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on Health Economics |
| By: | Bhalotra, Sonia (University of Essex & University of Warwick); Martin Karlsson (CINCH, University of Duisburg-Essen); Therese Nilsson (Lund University, Research Institute of Industrial Economics (IFN)); Schwarz, Nina (University of Duisburg-Essen) |
| Abstract: | We identify earnings impacts of exposure to an infant health intervention in Sweden, using individual linked administrative data to trace potential mechanisms. Leveraging quasi-random variation in eligibility, we estimate that exposure was associated with higher test scores in primary school for boys and girls. However only girls were more likely to score in the top quintile. Subsequent gains, in secondary schooling, employment, and earnings, are restricted to girls. We show that the differential gains for women accrued from both skills and opportunities, expansion of the welfare state having created unprecedented employment opportunities for women. |
| Keywords: | Infant health ; early life interventions ; cognitive skills ; education ; earnings ; occupational choice ; programme evaluation ; Sweden ; gender JEL Classification: I15 ; I18 ; H41 |
| Date: | 2021 |
| URL: | http://d.repec.org/n?u=RePEc:wrk:warwec:1345&r= |
| By: | Ben Artz (University of Wisconsin, Oshkosh); David G. Blanchflower (Bruce V. Rauner Professor of Economics, Dartmouth College, Adam Smith Business School, University of Glasgow, NBER and Bloomberg); Alex Bryson (University College London. IZA, Bonn. NIESR, London) |
| Abstract: | In this paper we revisit the well-known negative association between union coverage and individuals’ job satisfaction in the United States, first identified over forty years ago. We find the association has flipped since the Great Recession such that union workers are now more satisfied than their non-union counterparts. We show this to be the case for younger and older workers in the National Longitudinal Surveys of 1979 and 1997. The change is apparent when we use the panel data to account for fixed differences in those who are and are not unionized, suggesting changes in worker sorting into union status are not the reason for the change. The absence of substantial change in the union wage gap, and the stability of results when conditioning on wages, both suggest the change is not associated with changes in unions’ wage bargaining. Instead, we find some diminution in unions’ ability to lower quit rates – albeit confined to older workers - which is suggestive of a decline in their effectiveness in operating as a ‘voice’ mechanism for unionized workers. We also present evidence suggestive of unions’ ability to minimize covered workers’ exposure to underemployment, a phenomenon that has negatively impacted non-union workers. |
| Keywords: | job satisfaction; union coverage; union wage gap; quits; underemployment; panel; NLSY |
| JEL: | J28 J50 J51 |
| Date: | 2021–04–01 |
| URL: | http://d.repec.org/n?u=RePEc:qss:dqsswp:2113&r= |
| By: | Heiss, Florian (University of Düsseldorf); McFadden, Daniel (University of California, Berkeley); Winter, Joachim (LMU Munich); Wuppermann, Amelie (University of Halle-Wittenberg); Zhou, Bo (University of Southern California, Los Angeles) |
| Abstract: | Consumers’ health plan choices are highly persistent even though optimal plans change over time. This paper separates two sources of inertia, inattention to plan choice and switching costs. We develop a panel data model with separate attention and choice stages, linked by heterogeneity in acuity, i.e., the ability and willingness to make diligent choices. Using data from Medicare Part D, we find that inattention is an important source of inertia but switching costs also play a role, particularly for low-acuity individuals. Separating the two stages and allowing for heterogeneity is crucial for counterfactual simulations of interventions that reduce inertia. |
| Keywords: | medicare; prescription drugs; health insurance demand; dynamic discrete choice; |
| JEL: | I13 D12 J14 C25 |
| Date: | 2019–12–18 |
| URL: | http://d.repec.org/n?u=RePEc:rco:dpaper:221&r= |
| By: | Cyrus Aghamolla; Pinar Karaca-Mandic; Xuelin Li; Richard T. Thakor |
| Abstract: | This study examines the link between credit supply and hospital health outcomes. Using detailed data on hospitals and the banks that they borrow from, we use bank stress tests as exogenous shocks to credit access for hospitals that have lending relationships with tested banks. We find that affected hospitals shift their operations to enhance their profit margins in response to a negative credit shock, but reduce the quality of their care to patients across a variety of measures. In particular, affected hospitals exhibit significantly lower attentiveness in providing timely and effective treatment and procedures, and are rated substantially lower in patient satisfaction. This decline in care quality is reflected in health outcomes: affected hospitals experience a significant increase in risk-adjusted, unplanned 30-day readmission rates of recently discharged patients and in risk-adjusted 30-day patient mortality rates. Overall, the results indicate that access to credit can affect the quality of healthcare hospitals deliver, pointing to important spillover effects of credit market frictions on health outcomes. |
| JEL: | G21 G32 I11 I15 |
| Date: | 2021–04 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:28709&r= |
| By: | Olivia Bodnar (DICE, Heinrich-Heine-University Düsseldorf, Germany); Hugh Gravelle (Centre for Health Economics, University of York, York, UK.); Nils Gutacker (Centre for Health Economics, University of York, York, UK.); Annika Herr (Institute of Health Economics, Leibniz University Hannover, Germany) |
| Abstract: | Many healthcare systems prohibit primary care physicians from dispensing the drugs they prescribe due to concerns that this encourages excessive, ineffective or unnecessarily costly prescribing. Using data from the English National Health Service for 2011 to 2018, we estimate the impact of physician dispensing rights on prescribing behaviour at the extensive margin (comparing practices that dispense and those that do not) and the intensive margin (comparing practices with different proportions of patients to whom they dispense). Our empirical strategy controls for practices selecting into dispensing based on observable (OLS, entropy balancing) and unobservable practice characteristics (2SLS). We show that physician dispensing raises drug costs per patient by 4.2%, which reflects more and more expensive drugs being prescribed, including potentially inappropriate substances such as opioids. Dispensing practices also prescribe smaller packages as reimbursement is partly based on a fixed fee per prescription dispensed. Similar effects are observed at the intensive margin. |
| Keywords: | Physician dispensing, primary care, drug expenditure, financial incentives, physician agency |
| JEL: | I11 I18 L10 |
| Date: | 2021–04 |
| URL: | http://d.repec.org/n?u=RePEc:chy:respap:181cherp&r= |
| By: | Claudia Senik (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, PJSE - Paris Jourdan Sciences Economiques - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS Paris - École normale supérieure - Paris - PSL - Université Paris sciences et lettres - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement, SU - Sorbonne Université); Guglielmo Zappalà (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); Carine Milcent (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, PJSE - Paris Jourdan Sciences Economiques - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS Paris - École normale supérieure - Paris - PSL - Université Paris sciences et lettres - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement); Chloé Gerves-Pinquié (Institut Recherche en Santé Respiratoire des Pays de la Loire); Patricia Dargent-Molina (INSERM - Institut National de la Santé et de la Recherche Médicale) |
| Abstract: | We explore the effects of adapted physical exercise programs in nursing homes, in which some residents suffer from dementia and/or physical limitations and other do not. We use data from 452 participants followed over 12 months in 32 retirement homes in four European countries. Using a difference-in-difference with individual random effects model, we show that the program has exerted a significant impact on the number of falls and the self-declared health and health-related quality of life of residents (EQ-5D). The wide scope of this study, in terms of sites, countries, and measured outcomes, brings generality to previously existing evidence. A simple computation, in the case of France, suggests that such programs are highly cost-efficient. |
| Keywords: | falls,Subjective health,Impact study,Retirement homes,Physical activity |
| Date: | 2021–04 |
| URL: | http://d.repec.org/n?u=RePEc:hal:psewpa:halshs-03205172&r= |
| By: | Jialin Huang; Jianwei Xing; Eric Zou |
| Abstract: | Many human activities can be strategically timed around forecastable natural hazards to mute their impacts. We study air pollution shock mitigation in a high-stakes healthcare setting: hospital surgery scheduling. Using newly available inpatient surgery records from a major city in China, we track post-surgery survival for over 1 million patients, and document a significant increase of hospital mortality among those who underwent surgeries on days with high particulate matter pollution. This effect has two special features. First, pollution on the surgery day, rather than exposure prior to hospitalization, before or after the surgery, is primarily explanatory of the excess mortality. Second, a small but high-risk group – elderly patients undergoing respiratory or cancer operations – bears a majority of pollution’s damages. Based on these empirical findings, we build and analyze a model of hospital surgery scheduling. For over a third of the high-risk surgeries, there exists an alternative, lower-pollution day within three days such that moving the surgery may lead to a Pareto improvement in survival. |
| JEL: | C44 I18 O13 Q53 |
| Date: | 2021–04 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:28708&r= |
| By: | Timothy J. Moore; Todd Morris |
| Abstract: | Teens are risky drivers and often subject to extra restrictions. We examine the effects of an Australian intervention banning first-year drivers from carrying multiple passengers between 11:00pm and 4:59am, which had represented 3% of their accidents and 18% of their fatalities. Using daytime outcomes to account for counterfactual crash risks, we find the reform more than halves targeted crashes, casualties and deaths. The restriction also lowers crashes earlier in the evening and beyond the first year, suggesting it has broad and persistent effects on driving behavior. Overall, this targeted intervention delivers gains comparable to harsher restrictions that delay teen driving. |
| JEL: | I18 K32 |
| Date: | 2021–04 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:28707&r= |
| By: | Schmacker, Renke (DIW Berlin); Smed, Sinne (University of Copenhagen) |
| Abstract: | "Sin taxes" are high on the political agenda in the global fight against obesity. According to theory, they are welfare improving if consumers with low self-control are at least as price responsive as consumers with high self-control, even in the absence of externalities. In this paper, we investigate if consumers with low and high self-control react differently to sin tax variation. For identification, we exploit two sets of sin tax reforms in Denmark: first, the increase of the soft drink tax in 2012 and its repeal in 2014 and, second, the fat tax introduction in 2011 and its repeal in 2013. We assess the purchase response empirically using a detailed homescan household panel. Our unique dataset comprises a survey measure of self-control linked to the panelists, which we use to divide the sample into consumers with low and high levels of self-control. We find that consumers with low self-control reduce purchases less strongly than consumers with high self-control when taxes go up, but increase purchases to a similar extent when taxes go down. Hence, we document an asymmetry in the responsiveness to increasing and decreasing prices. We find empirical and theoretical support that habit formation shapes the differential response by self-control. The results suggest that price instruments are not an effective tool for targeting self-control problems. |
| Keywords: | self-control; soft drink tax; fat tax; sin tax; internality ; |
| JEL: | H20 D12 I18 |
| Date: | 2020–07–10 |
| URL: | http://d.repec.org/n?u=RePEc:rco:dpaper:250&r= |
| By: | Dean Yang; James Allen IV; Arlete Mahumane; James Riddell IV; Hang Yu |
| Abstract: | Using randomized methodologies, we study a common community HIV/AIDS program that seeks to promote HIV testing by improving knowledge and reducing stigmatizing attitudes. Contrary to expectations, the program has a substantial negative effect on HIV testing rates. We provide evidence of likely mechanisms behind the program's negative effect: it inadvertently increased misinformation about HIV, and worsened HIV-related stigmatizing attitudes. Subsequent household-level randomized treatments providing correct information and addressing stigma concerns counteract the program's negative effect on HIV testing. These findings highlight the importance of improving knowledge and alleviating stigma concerns when promoting HIV testing. |
| JEL: | D10 D80 I12 |
| Date: | 2021–04 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:28716&r= |
| By: | David (David Patrick) Madden |
| Abstract: | This paper examines mobility and changes in Body Mass Index (BMI) for a sample of Irish children/adolescents across three waves of the longitudinal Growing Up in Ireland dataset. Particular attention is paid to transitions across the key BMI thresholds of overweight and obesity. Analysis is carried out by gender and by maternal education. In general, mobility is observed, with intra-generational rank-rank BMI coefficients of around 0.63 compared to coefficients of around 0.77 for the mothers of the children over the same time period. Across the distribution as a whole there is relatively little variation by gender and maternal education. However there a gender difference in terms of mobility out of obesity with the Shorrocks mobility index across categories of normal weight/overweight/obesity taking a value of 0.56 for females as opposed to 0.71 for males. This relative lack of mobility is more observed in later rather than earlier adolescence. |
| Keywords: | Obesity; Motility; Transitions |
| JEL: | I12 I14 I39 |
| Date: | 2020–08 |
| URL: | http://d.repec.org/n?u=RePEc:ucn:oapubs:10197/12110&r= |
| By: | Anderson, D. Mark (Montana State University); Rees, Daniel I. (University of Colorado Denver) |
| Abstract: | Thirty-six states have legalized medical marijuana and 14 states have legalized the use of marijuana for recreational purposes. In this paper, we review the literature on the public health consequences of legalizing marijuana, focusing on studies that have appeared in economics journals as well as leading public policy, public health, and medical journals. Among the outcomes considered are: youth marijuana use, alcohol consumption, the abuse of prescription opioids, traffic fatalities, and crime. For some of these outcomes, there is a near consensus in the literature regarding the effects of medical marijuana laws (MMLs). As an example, leveraging geographic and temporal variation in MMLs, researchers have produced little credible evidence to suggest that legalization promotes marijuana use among teenagers. Likewise, there is convincing evidence that young adults consume less alcohol when medical marijuana is legalized. For other public health outcomes such as mortality involving prescription opioids, the effect of legalizing medical marijuana has proven more difficult to gauge and, as a consequence, we are less comfortable drawing firm conclusions. Finally, it is not yet clear how legalizing marijuana for recreational purposes will affect these and other important public health outcomes. We will be able to draw stronger conclusions when more post-treatment data are collected in states that have recently legalized recreational marijuana. |
| Keywords: | marijuana legalization, public health |
| JEL: | I1 H7 K42 |
| Date: | 2021–04 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp14292&r= |
| By: | Costa-Font, Joan (London School of Economics); Salmasi, Luca (Catholic University - Rome); Zaccagni, Sarah (University of Copenhagen) |
| Abstract: | Are workplace smoking bans (WSBs) more than a ban on smoking? We study whether WSBs influence smoking cessation and exert behavioural spillover effects on (i) a number of health behaviours, and (ii) on individuals not directly affected by the bans. Drawing upon quasi-experimental evidence from Russia (a country where about half of the population smokes), which introduced a WBS (in addition to a smoking ban on public places), and adopting a difference-in-differences (DiD) strategy, which compares employed individuals (exposed to the work and public place ban) to those unemployed (exposed only to the ban in public places), we document three sets of findings. First, unlike previous studies (focusing on smoking bans in public places), we find robust evidence that WSBs increase smoking cessation in 2.9 percentage points (pp) among men. Second, we find that upon the WSB, quitters are less likely to use alcohol (6.7pp reduction among men and 3.5 pp among women), reduce their alcohol consumption (10 percent among men) and increase their physical activity (in 4.3 percentage points among men). WSBs are found to influence health behaviours of those not directly affected by the reform, such as never smokers. Our findings are consistent with a model of joint formation of health behaviours, and suggest of the needs to account for a wider set of spillover effects when estimating the welfare effect of WSBs. |
| Keywords: | joint behavioural formation, workplace smoking bans, behavioural spillovers, smoking, drinking, physical activity, healthy identity, Russia |
| JEL: | I18 H75 L51 |
| Date: | 2021–04 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp14299&r= |
| By: | Jakub Grossmann |
| Abstract: | The system of sick-pay is critical for balancing the economic and health costs of infectious diseases. Surprisingly, most research on sick-pay reforms does not rely on variation in worker exposure to diseases when investigating absences from work. This paper studies the effects on absences from work of changes in health-insurance coverage of the first three days of sickness. We explore geographic variation in the prevalence of infectious diseases, primarily the seasonal flu, to provide variation in the need for sickness insurance. Estimates based on the Czech Structure of Earnings Survey imply that when sickness insurance is not available, total hours of work missed are not affected, but employees rely on paid and unpaid leave instead of sick-leave to stay home. The substitution effects are heterogenous across occupations and socio-demographic characteristics of employees, and suggest that workers do not spread infectious diseases at the workplace as a result of the absence of sickness insurance coverage in the first three days of sickness. |
| Keywords: | sickness insurance; exposure to sickness; policy reforms; Czech Republic; |
| JEL: | I13 I18 J3 |
| Date: | 2021–03 |
| URL: | http://d.repec.org/n?u=RePEc:cer:papers:wp690&r= |
| By: | Breunig, Christoph (Emory University); Haan, Peter (DIW Berlin and FU Berlin) |
| Abstract: | We consider the problem of regressions with selectively observed covariates in a nonparametric framework. Our approach relies on instrumental variables that explain variation in the latent covariates but have no direct effect on selection. The regression function of interest is shown to be a weighted version of observed conditional expectation where the weighting function is a fraction of selection probabilities. Nonparametric identification of the fractional probability weight (FPW) function is achieved via a partial completeness assumption. We provide primitive functional form assumptions for partial completeness to hold. The identification result is constructive for the FPW series estimator. We derive the rate of convergence and also the pointwise asymptotic distribution. In both cases, the asymptotic performance of the FPW series estimator does not suffer from the inverse problem which derives from the nonparametric instrumental variable approach. In a Monte Carlo study, we analyze the finite sample properties of our estimator and we demonstrate the usefulness of our method in analyses based on survey data. We also compare our approach to inverse probability weighting, which can be used alternatively for unconditional moment estimation. In the empirical application, we focus on two different applications. We estimate the association between income and health using linked data from the SHARE survey data and administrative pension information and use pension entitlements as an instrument. In the second application we revisit the question how income affects the demand for housing based on data from the Socio-Economic Panel Study. In this application we use regional income information on the residential block level as an instrument. In both applications we show that income is selectively missing and we demonstrate that standard methods that do not account for the nonrandom selection process lead to significantly biased estimates for individuals with low income. |
| Keywords: | selection model; instrumental variables; fractional probability weighting; nonparametric identification; partial completeness; incomplete data; series estimation; income distribution; health; |
| Date: | 2019–12–04 |
| URL: | http://d.repec.org/n?u=RePEc:rco:dpaper:206&r= |
| By: | Lechler, Marie (LMU Munich); Sunde, Uwe (LMU Munich) |
| Abstract: | Considerable evidence has documented that the elderly are more religious and that religiousness is associated with better health and lower mortality. Yet, little is known about the reverse role of life expectancy or proximity to death, as opposed to age, for religiousness. This paper provides evidence for the distinct role of expected remaining life years for the importance of religion in individuals’ lives. We combine individual survey response data for more than 311,000 individuals from 95 countries over the period 1994-2014 with information from period life tables. Contrary to wide-held beliefs, religiousness decreases with greater expected proximity to death. The findings have important implications regarding the consequences of population aging for religiousness and associated outcomes. |
| Keywords: | Religiousness; demographics; proximity of death; remaining life years; |
| JEL: | J10 N30 Z12 |
| Date: | 2020–05–29 |
| URL: | http://d.repec.org/n?u=RePEc:rco:dpaper:245&r= |
| By: | Anukriti, S (Development Research Group, The World Bank); Bhalotra, Sonia (University of Warwick); Tam, Eddy H. F. (University of Oxford) |
| Abstract: | Access to prenatal sex-detection technology in India has led to a phenomenal increase in abortion of girls. We find that it has also narrowed the gender gap in under-5 mortality, consistent with surviving girls being more wanted than aborted girls. For every three aborted girls, one additional girl survived to age five. Mechanisms include moderation of son-biased fertility stopping and narrowing of gender gaps in parental investments. However, surviving girls are more likely to be born in lower status families. Our findings have implications not only for counts of missing girls but also for the later life outcomes of girls. |
| Keywords: | abortion ; child mortality ; fertility ; gender ; health ; India ; missing girls ; parental investments ; prenatal sex detection ; sex-selection ; ultrasound JEL Classification: I15 ; J13 ; J16 |
| Date: | 2021 |
| URL: | http://d.repec.org/n?u=RePEc:wrk:warwec:1346&r= |
| By: | Manuela K. Fritz |
| Abstract: | Increasing ambient temperatures will severely affect human health in the decades to come and will exacerbate a variety of chronic health conditions. In this paper, I examine the temperature- morbidity relationship in the tropical climate environment of Indonesia with a focus on chronic, non-communicable diseases, namely diabetes, cardiovascular and respiratory diseases. Drawing on detailed individual level data from the Indonesian national health insurance scheme JKN and linking it with meteorological data on daily temperature realizations on a one spatial level, I estimate the e ect of high ambient temperatures on the daily number of primary health care visits. Exploiting the panel structure of the data and using a distributed lag model, I and that all-cause, diabetes and cardiovascular disease morbidity substantially increase at days with high mean temperatures. Specifically, on a day with a mean temperature above 29.5°C, the daily visits for diabetes and cardiovascular diseases increase by 29% and 19%, respectively, and these increases are permanent and not offset by visit displacement. Contrarily, I do not and any effects on respiratory disease morbidity. Heterogeneity analyses suggest that elderly and women suffer more severely from high temperatures. Back-of-the-envelope cost calculations indicate a substantial financial burden for the Indonesian health care system due to increasing temperatures. |
| Keywords: | Health, Non-Communicable Diseases, Temperature, Climate Change, Indonesia. |
| JEL: | I10 I13 I18 Q50 Q51 Q54 |
| Date: | 2021–04 |
| URL: | http://d.repec.org/n?u=RePEc:bav:wpaper:206_fritz&r= |
| By: | Landry Kuate (Department of Economics, University of Ottawa); Roland Pongou (Department of Economics, University of Ottawa, Ottawa, ON); Nicholas Rivers (Graduate School of Public and International Affairs, Institute of the Environment, University of Ottawa) |
| Abstract: | This paper offers new causal evidence on how the timing of prenatal temperature shocks affects fetal health, sex ratio at birth, and early-age human capital. Analyzing data on nearly 2 million live births from sub-Saharan African countries and exploiting exogenous spatial and temporal variation in monthly temperature, we uncover three findings. First, we find that a cold temperature shock decreases the likelihood of a male birth. This effect is non-linear, being larger in the first and third trimesters of pregnancy. It is also highly heterogeneous, being larger for older women, higher parity births, and rural areas. Second, combining our empirical estimates with a climate model, we find that the number of fetal deaths caused by climate change will rise from 200 to 400 per 100,000 live births by 2050 throughout sub-Saharan Africa. Third, in contrast to their differential effect on fetal mortality, prenatal temperature shocks increase infant mortality more for females than for males, suggesting that only healthier male fetuses survive to adverse in utero conditions. Our analysis implies that the design of policies to avert the negative impacts of climate change on children should account for stages of fetal development. |
| Keywords: | Climate Change; Timing of Prenatal Temperature Shocks; Impact Heterogeneity; Fetal Mortality; Sex Ratio; Infant Mortality; Human Capital; Sub-Saharan Africa. |
| Date: | 2021 |
| URL: | http://d.repec.org/n?u=RePEc:ott:wpaper:2102e&r= |
| By: | Czura, Kristina (LMU Munich); Menzel, Andreas (CERGE-EI Prague); Miotto, Martina (CERGE-EI Prague) |
| Abstract: | We conducted a randomised controlled trial (RCT) on a sample of 1,000 female garment workers in three factories in Bangladesh, offering access to free sanitary pads at work to 500 of the workers. We cross-randomised participation in information sessions for hygienic menstrual health care implemented by an experienced local NGO, and we vary the salience of commonly perceived taboos in the pad collection process. We find effects of the free pads and information sessions on self-reported pad use, but not of the taboo variations. We find effects on absenteeism and adherence to traditional restrictive and health-adverse taboos surrounding menstruation, but not on worker turnover or self-reported well-being at work. |
| Keywords: | menstrual health; taboos; productivity; export manufacturing; |
| JEL: | O14 O15 O35 M54 J32 J81 |
| Date: | 2019–11–29 |
| URL: | http://d.repec.org/n?u=RePEc:rco:dpaper:203&r= |
| By: | Da Mata, Daniel (São Paulo School of Economics-FGV); Emanuel, Lucas (Universidade Federal de Pernambuco); Pereira, Vitor (National School of Public Administration); Sampaio, Breno (Universidade Federal de Pernambuco) |
| Abstract: | This paper studies how in utero exposure to a large-scale climate adaptation program affects birth outcomes. The program built around one million cisterns in Brazil's poorest and driest region to promote small-scale decentralized rainfall harvesting. Access to cisterns during early pregnancy increased birth weight, particularly for more educated women. Data suggest that more educated women complied more with the program's water disinfection training, highlighting that even simple, low-cost technologies require final users' compliance ("the last mile") to be effective. In the context of growing water scarcity, adaptation policies can foster neonatal health and thus have positive long-run implications. |
| Keywords: | climate, adaptation, birth outcomes, cisterns, water |
| JEL: | Q54 Q58 Q25 I15 |
| Date: | 2021–04 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp14295&r= |
| By: | Leroux, Marie-Louise (Université catholique de Louvain, LIDAM/CORE, Belgium); Pestieau, Pierre (Université catholique de Louvain, LIDAM/CORE, Belgium) |
| Abstract: | This paper studies the design of an optimal non linear inheritance taxation when individuals differ in wage as well as in their risks of both mortality and old-age dependance. We assume that the government cannot distinguish between bequests motives, that is whether bequests result from precautionary reasons or from pure joy of giving reasons. Instead, we assume that it only observes whether bequests are made early in life or late in life, and in the latter case, whether the donor is autonomous or not. The main result is that, under asymmetric information, in addition to labour income taxation, early bequests of the low-productivity agent should be distorted downward, that is, they should be taxed so as to relax incentive constraints. |
| Keywords: | Bequest taxation; Long term care; Utilitarianism; Old-age dependency; Non linear taxation |
| JEL: | H21 H23 I14 |
| Date: | 2021–04–05 |
| URL: | http://d.repec.org/n?u=RePEc:cor:louvco:2021002&r= |
| By: | Abel Brodeur (University of Ottawa and IZA); Suraiya Bhuyian (Department of Economics, University of Ottawa); Anik Islam (Department of Economics, University of Ottawa); David Gray (Department of Economics, University of Ottawa) |
| Abstract: | The goal of this piece is to survey the developing and rapidly growing literature on the economic consequences of COVID-19 and the governmental responses, and to synthetize the insights emerging from a very large number of studies. This survey: (i) provides an overview of the data sets and the techniques employed to measure social distancing and COVID-19 cases and deaths; (ii) reviews the literature on the determinants of compliance with and the effectiveness of social distancing; (iii) the macroeconomic and financial impacts, including the modelling of plausible mechanisms; (iv) summarizes the literature on the socio-economic consequences of COVID-19, focusing on those aspects related to labor, health, gender, discrimination, and the environment, and v) summarizes the literature on public policy responses. |
| Keywords: | COVID-19, coronavirus, employment, lockdowns. |
| JEL: | E00 I15 I18 J20 |
| Date: | 2021 |
| URL: | http://d.repec.org/n?u=RePEc:ott:wpaper:2103e&r= |
| By: | Bartoš, Vojtěch (LMU Munich); Bauer, Michal (CERGE-EI Prague); Cahlíková, Jana (MPI for Tax Law and Public Finance Munich); Chytilová, Julie (CERGE-EI Prague) |
| Abstract: | Intergroup conflicts represent one of the most pressing problems facing human society. Sudden spikes in aggressive behavior, including pogroms, often take place during periods of economic hardship or health pandemics, but little is known about the underlying mechanism behind such change in behavior. Many scholars attribute it to scapegoating, a psychological need to redirect anger and to blame an out-group for hardship and problems beyond one's own control. However, causal evidence of whether hardship triggers out-group hostility has been lacking. Here we test this idea in the context of the Covid-19 pandemic, focusing on the common concern that it may foster nationalistic sentiments and racism. Using a controlled money-burning task, we elicited hostile behavior among a nationally representative sample (n = 2,186) in a Central European country, at a time when the entire population was under lockdown and border closure. We find that exogenously elevating salience of thoughts related to Covid-19 pandemic magnifies hostility and discrimination against foreigners, especially from Asia. This behavioral response is large in magnitude and holds across various demographic sub-groups. For policy, the results underscore the importance of not inflaming racist sentiments and suggest that efforts to recover international trade and cooperation will need to address both social and economic damage. |
| Keywords: | COVID-19 pandemic; scapegoating; hostility; inter-group conflict; discrimination; experiment; |
| JEL: | C90 D01 D63 D91 J15 |
| Date: | 2020–05–14 |
| URL: | http://d.repec.org/n?u=RePEc:rco:dpaper:243&r= |
| By: | Giovanis, Eleftherios; Ozdamar, Oznur |
| Abstract: | In response to the threat posed by COVID-19, the UK prime minister announced on the 23rd of March strict lockdowns and introduced a new way of living and working, at least temporarily. This included working from home wherever possible. Many experts from the IT industry were long arguing about the potential for working from home, which suddenly now became indisputable. The objective of this study is to evaluate the impact of working from home on the individuals’ perception about their future financial situation and their mental well-being. We apply a difference-in-differences framework using data from the UK Household Longitudinal Study (UKHLS) combined with the UKHLS COVID-19 survey conducted in April 2020. Our findings suggest that those who have not experienced a shift from working at the employer’s premises to working from home became more concerned about their future financial situation. However, we find that working from home has a negative impact on mental well-being. On the other hand, we find no difference in the mental well-being when we consider those who work from home on occasion. The findings of this study have policy implications for government, firms and health practitioners. In particular, a balance between working from home and at the employer’s premises may provide both financial security and maintain the mental and psychological well-being at satisfying levels. |
| Keywords: | COVID-19; Difference-in-Differences; Financial Well-Being; Mental Well-being; Working from Home |
| JEL: | I14 I31 |
| Date: | 2021 |
| URL: | http://d.repec.org/n?u=RePEc:pra:mprapa:107444&r= |
| By: | Sarracino, Francesco; Greyling, Talita; O'Connor , Kelsey; Peroni, Chiara; Rossouw, Stephanie |
| Abstract: | In this article we describe how well-being changed during 2020 in ten countries, namely Australia, Belgium, France, Germany, Great Britain, Italy, Luxembourg, New Zealand, South Africa, and Spain. Our measure of well-being is the Gross National Happiness (GNH), a country-level index built applying sentiment analysis to data from Twitter. Our aim is to describe how GNH changed during the pandemic within countries, to assess its validity as a measure of well-being, and to analyse its correlates. We take advantage of a unique data-set made of daily observations about GNH, generalized trust and trust in national institutions, fear concerning the economy, loneliness, infection rate, policy stringency and distancing. To assess the validity of data sourced from Twitter, we exploit various sources of survey data, such as Eurobarometer and consumer satisfaction, and big data, such as Google Trends. Results indicate that sentiment analysis of Tweets an provide reliable and timely information on well-being. This can be particularly useful to timely inform decision-making. |
| Keywords: | happiness,Covid-19,Big Data,Twitter,Sentiment Analysis,well-being,public policy,trust,fear,loneliness |
| JEL: | C55 I10 I31 H12 |
| Date: | 2021 |
| URL: | http://d.repec.org/n?u=RePEc:zbw:glodps:831&r= |
| By: | Mayvis Rebeira; Eric Nauenberg |
| Abstract: | The economic stimulus package in the United States, which totaled $2.48 trillion, was designed to soften the economic impact of sweeping containment measures including shelter-in-place orders that were put in place to control the COVID-19 pandemic. In healthcare, interventions are rarely justified simply in terms of the number of lives saved but also in terms of a myriad of other trade-off factors including value-for-money or cost-effectiveness. The data suggest the incremental costs per life-year gained related to the economic shutdown can span a wide range depending on the baseline number of deaths in the absence of any containment measures. The results show that in the US, under no scenario for life-years gained does the stimulus package compare favourably to other healthcare interventions that have had favourable cost-effectiveness profiles. However, when comparing value-of-statistical-life-year (VSLY) threshold measures used in other sectors, it is plausible that the stimulus package could be viewed more favourably in the US. |
| Keywords: | cost-effectiveness, economic stimulus, pandemic, COVID-19, trade-offs |
| Date: | 2021–04 |
| URL: | http://d.repec.org/n?u=RePEc:cch:wpaper:210003&r= |
| By: | Niermann, Lennart; Pitterle, Ingo A. |
| Abstract: | The COVID-19 pandemic has caused the most universal health and socio-economic crisis in recent history. However, the magnitude of the economic damage has differed widely; some countries were hit particularly hard, while others have managed to weather the storm much better. In this paper, we employ a cross-country analysis to identify factors that help explain the differences in the growth impact of the COVID-19 shock. Our findings underscore the critical role of balancing health and economic concerns in managing the pandemic as both a country’s exposure to the coronavirus and the stringency of containment measures are strongly correlated with its growth performance. In addition, our results shed light on several aspects of economic resilience. Good governance, provision of fiscal support and strong macroeconomic fundamentals all helped cushion the economic impact. By contrast, a lack of economic diversification – reflected in overreliance on the tourism sector or oil production – has significantly amplified the shock. |
| Keywords: | COVID-19; growth performance; transmission of shocks; economic resilience |
| JEL: | E61 E66 H12 H51 H63 I15 I18 O11 O47 |
| Date: | 2021–04 |
| URL: | http://d.repec.org/n?u=RePEc:pra:mprapa:107414&r= |
| By: | Stephen D. Younger; Albert Musisi; Wilson Asiimwe; Nicole Ntungire; Jakob Rauschendorfer; Priya Manwaring |
| Abstract: | The recent COVID-19 pandemic has come at an overwhelming cost to both developed and developing countries; Uganda is no exception. Despite having relatively few cases, the pandemic’s indirect effects arising from an economic contraction and global recession, as well as the direct effects through ill health and death, are likely to have a devastating impact on poverty levels and people’s livelihoods. This paper aims to forecast the distributional consequences of the crisis in terms of its effects on poverty and inequality, and to understand how certain policy responses to the crisis might help to offset those effects. Our findings indicate that the income losses from the crisis are severe, erasing poverty gains of the past 10 years, and reaching well beyond Kampala. Using household-level information from the 2016/17 Uganda National Household survey, we explore four different transfer schemes that the government might use to offset the poverty consequences of the crisis: (i) a universal transfer to all households based on their adult equivalence size, but excluding households with income from employment in the public sector or a public sector pension; (ii) a transfer of the same size as in (i), but targeted to only those households that were poor before the crisis began; (iii) an expansion of the SAGE grant to all those 65 years old and older; and (iv) a labor-intensive public works program directed at the hardest hit urban areas. |
| Keywords: | COVID-19, inequality, poverty, mobility, microsimulations, Africa, Uganda |
| JEL: | C63 D31 I32 I38 |
| Date: | 2020–11 |
| URL: | http://d.repec.org/n?u=RePEc:tul:ceqwps:110&r= |
| By: | Ainaa, Carmen; Brunetti, Irene; Mussida, Chiara; Scicchitano, Sergio |
| Abstract: | This paper investigates what happened to the wage distribution in Italy during the first wave of the COVID-19 pandemic. It shows which categories of workers and economic sectors have suffered more than others and to what extent both the actual level of smart-working and the ability to Working From-Home can influence the wage distribution. We use a unique dataset relying on the merging of two sample surveys: the Italian Labor Force Survey set up by National Institute of Statistics and the Italian Survey of Professions conducted by the National Institute for Public Policy Analysis. We estimate quantile regression models accounting for selection. First, the findings reveal that the pandemic has affected the wages of the whole workers, but the effect is higher at the bottom of the wage distribution. Second, the actual working from home mitigates the negative distributional consequences of the COVID-19 observed for those at the bottom of the wage distribution. However, the advantage of workers at the bottom tail of the wage distribution seems to lessen in the long term once the health emergency is passed. Third, looking at sectoral heterogeneity, retail and the restaurant are the most hit sectors in terms of wage loss. Fourth, separating by gender, men have been mostly hit by the pandemic, particularly at lowest deciles, though they benefited more from working at home at higher deciles. Finally, women appear as the one that in the long run would benefit more from increasing working from home possibility. |
| Keywords: | Wage inequality,COVID-19,Working from home,Quantile regression |
| Date: | 2021 |
| URL: | http://d.repec.org/n?u=RePEc:zbw:glodps:829&r= |
| By: | Gohl, Niklas (DIW Berlin and Potsdam University); Haan, Peter (DIW Berlin and FU Berlin); Kurz, ElisabethWeinhardt, Felix (DIW Berlin, CESifo, IZA, CEP/LSE) |
| Abstract: | In this paper we present a life-cycle model with human capital investment during working life through training and provide a novel empirical test of human capital theory. Using a sizable pension reform which shifts the retirement age between two adjacent cohorts by three years, we document causal evidence that an increase in the working life increases investment into human capital through training. We estimate this effect using a regression discontinuity design based on a large sample from the German microcensus. We discuss and test further predictions regarding the relation between initial schooling, training, and the reform effect and show that only individuals with a college degree increase human capital investment. Our results speak to a large class of human capital models as well as policies extending or shortening working life. |
| Keywords: | human capital; retirement policies; RDD; |
| JEL: | J24 J26 H21 |
| Date: | 2019–12–11 |
| URL: | http://d.repec.org/n?u=RePEc:rco:dpaper:212&r= |
| By: | Geoffrey T. Sanzenbacher |
| Abstract: | The discussion proceeds as follows. The first section describes the CPS data. The second section presents the results for those ages 50-61, and the third section presents the results for those 62+. The final section concludes that, not surprisingly, recessions generally hit low earners harder than high earners. And, for low earners as a group, the COVID Recession was slightly worse than the Great Recession. Interestingly, the oldest high earners (ages 62+) did worse in the COVID Recession than they did in the Great Recession, both in terms of general labor force exits and outright retirement. |
| Date: | 2021–04 |
| URL: | http://d.repec.org/n?u=RePEc:crr:issbrf:ib2021-07&r= |
| By: | Kristensen, Frederikke Frehr (University of Southern Denmark); Sharp, Paul (University of Southern Denmark and CAGE) |
| Abstract: | The importance of testing and reporting has frequently been stated during the COVID-19 pandemic, but studies on the effectiveness of surveillance are still lacking. We thus turn to the last great epidemic, HIV/AIDS. In 1985 the first blood test for HIV became available, but prior to 1996 no effective medical treatment was available. We exploit the differential rollout of HIV surveillance across US states between 1985 and 2008 and find that HIV reporting helped reduce both AIDS cases and mortality. After the introduction of the effective treatment, HAART, there is no longer a significant effect on mortality, but the effect on reducing cases remains. For blacks, however, the impact on mortality is apparent even after 1996. Surveillance is therefore an important tool for combating epidemics, even in the presence of effective treatments, perhaps due to its impact on the avoidance of risky behavior. |
| Keywords: | AIDS, HIV, surveillance, United States JEL Classification: I18, J18, N32 |
| Date: | 2021 |
| URL: | http://d.repec.org/n?u=RePEc:cge:wacage:553&r= |
| By: | Bettina Siflinger; Michaela Paffenholz; Sebastian Seitz; Moritz Mendel; Hans-Martin von Gaudecker |
| Abstract: | Since the start of the CoViD-19 pandemic, a major source of concern has been its effect on mental health. Using pre-pandemic information and five customized questionnaires in the Dutch LISS panel, we investigate how mental health in the working population has evolved along with the most prominent risk factors associated with the pandemic. Overall, mental health decreased sharply with the onset of the first lockdown but recovered fairly quickly. In December 2020, levels of mental health are comparable to those in November 2019. We show that perceived risk of infection, labor market uncertainty, and emotional loneliness are all associated with worsening mental health. Both the initial drop and subsequent recovery are larger for parents of children below the age of 12. Among parents, the patterns are particularly pronounced for fathers if they shoulder the bulk of additional care. Mothers' mental health takes a particularly steep hit if they work from home and their partner is designated to take care during the additional hours. |
| Keywords: | COVID-19, mental health, gender inequality, lockdown |
| JEL: | I10 I14 I18 I30 J22 |
| Date: | 2021–04 |
| URL: | http://d.repec.org/n?u=RePEc:bon:boncrc:crctr224_2021_271&r= |
| By: | Maria Tresita V. Paul; Uma N. Devi |
| Abstract: | COVID-19 pandemic has shaken the roots of healthcare facilities worldwide, with the US being one of the most affected countries irrespective of being a superpower. Along with the current pandemic, COVID-19 can cause a secondary crisis of mental health pandemic if left unignored. Various studies from past epidemics, financial turmoil and pandemic, especially SARS and MERS, have shown a steep increase in mental and psychological issues like depression, low quality of life, self-harm and suicidal tendencies among general populations. The most venerable being the individuals infected and cured due to social discrimination. The government is taking steps to contain and prevent further infections of COVID-19. However, the mental and psychological wellbeing of people is still left ignored in developing countries like India. There is a significant gap in India concerning mental and psychological health still being stigmatized and considered 'non-existent'. This study's effort is to highlight the importance of mental and psychological health and to suggest interventions based on positive psychology literature. These interventions can support the wellbeing of people acting as a psychological first aid. Keywords: COVID-19, Coronavirus, Pandemic, Mental wellbeing, Psychological Wellbeing, Positive Psychology Interventions. |
| Date: | 2021–04 |
| URL: | http://d.repec.org/n?u=RePEc:arx:papers:2104.11726&r= |
| By: | Seres, Gyula (HU Berlin); Balleyer, Anna Helen (University of Groningen); Cerutti, Nicola (Berlin School of Economics and Law); Danilov, Anastasia (HU Berlin); Friedrichsen, Jana (DIW and HU Berlin); Liu, Yiming (HU and WZB Berlin); Süer, Müge (HU Berlin) |
| Abstract: | Governments across the world have implemented restrictive policies to slow the spread of COVID-19. Recommended face mask use has been a controversially discussed policy, among others, due to potential adverse effects on physical distancing. Using a randomized field experiment (N=300), we show that individuals keep a significantly larger distance from someone wearing a face mask than from an unmasked person. According to an additional survey experiment (N=456), masked individuals are not perceived as being more infectious than unmasked ones, but they are believed to prefer more distancing. This result suggests that, in times where mask use is voluntary, wearing a mask serves as a social signal for a preferred greater distance that is respected by others. Our findings provide strong evidence against the claim that mask use creates a false sense of security that would negatively affect physical distancing. |
| Keywords: | COVID-19; health policy; compliance; face masks; risk compensation; field experiment; |
| JEL: | C93 I12 |
| Date: | 2020–08–14 |
| URL: | http://d.repec.org/n?u=RePEc:rco:dpaper:253&r= |
| By: | Clemens Fuest; Lea Immel; Florian Neumeier; Andreas Peichl |
| Abstract: | Information provided by experts is widely believed to play a key role in shaping attitudes towards policy responses to the COVID-19 pandemic. This paper uses a survey experiment to assess whether providing citizens with expert information about the health risk of COVID-19 and the economic costs of lockdown measures affects their attitudes towards these policies. Our findings show that providing respondents with information about COVID-19 fatalities among the elderly raises support for lockdown measures, while information about their economic costs decreases support. However, different population subgroups react very differently. Men and younger respondents react more sensitively to information about lockdown costs, while women and older respondents are more susceptible towards information regarding fatality rates. Strikingly, the impact of the information treatment is entirely driven by West German respondents, while East Germans do not react. Finally, our results are entirely driven by respondents who underestimate the fatality of COVID-19, who represent a clear majority. |
| Keywords: | Corona, Covid-19, pandemic, lockdown, survey experiment, Germany |
| JEL: | H12 I10 I18 |
| Date: | 2021 |
| URL: | http://d.repec.org/n?u=RePEc:ces:ceswps:_9024&r= |
| By: | Hideki Toya; Mark Skidmore |
| Abstract: | Over the last year the world experienced the COVID-19 pandemic coupled with unprecedented policy responses. In this paper we examine the determinants of COVID-19 infections and fatalities in a cross-country analysis. We find that countries with greater income, less dense and greater elderly populations, fewer hospital beds, and more freedom experienced greater fatalities, and that travel restrictions and use of hydroxychloroquine reduced deaths. However, we find little evidence that lockdowns reduced fatalities, and though use of PCR testing resulted in more recorded infections, it was unassociated with fatalities. |
| Keywords: | pandemic, Covid-19, fatalities |
| JEL: | O10 O20 Q54 |
| Date: | 2021 |
| URL: | http://d.repec.org/n?u=RePEc:ces:ceswps:_9028&r= |
| By: | Fiona Burlig; Anant Sudarshan; Garrison Schlauch |
| Abstract: | Domestic mobility restrictions to control the spread of COVID-19 are widespread in developing countries, and have trapped millions of migrant workers in hotspot cities. We show that bans can increase cumulative infections relative to a counterfactual sans restrictions. A SEIR model shows bans’ impacts are nonlinear in duration. We empirically test this hypothesis using a natural experiment in India as well as data from China, Indonesia, the Philippines, South Africa, and Kenya. Although very short and long restrictions limit the spread of disease, moderately lengthy restrictions substantially increase infections. This underscores the importance of considering duration in mobility-restricting policy decisions in developing countries. |
| JEL: | I18 J60 O12 |
| Date: | 2021–04 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:28699&r= |