nep-hea New Economics Papers
on Health Economics
Issue of 2021‒04‒05
25 papers chosen by
Nicolas R. Ziebarth
Cornell University

  1. Family Companionship and Elderly Suicide: Evidence from the Chinese Lunar New Year By Hanming Fang; Ziteng Lei; Liguo Lin; Peng Zhang
  2. The Value of Employer-Sponsored Health Insurance By Casey B. Mulligan
  3. Sleep, Worker's Health, and Social Welfare By Yoshida, Ken
  4. Labour supply and informal care responses to health shocks within couples: evidence from the UKHLS By Macchioni Giaquinto, Annarita; Jones, Andrew M.; Rice, Nigel; Zantomio, Francesca
  5. Trading Spaces: Medicare’s Regulatory Spillovers on Treatment Setting for Non-Medicare Patients By Michael Geruso; Michael R. Richards
  6. A Unified Model of Cohort Mortality for Economic Analysis By Flavien Moreau; Adriana Lleras-Muney
  7. Climate change and population: an integrated assessment of mortality due to health impacts By Antonin Pottier; Marc Fleurbaey; Aurélie Méjean; Stéphane Zuber
  8. The welfare implications of climate change-related mortality: Inequality and population ethics By Marc Fleurbaey; Aurélie Méjean; Antonin Pottier; Stéphane Zuber
  9. Understanding the Puzzle of Primary Health-care Use: Evidence from India By Pramod Kumar Sur
  10. A Community-Response Approach to Mental-Health and Substance-Abuse Crises Reduced Crime By Dee, Thomas Sean; Pyne, Jaymes
  11. Mental Health and Abortions among Young Women: Time-varying Unobserved Heterogeneity, Health Behaviors, and Risky Decisions By Lena Janys; Bettina Siflinger
  12. The Causal Effect of Depression and Anxiety on Life Satisfaction: An Instrumental Variable Approach By Arnar Buason; Edward C. Norton; Paul McNamee; Edda Bjork Thordardottir; Tinna Laufey Asgeirsdóttir
  13. The Value of Data for Prediction Policy Problems: Evidence from Antibiotic Prescribing By Shan Huang; Michael Allan Ribers; Hannes Ullrich
  14. SIR Economic Epidemiological Models with Disease Induced Mortality By Aditya Goenka; Lin Liu; Manh-Hung Nguyen
  15. Influenza Pandemics and Macroeconomic Fluctuations in Recent Economic History By Fraser Summerfield; Livio Di Matteo
  16. Can Disaster Preparedness Change the Game? Mitigating the Health Impact of Disease Outbreaks By Amira El-Shal; Mahmoud Mohieldin; Eman Moustafa
  17. Measuring the direct population impact of COVID-19 in Scotland, 2020: estimating disability-adjusted life years (DALYs) during the first full calendar year By Wyper, Grant Mark Andrew; Fletcher, Eilidh; Grant, Ian; McCartney, Gerry; Fischbacher, Colin; Harding, Oliver; Jones, Hannah; de Haro Moro, Maria Teresa; Speybroek, Niko; Devleesschauwer, Brecht
  18. Women in Distress: Mental Health and the COVID-19 Pandemic By Barili, E.; Grembi, V.; Rosso, A.C.
  19. The role of economic structural factors in determining pandemic mortality rates: Evidence from the COVID-19 outbreak in France By Stéphane Goutte; Thomas Péran; Thomas Porcher
  20. Economic Inequality and Covid-19 Death Rates in the First Wave, a Cross-Country Analysis By James Davies
  21. Persuasion in Medicine: Messaging to Increase Vaccine Demand By Marcella Alsan; Sarah Eichmeyer
  22. COVID-19, Race, and Gender By Graziella Bertocchi; Arcangelo Dimico
  23. Who cares about health and the economy through the Covid-19 pandemic? Longitudinally tracking changes and heterogeneity in people’s perceptions of risks By Ferragina, Emanuele; Pasqualini, Marta; Ricchi, Ettore; Zola, Andrew
  24. Mobility Functional Areas and COVID-19 Spread By Stefano Maria Iacus; Carlos Santamaria; Francesco Sermi; Spyridon Spyratos; Dario Tarchi; Michele Vespe
  25. Optimal Lockdown in an Epidemiological-Macroeconomic Model By Paul Levine; Neil Rickman

  1. By: Hanming Fang; Ziteng Lei; Liguo Lin; Peng Zhang
    Abstract: Mental health problems among the elderly have attracted increasing attention. The most serious mental health problems may result in suicide, and lack of family companionship is often speculated to be a major cause. In this paper, we use high-frequency suicide rate data and utilize a novel temporal variation in the lunisolar calendar to provide evidence on the protective effects of the Chinese Lunar New Year (when the elderly people receive unusually high level of family companionship) on elderly suicide. We find that elderly suicide rate decreases by 8.7% during the Chinese Lunar New Year. In addition, the protective effects are stronger in counties where the typical level of daily family companionship for the elderly is lower. By contrast, we do not find similar protective effects for young and middle-age cohorts. We consider a variety of alternative mechanisms, and conclude that family companionship is an important channel for the protective effects of the Chinese Lunar New Year. Our study calls for greater attention to the mental health status and suicide problem of the elderly, especially with the rapid population aging and increasing prevalence of the “empty-nest” elderly in developing countries.
    JEL: I12 J14
    Date: 2021–03
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:28566&r=all
  2. By: Casey B. Mulligan
    Abstract: Based on published estimates of its price elasticity of demand and of tax wedges, as well as the method of revealed preference, I estimate that the annual social value of ESI is about $1.5 trillion beyond what policyholders, their employers, and taxpayers pay for it. The private component of that value, which in some respects is the other side of “job lock,” derives in part from group plans, with the group determined by many characteristics other than the demand for healthcare. With voluntary groups formed this way, adverse risk selection is reduced, the groups can be effective at obtaining substantial discounts and rebates for their members, and division of labor employed in shopping for health providers. ESI is also a mechanism for employers to act on their incentives for a healthy and productive workforce. External effects include tax externalities (in both directions), encouraging work, and easing government expenditure obligations by helping to prevent people from going without health insurance.
    JEL: D40 D71 H30 I13 J32
    Date: 2021–03
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:28590&r=all
  3. By: Yoshida, Ken
    Abstract: The aims of this paper are to construct a theoretical model treating sleep as investment in health capital and to analyze how sleep affects a worker's health capital and social welfare. By regarding sleep as investment in health capital and including sleep in time constraint, it was revealed how workers decide hours slept. Of particular importance is the result that a worker stores their health capital by taking more sleep than the optimal value at a young age, and this leads to increased output. Moreover, we identified a complementary relation between consumption and labor supply. These results showed that policies to reduce hours worked could improve worker's health capital and social welfare.
    Keywords: sleep; worker's health; social welfare; health investment; sleep--consumption model.
    JEL: I18 I19 I31
    Date: 2021
    URL: http://d.repec.org/n?u=RePEc:pra:mprapa:106573&r=all
  4. By: Macchioni Giaquinto, Annarita; Jones, Andrew M.; Rice, Nigel; Zantomio, Francesca
    Abstract: Shocks to health have been shown to reduce labour supply for the individual affected. Less is known about household self-insurance through a partner's response to a health shock. Previous studies have presented inconclusive empirical evidence on the existence of a healthrelated 'added worker effect'. We use UK longitudinal data to investigate within households both the labour supply and informal care responses of an individual to the event of an acute health shock to their partner. Relying on the unanticipated timing of shocks, we combine coarsened exact matching and entropy balancing algorithms with parametric analysis and exploit lagged outcomes to remove bias from observed confounders and time-invariant unobservables. We find no evidence of a health-related 'added worker effect'. A significant and sizeable increase in spousal informal care, irrespective of spousal labour market position or household financial status and ability to purchase formal care provision, suggests a substitution to informal care provision, at the expense of time devoted to leisure activities.
    Keywords: health shocks,added worker effect,labour supply,informal care,matching methods,panel data
    JEL: C14 I10 I13 J14 J22
    Date: 2021
    URL: http://d.repec.org/n?u=RePEc:zbw:glodps:806&r=all
  5. By: Michael Geruso; Michael R. Richards
    Abstract: Medicare pricing is known to indirectly influence provider prices and care provision for non-Medicare patients; however, Medicare’s regulatory externalities beyond fee-setting are less well understood. We study how physicians’ outpatient surgery choices for non-Medicare patients responded to Medicare removing a ban on ambulatory surgery center (ASC) use for a specific procedure. Following the rule change, surgeons began reallocating both Medicare and commercially insured patients to ASCs. Specifically, physicians became 70% more likely to use ASCs for the policy-targeted procedure among their non-Medicare patients. These novel findings demonstrate that Medicare rulemaking affects physician behavior beyond the program’s statutory scope.
    JEL: H23 H42 H51 I11 I13 I18
    Date: 2021–03
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:28576&r=all
  6. By: Flavien Moreau; Adriana Lleras-Muney
    Abstract: We propose a dynamic production function of population health and mortality from birth onwards. Our parsimonious model provides an excellent fit for the mortality and survival curves for both primate and human populations since 1816. The model sheds light on the dynamics behind many phenomena documented in the literature, including (i) the existence and evolution of mortality gradients across socio-economic statuses, (ii) non-monotonic dynamic effects of in-utero shocks, (iii) persistent or “scarring” effects of wars and (iv) mortality displacement after large temporary shocks such as extreme weather.
    Keywords: Health;Aging;Population and demographics;Women;Environment;Mortality,In-utero shocks,Selection,Scarring,WP,health stock,health distribution,investment schedule,log mortality rates,health shock
    Date: 2021–02–12
    URL: http://d.repec.org/n?u=RePEc:imf:imfwpa:2021/037&r=all
  7. By: Antonin Pottier (CIRED - Centre International de Recherche sur l'Environnement et le Développement - Université Paris-Saclay - AgroParisTech - EHESS - École des hautes études en sciences sociales - Cirad - Centre de Coopération Internationale en Recherche Agronomique pour le Développement - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique); Marc Fleurbaey (PSE - Paris School of Economics - ENPC - École des Ponts ParisTech - ENS Paris - École normale supérieure - Paris - PSL - Université Paris sciences et lettres - UP1 - Université Paris 1 Panthéon-Sorbonne - CNRS - Centre National de la Recherche Scientifique - EHESS - École des hautes études en sciences sociales - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement, CNRS - Centre National de la Recherche Scientifique); Aurélie Méjean (CIRED - Centre International de Recherche sur l'Environnement et le Développement - Université Paris-Saclay - AgroParisTech - EHESS - École des hautes études en sciences sociales - Cirad - Centre de Coopération Internationale en Recherche Agronomique pour le Développement - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique); Stéphane Zuber (PSE - Paris School of Economics - ENPC - École des Ponts ParisTech - ENS Paris - École normale supérieure - Paris - PSL - Université Paris sciences et lettres - UP1 - Université Paris 1 Panthéon-Sorbonne - CNRS - Centre National de la Recherche Scientifique - EHESS - École des hautes études en sciences sociales - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement, CES - Centre d'économie de la Sorbonne - UP1 - Université Paris 1 Panthéon-Sorbonne - CNRS - Centre National de la Recherche Scientifique, CNRS - Centre National de la Recherche Scientifique)
    Abstract: We develop an integrated assessment model with endogenous population dynamics accouting for the impact of global climate change on mortality through five channels (heat, diarrhoeal disease, malaria, dengue, undernutrition). An age-dependent endogenous mortality rate, which depends linearly on global temperature increase, is introduced and calibrated. We consider three emission scenarios (business-as-usual, 3°C and 2°C scenarios) and find that the five risks induce deaths in the range from 160,000 per annum (in the near term) to almost 350,000 (at the end of the century) in the business-as-annual. We examine the number of life-years lost due to the five selected risks and find figures ranging from 5 to 10 millions annually. These numbers are too low to impact the aggregate dynamics and we do not find significant feedback effects of climate mortality to production, and thus emissions and temperature increase. But we do find interesting evolution patterns. The number of life-years lost is constant (business-as-usual) or decreases over time (3°C and 2°C). For the stabilisation scenarios, we find that the number of life-years lost is higher today than in 2100, due to improvements in generic mortality conditions, the bias of those improvements towards the young, and an ageing population. From that perspective, the present generation is found to bear the brunt of the considered climate change impacts.
    Keywords: Climate change,Impacts,Integrated assessment model,Mortality risk,Endogenous population
    Date: 2020–11
    URL: http://d.repec.org/n?u=RePEc:hal:journl:halshs-03048602&r=all
  8. By: Marc Fleurbaey (PSE - Paris School of Economics - ENPC - École des Ponts ParisTech - ENS Paris - École normale supérieure - Paris - PSL - Université Paris sciences et lettres - UP1 - Université Paris 1 Panthéon-Sorbonne - CNRS - Centre National de la Recherche Scientifique - EHESS - École des hautes études en sciences sociales - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement, CNRS - Centre National de la Recherche Scientifique); Aurélie Méjean (CIRED - Centre International de Recherche sur l'Environnement et le Développement - Université Paris-Saclay - AgroParisTech - EHESS - École des hautes études en sciences sociales - Cirad - Centre de Coopération Internationale en Recherche Agronomique pour le Développement - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique); Antonin Pottier (CIRED - Centre International de Recherche sur l'Environnement et le Développement - Université Paris-Saclay - AgroParisTech - EHESS - École des hautes études en sciences sociales - Cirad - Centre de Coopération Internationale en Recherche Agronomique pour le Développement - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique); Stéphane Zuber (CES - Centre d'économie de la Sorbonne - UP1 - Université Paris 1 Panthéon-Sorbonne - CNRS - Centre National de la Recherche Scientifique, PSE - Paris School of Economics - ENPC - École des Ponts ParisTech - ENS Paris - École normale supérieure - Paris - PSL - Université Paris sciences et lettres - UP1 - Université Paris 1 Panthéon-Sorbonne - CNRS - Centre National de la Recherche Scientifique - EHESS - École des hautes études en sciences sociales - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement, CNRS - Centre National de la Recherche Scientifique)
    Abstract: Climate change-related mortality may strongly affect human well-being. By reducing life expectancy, it reduces the well-being of some infividuals. This may exacerbate existing inequalities: ex-ante inequality among people in different groups or regions of the world; ex-post inequality in experienced well-being by people in the same generation. But mortality may also reduce total population size by preventing some individuals from having children. This raises the population-ethical problem of how total population size should be valued. This paper proposes a methodology to measure te welfare effects of climate change through population and inequality change. We illustrate the methodology using a climate-economy integrated assessment model involving endogenous population change due to climate change-related mortality.
    Keywords: Climate change-related mortality,fairness,inequality,population ethics
    Date: 2020–03
    URL: http://d.repec.org/n?u=RePEc:hal:journl:halshs-03048370&r=all
  9. By: Pramod Kumar Sur
    Abstract: In India, households' use of primary health-care services presents a puzzle. Even though most private health-care providers have no formal medical qualifications, a significant fraction of households use fee-charging private health-care services, which are not covered by insurance. Although the absence of public health-care providers could partially explain the high use of the private sector, this cannot be the only explanation. The private share of health-care use is even higher in markets where qualified doctors offer free care through public clinics; despite this free service, the majority of health-care visits are made to providers with no formal medical qualifications. This paper examines the reasons for the existence of this puzzle in India. Combining contemporary household-level data with archival records, I examine the aggressive family planning program implemented during the emergency rule in the 1970s and explore whether the coercion, disinformation, and carelessness involved in implementing the program could partly explain the puzzle. Exploiting the timing of the emergency rule, state-level variation in the number of sterilizations, and an instrumental variable approach, I show that the states heavily affected by the sterilization policy have a lower level of public health-care usage today. I demonstrate the mechanism for this practice by showing that the states heavily affected by forced sterilizations have a lower level of confidence in government hospitals and doctors and a higher level of confidence in private hospitals and doctors in providing good treatment.
    Date: 2021–03
    URL: http://d.repec.org/n?u=RePEc:arx:papers:2103.13737&r=all
  10. By: Dee, Thomas Sean (Stanford University); Pyne, Jaymes
    Abstract: Police officers often serve as first responders to mental-health and substance-abuse crises. Concerns over the unintended consequences and high costs associated with this approach have motivated new emergency-response models that augment or completely remove police involvement. However, there is little causal evidence evaluating these programs. This pre-registered study presents quasi-experimental evidence on the impact of an innovative “community response” pilot in Denver that directed targeted emergency calls to health-care responders instead of the police. We find robust evidence that the program reduced targeted, less serious crimes (e.g., trespassing, public disorder, resisting arrest) by 34 percent. We also find that this community-response approach has substantially lower costs relative to engaging such crises through the criminal-justice system.
    Date: 2021–03–14
    URL: http://d.repec.org/n?u=RePEc:osf:osfxxx:zsaf5&r=all
  11. By: Lena Janys; Bettina Siflinger
    Abstract: In this paper, we provide causal evidence on abortions and risky health behaviors as determinants of mental health development among young women. Using administrative in- and outpatient records from Sweden, we apply a novel grouped fixed-effects estimator proposed by Bonhomme and Manresa (2015) to allow for time-varying unobserved heterogeneity. We show that the positive association obtained from standard estimators shrinks to zero once we control for grouped time-varying unobserved heterogeneity. We estimate the group-specific profiles of unobserved heterogeneity, which reflect differences in unobserved risk to be diagnosed with a mental health condition. We then analyze mental health development and risky health behaviors other than unwanted pregnancies across groups. Our results suggest that these are determined by the same type of unobserved heterogeneity, which we attribute to the same unobserved process of decision-making. We develop and estimate a theoretical model of risky choices and mental health, in which mental health disparity across groups is generated by different degrees of self-control problems. Our findings imply that mental health concerns cannot be used to justify restrictive abortion policies. Moreover, potential self-control problems should be targeted as early as possible to combat future mental health consequences.
    Date: 2021–03
    URL: http://d.repec.org/n?u=RePEc:arx:papers:2103.12159&r=all
  12. By: Arnar Buason; Edward C. Norton; Paul McNamee; Edda Bjork Thordardottir; Tinna Laufey Asgeirsdóttir
    Abstract: Within the vast body of literature on the relationship between mental disorders and life satisfaction, no satisfactory treatment has been proposed to deal with the bi-directional relationship between the two. We estimate the causal effect of depression and anxiety on life satisfaction by applying an instrumental-variable regression approach to the Household, Income and Labour Dynamics in Australia (HILDA) survey. Our identification strategy exploits regional variation in the tendency to diagnose depression and anxiety, while also using an individual-level panel-data method. Our results show that previous research seriously overestimates the effect of depression and anxiety on life satisfaction. The most comparable estimate from previous research is over five times the size of our estimate. Furthermore, those papers that use such estimates to measure the monetary value of not suffering from depression or anxiety find it to be between $14 to $600 million a year per individual, compared to our estimate of around $60 thousand. Another source of bias which further inflates previous monetary estimates is the endogeneity of income. We account for this issue by using irregular sources of income, such as lottery winnings, instead of regular household income.
    JEL: I12 I14 I31
    Date: 2021–03
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:28575&r=all
  13. By: Shan Huang; Michael Allan Ribers; Hannes Ullrich
    Abstract: Large-scale data show promise to provide efficiency gains through individualized risk predictions in many business and policy settings. Yet, assessments of the degree of data-enabled efficiency improvements remain scarce. We quantify the value of the availability of a variety of data combinations for tackling the policy problem of curbing antibiotic resistance, where the reduction of inefficient antibiotic use requires improved diagnostic prediction. Fousing on antibiotic prescribing for suspected urinary tract infections in primary care in Denmark, we link individual-level administrative data with microbiological laboratory test outcomes to train a machine learning algorithm predicting bacterial test results. For various data combinations, we assess out of sample prediction quality and efficiency improvements due to prediction-based prescription policies. The largest gains in prediction quality can be achieved using simple characteristics such as patient age and gender or patients’ health care data. However, additional patient background data lead to further incremental policy improvements even though gains in prediction quality are small. Our findings suggest that evaluating prediction quality against the ground truth only may not be sufficient to quantify the potential for policy improvements.
    Keywords: Prediction policy; data combination; machine learning; antibiotic prescribing
    JEL: C10 C55 I11 I18 Q28
    Date: 2021
    URL: http://d.repec.org/n?u=RePEc:diw:diwwpp:dp1939&r=all
  14. By: Aditya Goenka (Unknown); Lin Liu (Unknown); Manh-Hung Nguyen (TSE - Toulouse School of Economics - UT1 - Université Toulouse 1 Capitole - EHESS - École des hautes études en sciences sociales - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement)
    Abstract: This paper studies an optimal growth model where there is an infectious disease with SIR dynamics which can lead to mortality. Health expenditures (alternatively intensity of lockdowns) can be made to reduce infectivity of the disease. We study implications of two different ways to model the disease related mortality - early and late in infection mortality - on the equilibrium health and economic outcomes. In the former, increasing mortality reduces infections by decreasing the fraction of infectives in the population, while in the latter the fraction of infectives increases. We characterize the steady states and the outcomes depend in the way mortality is modeled. With early mortality, increasing mortality leads to higher equilibrium per capita output and consumption while in the late mortality model these decrease. We establish sufficiency conditions and provide the first results in economic models with SIR dynamics with and without disease related mortality - a class of models which are non-convex and have endogenous discounting so that no existing results are applicable.
    Keywords: Prevention,Lockdown,Economic growth,Sufficiency conditions,Mortality,SIR model,Covid-19,Infectious diseases,Health expenditure
    Date: 2021–03
    URL: http://d.repec.org/n?u=RePEc:hal:journl:hal-03170689&r=all
  15. By: Fraser Summerfield; Livio Di Matteo
    Abstract: COVID-19 and the associated economic disruption is not a unique pairing. Catastrophic health events including the Black Death and the Spanish Flu also featured major economic disruptions. This paper focuses on significant health shocks during 1870-2016 from a singular virus: influenza. Our analysis builds on a literature dominated by long-run analyses by documenting the causal impact of influenza pandemics on short-run macroeconomic fluctuations. We examine 16 developed economies combining the Jorda-Schularick-Taylor Macro History Database with the Human Mortality Database. Our results reveal important negative impacts. Further, we illustrate that these effects operate through different channels over time. Prior to vaccines, pandemic-induced mortality was responsible for economic contractions while modern flu-induced cycles appear to arise because of pandemic-induced consumption decreases.
    Keywords: Pandemics, Business Cycles, Mortality, Consumption, GDP Fluctuations
    JEL: E32 I18
    Date: 2021–03
    URL: http://d.repec.org/n?u=RePEc:cch:wpaper:210002&r=all
  16. By: Amira El-Shal (Cairo University); Mahmoud Mohieldin (Cairo University); Eman Moustafa (General Authority for Investment & Free Zones)
    Abstract: In times of epidemics and pandemics, depletion or diversion of health system resources from routine health care is common, posing serious threats to primary care. This paper estimates the contemporaneous and long-run effects of health disasters on maternal and child mortality in 111 countries during 2000-2019 using two-way fixed-effects and two-step system general method of moments frameworks. We also provide evidence that indicates how health system, macroeconomic, institutional, and structural characteristics can mitigate disaster effects. In low- and middle-income countries, health disasters increase maternal, under-5, and neonatal mortalities by 0.3%, 0.3%, and 0.2% instantaneously and by 35%, 80%, and 26% after one year, respectively. Our estimates show that disaster preparedness can prevent these effects. However, other mitigators, namely health emergency finance, universal health coverage, education, gender equality, and water, sanitation, and hygiene coverage, have greater impact.
    Date: 2021–03–20
    URL: http://d.repec.org/n?u=RePEc:erg:wpaper:1466&r=all
  17. By: Wyper, Grant Mark Andrew; Fletcher, Eilidh; Grant, Ian; McCartney, Gerry; Fischbacher, Colin; Harding, Oliver; Jones, Hannah; de Haro Moro, Maria Teresa; Speybroek, Niko; Devleesschauwer, Brecht
    Abstract: Background: Disability-adjusted life years (DALYs) combine the impact of morbidity and mortality and can enable comprehensive, and comparable, assessments of direct and indirect health harms due to COVID-19. Our aim was to estimate DALYs directly due to COVID-19 in Scotland, during 2020; and contextualise its population impact relative to other causes of disease and injury. Methods: National deaths and daily case data were used. Deaths were based on underlying and contributory causes recorded on death certificates. We calculated DALYs based on the COVID-19 consensus model and methods outlined by the European Burden of Disease Network. DALYs were presented as a range, using a sensitivity based on Years of Life Lost estimates using: cause-specific; and COVID-19 related deaths. All estimates were for 2020. Findings: In 2020, estimates of COVID-19 DALYs in Scotland ranged from 96,500 to 108,200. Direct COVID-19 DALYs were substantial enough to be framed as the second leading cause of disease and injury, with only ischaemic heart disease having a larger impact on population health. Mortality contributed 98% of total DALYs. Interpretation: The direct population health impact of COVID-19 has been very substantial. Despite unprecedented mitigation efforts, COVID-19 developed from a single identified case in early 2020 to a condition with an impact in Scotland second only to ischaemic heart disease. Periodic estimation of DALYs during 2021, and beyond, will provide indications of the impact of DALYs averted due to the national roll-out of the vaccination programme and other continued mitigation efforts, although new variants may pose significant challenges.
    Date: 2021–03–24
    URL: http://d.repec.org/n?u=RePEc:osf:socarx:ey36d&r=all
  18. By: Barili, E.; Grembi, V.; Rosso, A.C.
    Abstract: Relying on a survey of more than 4,000 female respondents, we investigate the main determinants of women's mental distress during the first wave of the COVID-19 pandemic in Italy. We focus on two groups of variables to capture both the health and the economic emergency: present concerns and future expectations. Our results show that the main predictors of mental health are future expectations, such as the fear of losing a job, which is more relevant than concerns related to the spread of the virus. Younger women (less than 35), those lacking a high school degree, and those working in education or in remote work with school-aged children are in most distress. Using a panel fixed effects model that includes respondents to a re-call run in February 2021, we show that there was no adjustment to the new normal. Finally, using data on gender norms, we show that where the role of women is conceived in a more traditional way, the level of mental distress as driven by future employment is lower, suggesting that women's expectations for their role in society do play a relevant role in self-assessed well-being.
    Keywords: mental health; COVID-19; expectations; gender stereotypes
    JEL: I1 I12 J16
    Date: 2021–03
    URL: http://d.repec.org/n?u=RePEc:yor:hectdg:21/07&r=all
  19. By: Stéphane Goutte (Cemotev - Centre d'études sur la mondialisation, les conflits, les territoires et les vulnérabilités - UVSQ - Université de Versailles Saint-Quentin-en-Yvelines, VNU - Vietnam National University [Hanoï]); Thomas Péran (UP UFR SS - Université de Paris - UFR Sciences sociales - UP - Université de Paris); Thomas Porcher
    Abstract: Among the majority of research on individual factors leading to coronavirus mortality, age has been identified as a dominant factor. Health and other individual factors including gender, comorbidity, ethnicity and obesity have also been identified by other studies. In contrast, we examine the role of economic structural factors on COVID-19 mortality rates. Particularly, focusing on a densely populated region of France, we document evidence that higher economic "precariousness indicators" such as unemployment and poverty rates, lack of formal education and housing are important factors in determining COVID-19 mortality rates. Our study will help inform policy makers regarding the role of economic factors in managing pandemics.
    Keywords: COVID-19,Health system,Housing,Pandemic,Poverty,Social distancing,Territorial vulnerabilities
    Date: 2020
    URL: http://d.repec.org/n?u=RePEc:hal:journl:hal-03109162&r=all
  20. By: James Davies
    Abstract: The cross-country relationship between Covid-19 crude mortality rates and previously measured income inequality and poverty in the pandemic’s first wave is studied, controlling for other underlying factors, in a sample of 141 countries. An older population, fewer hospital beds, lack of universal BCG (tuberculosis) vaccination, and greater urbanization are associated with higher mortality. The death rate has a consistent strong positive relationship with the Gini coefficient for income. Poverty as measured by the $1.90 per day standard has a small negative association with death rates. The elasticity of Covid-19 deaths with respect to the Gini coefficient, evaluated at sample means, is 0.9. Assuming the observed empirical relationships unchanged, if the Gini coefficient in all countries where it is above the OECD median was instead at that median, 67,000 fewer deaths would have been expected after 150 days of the pandemic - - a reduction of 10%. Shrinking “excess Gini’s” down to the G7 median reduces predicted deaths by 88,500, or 14%.
    Keywords: Covid-19 pandemic inequality poverty mortality
    JEL: I14 I39
    Date: 2021
    URL: http://d.repec.org/n?u=RePEc:ces:ceswps:_8957&r=all
  21. By: Marcella Alsan; Sarah Eichmeyer
    Abstract: High-value preventive care is often underutilized. We study persuasion regarding the medical benefits of influenza vaccination by experimentally varying race concordance between sender and receiver, and, among Black respondents, a discordant sender’s acknowledgement of historical injustice and the expertise of a concordant sender. Race concordance improves ratings of the sender and signal among Black respondents but has no effect among White respondents. Acknowledgement of injustice improves signal ratings as much as concordance, though neither alters vaccine behavior except among those previously vaccinated. Non-expert concordant senders increase intended and self-reported vaccine take-up the most, particularly among individuals with no vaccination experience.
    JEL: I1 I12 I14
    Date: 2021–03
    URL: http://d.repec.org/n?u=RePEc:nbr:nberwo:28593&r=all
  22. By: Graziella Bertocchi (University of Modena and Reggio Emilia, EIEF, CEPR, CHILD, Dondena, GLO, and IZA); Arcangelo Dimico (Queen's University Belfast, GLO, IZA, CHaRMS, and QUCEH)
    Abstract: The mounting evidence on the demographics of COVID-19 fatalities points to an overrepresentation of minorities and an underrepresentation of women. Using individual-level, race-disaggregated, and georeferenced death data collected by the Cook County Medical Examiner, we jointly investigate the racial and gendered impact of COVID-19, its timing, and its determinants. Through an event study approach we establish that Blacks individuals are affected earlier and more harshly and that the effect is driven by Black women. Rather than comorbidity or aging, the Black female bias is associated with poverty and channeled by occupational segregation in the health care and transportation sectors and by commuting on public transport. Living arrangements and lack of health insurance are instead found uninfluential. The Black female bias is spatially concentrated in neighborhoods that were subject to historical redlining.
    Date: 2021
    URL: http://d.repec.org/n?u=RePEc:eie:wpaper:2106&r=all
  23. By: Ferragina, Emanuele; Pasqualini, Marta; Ricchi, Ettore; Zola, Andrew
    Abstract: The Covid-19 pandemic is widely interpreted as a double-edged crisis between the preservation of health and economic functioning. Considering individuals’ perceptions of the pandemic risks, we devised a ten-point tradeoff scale asking people to situate their concern between health and the economy. We administered this question seven times to a representative panel of French residents from April until November 2020, establishing a barometer that tracked changes and heterogeneity between these two concerns. We find overall concern moved in favor of the economy over time. There is substantial heterogeneity across respondents: those reporting risk from Covid-19, lower subjective social status and politically leftwing preferences were more concerned with health than the rest of the population. This partially applies to the less educated, the less wealthy and the young, suggesting the pandemic reinforces preexisting social cleavages. Beyond the pandemic situation, longitudinal tradeoff scales are a promising way to investigate risk perceptions.
    Date: 2021–03–20
    URL: http://d.repec.org/n?u=RePEc:osf:socarx:rv7e3&r=all
  24. By: Stefano Maria Iacus; Carlos Santamaria; Francesco Sermi; Spyridon Spyratos; Dario Tarchi; Michele Vespe
    Abstract: This work introduces a new concept of functional areas called Mobility Functional Areas (MFAs), i.e., the geographic zones highly interconnected according to the analysis of mobile positioning data. The MFAs do not coincide necessarily with administrative borders as they are built observing natural human mobility and, therefore, they can be used to inform, in a bottom-up approach, local transportation, health and economic policies. After presenting the methodology behind the MFAs, this study focuses on the link between the COVID-19 pandemic and the MFAs in Austria. It emerges that the MFAs registered an average number of infections statistically larger than the areas in the rest of the country, suggesting the usefulness of the MFAs in the context of targeted re-escalation policy responses to this health crisis.
    Date: 2021–03
    URL: http://d.repec.org/n?u=RePEc:arx:papers:2103.16894&r=all
  25. By: Paul Levine (University of Surrey and CIMS); Neil Rickman (University of Surrey)
    Abstract: This paper sets out a coherent framework for studying the economic effects of the Covid-19 pandemic, and policies aimed at controlling both the health and economic trade-offs that it poses. It does this by combining two key epidemiological and macroeconomic models: the SIR model and the RBC model. We argue that much of the present literature can be understood using this framework. The SIR-type epidemiology model in the paper has the novel feature of both no-disease and endemic steady states, two possible outcomes of Covid-19. The stability properties of these equilibria are examined and are shown to depend on the reproduction number and also, possibly, on the complex dynamics introduced by `predator-prey' behaviour of the virus. In addition, we show how endogenous social interaction fits within the model. Lockdown - reducing the size of the susceptible population - is then introduced into the RBC model as a social planner's problem. By linking this epidemiolgy model with a simple RBC model, we provide an integrated framework for examining the economic effects of Covid-related policies and the economic cost of lockdown policies of particular scope and duration. In principle an empirical implementation of this framework can be used to deduce the price of a life implied by a particular lockdown policy. Looking forward, extensions of our framework offer the chance to study economic challenges in areas such as debt financing, human capital shocks, or vaccine production and roll-out, all of which are inevitably emerging.
    JEL: C63 D58 E24 E27 E32 E37
    Date: 2021–03
    URL: http://d.repec.org/n?u=RePEc:sur:surrec:0421&r=all

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