nep-hea New Economics Papers
on Health Economics
Issue of 2020‒11‒02
33 papers chosen by
Nicolas R. Ziebarth
Cornell University

  1. Health of Elderly Parents, Their Children's Labor Supply, and the Role of Migrant Care Workers By Frimmel, Wolfgang; Halla, Martin; Paetzold, Jörg; Schmieder, Julia
  2. School Selectivity, Peers, and Mental Health By Bütikofer, Aline; Ginja, Rita; Landaud, Fanny; Loken, Katrine Vellesen
  3. Crimes against Morality: Unintended Consequences of Criminalizing Sex Work By Cameron, Lisa A.; Seager, Jennifer; Shah, Manisha
  4. Maternal Stress and Offspring Lifelong Labor Market Outcomes By Vincenzo Atella; Edoardo Di Porto; Joanna Kopinska; Maarten Lindeboom
  5. Families of Austerity: Welfare Cuts and Family Stress in Britain By Mari, Gabriele; Keizer, Renske
  6. Baby Bonus, Fertility, and Missing Women By Wookun Kim
  7. Hassles and Environmental Health Screenings: Evidence from Lead Tests in Illinois By Gazze, Ludovica
  8. Epidemics, Inequality and Poverty in Preindustrial and Early Industrial Times By , Stone Center; Alfani, Guido
  9. The Effect of Antimalarial Campaigns on Child Mortality and Fertility in Sub-Saharan Africa By Wilde, Joshua; Apouey, Bénédicte; Coleman, Joseph; Picone, Gabriel
  10. Working Less to Take Care of Parents? Labor Market Effects of Family Long-Term Care in Four Latin American Countries By Stampini, Marco; Oliveri, María Laura; Ibarrarán, Pablo; Londoño, Diana; Rhee, Ho June (Sean); James, Gillinda M.
  11. Safer Spaces: The impact of a reduction in road fatalities on the life expectancy of South Africans By Liliana de Abreu; Anke Hoeffler
  12. Re-Examining Supplier-Induced Demand in Health Care: Comparisons among Patients Affiliated and Not Affiliated with Healthcare Professionals in China By Si, Yafei; Zhou, Zhongliang; Su, Min; Hu, Han; Yang, Zesen; Chen, Xi
  13. Dealing with Demand Heterogeneity on Health Care Provider Choice –The Case of Rural China By Martine Audibert; Yong He; Jacky Mathonnat
  14. The Peace Baby Boom: Evidence from Colombia’s peace agreement with the FARC By Prem, M; Guerra, M. E.; Rodríguez, P; Vargas, J. F.
  15. SCARE: When Economics Meets Epidemiology with COVID-19 By André de Palma; Nathalie Picard; Stef Proost
  16. Contributing Factors to Personal Protective Equipment Shortages during the COVID-19 Pandemic By Cohen, Jennifer; Rodgers, Yana
  17. The medium-term impact of non-pharmaceutical interventions. The case of the 1918 influenza in US cities By Guillaume Chapelle
  18. Excess mortality: Measuring the direct and indirect impact of COVID-19 By David Morgan; Junya Ino; Gabriel Di Paolantonio; Fabrice Murtin
  19. Exposure to the Covid-19 pandemic and generosity By Brañas-Garza, Pablo; Jorrat, Diego; Alfonso-Costillo, Antonio; Espín, Antonio M.; Garcia, Teresa; Kovářík, Jaromír
  20. No more visits. Informal care in nursing homes prior to the outbreak of Covid-19. By Lucas Jeanneau; Quitterie Roquebert; Marianne Tenand
  21. Employment Opportunities and High School Completion during the COVID-19 Recession By Ahn, Kunwon; Lee, Jun Yeong; Winters, John V.
  22. Economics and Epidemics: Evidence from an Estimated Spatial Econ-SIR Model By Bognanni, Mark; Hanley, Doug; Kolliner, Daniel; Mitman, Kurt
  23. Employment Opportunities and High School Completion during the COVID-19 Recession By Ahn, Kunwon; Lee, Jun Yeong; Winters, John V.
  24. Contraception, Intra-household Behaviour and Epidemic: Evidence from the Zika crisis in Colombia By Cortés, D; Gamboa, L. F.; Rodríguez, P
  25. Misinformation During a Pandemic By Bursztyn, Leonardo; Rao, Aakaash; Roth, Christopher; Yanagizawa-Drott, David
  26. Export restrictions during global health crises: The international community can and must do better By Laura Puccio; André Sapir
  27. Real-time tracking of COVID-19 impacts across Europe reveals that seeking ''herd immunity'' provides no economic benefits By Carlo Fezzi; Valeria Fanghella
  28. Health Vulnerability versus Economic Resilience to the Covid-19 pandemic: Global Evidence By Simplice A. Asongu; Samba Diop; Joseph Nnanna
  29. Pandemics and Protectionism: Evidence from the “Spanish” flu By Boberg-Fazlic, Nina; Lampe, Markus; Pedersen, Maja Uhre; Sharp, Paul
  30. Export Restrictions: A Negative-Sum Policy Response to the COVID-19 crisis By Bernard Hoekman; Matteo Fiorini; Aydin Yildirim
  31. Evaluating the Effectiveness of Policies Against a Pandemic By Christian Alemán; Christopher Busch; Alexander Ludwig; Raül Santaeulàlia-Llopis
  32. Demographic shocks and women’s labor market participation: evidence from the 1918 influenza pandemic in India By Fenske, James; Gupta, Bishnupriya; Yuan, Song
  33. Love Thy Neighbor? Perceived Community Abidance and Private Compliance to COVID-19 Norms in India By Upasak Das; Prasenjit Sarkhel; Sania Ashraf

  1. By: Frimmel, Wolfgang (University of Linz); Halla, Martin (University of Linz); Paetzold, Jörg (University of Salzburg); Schmieder, Julia (DIW Berlin)
    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
  2. By: Bütikofer, Aline (Norwegian School of Economics); Ginja, Rita (University of Bergen); Landaud, Fanny (Norwegian School of Economics); Loken, Katrine Vellesen (Norwegian School of Economics)
    Abstract: Although many students suffer from anxiety and depression, and students often identify school pressure and concerns about their futures as the main reasons for their worries, little is known about the consequences of a selective school environment on students' physical and mental health. In this paper, we draw on rich administrative data and the features of the high school assignment system in the largest Norwegian cities to consider the long-term consequences of enrollment in a more selective high school. Using a regression discontinuity analysis, we show that eligibility to enroll in a more selective high school increases the probability of enrollment in higher education and decreases the probability of diagnosis or treatment by a general medical practitioner for psychological symptoms and diseases. We further document that enrolling in a more selective high school has a greater positive impact when there are larger changes in the student–teacher ratio, teachers' age, and the proportion of female teachers. These findings suggest that changes in teacher characteristics are important for better understanding the effects of a more selective school environment.
    Keywords: selective high schools, higher education, health, mental health, peers
    JEL: I26 I12
    Date: 2020–10
  3. By: Cameron, Lisa A. (University of Melbourne); Seager, Jennifer (George Washington University); Shah, Manisha (University of California, Los Angeles)
    Abstract: We examine the impact of criminalizing sex work, exploiting an event in which local officials unexpectedly criminalized sex work in one district in East Java, Indonesia, but not in neighboring districts. We collect data from female sex workers and their clients before and after the change. We find that criminalization increases sexually transmitted infections among female sex workers by 58 percent, measured by biological tests. This is driven by decreased condom access and use. We also find evidence that criminalization decreases earnings among women who left sex work due to criminalization, and decreases their ability to meet their children’s school expenses while increasing the likelihood that children begin working to supplement household income. While criminalization has the potential to improve population STI outcomes if the market shrinks permanently, we show that five years post-criminalization the market has rebounded and the probability of STI transmission within the general population is likely to have increased.
    Keywords: sex work, criminalization, sexually-transmitted infections, Indonesia
    JEL: I18 K42 J16
    Date: 2020–10
  4. By: Vincenzo Atella (Università di Roma Tor Vergata and CHP Stanford University); Edoardo Di Porto (Università di Napoli Federico II, INPS and CSEF); Joanna Kopinska (Università di Roma La Sapienza , CEIS Tor Vergata, Università di Roma Tor Vergata); Maarten Lindeboom (Vrije Universiteit Amsterdam; Centre for Health Economics, Monash University; Tinbergen Institute; IZA)
    Abstract: This paper examines the effects of in-utero exposure to stress on lifelong labor market outcomes. We exploit a unique natural experiment that involved randomly placed Nazi raids on municipalities in Italy during WWII. We use administrative data on the universe of private sector workers in Italy and link this data to unique historical data with detailed information about war casualties and Nazi raids across space (Municipality) and time. We find that prenatal stress exposure leads to lower wage earnings when workers start their career, and that this effect persists until retirement. The earnings penalty is in large part due to the type of job that people hold and interruptions in their working career due to unemployment. We further show that workers exposed to in-utero stress face larger earnings reductions after job loss due to mass layoffs. This earnings loss deepens their relative disadvantage over time.
    Keywords: Early-life; Stress; Life-long earnings; Mass Layoff; Dynamic Complementarities.
    JEL: I1 O1
    Date: 2020–10–16
  5. By: Mari, Gabriele; Keizer, Renske
    Abstract: Studies have widely documented how families fare when receiving income boosts. Relatively little is known about the intergenerational effects of income losses, especially those resulting from austerity measures pursued after the Great Recession. Income loss can trigger family stress, whereby financial hardship hastens psychological distress and disrupts parenting and parent-child relationships. Such family stress can hinder socio-emotional development in children, a key factor shaping their future life chances. We assess if and how austerity measures can aggravate family stress and its consequences, tackling the case of Britain in the period 2009-2018. Extensive tax-benefit reform is exploited for identification. Based on a large longitudinal sample of parents and their adolescent children (UK Household Longitudinal Study), we show that austerity-induced benefit income loss may impinge on household finances, as signalled by housing arrears, and lead to worsening maternal mental health, strained parent-child relationships and less effective parenting, as well as increased problem behaviour among boys. Although benefit income loss also pushes parents into employment, neither the economic losses nor the stress stemming from welfare cutbacks are found to be offset by labour earnings in low-income households, where parents and children bear the brunt of austerity.
    Date: 2020–10–07
  6. By: Wookun Kim (Southern Methodist University)
    Abstract: This paper estimates the effects of pro-natalist cash transfers (baby bonus) on birth outcomes. I exploit rich spatial and temporal variation in these cash transfers and administrative data on the universe of birth and death registry records in South Korea. I find that the pro-natalist cash transfers increased the number of children ever born by women. The total fertility rate in 2015 would have been 3% lower without the cash transfers. The elasticities of birth rates with respect to cash transfers vary widely across birth order and mother’s age. These financial incentives encouraged working mothers to have second and third children. I observe a decrease in gestational age among these working mothers, which in turn led to an overall reduction in birth weight. There is no evidence of changes in early life mortality, but the cash transfers shifted the male-skewed sex ratio towards its natural level.
    Keywords: cash transfer, fertility, neonatal health, missing women, son preference.
    JEL: H40 H75 J13 J16 J18
    Date: 2020–10
  7. By: Gazze, Ludovica (University of Warwick)
    Abstract: I study the determinants of childhood lead screening using all Illinois birth records (2001-2014), matched to lead testing records and geocoded housing age data. Housing age measures lead risk, as older houses disproportionally have lead paint. Changes in providers’ availability, inferred from testing data, provide variation in non-monetary costs of testing. Travel costs reduce screening among low- and high-risk households alike. Thus, self-selection based on travel costs does not appear to improve targeting, even though high-risk households are willing to pay $29-389 more than low-risk households for screening. Screening incentives would be cost-effective for reasonable values of lead poisoning externalities.
    Keywords: JEL Classification: I1, Q52
    Date: 2020
  8. By: , Stone Center (The Graduate Center/CUNY); Alfani, Guido
    Abstract: Recent research has explored the distributive consequences of major historical epidemics, and the current crisis triggered by Covid-19 prompts us to look at the past for insights about how pandemics can affect inequalities in income, wealth, and health. The fourteenth-century Black Death, which is usually believed to have led to a significant reduction in economic inequality, has attracted the greatest attention. However, the picture becomes much more complex if other epidemics are considered. This article covers the worst epidemics of preindustrial times, from Justinian’s Plague of 540-41 to the last great European plagues of the seventeenth century, as well as the cholera waves of the nineteenth. It shows how the distributive outcomes of lethal epidemics do not only depend upon mortality rates, but are mediated by a range of factors, chief among them the institutional framework in place at the onset of each crisis. It then explores how past epidemics affected poverty, arguing that highly lethal epidemics could reduce its prevalence through two deeply different mechanisms: redistribution towards the poor, or extermination of the poor. It concludes by recalling the historical connection between the progressive weakening and spacing in time of lethal epidemics and improvements in life expectancy, and by discussing how epidemics affected inequality in health and living standards. (Stone Center on Socio-Economic Inequality Working Paper Series)
    Date: 2020–10–08
  9. By: Wilde, Joshua (Max Planck Institute for Demographic Research); Apouey, Bénédicte (Paris School of Economics); Coleman, Joseph (University of South Florida); Picone, Gabriel (University of South Florida)
    Abstract: We examine the extent to which recent declines in child mortality and fertility in Sub- Saharan Africa can be attributed to insecticide-treated bed nets (ITNs). Exploiting the rapid increase in ITNs since the mid-2000s, we employ a difference-in-differences estimation strategy to identify the causal effect of ITNs on mortality and fertility. We show that the ITN distribution campaigns reduced all-cause child mortality, but surprisingly increased total fertility rates in the short run in spite of reduced desire for children and increased contraceptive use. We explain this paradox in two ways. First, we show evidence for an unexpected increase in fecundity and sexual activity due to the better health environment after the ITN distribution. Second, we show evidence that the effect on fertility is positive only temporarily – lasting only 1-3 years after the beginning of the ITN distribution programs – and then becomes negative. Taken together, these results suggest the ITN distribution campaigns may have caused fertility to increase unexpectedly and temporarily, or that these increases may just be a tempo effect – changes in fertility timing which do not lead to increased completed fertility.
    Keywords: Malaria, bed nets, child mortality, fertility, Sub-Saharan Africa
    JEL: I15 J13 O10 O15
    Date: 2020–10
  10. By: Stampini, Marco (Inter-American Development Bank); Oliveri, María Laura (Inter-American Development Bank); Ibarrarán, Pablo (Inter-American Development Bank); Londoño, Diana (University of Rosario); Rhee, Ho June (Sean) (Middlebury College); James, Gillinda M. (Middlebury College)
    Abstract: We use data from time-use surveys and the Mexican Health and Aging Study (MHAS) to analyze the relationship between family long-term care (LTC) and female labor supply in four Latin American countries. Time-use survey data from Chile, Colombia, Costa Rica and Mexico shows that: (i) women provide the vast majority of family LTC; (ii) consistently across countries, women who provide LTC are less likely to work, and those who do work less hours per week and have a double burden of work and LTC. Multivariate analysis of longitudinal MHAS data shows that, after accounting for both individual and time fixed effects, parents' need for LTC is associated with both a significant drop in the likelihood of working (by 2.42 percentage points) and a reduction in the number of hours worked among women ages 50–64 who remain employed (by 7.03%). This finding has important gender equality implications. Also, in a region that is aging faster than any other in the world, social trends make this family provision of LTC unsustainable, increasing the need for policy action.
    Keywords: female labor supply, Long-Term Care (LTC), elderly care, care dependence, time-use surveys, Mexican Health and Aging Study (MHAS), Latin America, Chile, Colombia, Costa Rica, Mexico
    JEL: J14 J16 J18 J21 J22
    Date: 2020–10
  11. By: Liliana de Abreu (Department of Politics and Public Administration, University of Konstanz); Anke Hoeffler (Department of Politics and Public Administration, University of Konstanz)
    Abstract: In this paper we determine the cost of fatalities resulting from road traffic injuries (RTIs) in South Africa. We express the costs in terms of reduced life expectancy and years of potential life lost (YPLL). Our main data source is the Injury Mortality Survey, a retrospective descriptive study carried out in 2009 in South Africa. Using the mortality rates by sex and age from the mortuary data we calculate actual life expectancy at birth. In our counterfactual analysis we assume a reduction of 15% reduction per year in road fatalities for a period of 10 years. A comparison of the estimated actual and counterfactual life expectancies suggests that the average gain in life expectancy at birth would be 0.58 years. Since the overwhelming majority of road traffic fatalities are male (75.7%), there is a considerable gender difference. Men would gain 0.85 years while women would gain 0.30 years in life expectancy, closing the gender gap in life expectancy by about 14%. We then discuss how a reduction in RTIs could be achieved. South Africa’s legislation already covers all important aspects of road safety (e.g. seat belt use, drink driving restrictions, speed limits, infrastructure improvements), however, enforcement is relatively weak and should be improved. There are a raft of measures that have been well researched in other countries, most interventions aim to modify the behaviour of road users and have been found to be cost effective. In addition to stricter enforcement, evidence from social science suggests that compliance could be increased through a change in social norms regarding road usage.
    Keywords: road traffic fatalities, road safety, life expectancy, South Africa
    JEL: I15 I18 J19 O55
    Date: 2020
  12. By: Si, Yafei (University of New South Wales); Zhou, Zhongliang (Xi’an Jiaotong University); Su, Min (Inner Mongolia University); Hu, Han (Xi’an Jiaotong University); Yang, Zesen (Tsinghua University); Chen, Xi (Yale University)
    Abstract: Doing "more" in healthcare can be a major threat to the delivery of high-quality health care. This study used coarsened exact matching to test the hypothesis of supplier-induced demand (SID) by comparing health care utilization and expenditures between patients affiliated with healthcare professionals and their counterpart patients not affiliated with healthcare professionals. Using the China Labor-force Dynamics Survey (CLDS) in 2014, we identified 806 patients affiliated with healthcare professionals and 22,788 patients not affiliated with healthcare professionals. The matched outpatient proportion of patients not affiliated with healthcare professionals was 0.6% higher (p=.754) than that of their counterparts, and the matched inpatient proportion was 1.1% lower (p =.167). Patients not affiliated with healthcare professionals paid significantly more (680 CNY or 111 USD, p
    Keywords: supplier-induced demand, health care utilization, healthcare professionals, China
    JEL: I11 D82 I12 D90
    Date: 2020–10
  13. By: Martine Audibert (CERDI - Centre d'Études et de Recherches sur le Développement International - Clermont Auvergne - UCA - Université Clermont Auvergne - CNRS - Centre National de la Recherche Scientifique); Yong He (CERDI - Centre d'Études et de Recherches sur le Développement International - Clermont Auvergne - UCA - Université Clermont Auvergne - CNRS - Centre National de la Recherche Scientifique); Jacky Mathonnat (FERDI - Fondation pour les Etudes et Recherches sur le Développement International)
    Abstract: We built a database of two samples of patients surveyed within the same regions in rural China over a time interval of 18 years, and presumed varying demand heterogeneity due to income increase and people aging. We find that while the mean price and distance negative effects on patients choice were present in both time periods, their differences in heterogeneity, which were confirmed with the mixed multinomial logit (MMNL), could have crucial importance in avoiding erroneous policy making based merely on mean price and distance effects. We also find that while both the multinomial logit (MNL) and the MMNL are able to predict price and distance effects with low heterogeneity, only the MMNL appears able to detect the price effect when heterogeneity is high. These findings suggest using caution when interpreting estimation results with the MNL in cases of high heterogeneity.
    Keywords: Chinese rural households,Healthcare choice,Distance effect,Price effect,Mixed multinomial logit models,Multinomial logit,Preference heterogeneity
    Date: 2020–10–07
  14. By: Prem, M; Guerra, M. E.; Rodríguez, P; Vargas, J. 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-indifferences, 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 that generalised reductions in total fertility rate were slowed down for municipalities traditionally affected by conflict as a result of the permanent ceasefire declared by the FARC insurgency. Total fertility rate observed a relative increase of 2.6% in the formerly conflict-affected areas, in all age groups. 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 mines victims and expelled population by forced displacement before the ceasefire have significantly higher total fertility rate in the four years following the ceasefire. We argue that the mechanism behind this result is the optimism to raise the children in a better environment due to the reduction in victimisation in areas that experience FARC violence.
    Keywords: fertility; pregnancy; mortality; armed conflict; violence
    JEL: I12 I15
    Date: 2020–09–18
  15. By: André de Palma; Nathalie Picard; Stef Proost
    Abstract: We develop an epidemic model to explain and predict the dynamics of the SARS-CoV-2 virus and to assess the economic costs of lockdown scenarios. The standard epidemic three-variable model, SIR (Susceptible, Infected and Removed) is extended into a five-variable model SCARE: Susceptible, Carrier, Affected (i.e. sick), Recovered and Eliminated (i.e. dead). Using WHO and Oxford data on cases and deaths, we rely on indirect inference techniques to estimate the parameters of SIR and SCARE. We consider different observation rates and stringencies of lockdown. Both models are estimated for five countries and provide predictions on the number of cases, the number of deaths, and the basic reproduction number, R0. SCARE is used to test the impact of lockdown policies on economic costs for the well-documented Belgium case. Economic assessments of epidemic results on hospital, morbidity and mortality together with macro-economic impacts show that the total net benefits of the Belgian lockdown policy is negative for low valuations of life years lost. The gains of extending the Belgian lockdown policy are negative even for high valuation of life.
    Keywords: COVID-19, public health, policy, simulation, social contact
    Date: 2020
  16. By: Cohen, Jennifer; Rodgers, Yana
    Abstract: This study investigates the forces that contributed to severe shortages in personal protective equipment in the US during the COVID-19 crisis. Problems from a dysfunctional costing model in hospital operating systems were magnified by a very large demand shock triggered by acute need in healthcare and panicked marketplace behavior that depleted domestic PPE inventories. The lack of appropriate action on the part of the federal government to maintain and distribute domestic inventories, as well as severe disruptions to the PPE global supply chain, amplified the problem. Analysis of trade data shows that the US is the world’s largest importer of face masks, eye protection, and medical gloves, making it highly vulnerable to disruptions in exports of medical supplies. We conclude that market prices are not appropriate mechanisms for rationing inputs to health because health is a public good. Removing the profit motive for purchasing PPE in hospital costing models and pursuing strategic industrial policy to reduce the US dependence on imported PPE will both help to better protect healthcare workers with adequate supplies of PPE.
    Keywords: Personal Protective Equipment; COVID-19; coronavirus; N95; gloves; PPE; nurses; supply chain; shortage; public good
    JEL: F1 H5 I1
    Date: 2020–10–02
  17. By: Guillaume Chapelle (Sciences Po)
    Abstract: This paper uses a difference-in-differences (DID) framework to estimate the impact of Non-Pharmaceutical Interventions (NPIs) used to fight the 1918 influenza pandemic and control the resultant mortality in 43 U.S. cities. The results suggest that NPIs such as school closures and social distancing, as implemented in 1918, and when applied for a relatively long and sustained time, might have reduced individual and herd immunity and the population general health condition, thereby leading to a significantly higher number of deaths in subsequent years.
    Keywords: non-pharmaceutical interventions ; 1918 influenza ; difference-in-differences ; health policies
    Date: 2020–10
  18. By: David Morgan (OECD); Junya Ino (OECD); Gabriel Di Paolantonio (OECD); Fabrice Murtin (OECD)
    Abstract: Assessing the direct and indirect health impact of the COVID 19 pandemic is central in managing public health and other policy measures while learning to co-exist with the virus. Many countries are publishing statistics on COVID 19 related mortality. While the frequent and timely publication of such figures provides insights into the ongoing trends in a given country, differences in coding and reporting practices pose challenges for international comparisons. Looking at the number of total deaths can help to overcome some of these differences in national practices whilst also providing a better view of the overall impact of COVID 19, by taking into account not just the possible underreporting of COVID 19 deaths but also indirect mortality caused, for example, by health systems not being able to cope with other conditions – acute and chronic.
    JEL: I30 I10
    Date: 2020–10–20
  19. By: Brañas-Garza, Pablo; Jorrat, Diego; Alfonso-Costillo, Antonio; Espín, Antonio M.; Garcia, Teresa; Kovářík, Jaromír
    Abstract: We report data from an online experiment, which allow us to study whether generosity has changed during the early Covid-19 pandemic. We have gathered data from Spanish participants over a six-day period in which Covid-19-associated deaths in Spain, one of the most affected countries, increased fourfold. In our experiment, participants could donate a fraction of a €100 prize to a charity. Our data are particularly rich in the age distribution and we complement them with daily public information about the Covid-19-related deaths, infections, and hospital admissions. We find that donations decreased in the period under study and scale down with the public information about the life and health impact of the pandemic. The effect is particularly pronounced among older subjects. Our analysis of the mechanisms behind the detected decrease in solidarity highlights the key—but independent—role of expectations about others’ behavior, perceived mortality risk, and (alarming) information in behavioral adaptation.
    Keywords: Generosity, Covid-19, Experiments, Social Preferences
    JEL: C93 D64
    Date: 2020–08
  20. By: Lucas Jeanneau; Quitterie Roquebert; Marianne Tenand
    Abstract: Amid the spread of the Covid-19, restrictions on external visits to nursing home residents were widely implemented. Such measures may affect the well-being of the institutionalized elderly, notably by depriving them of care that would be otherwise be provided by relatives and friends. There is little quantitative evidence about informal care receipt by residents in `normal times’. The aim of this study is twofold. First, it investigates quantitatively the importance of informal care in nursing homes, the forms it takes and its determinants outside the corona-crisis. Second, based on the findings, it discusses the likely implications of the Covid-19 restrictions on visits for nursing home residents. It relies on a sample representative of the French 60+ population living in nursing homes (N=3,223) from the 2016 CARE-Institutions survey. Over 80% of residents receive informal support. Relatives are primarily involved in help with the activities of daily living), which generally comes along with moral support. Residents are mostly helped with administrative tasks and activities related to mobility and the outside. Both the probability to receive informal care and its intensity highly depend on having close relatives alive (partner, children, siblings), age and health status. Loss of informal care due to visit bans may undermine the well-being of residents and entail medium- run adverse effects, in terms of further activity restrictions and deterioration of mental health. Policy makers should factor in the usual role of informal caregivers when assessing the benefits and costs of restrictions on visits for nursing home residents.
    Keywords: Nursing home; Informal care; Long-term care; Covid-19.
    JEL: J14 I1 C2
    Date: 2020
  21. By: Ahn, Kunwon (Iowa State University); Lee, Jun Yeong (Iowa State University); Winters, John V. (Iowa State University)
    Abstract: COVID-19 created major disruptions for young people including health concerns, school closures, reduced social opportunities, and a wilting economy. We examine the effect of COVID-19 on high school completion in the United States. We find that high school completion rates increased considerably in 2020 compared to previous years. We investigate various mechanisms and find that worse employment conditions were the driving force. The lower opportunity costs of schooling because of the pandemic recession encouraged more young people to complete high school. The pandemic created extensive problems in education, but fortunately it did not reduce overall high school completion rates.
    Keywords: education, employment, recession, COVID-19, human capital
    JEL: I2 J24
    Date: 2020–10
  22. By: Bognanni, Mark (Federal Reserve Board of Governors); Hanley, Doug (University of Pittsburgh); Kolliner, Daniel (University of Maryland); Mitman, Kurt (Stockholm University)
    Abstract: Economic analysis of effective policies for managing epidemics requires an integrated economic and epidemiological approach. We develop and estimate a spatial, micro-founded model of the joint evolution of economic variables and the spread of an epidemic. We empirically discipline the model using new U.S. county-level data on health, mobility, employment outcomes, and non-pharmaceutical interventions (NPIs) at a daily frequency. Absent policy or medical interventions, the model predicts an initial period of exponential growth in new cases, followed by a protracted period of roughly constant case levels and reduced economic activity. Nevertheless, if vaccine development proved impossible, and suppression cannot entirely eradicate the disease, a utilitarian policymaker cannot improve significantly over the laissez-faire equilibrium by using lockdowns. Conversely, if a vaccine will arrive within two years, NPIs can improve upon the laissez-faire outcome by dramatically decreasing the number of infectious agents and keeping infections low until vaccine arrival. Mitigation measures that reduce viral transmission (e.g., mask-wearing) both reduce the virus's spread and increase economic activity.
    Keywords: Econ-SIR, COVID-19, economic policy, epidemics
    JEL: E1 H0 I18
    Date: 2020–10
  23. By: Ahn, Kunwon; Lee, Jun Yeong; Winters, John V.
    Abstract: COVID-19 created major disruptions for young people including health concerns, school closures, reduced social opportunities, and a wilting economy. We examine the effect of COVID-19 on high school completion in the United States. We find that high school completion rates increased considerably in 2020 compared to previous years. We investigate various mechanisms and find that worse employment conditions were the driving force. The lower opportunity costs of schooling because of the pandemic recession encouraged more young people to complete high school. The pandemic created extensive problems in education, but fortunately it did not reduce overall high school completion rates.
    Date: 2020–10–19
  24. By: Cortés, D; Gamboa, L. F.; Rodríguez, P
    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: 2020–10–01
  25. By: Bursztyn, Leonardo (University of Chicago and NBER); Rao, Aakaash (Harvard University); Roth, Christopher (University of Warwick, CAGE Warwick, CESifo, CEPR, briq); Yanagizawa-Drott, David (University of Zurich and CEPR)
    Abstract: We study the effects of COVID-19 coverage early in the pandemic by the two most popular cable news shows in the US, both on Fox News, on health outcomes. We document large differences in content between the shows and in cautious behavior among viewers. Through both a selection-on-observables strategy and a novel instrumental variable approach, we find that areas with greater exposure to the show downplaying the threat of COVID-19 experienced a greater number of cases and deaths. We assess magnitudes through an epidemiological model highlighting the role of externalities and provide evidence that misinformation is a key underlying mechanism.
    Keywords: Media, Health, Coronavirus JEL Classification: D1, I31, Z13
    Date: 2020
  26. By: Laura Puccio; André Sapir
    Abstract: COVID-19 represents one of the biggest pandemic faced by humanity in recent times, spreading to almost all countries and territories on all continents. Because it spread so suddenly and quickly, COVID-19 produced an unparalleled increase in demand in personal protective equipment, medical products and devices, which far outpaced the ability to increase supply. The outcome was a shortage in these products, which lead several countries to introduce export restrictions. This paper offers a legal and economic assessment of these export restrictions and argues that the current international rules – administered respectively by the World Health Organisation (WHO) and the World Trade Organisation (WTO) – are ill-suited to deal with critical shortages that are likely to arise during, or at least in the early days of, a pandemic. Absent better rules and greater international cooperation, there was no alternative to the proliferation of export restrictions. The paper proposes the establishment of a new normative framework involving both WHO and WTO to avert supply shortages and export restrictions during a pandemic.
    Keywords: export restrictions, pandemic, covid-19, WTO, WHO, 2005 International Health Regulation, supply shortage
    Date: 2020–10
  27. 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.
    Keywords: COVID-19, lockdown, economic impact, mortality, GDP, electricity demand, high frequency data, real time indicators
    Date: 2020
  28. By: Simplice A. Asongu (Yaounde, Cameroons); Samba Diop (Alioune Diop University, Bambey, Senegal); Joseph Nnanna (The Development Bank of Nigeria, Abuja, Nigeria)
    Abstract: The purpose of this study is to understand how countries have leveraged on their economic resilience to fight the Covid-19 pandemic. The focus is on a global sample of 150 countries divided into four main regions, namely: Africa, Asia-Pacific and the Middle East, America and Europe. The study develops a health vulnerability index (HVI) and leverages on an existing economic resilience index (ERI) to provide four main scenarios from which to understand the problem statement, namely: ‘low HVI-low ERI’, ‘high HVI-low ERI’, ‘high HVI-high ERI’ and ‘low HVI-high ERI’ quadrants. It is assumed that countries that have robustly fought the pandemic are those in the ‘low HVI-high ERI’ quadrant and to a less extent, countries in the ‘low HVI-low ERI’ quadrant. Most European countries, one African country (i.e. Rwanda), four Asian countries (Japan, China, South Korea and Thailand) and six American countries (USA, Canada, Uruguay, Panama, Argentina and Costa Rica) are apparent in the ideal quadrant.
    Keywords: Novel coronavirus, health vulnerability, economic resilience
    JEL: E10 E12 E20 E23 I10 I18
    Date: 2020–09
  29. By: Boberg-Fazlic, Nina (University of Southern Denmark); Lampe, Markus (WU Vienna University of Economics and Business, CEPR); Pedersen, Maja Uhre (University of Southern Denmark); Sharp, Paul (University of Southern Denmark, CAGE, CEPR)
    Abstract: The impact of COVID-19 on recent tendencies towards international isolationism has been much speculated on but remains to be seen. We suggest that valuable evidence can be gleaned from the “Spanish” flu of 1918-20. It is well-known that the world fell into a protectionist spiral following the First World War, but scholars have almost exclusively ignored the impact of the pandemic. We employ a difference-in-differences strategy on data for Europe and find that excess deaths had a significant impact on trade policy, independent of the war. A one standard deviation increase in excess deaths during the outbreak implied 0.022 percentage points higher tariffs subsequently, corresponding to an increase of one third of a standard deviation in tariffs. Health policy should aim to avoid the experience of the interwar period and consider the international macroeconomic impact of measures (not) taken.
    Keywords: Pandemics, protectionism, trade JEL Classification: F13, I19, N74
    Date: 2020
  30. By: Bernard Hoekman; Matteo Fiorini; Aydin Yildirim
    Abstract: Many countries, including China, European member states, the European Union, India and the United States have put in place measures to restrict exports of medical products as part of their response to the COVID-19 pandemic. The objective is to allocate domestic supplies to national healthcare systems and citizens. These policies break supply chains that rely on sourcing of inputs from different countries, reduce access to critically needed supplies and foster excessive price spikes and volatility, and generate foreign policy tensions. Experience with widespread use of export restrictions by food exporting countries in times of market disruption and supply shortages suggests a priority for the G20 should be to work with industry to put in place systems to enhance access to information on production capacity, investments to boost supplies and address supply chain bottlenecks affecting production and trade in essential medical supplies.
    Keywords: Coronavirus, COVID-19 pandemic, export restrictions, trade policy, G20
    Date: 2020–04
  31. By: Christian Alemán; Christopher Busch; Alexander Ludwig; Raül Santaeulàlia-Llopis
    Abstract: We develop a novel empirical approach to identify the effectiveness of policies against a pandemic. The essence of our approach is the insight that epidemic dynamics are best tracked over stages, rather than over time. We use a normalization procedure that makes the pre-policy paths of the epidemic identical across regions. The procedure uncovers regional variation in the stage of the epidemic at the time of policy implementation. This variation delivers clean identification of the policy effect based on the epidemic path of a leading region that serves as a counterfactual for other regions. We apply our method to evaluate the effectiveness of the nationwide stay-home policy enacted in Spain against the Covid-19 pandemic. We find that the policy saved 15.9% of lives relative to the number of deaths that would have occurred had it not been for the policy intervention. Its effectiveness evolves with the epidemic and is larger when implemented at earlier stages.
    Keywords: macroeconomics, pandemic, stages, COVID-19, stay-home, policy effects, identification
    JEL: E01 E22 E25
    Date: 2020–10
  32. By: Fenske, James (University of Warwick); Gupta, Bishnupriya (University of Warwick); Yuan, Song (University of Warwick)
    Abstract: How did the 1918 influenza pandemic affect female labor force participation in India over the short run and the medium run? We use an event-study approach at the district level and four waves of decadal census data in order to answer this question. We find that districts most adversely affected by influenza mortality saw a temporary increase in female labor force participation in 1921, an increase that was concentrated in the service sector. By 1931, this increase had been reversed. We find suggestive evidence that distress labor supply by widows and rising wages help account for these results
    Keywords: JEL Classification:
    Date: 2020
  33. By: Upasak Das; Prasenjit Sarkhel; Sania Ashraf
    Abstract: Compliance with measures like social distancing, hand-washing and wearing masks have emerged as the dominant strategy to combat health risk from the COVID-19 pandemic. These behaviors are often argued to be pro-social, where one must incur private cost to benefit or protect others. Using self-reported data across India (n=934) through online survey, we assess if changes in perceived community compliance can predict changes in individual compliance behavior, controlling for the potential confounders. We observe statistically significant and positive relationship between the two, even after accounting for omitted variable bias, plausibly allowing us to view the results from a plausible causal lens. Further, we find subsequent lockdowns such as the ones imposed in India, have a detrimental effect on individual compliance though the gains from higher perceived community compliance seems to offset this loss. We also find that sensitization through community can be particularly effective for people with pre-existing co-morbidities. Our findings underscore the need for multi-level behavioral interventions involving local actors and community institutions to sustain private compliance during the pandemic.
    Date: 2020–10

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