided.
    Date: 2020–09–25
  18. By: Aditya Goenka; Lin Liu; Manh-Hung Nguyen
    Abstract: This paper studies optimal quarantines (can also be interpreted as lockdowns or selfisolation) when there is an infectious disease with SIS dynamics and infections can cause disease related mortality in a dynamic general equilibrium neoclassical growth framework. We characterize the optimal decision and the steady states and how these change with changes in effectiveness of quarantine, productivity of working from home, contact rate of disease and rate of mortality from the disease. A standard utilitarian welfare function gives the counter-intuitive result that increasing mortality reduces quarantines but increases mortality and welfare while economic outcomes and infections are largely unaffected. With an extended welfare function incorporating welfare loss due to disease related mortality (or infections generally) however, quarantines increase, and the decreasing infections reduce mortality and increase economic outcomes. Thus, there is no optimal trade-off between health and economic outcomes. We also study sufficiency conditions and provide the first results in economic models with SIS dynamics with disease related mortality - a class of models which are non-convex and have endogenous discounting so that no existing results are applicable
    Keywords: Infectious diseases, Covid-19, SIS model, mortality, sufficiency conditions, economic growth, lockdown, quarantine, self-isolation
    JEL: E13 E22 D50 D63 I10 I15 I18 O41 C61
    Date: 2020–09
  19. By: Hasanzadeh, Samira; Alishahi, Modjgan
    Abstract: In response to the COVID-19 pandemic, many countries, including the U.S., set a mandatory stay-at-home order in attempts to avert the spread. Although the primary goal of such a policy is to protect societies and save lives, it might result in other potential physical and psychological health threats. This paper examines the impact of stay-at-home policies on people’s health behaviours towards weight gain and probable obesity attributable to imposing the order. Using Google Trends data, we investigate whether the lockdowns that were implemented in the U.S. led to changes in weight-gain-related online search behaviours. To probe the causal link between lockdown policies and changes in weight-gain-related topics, we employ the differences-in-differences method and regression discontinuity design and we find a significant increase in the search intensity for workout and weight loss, while the search intensity for fitness, nutrition, and fast food appears to have declined. Our results from using event study regression suggest that changes in health behaviours began weeks before lockdown orders were implemented contemporaneously with emergency declarations and other partial closures about COVID-19. The findings suggest that people’s health-related behaviours regarding weight gain were affected by the lockdowns.
    Keywords: COVID-19, lockdown, health behaviours, weight gain, Obesity
    JEL: H12 I12 I18
    Date: 2020–08–31
  20. By: Wes Austin; Stefano Carattini; John Gomez Mahecha; Michael Pesko
    Abstract: We examine the relationship between contemporaneous fine particulate matter exposure and COVID-19 morbidity and mortality using an instrumental variable approach based on wind direction. Harnessing daily changes in county-level wind direction, we show that arguably exogenous fluctuations in local air quality impact the rate of confirmed cases and deaths from COVID-19. In our preferred high dimensional fixed effects specification with state-level policy and social distancing controls, we find that a one μg/m3 increase in PM 2.5 increases the number of confirmed cases by roughly 2% from the mean case rate in a county. These effects tend to increase in magnitude over longer time horizons, being twice as large over a 3-day period. Meanwhile, a one μg/m3 increase in PM 2.5 increases the same-day death rate by 3% from the mean. Our estimates are robust to a host of sensitivity tests. These results suggest that air pollution plays an important role in mediating the severity of respiratory syndromes such as COVID-19, for which progressive respiratory failure is the primary cause of death, and that policy levers to improve air quality may lead to improvements in COVID-19 outcomes.
    Keywords: pollution, air quality, PM 2.5, COVID-19, health, mortality
    JEL: D62 I10 Q53
    Date: 2020
  21. By: Chiba, Asako
    Abstract: This study simulates the spread of the coronavirus disease (COVID-19) using a detailed agent-based model and the census data of Japan to provide a comprehensive analysis of the effects of contact-tracing apps. The results reveal some crucial characteristics of these apps. First, with regard to contacts of those diagnosed with COVID-19, the apps that require them to be quarantined upon receiving an alert are successful in achieving containment; however, the apps that require them to get tested have a limited curve-flattening effect. Second, the former category of apps perform better than the latter because they quarantine those who are infected but have not become infectious yet; these are individuals who cannot be detected by the current testing technology. Third, if the download rate of the apps is extremely high, the apps that require quarantine achieve containment with a small number of quarantined people, thereby indicating high efficiency. Finally, given a fixed download rate, increasing the number of tests per day enhances the effectiveness of the apps, although the degree of improved effectiveness is not proportional to the change in the number of tests.
    Keywords: COVID-19, contact-tracing apps, testing, quarantine, efficiency
    JEL: C63 I00 I18
    Date: 2020–10–03
  22. By: Aburto, Jose Manuel (University of Oxford, University of Southern Denmark); Kristensen, Frederikke Frehr (University of Southern Denmark); Sharp, Paul (University of Southern Denmark, CAGE, CEPR)
    Abstract: Covid-19 has demonstrated again that epidemics can affect minorities more than the population in general. We consider one of the last major epidemics in the United States: HIV/AIDS from ca. 1980-2000. We calculate life expectancy and lifespan disparity (a measure of variance in age at death) for thirty US states, finding noticeable differences both between states and between the black and white communities. Lifespan disparity allows us to examine distributional effects, and, using decomposition methods, we find that for six states lifespan disparity for blacks increased between 1980 and 1990, while life expectancy increased less than for whites. We find that we can attribute most of this to the impact of HIV/AIDS.
    Keywords: AIDS, HIV, life expectancy, lifespan disparity JEL Classification: I14, J15, N32
    Date: 2020
  23. By: Florida, Richard (University of Toronto’s Rotman School of Management and School of Cities); Mellander , Charlotta (Jönköping International Business School & Centre of Excellence for Science and Innovation Studies (CESIS))
    Abstract: This paper examines the geographic factors that are associated with the spread of COVID-19 in Sweden. The country is a useful case study to examine because it did not impose mandatory lockdowns, and thus we would expect the virus to spread in a more unimpeded way across communities. A growing body of research has examined the role of factors like density, household size, air connectivity, income, race and ethnicity, age, political affiliation, temperature and climate, and policy measure like lockdowns and physical distancing among others. The research examines the effects of some of these factors on the geographic variation of COVID-19 cases and on deaths, across both municipalities and neighborhoods. Our findings show that the geographic variation in COVID-19 is significantly but modestly associated with variables like density, population size, and the socio-economic characteristics of places, and somewhat more associated with variables for household size. What matters more is the presence of high-risk nursing homes and the onset of infections with places that were hit earlier by COVID-19 cases experiencing more severe outbreaks. Still, all these variables explain little of the geographic variation in COVID-19 across Sweden. There appears to be a high degree of randomness in the geographic variation of COVID-19 across Sweden and the degree to which some places were hit harder than others.
    Keywords: COVID-19; Sweden; geography; density; connectivity
    JEL: I10 J19 R23
    Date: 2020–10–13
  24. By: Constantin Bürgi; Nisan Gorgulu
    Abstract: This study documents how the demographics of new infections and mortality changed over time across US counties. We find that counties with a larger population share aged above 60 were hit harder initially in terms of both cases and mortality in March and April while counties with a larger population share aged below 20 were hit harder in June and July. At the same time, how counties that voted Democratic in 2016 are affected does not change over time. Subsequently, we simulate an alternative evolution of the pandemic, assuming that states extended the lockdown measures until daily new cases reach the levels of European countries after their lockdown measures were relaxed. In the baseline simulation, we find that cases and deaths would have increased by around 50% less by the end of June, but it would have led to a 2 percentage point larger drop in Q2 GDP.
    Keywords: spatial population distribution, pandemic, Covid-19, lockdown, stay-at-home order, economic impact, non-pharmaceutical interventions
    JEL: C53 H12 I18 R11
    Date: 2020
  25. By: Dasgupta, Utteeyo; Jha, Chandan Kumar; Sarangi, Sudipta
    Abstract: Outbreaks of infectious diseases bring behavior and policy responses into sharp focus since societies face acute constraints and uncertainties. This paper compares two infectious disease outbreaks: the Covid-19 pandemic and the 1665 London plague outbreak described by Daniel Defoe in A Journal of the Year of the Plague published in 1722. We compare three aspects: individual behavior, social behavior and governance and find striking similarities in behavior in spite of these events being separated by 350 years. We contend that the same models of behavior can be used to explain human responses during such outbreaks regardless of when they occur.
    Keywords: pandemics, infectious diseases, economic behavior, comparative analysis
    JEL: A10 B52 Z11
    Date: 2020–08
  26. By: Carlo Fezzi; Valeria Fanghella
    Abstract: This paper develops a methodology for tracking in real time the impact of the COVID-19 pandemic on economic activity by analyzing high-frequency electricity market data. The approach is validated by several robustness tests and by contrasting our estimates with the official statistics on the recession caused by COVID-19 in different European countries during the first two quarters of 2020. Compared with the standard indicators, our results are much more chronologically disaggregated and up-to-date and, therefore, can inform the current debate on the appropriate policy response to the pandemic. Unsurprisingly, we find that nations that experienced the most severe initial outbreaks also grappled with the hardest economic recessions. However, we detect diffused signs of recovery, with economic activity in most European countries returning to its pre-pandemic level by August 2020. Furthermore, we show how delaying intervention or pursuing 'herd immunity' are not successful strategies, since they increase both economic disruption and mortality. The most effective short-run strategy to minimize the impact of the pandemic appears to be the introduction of early and relatively less stringent non-pharmaceutical interventions.
    Date: 2020–09
  27. By: Relihan, Lindsay; Ward, Marvin; Wheat, Chris W.; Farrell, Diana
    Abstract: We document a number of striking features about the initial impact of the pandemic on local commerce across 16 US cities. There are two novel contributions from this analysis: exploration of neighborhood-level effects and shifts between offline and online purchasing channels. In our analysis we use approximately 450 million credit card transactions per month from a rolling sample of 11 million anonymized customers between October 2019 and March 2020. Across the 16 cities we profile, consumers decreased spend on the set of goods and services we define as “local commerce” by 12.8% between March 2019 and March 2020. Growth in all 16 cities was negative. Consumers shifted a substantial share of local commerce spend online, such that year-over-year growth in online spend was small, but positive, at 1.5%. With respect to grocery and pharmacy purchases, online spend grew at least three times as fast as offline spend. Overall spend declines were uniform across neighborhoods of differing median household income, though lower-income neighborhoods experienced the highest proportion of extreme negative declines. We also find evidence that many low-income neighborhoods are increasing spend on online grocery slower than others, but increasing their use of online restaurants the fastest. Consumers in low-income neighborhoods also tend to live farther from the grocery stores at which they shop. Compared to their counterparts in higher-income neighborhoods, consumers in low-income neighborhoods have not been more likely to shop at grocery stores closer to where they live since the onset of the pandemic.
    Keywords: coronavirus; Covid-19
    JEL: L81
    Date: 2020–06–12
  28. By: Hsu, Wen-Tai (School of Economics, Singapore Management University); Lin, Hsuan-Chih (Luke) (Institute of Economics, Academia Sinica); Yang, Han (Institute of Economics, Academia Sinica)
    Abstract: This paper studies optimal containment policy for combating a pandemic in an open-economy context. It does so via quantitative analyses using a model that incorporates a standard epidemiological compartmental model in a multi-country, multi-sector Ricardian model of international trade with full-fledged input-output linkages. We devise a novel approach in computing optimal national policies in the long run, and contrast these policies with a baseline in which countries maintain their current policies until vaccine availability. The welfare gains under optimal policies are asymmetric as the gains for the set of countries which should tighten up the containment measures are much larger than those which should relax. We also find that the welfare implications of optimal policies in open economies differ significantly from those in closed ones.
    Keywords: COVID-19; pandemic; welfare analysis; containment policy; optimal policy; open economy; trade; input-output linkages
    JEL: E27 F11 F40 I18
    Date: 2020–10–05
  29. By: James B. Bullard
    Abstract: During a virtual presentation for the Global Interdependence Center, St. Louis Fed President James Bullard said there has been substantial progress in managing the global health crisis. In addition, he noted that U.S. macroeconomic news has surprised dramatically to the upside and that economic activity will likely show outsized growth in the third quarter.
    Keywords: COVID-19
    Date: 2020–09–24
  30. By: Rawley Heimer; Haoyang Liu; Xiaohan Zhang
    Abstract: More than six months into the COVID-19 outbreak, the number of new cases in the United States remains at an elevated level. One potential reason is a lack of preventative efforts either because people believe that the pandemic will be short-lived or because they underestimate their own chance of infection despite it being a public risk. To understand these possibilities, we elicit people’s perceptions of COVID-19 as a public health concern and a personal concern over the next three months to the following three years within the May administration of the Survey of Consumer Expectations (SCE). This post reports results from these survey questions.
    Keywords: COVID-19; overconfidence
    JEL: I12
    Date: 2020–10–07
  31. By: Mohajan, Haradhan
    Abstract: The novel (new) coronavirus (CoV) fatal disease (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-COV- 2 or 2019-nCoV). It has been identified as the causative agent of the viral pneumonia outbreak in Wuhan, China, at the end of 2019. At present it becomes great global public health concern and as well as global economic depression. The International Monetary Fund (IMF) estimates that due to COVID-19 outbreak cost the world economy up to $9 trillion. After COVID-19 outbreak, home quarantines, lockdown, widespread restrictions on labor mobility and travel, border closings and closing of economic activities affect global supply chains, oil prices, travel and tourism, restaurants, conferences, sporting events, government budget, etc. The amount of the global economic damage is very uncertain at present, but it is estimated that it will be large depending on the length of COVID-19. The paper discusses the social, economic, and health impacts on the world’s poorest countries. The purpose of this study is to examine the economic impacts due to COVID-19 pandemic outbreak. An attempt has been taken here to discuss the current economic situation of the world and analyses the potential consequences on global economy in future.
    Keywords: SARS-CoV-2, COVID-19 outbreak, pandemic, lockdown, economic consequences
    JEL: I15
    Date: 2020–03–10
  32. By: Esther Blanco; Alexandra Baier; Felix Holzmeister; Tarek Jaber-Lopez; Natalie Struwe
    Abstract: Think tanks and political leaders have raised concerns about the implications that the Covid-19 response and reconstruction might have on other social objectives that were setting the international agenda before the Covid-19 pandemic. We present experimental evidence for eight consecutive weeks during April-May 2020 for Austria, testing the extent to which Covid-19 concerns might substitute other social concerns such as the climate crisis or the protection of vulnerable sectors of the society. We measure behavior in a simple donation task where participants receive Euro 3 that they can distribute between themselves and different charities. While participants in one treatment have the opportunity to donate, if any, to eight different charities including a rich set of social concerns (Baseline), participants in a second treatment can choose to donate, if any, to the same charities and, in addition, to the Covid-19 Solidarity Response Fund for the World Health Organization (Covid-19). In a third treatment, participants can only decide on distributing the Euro 3 between themselves and the Covid-19 Solidarity Response Fund (Covid-19 Only). Our results show that introducing the Covid-19 Solidarity Response Fund does not significantly change aggregate donations (donations represent 76.3% of endowment in Baseline and 70.2% in Covid-19, t(584) = 1.938, p = 0.053, n = 585). But, given positive donations to the Covid19 Solidarity Response Fund, this entails significantly lower donations to the other eight charities (76.3% in Baseline and 60.8% in Covid-19, t(584) = 5.868, p
    Keywords: Charitable donation, Covid-19 pandemic, climate crisis, poverty, substitution of social concerns
    JEL: D64 Q54 I3 D9
    Date: 2020
  33. By: Klaus Wälde (Johannes Gutenberg University)
    Abstract: BACKGROUND. Public health measures and private behaviour are based on reported numbers of SARS-CoV-2 infections. Some argue that testing influences the confirmed number of infections. OBJECTIVES/METHODS. Do time series on reported infections and the number of tests allow one to draw conclusions about actual infection numbers? A SIR model is presented where the true numbers of susceptible, infectious and removed individuals are unobserved. Testing is also modelled. RESULTS. Official confirmed infection numbers are likely to be biased and cannot be compared over time. The bias occurs because of different reasons for testing (e.g. by symptoms, representative or testing travellers). The paper illustrates the bias and works out the effect of the number of tests on the number of reported cases. The paper also shows that the positive rate (the ratio of positive tests to the total number of tests) is uninformative in the presence of non-representative testing. CONCLUSIONS. A severity index for epidemics is proposed that is comparable over time. This index is based on Covid-19 cases and can be obtained if the reason for testing is known.
    Keywords: Covid-19, number of tests, reported number of CoV-2 infections, (correcting the) bias, SIR model, unbiased epidemiological severity index
    Date: 2020–10–09

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