nep-hea New Economics Papers
on Health Economics
Issue of 2021‒03‒15
25 papers chosen by
Nicolas R. Ziebarth
Cornell University

  1. Urban air pollution and sick leaves: evidence from social security data By Felix Holub; Laura Hospido; Ulrich J. Wagner
  2. Sharing the Burden of Subsidization: Evidence on Pass-Through from a Subsidy Revision in Medicare Part D By Colleen Carey
  3. Paying for pharmaceuticals: uniform pricing versus two-part tariffs By Kurt R. Brekke; Dag Morten Dalen; Odd Rune Straume
  4. Voice at Work By Jarkko Harju; Simon Jäger; Benjamin Schoefer
  5. Revisiting Offsets of Psychotherapy Coverage By Benjamin Ly Serena
  6. Moral Hazard Heterogeneity: Genes and Health Insurance Influence Smoking after a Health Shock By Biroli, Pietro; Zwyssig, Laura
  7. The Role of Maternal Postpartum Depression on Newborn and Siblings' Behaviour. By Schiavon, Lucia
  8. Public Safety under Imperfect Taxation By Treich, Nicolas; Yang, Yuting
  9. Mortality and life expectancy trends for male pensioners by pension income level By Juan Manuel Pérez-Salamero González; Marta Regúlez Castillo; Carlos Vidal-Meliá
  10. The Health Benefits of Solar Power Generation: Evidence from Chile By Nathaly M Rivera; Cristobal Ruiz Tagle, Elisheba Spiller
  11. Age, Inequality and the Public Provision of Healthcare By Anirban Mitra
  12. Disability Weights Measurement for 17 Diseases in Japan: A Survey Based on Medical Professionals By PIAO, Xiangdan; TSUGAWA, Shuichi; TAKEMURA, Yukie; ICHIKAWA, Naoko; KIDA, Ryohei; KUNIE, Keiko; MANAGI, Shunsuke
  13. COVID Angels Fighting Daily Demons? Mental Health of Healthcare Workers and Religion By Barili, E.; Bertoli, P.; Grembi, V.; Rattini, V.
  14. Adverse Childhood Circumstances and Cognitive Function in Middle-aged and Older Chinese Adults: Lower Level or Faster Decline? By Lin, Zhuoer; Chen, Xi
  15. Mobile phones and HIV testing: Multi-country evidence from sub-Saharan Africa By Iacoella, Francesco; Tirivayi, Nyasha
  16. A rapid literature review on inequalities and ethnicity in healthcare workers’ experiences of delivering care during the COVID-19 pandemic By Chisnall, Georgia; Vindrola-Padros, Cecilia
  17. Why is the Vaccination Rate Low in India? By Pramod Kumar Sur
  18. The Trade-off Between Prioritization and Vaccination Speed Depends on Mitigation Measures By Nikhil Agarwal; Andrew Komo; Chetan A. Patel; Parag A. Pathak; M. Utku Ünver
  19. COVID-19 Has Strengthened the Relationship Between Alcohol Consumption and Domestic Violence By Aaron Chalfin; Shooshan Danagoulian; Monica Deza
  20. Was there a COVID-19 harvesting effect in Northern Italy? By Augusto Cerqua; Roberta Di Stefano; Marco Letta; Sara Miccoli
  21. Socioeconomic Disparities in the Effects of Pollution on Spread of Covid-19: Evidence from US Counties By Allen, Osvalso; Brown, Ava; Wang, Ersong
  22. Make it or Break it: Vaccination Intention at the Time of Covid-19 By Jacques Bughin; Michele Cincera; Kelly Peters; Dorota Reykowska; Marcin Zyszkiewicz; Rafal Ohme
  23. The Great Employee Divide: Clustering Employee « Well-being » Challenge during Covid-19 By Jacques Bughin; Michele Cincera; Dorota Reykowska; Marcin Zyszkiewicz; Rafal Ohme
  24. Covid-19 Endemism and the Control Skeptics By Jacques Bughin; Michele Cincera; Dorota Reykowska; Marcin Zyszkiewicz; Rafal Ohme
  25. The Impact of COVID-19 on Fertility behaviour and Intentions in the Republic of Moldova By Emery, Tom; Koops, Judith C.

  1. By: Felix Holub (University of Mannheim); Laura Hospido (Banco de España); Ulrich J. Wagner (University of Mannheim)
    Abstract: We estimate the causal impact of air pollution on the incidence of sick leaves in a representative panel of employees affiliated to the Spanish social security system. Using over 100 million worker-by-week observations from the period 2005-2014, we estimate the relationship between the share of days an individual is on sick leave in a given week and exposure to particulate matter (PM10) at the place of residence, controlling for weather, individual effects, and a wide range of time-by-location controls. We exploit quasi-experimental variation in PM10 that is due to Sahara dust advection in order to instrument for local PM10 concentrations. We estimate that the causal effect of PM10 on sick leaves is positive and varies with respect to worker and job characteristics. The effect is stronger for workers with pre-existing medical conditions, and weaker for workers with low job security. Our estimates are instrumental for quantifying air pollution damages due to changes in labor supply. We estimate that improved ambient air quality in urban Spain between 2005 and 2014 saved at least €503 million in foregone production by reducing worker absence by more than 5.55 million days.
    Keywords: air pollution, health, sickness insurance, labor supply
    JEL: I12 I13 Q51 Q53
    Date: 2020–12
  2. By: Colleen Carey
    Abstract: In many federally-subsidized insurance markets, insurers are subsidized on the basis of enrollee characteristics; in principle, subsidies that are "risk adjusted" in this way compensate insurers for ex ante differences in expected cost. Between 2010 and 2011, the subsidies in Medicare Part D were revised, sharply changing the subsidy for diagnoses and demographic characteristics. This paper uses the response of insurers to the subsidy update to estimate pass-through of government subsidies to two insurer choice variables: premiums and out-of-pocket costs. We find that diagnostic subsidies are passed-through at a rate of 40% to the out-of-pocket costs for relevant drugs. Premiums are not responsive to overall subsidies, but do reflect changes in the demographic component of subsidies.
    JEL: H51 I11 L13
    Date: 2021–03
  3. By: Kurt R. Brekke (Norwegian School of Economics); Dag Morten Dalen (Norwegian Business School); Odd Rune Straume (NIPE and Department of Economics, University of Minho and Department of Economics, University of Bergen)
    Abstract: Two-part pricing (the Netflix model) has recently been proposed instead of uniform pricing for pharmaceuticals. Under two-part pricing the health plan pays a fixed fee for access to a drug at unit prices equal to marginal costs. Despite two-part pricing being socially efficient, we show that the health plan is worse off when the drug producer is a monopolist, as all surplus is extracted. This result is reversed with competition, as two-part pricing yields higher patient utility and lower drug costs for the health plan. However, if we allow for exclusive contracts, uniform pricing is preferred by the health plan.
    Keywords: Pharmaceuticals; Health Plans; Payment schemes
    JEL: I11 I18 L13 L65
    Date: 2021
  4. By: Jarkko Harju; Simon Jäger; Benjamin Schoefer
    Abstract: We estimate the effects of worker voice on job quality and separations. We leverage the 1991 introduction of worker representation on boards of Finnish firms with at least 150 employees. In contrast to exit-voice theory, our difference-in-differences design reveals no effects on voluntary job separations, and at most small positive effects on other measures of job quality (job security, health, subjective job quality, and wages). Worker voice slightly raised firm survival, productivity, and capital intensity. A 2008 introduction of shop-floor representation had similarly limited effects. Interviews and surveys indicate that worker representation facilitates information sharing rather than boosting labor’s power.
    JEL: G3 J3 J5 J63 L22
    Date: 2021–03
  5. By: Benjamin Ly Serena (University of Copenhagen)
    Abstract: Mental illness is a leading cause of disability worldwide with vast costs to society. Yet, insurance coverage for effective treatments remains limited. This paper revisits the Offset Hypothesis, which claims insurance coverage for psychotherapy is self-financing through reductions in the use of other health care services and improved labor market outcomes. I study a 2008 reform of the Danish public health care system that introduced 60 percent coverage of the cost of psychotherapy for depression and anxiety patients below age 38. Using Regression Discontinuity and Difference-in-Difference designs, I show that psychotherapy coverage reduces the use of other mental health services, physical health care and suicide attempts, but does not impact employment, sick leave or disability pension receipt. Still, the reduction in health care costs is sufficiently large to finance the policy. This suggests mental health coverage is both welfare improving and cost reducing.
    Keywords: mental health, health insurance, health care, offset, labor market
    JEL: I13 I18 I38 H51 H55
    Date: 2021–03–04
  6. By: Biroli, Pietro (University of Zurich); Zwyssig, Laura (University of Zurich)
    Abstract: Decision-making in the realm of health behaviors, such as smoking or drinking, is influenced both by biological factors, such as genetic predispositions, as well as environmental factors, such as financial liquidity and health insurance status. We show how the choice of smoking after a cardio-vascular health shock is jointly determined by the interplay between these biological and environmental constraints. Individuals who suffer a health shock when uninsured are 25.6 percentage points more likely to reduce smoking, but this is true only for those who have a low index of genetic predisposition to smoking. Individuals with a low index of genetic predisposition are more strategic and flexible in their behavioral response to an external shock. This differential elasticity of response depending on your genetic variants is evidence of individual-level heterogeneity in moral hazard. These results suggest that genetic heterogeneity is a factor that should be considered when evaluating the effectiveness and fairness of health insurance policies.
    Keywords: moral hazard, genetics, smoking, medicare
    JEL: I12 I13 D63 D91
    Date: 2021–03
  7. By: Schiavon, Lucia (University of Turin)
    Abstract: In this paper, we study whether maternal postpartum depression affects children's behaviour, not only of the newborn but also of his older siblings. Moreover, we investigate if the presence of older siblings in household softens the impact of maternal distress on the behaviour of the newborn. Using data from the Millennium Cohort Study (UK data service), we estimate the effect of maternal postpartum depression on five behavioural dimensions derived from the Strengths and Diculties questionnaire, for both newborn and older siblings (when present). Results confirm the association between maternal postpartum depression and behavioural problems. Conversely no significant difference emerged between newborn and older siblings, we found no evidence of a role of older siblings in mitigating the negative consequences of maternal postpartum depression on newborn non-cognitive development. Our findings are robust to different specification of behavioural problems. Overall, our results suggest that newborn and older siblings are similarly exposed to the negative consequences of maternal distress.
    Date: 2021–02
  8. By: Treich, Nicolas; Yang, Yuting
    Abstract: Standard benefit-cost analysis often ignores distortions caused by taxation and the heterogeneity of taxpayers. In this paper, we theoretically and numerically explore the effect of imperfect taxation on the public provision of mortality risk reductions (or public safety). We show that this effect critically depends on the source of imperfection as well as on the individual utility and survival probability functions. Our simulations based on the calibration of distributional weights and applied to the COVID-19 example suggest that the value per statistical life, and in turn the optimal level of public safety, should be adjusted downwards because of imperfect taxation. However, we also identify circumstances under which this result is reversed, so that imperfect taxation cannot generically justify less public safety.
    Keywords: Public safety; Environmental health; Imperfect taxation; Value per statistical life; Distortionary taxation; Wealth inequality; Risk aversion
    JEL: D61 H21 H41 I18 Q51
    Date: 2021–02–07
  9. By: Juan Manuel Pérez-Salamero González (Department of Financial Economics and Actuarial Science, University of Valencia.); Marta Regúlez Castillo (Department of Quantitative Methods. University of the Basque Country (UPV/EHU).); Carlos Vidal-Meliá (Department of Financial Economics and Actuarial Science, University of Valencia, Instituto Complutense de Análisis Económico, Complutense (ICAE), University of Madrid, Spain (research affiliate) and Centre of Excellence in Population Ageing Research (CEPAR), UNSW, Sydney, Australia.)
    Abstract: We draw on the Continuous Sample of Working Lives (CSWL) to investigate the differences in socioeconomic mortality among retired men aged 65 and above over the longest possible period covered by this data source: 2005–2018. This paper deals with the case of Spain, since very little evidence concerning retirement pensioners is available for this country. The only indicator of socioeconomic status we use is the amount of the initial pension of the retired population. For 2005-2010 we find a gap in life expectancy of 1.49 years between pensioners in the highest and lowest income groups. This gap widens over time and reaches 2.58 years for the period 2015–2018. The increase in life expectancy inequality cannot be attributed to the pension system reforms carried out over the period 2011-2013, given that the system has become more redistributive and there has been a clear increase in real terms in the amounts of minimum pensions over recent years. The causes might be traced back to the decrease in public spending on health over the period 2009-2018 and the increased spending on private health, which would presumably be of more benefit to those retirees with bigger pensions.
    Keywords: Inequalities; Life Expectancy; Life Tables; Mortality; Socioeconomic Factors.
    JEL: C81 H55 I14 J26
    Date: 2021–02
  10. By: Nathaly M Rivera; Cristobal Ruiz Tagle, Elisheba Spiller
    Abstract: Renewable energy can yield social benefits through local air quality improvements and their subsequent effects on human health. We estimate some of these benefits using data gathered during the rapid adoption of large-scale solar power generation in Chile over the last decade. Relying on exogenous variation from incremental solar generation capacity over time, we find that solar energy displaces fossil fuel generation (primarily coal-fired generation) and curtails hospital admissions, particularly those due to lower respiratory diseases. These effects are noted mostly in cities downwind of displaced fossil fuel generation and are present across all age groups. Our results document the existence of an additional channel through which renewable energy can increase social welfare.
    Keywords: Coal-fired power plants; coal displacement; solar generation; power plants; pollution; morbidity; developing countries; Latin America
    JEL: I18 L94 Q42 Q53
    Date: 2021–03–08
  11. By: Anirban Mitra
    Abstract: How does economic inequality affect public spending on healthcare in democracies? Does this depend upon the demographic composition of the electorate? We build a multidimensional model of political decision-making with endogenous political parties to analyse such questions. Voters in our model differ in terms of income and age. The tax rate, the allocation of the revenue between income redistribution and two forms of public spending - healthcare and capital investment - are determined through political competition. All agents value healthcare equally but the young like capital investment more than the old do. We find that when the young are a majority, public healthcare spending tends to be lower on average than when the young are a minority. Moreover, when the old are a majority the equilibrium public healthcare provision depends critically upon the extent of income inequality. We also discuss implications regarding the on-going demographic transition (population ageing) and the Covid-19 pandemic.
    Keywords: Demography; Economic Inequality; Healthcare; Voting
    JEL: D72 H42 I14
    Date: 2021–03
  12. By: PIAO, Xiangdan; TSUGAWA, Shuichi; TAKEMURA, Yukie; ICHIKAWA, Naoko; KIDA, Ryohei; KUNIE, Keiko; MANAGI, Shunsuke
    Abstract: When judging a population’s health to determine disability-adjusted life years, disability weight is a tool for measuring the severity of disability caused by a disease. However, previous studies have pointed out that surveys targeting ordinary citizens produce unclear disability weight values. Therefore, in an attempt to obtain clearer estimations, we conduct a paper-based questionnaire survey of medical professionals—nurses with over ten years of experience—believed to have extensive knowledge of diseases and experience in patient care. We find that disability weight estimations based on the survey of medical professionals presents higher values than those based on a survey of ordinary citizens using the same estimation approach, especially for non-terminal-stage diseases. This suggests that medical-professionals-based surveys may correct the underestimated disability weights of non-terminal diseases (e.g., early stage of cancers and mellitus) found through ordinary-citizens-based surveys. Moreover, we illustrate that depressive disorder and early-stage cancers have almost the same health loss since their disability weights are similar. While regulating policy, it is recommended that more attention be paid to non-terminal diseases and depression.
    Keywords: Disability weights; Japan; Medical professionals
    JEL: I19
    Date: 2021–02–01
  13. By: Barili, E.; Bertoli, P.; Grembi, V.; Rattini, V.
    Abstract: Relying on a unique survey of more than 15,000 respondents in Italy conducted immediately after the first wave of the COVID-19 pandemic, we show that randomly priming religiosity in healthcare workers decreases their self-assessed level of mental distress. The effect is stronger for nurses (-11.2%) than for physicians (-7.6%). Similar results are also confirmed at the level of self-assessed concerns over different aspects of workers' lives and personal networks, potential sources of distress. Consistent with the idea that religion serves as a coping mechanism, the effect is stronger for more impacted categories (females and hospital workers) and for respondents facing more stressful situations, such as being reassigned due to the COVID-19 emergency or working in a COVID-19-related specialty (e.g., emergency care), among others. Self-classifying as religious explains the larger impact of religious priming on physicians but not on nurses. We argue that the spiritual identity of nurses was more connected by a unique media campaign that identified them as COVID angels. Hence, ad hoc messages in times of distress might reinforce the positive effect of coping mechanisms.
    Keywords: Healthcare Workers; Mental Health; COVID-19; Coping Mechanisms; Religiosity;
    JEL: I10 N34 Z12
    Date: 2021–03
  14. By: Lin, Zhuoer; Chen, Xi
    Abstract: We examine the long-term relationship between childhood circumstances and cognitive aging. In particular, we differentiate the level of cognitive deficit from the rate of cognitive decline. Applying a linear mixed-effect model to three waves of China Health and Retirement Longitudinal Surveys (CHARLS 2011, 2013, 2015) and matching cognitive outcomes to CHARLS Life History Survey (2014), we find that key domains of childhood circumstances, including family socioeconomic status (SES), neighborhood cohesion, friendship and health conditions, are significantly associated with both the level of cognitive deficit and the rate of decline. In contrast, childhood neighborhood safety only affects the level of cognitive deficit. Childhood relationship with mother only affects the rate of cognitive decline. The effects of adverse childhood circumstances are generally larger on level of cognitive deficit than on rate of cognitive decline. Moreover, education plays a more important role in mediating the relationships compared to other later-life factors. These findings suggest that exposure to disadvantaged childhood circumstances can exacerbate cognitive deficit as well as cognitive decline over time, which may be partially ameliorated by educational attainment.
    Keywords: Childhood circumstances,life course factors,cognitive aging,education
    JEL: I14 I24 J13 J14
    Date: 2021
  15. By: Iacoella, Francesco (UNU-MERIT); Tirivayi, Nyasha (UNU-MERIT, and UNICEF Innocenti RC)
    Abstract: This study investigates the role of mobile phone connectivity on HIV testing in sub-Saharan Africa. We make use of the novel and comprehensive OpencellID cell tower database, and DHS geocoded information for over 400,000 women in 28 Sub-Saharan African countries. We examine whether women's community distance from the closest cell-tower influences knowledge about HIV testing facilities and the likelihood of ever been tested for HIV. After finding a negative and significant impact of distance on our main outcomes, we investigate the mechanisms through which such effects might occur. Our analysis shows that proximity to a cell tower increases HIV-related knowledge as well as reproductive health knowledge. Similar results are observed when the analysis is performed at community level. Results suggest that the effect of mobile phone connectivity is channelled through increased knowledge of HIV, STIs, and modern contraceptive methods. Further analysis shows that cell phone ownership has an even larger impact on HIV testing and knowledge. This paper adds to recent literature on the impact of mobile-based HIV prevention schemes by showing through large-scale analysis that better mobile network access is a powerful tool to spread reproductive health knowledge and increase HIV awareness.
    Keywords: Technological change, mobile technology, public health, HIV, reproductive health
    JEL: O33 D83 I15 I18
    Date: 2021–03–09
  16. By: Chisnall, Georgia; Vindrola-Padros, Cecilia
    Abstract: A rapid literature review was conducted regarding inequalities faced by frontline BAME healthcare workers (HCWs) responding to the COVID-19 pandemic within the United Kingdom. A number of key themes and sub-themes were identified within the literature. Firstly, in relation to viral exposure. BAME HCWs are more likely to be exposed to COVID-19 on account of: frontline prevalence (driven by pre-existing systemic racism pre-pandemic, disproportionate redeployment and location of redeployment compared to White counterparts); complications with Personal Protective Equipment (PPE) (driven by lack of access, training and fit-testing compared to White counterparts); and, being afraid to speak up in a ‘bully’ culture (redeployment and PPE access worse for minoritized groups due to lack of ability to say ‘no’, fearful of repercussions). Secondly, in relation to emotional impact. BAME HCWs may experience heightened and unique emotional strain on account of: increased anxiety (due to their increased mortality risk, a greater ‘tear’ between personal risk and sense of duty, and through risk posed to family due to intergenerational living); and, due to racial abuse (experience of racially motivated verbal abuse from patients or patient families, and in some instances even peers, can dramatically change experience of providing care). There is a clear wealth of evidence which exemplifies inequalities in BAME HCWs’ experiences of care provision during COVID-19. Steps should be taken not only to prioritise physical BAME HCWs’ wellbeing but also their emotional and mental health needs. There is greater need for primary research, in particular qualitative data to narrate and capture the lived experiences of BAME HCWs during this pandemic.
    Date: 2021–03–05
  17. By: Pramod Kumar Sur
    Abstract: India has had an established universal immunization program since 1985 and immunization services are available for free in healthcare facilities. Despite this, India has one of the lowest vaccination rates globally and contributes to the largest pool of under-vaccinated children in the world. Why is the vaccination rate low in India? This paper explores the importance of historical events in shaping India's current vaccination practices. We examine India's aggressive family planning program implemented during the period of emergency rule in the 1970s, under which millions of individuals were sterilized. We find that greater exposure to the forced sterilization policy has had negative effects on the current vaccination rate. We explore the mechanism and find that institutional delivery and antenatal care are low in states where policy exposure is high. Finally, we examine the consequence of lower vaccination suggesting that child mortality is currently high in states with greater sterilization exposure. Together, the evidence suggests that the forced sterilization policy has had a persistent effect on health-seeking behavior in India.
    Date: 2021–03
  18. By: Nikhil Agarwal; Andrew Komo; Chetan A. Patel; Parag A. Pathak; M. Utku Ünver
    Abstract: Calls for eliminating prioritization for SARS-CoV-2 vaccines are growing amid concerns that prioritization reduces vaccination speed. We use an SEIR model to study the effects of vaccination distribution on public health, comparing prioritization policy and speed under mitigation measures that are either eased during the vaccine rollout or sustained through the end of the pandemic period. NASEM's recommended prioritization results in fewer deaths than no prioritization, but does not minimize total deaths. If mitigation measures are eased, abandoning NASEM will result in about 134,000 more deaths at 30 million vaccinations per month. Vaccination speed must be at least 53% higher under no prioritization to avoid increasing deaths. With sustained mitigation, discarding NASEM prioritization will result in 42,000 more deaths, requiring only a 26% increase in speed to hold deaths constant. Therefore, abandoning NASEM's prioritization to increase vaccination speed without substantially increasing deaths may require sustained mitigation.
    JEL: I1
    Date: 2021–03
  19. By: Aaron Chalfin; Shooshan Danagoulian; Monica Deza
    Abstract: A large body of evidence documents a link between alcohol consumption and violence involving intimate partners and close family members. Recent scholarship suggests that since the onset of the COVID-19 pandemic and subsequent stay-at-home orders, there has been a marked increase in domestic violence. This research considers an important mechanism behind the increase in domestic violence during the COVID-19 pandemic: an increase in the riskiness of alcohol consumption. We combine 911 call data with newly-available high-resolution microdata on visits to bars and liquor stores in Detroit, MI and find that the strength of the relationship between visits to alcohol outlets and domestic violence more than doubles starting in March 2020. We find more limited evidence with respect to non-domestic assaults, supporting our conclusion that it is not alcohol consumption per se but alcohol consumption at home that is a principal driver of domestic violence
    JEL: I1
    Date: 2021–03
  20. By: Augusto Cerqua; Roberta Di Stefano; Marco Letta; Sara Miccoli
    Abstract: We investigate the possibility of a harvesting effect, i.e. a temporary forward shift in mortality, of the COVID-19 pandemic by looking at the excess mortality trends of one of the areas with the highest death toll in the world, Northern Italy. We do not find any evidence of a sizable COVID-19 harvesting effect, neither in the summer months following the slowdown of the first wave nor at the beginning of the second wave. According to our estimates, only a minor share of the total excess deaths detected in Northern Italy over the entire period under scrutiny (February - November 2020) can be attributed to an anticipatory role of COVID-19. A somewhat more sizable harvesting effect is detected for the most severely affected areas (the provinces of Bergamo and Brescia, in particular), but even in these territories, the harvesting effect only accounts for less than 20% of excess deaths. Furthermore, the lower excess mortality rates observed in these areas at the beginning of the second wave could be due to several factors other than a harvesting effect, including behavioral change and some degree of temporary herd immunity. The very limited presence of mortality displacement in the short-run restates once more the case for containment policies aimed at minimizing the health impacts of the pandemic.
    Date: 2021–03
  21. By: Allen, Osvalso; Brown, Ava; Wang, Ersong
    Abstract: This paper explores disparities in the effect of pollution on confirmed cases of Covid-19 based on counties’ socioeconomic and demographic characteristics. Using data on all US counties on a daily basis over the year 2020 and applying a rich panel data fixed effect model, we document that: 1) there are discernible social and demographic disparities in the spread of Covid-19. Blacks, low educated, and poorer people are at higher risks of being infected by the new disease. 2) The criteria pollutants including Ozone, CO, PM10, and PM2.5 have the potential to accelerate the outbreak of the novel coronavirus. 3) The disadvantaged population is more vulnerable to the effects of pollution on the spread of coronavirus. Specifically, the effects of pollution on confirmed cases become larger for blacks, low educated, and counties with lower average wages in 2019.
    Keywords: Covid-19, Racial Disparities, Education, Health, Pandemic, Pollution, Environment
    JEL: H51 J15 K32 P36 Q53
    Date: 2021–02–09
  22. By: Jacques Bughin; Michele Cincera; Kelly Peters; Dorota Reykowska; Marcin Zyszkiewicz; Rafal Ohme
    Abstract: This research updates early studies on the intention to be vaccinated against the Covid-19 virus among a representative sample of adults in 6 European countries (France, Germany, Italy, Spain, Sweden, and the UK) and differentiated by groups of “acceptors”, “refusers”, and “ hesitant”. The research relies on a set of traditional logistic and more complex classification techniques such as Neural Networks and Random Forest techniques to determine common predictors of vaccination preferences. The findings highlight that socio-demographics are not a reliable measure of vaccination propensity, after one controls for different risk perceptions, and illustrate the key role of institutional and peer trust for vaccination success. Policymakers must build vaccine promotion techniques differentiated according to “acceptors”, “refusers”, and “ hesitant”, while restoring much larger trust in their actions upfront since the pandemics if one wishes the vaccination coverage to close part of the gap to the level of herd immunity.
    Keywords: Covid-19, vaccine strategy, deconfinement, priority groups, random-forest, tree classification
    Date: 2021–01
  23. By: Jacques Bughin; Michele Cincera; Dorota Reykowska; Marcin Zyszkiewicz; Rafal Ohme
    Abstract: The Covid-19 pandemic has triggered unprecedented levels of disruption and stress for workers. Still, little is relatively known about the state of mind of the workforce, even if its well-being is increasingly recognized as a driver of productivity. This paper encompasses multiple forms of stress - health, economic, social, and psychological – faced by the workforce, and demonstrates that not only have workers been facing large levels of stress during the Covid-19 pandemic beyond health issues, but that stress is not uniformly distributed among workers. While it is known that Covid-19 has been building a divide between remote and on-site workers, we uncover a much larger divide than the ones induced by work location alone, with the divide being due to different perceptions of mix and level of worries. Human resources practices may have to be much more personalized and include all forms of stress to diagnose the level of workers’ state of fragility if they wish to create a much more resilient and productive workforce.
    Keywords: Covid-19, Coronavirus, Economic shutdowns, Reopening the economy, Preventative behaviors, Risk-taking tendencies, Prosocial tendencies, Workforce burnout
    Date: 2020–12
  24. By: Jacques Bughin; Michele Cincera; Dorota Reykowska; Marcin Zyszkiewicz; Rafal Ohme
    Abstract: This paper analyses the widespread difference in Covid-19 vaccination and Non-Pharmaceutical interventions (NPI) acceptance by the European population and finds that this difference can be clustered in nine archetype clusters. Calibrating a SIR model with control acceptance on Covid-19 pandemics, it is also estimated that three anti-control segments (standing in aggregate for 15% of the population) may be contributing to the entire bulk of the endemism of the Covid-19. While poorly compliant segments have lower risk perception than others, tend to be younger, and less educated, or are more self-centric, trust with respect to media, governmental, and healthcare institutions are significantly shaping control acceptance by the population. In particular, the way to overturn a large set of vaccination “hesitant” (20% of the population), must pass by rebuilding much higher trust in how the current crisis is managed by the government and healthcare system
    Keywords: Covid-19, Pandemic Endemism, vaccine strategy, Non-Pharmaceutical Interventions, SIR
    Date: 2021–03
  25. By: Emery, Tom (NIDI); Koops, Judith C.
    Abstract: The COVID Pandemic could affect fertility behaviour and intentions in many ways. Restrictions on service provision may reduce access to family planning services and increase fertility in the short term. By contrast, the economic uncertainty brought about by the pandemic and its impact on mental health and well-being may reduce fertility. These various pathways have been explored in the context of high income countries such as the United States and Western Europe, but little is known about middle income countries. In this paper we asses the impact of the COVID pandemic on fertility intentions and behaviour in the Republic of Moldova, a middle income country in Eastern Europe, using the Generations and Gender Survey. This survey was conducted partially before and partially after the pandemic, allowing for detailed analysis of individual circumstances. The results indicate that the pandemic reduced contraceptive use by 40%. Conversely couples were also 41% less likely to be trying to conceive after the onset of the pandemic, although medium term fertility intentions were unchanged. Indicators therefore suggest that in the medium term fertility intentions may not be affected by the pandemic but access to family planning services and deferring attempts to conceive may change which individuals have children and when.
    Date: 2021–03–05

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