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on Health Economics |
| By: | Hunt Allcott; Matthew Gentzkow; Lena Song |
| Abstract: | Many have argued that digital technologies such as smartphones and social media are addictive. We develop an economic model of digital addiction and estimate it using a randomized experiment. Temporary incentives to reduce social media use have persistent effects, suggesting social media are habit forming. Allowing people to set limits on their future screen time substantially reduces use, suggesting self-control problems. Additional evidence suggests people are inattentive to habit formation and partially unaware of self-control problems. Looking at these facts through the lens of our model suggests that self-control problems cause 31 percent of social media use. |
| JEL: | D12 D61 D90 D91 I31 L86 O33 |
| Date: | 2021–06 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:28936&r= |
| By: | Dolan, Paul (London School of Economics); Krekel, Christian (London School of Economics); Shreedhar, Ganga (London School of Economics); Lee, Helen (National Health Service); Marshall, Claire (National Health Service); Smith, Allison (Royal Voluntary Service) |
| Abstract: | There is a strong suggestion from the existing literature that volunteering improves the wellbeing of those who give up their time to help others, but much of it is correlational and not causal. In this paper, we estimate the wellbeing benefits from volunteering for England's National Health Service (NHS) Volunteer Responders programme, which was set up in response to the Covid-19 pandemic. Using a sample of over 9,000 volunteers, we exploit the oversubscription of the programme and the random assignment of volunteering tasks to estimate causal wellbeing returns, across multiple counterfactuals. We find that active volunteers report significantly higher life satisfaction, feelings of worthwhileness, social connectedness, and belonging to their local communities. A social welfare analysis shows that the benefits of the programme were at least 140 times greater than its costs. Our findings advance our understanding of the ways in which pro-social behaviours can improve personal wellbeing as well as social welfare. |
| Keywords: | subjective wellbeing, volunteering, pro-social action, quasi-natural experiment, social welfare analysis, COVID-19 |
| JEL: | I31 I38 D61 D64 |
| Date: | 2021–05 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp14431&r= |
| By: | Ari Bronsoler; Jonathan Gruber; Enrique Seira |
| Abstract: | There are ongoing debates around the world over the value of private supplements to public health insurance systems. We investigate this issue in the context of one of the world’s deadliest diseases, diabetes, and one of the countries with the worst diabetes problems in the world, Mexico. We implement a novel deniers randomization approach to cost-effectively provide a causal estimate of enrollment in private supplement to the free public health system. Our final sample of more than 1000 diabetics randomized into a large price subsidy for enrollment in the private plan is well balanced. We estimate enormous impacts of the private supplement, with HbA1c blood sugar levels falling by a full point (relative to a control mean of 8.5%), and to increase the share of those treated who are under control by 69%. We show that this effect arises through both improved treatment compliance and health behaviors, and that diabetes complications fall even in the short run. The net costs of this intervention are at most one-third of the gross costs due to offsetting public sector savings, and the health benefits are many multiples of gross costs. But the returns to private care do not appear to reflect more productive delivery of care per visit, which is comparable in a separate quasi-experimental analysis of public insurance; rather, effects arise through more attachment to medical care in the private alternative. |
| JEL: | H11 H51 I11 |
| Date: | 2021–06 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:28913&r= |
| By: | Mark Duggan; Craig Garthwaite; Adelina Yanyue Wang |
| Abstract: | State governments face the classic “make or buy” decision for the provision of Medicaid services. Over the past two decades, the majority of states have outsourced the provision of social health insurance through Medicaid Managed Care (MMC) programs. These programs have been extensively studied in the literature – with little evidence of large positive or negative effects. However, most states initially allowed older and sicker enrollees to remain enrolled in the government run fee for service (FFS) programs. It is possible that these more fragile enrollees could have a different experience in managed care. In this paper we study California’s mandatory enrollment of the senior and persons with disabilities (SPD) population in MMC. We find this mandatory enrollment caused an increased use of the emergency department and transfers between hospitals. This was not simply a hassle cost for enrollees – we also estimate an increase in mortality for the affected population. These effects were strongest for the sickest enrollees – the types of enrollees that might be expected to have a different experience with managed care. Our results suggest the adverse impact of MMC varies by the enrollee health, which should inform the optimal outsourcing decision for governments. |
| JEL: | H0 H1 I1 I10 I13 I18 |
| Date: | 2021–06 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:28944&r= |
| By: | Manasi Deshpande; Lee Lockwood |
| Abstract: | The public debate over disability insurance has centered on concerns about individuals without severe health conditions receiving benefits. We go beyond health risk alone to quantify the overall insurance value of U.S. disability programs, including value from insuring non-health risk. We find that disability recipients, especially those with less-severe health conditions, are much more likely to have experienced a wide variety of non-health shocks than non-recipients. Selection into disability receipt on the basis of non-health shocks is so strong among individuals with less-severe health conditions that by many measures less-severe recipients are worse off than more-severe recipients. As a result, under baseline assumptions, benefits to less-severe recipients have an annual surplus value (insurance benefit less efficiency cost) over cost-equivalent tax cuts of $7,700 per recipient, about three-fourths that of benefits to more-severe recipients ($9,900). Insurance against non-health risk accounts for about one-half of the value of U.S. disability programs. |
| JEL: | H5 I3 |
| Date: | 2021–05 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:28852&r= |
| By: | Janet Currie; Jonathan Zhang |
| Abstract: | This paper uses data from 802,777 veterans assigned to 7,548 primary care providers (PCPs) within the Veterans Health Administration (VHA) to examine variations in the efficacy of primary care providers (PCPs), their consequences for health outcomes, and their determinants. Leveraging quasi-random assignment of veterans to PCPs, we measure PCP effectiveness along three dimensions: the probability their patients have subsequent hospitalizations or emergency department (ED) visits for mental health conditions, circulatory conditions, or a hospitalization for ambulatory care sensitive conditions (ACSC). We find a significant range in these effectiveness measures across PCPs. For example, a one standard deviation improvement in our measure of mental health effectiveness predicts a 0.21 percentage point (3.8%) lower risk of patient death over the next three years and 4.4% lower total costs. We also find moderate correlations between the three metrics, indicating that doctors who are effective at treating one type of condition also tend to be more effective in treating others. Our strongest conclusion is that more effective PCPs do more with less: Their patients have fewer primary care visits, referrals to specialists, lab panels or imaging tests. Effective PCPs are slightly more likely to comply with guidelines for mental health screenings, and slightly less likely to comply with guidelines for physical health screenings, but these differences in screening propensities are negligible in magnitude. |
| JEL: | I1 J24 |
| Date: | 2021–06 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:28929&r= |
| By: | Yoshida, Jun |
| Abstract: | Many couples have had unsuccessful fertility treatments. In 2009, the U.K. government launched an online service to provide patients with the success rates of individual clinics. I use anonymized individual patient data between 1991 and 2016 with the instrumental variable technique to investigate whether the disclosure of success rates induces patients to move to a new clinic, resulting in improved treatment outcomes. I find four main results. (i) The disclosure increases the probability that a patient moves to a new clinic. (ii) The greater the number of treatment cycles a patient has previously had, the greater the probability of moving to a new clinic. (iii) When moving to a new clinic, a patient aged over 40 has a higher probability of getting one or more transferable embryos in one treatment cycle, while a patient aged under 39 has a low probability. (iv) Regardless of age, patients who have had five or more treatments have a higher probability of obtaining an embryo in a single treatment cycle. These results suggest that public disclosure of information can facilitate efficient matching between clinics and patients over the age of 40 who have had unsuccessful IVF attempts, resulting in higher success rates. |
| Keywords: | In Vitro Fertilization, Information disclosure, Patient behavior, Success rates, instrumental variable |
| JEL: | D8 I12 I18 |
| Date: | 2021–05–01 |
| URL: | http://d.repec.org/n?u=RePEc:pra:mprapa:108441&r= |
| By: | Haizhen Lin; Ian M. McCarthy; Michael R. Richards |
| Abstract: | The organizational structure of U.S. health care has changed dramatically in recent years, with nearly half of physicians now employed by hospitals. This trend toward increasing vertical alignment between physicians and hospitals may alter physician behavior relative to physicians remaining in independent or group practices. We examine the effects of such vertical alignment using an instrumental variable strategy and a clinical context facilitating well-defined episodes of care. We find relatively modest positive effects (point estimates of 7% or lower) on total Medicare payments per episode, characterized by an increase in billable activity among other integrated physicians alongside a large decrease in activity among non-integrated providers. Acquiring hospitals ultimately capture more revenue following a physician practice acquisition; yet, the smaller overall bundle of care generates no net savings to Medicare due to location-based payment rules favorable to hospitals. |
| JEL: | H51 I11 I18 |
| Date: | 2021–05 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:28859&r= |
| By: | Mohamed Ali Ben Halima (LIRSA - Laboratoire interdisciplinaire de recherche en sciences de l'action - CNAM - Conservatoire National des Arts et Métiers [CNAM], CEET - Centre d'études de l'emploi et du travail - CNAM - Conservatoire National des Arts et Métiers [CNAM] - M.E.N.E.S.R. - Ministère de l'Education nationale, de l’Enseignement supérieur et de la Recherche - Ministère du Travail, de l'Emploi et de la Santé, TEPP - Travail, Emploi et Politiques Publiques - CNRS - Centre National de la Recherche Scientifique - UPEM - Université Paris-Est Marne-la-Vallée); Nathalie Greenan (LIRSA - Laboratoire interdisciplinaire de recherche en sciences de l'action - CNAM - Conservatoire National des Arts et Métiers [CNAM], CEET - Centre d'études de l'emploi et du travail - CNAM - Conservatoire National des Arts et Métiers [CNAM] - M.E.N.E.S.R. - Ministère de l'Education nationale, de l’Enseignement supérieur et de la Recherche - Ministère du Travail, de l'Emploi et de la Santé, TEPP - Travail, Emploi et Politiques Publiques - CNRS - Centre National de la Recherche Scientifique - UPEM - Université Paris-Est Marne-la-Vallée); Joseph Lanfranchi (LEMNA - Laboratoire d'économie et de management de Nantes Atlantique - IEMN-IAE Nantes - Institut d'Économie et de Management de Nantes - Institut d'Administration des Entreprises - Nantes - UN - Université de Nantes - IUML - FR 3473 Institut universitaire Mer et Littoral - UBS - Université de Bretagne Sud - UM - Le Mans Université - UA - Université d'Angers - CNRS - Centre National de la Recherche Scientifique - IFREMER - Institut Français de Recherche pour l'Exploitation de la Mer - UN - Université de Nantes - ECN - École Centrale de Nantes, CEET - Centre d'études de l'emploi et du travail - CNAM - Conservatoire National des Arts et Métiers [CNAM] - M.E.N.E.S.R. - Ministère de l'Education nationale, de l’Enseignement supérieur et de la Recherche - Ministère du Travail, de l'Emploi et de la Santé) |
| Abstract: | The article evaluates the impact of organisational changes on long-term sickness absence. We use a unique dataset matching a company level survey on computerisation and organisational changes with an administrative file allowing to follow up health issues in the working population. We implement a difference in difference approach using two time windows: a three years' time period after changes have occurred and another one during the implementation of changes. Guided by the perspective that organisations change through the implementation of new tools and practices, we consider Information and Communication Technologies (ICTs) on one hand and management tools on the other. This allows to identify three treatments according to the sets of tools implemented by companies: ICT changes only, management changes only, both ICT and management changes. We find the following core result: changes in the management dimension alone reduce long-term sickness absences when joint changes in ICT and management tools increase occupational risks. There are however gendered differences in the timing and strength of impacts as women are mainly impacted during the period when changes are implemented and impacts are stronger while men are impacted afterwards. Also, older employees seem protected against the serious health consequences of any form of changes. These results point to the need to better understand the process of organisational change (its complexity, intensity, dynamics), the gendered construction of health behaviours as well as that of technology and management tools uses in devising occupational safety and health policies targeted at evolving work environments. |
| Keywords: | organisational change,information and communication technologies,long-term sickness absence,gender and age behaviour |
| Date: | 2021–05–31 |
| URL: | http://d.repec.org/n?u=RePEc:hal:wpaper:hal-03243494&r= |
| By: | Davide Cerruti (CER–ETH – Center of Economic Research at ETH Zurich, Switzerland); Massimo Filippini (CER–ETH – Center of Economic Research at ETH Zurich and Facoltà di Scienze Economiche, Università della Svizzera Italiana, Switzerland) |
| Abstract: | Vehicle accidents represent an important source of externalities from driving. Using a detailed dataset on accident location and characteristics in Switzerland, we estimate the effect of switching from a 50 km/h speed limit to a 30 km/h limit on the probability of vehicle accident injuries. After an initial country-wide analysis, we exploit the quasi-experimental variation of the timing of introduction of 30 km/h zones in the municipality of Basel, using a difference in differences strategy. We find a significant reduction in accident severity due to lower speed limits, and substantial heterogeneities based on the circumstances of the accident. |
| Keywords: | Speed limits; vehicle accidents; 30 km/h zones; externalities; road transport; urban roads |
| JEL: | R41 R42 R48 H41 |
| Date: | 2021–06 |
| URL: | http://d.repec.org/n?u=RePEc:eth:wpswif:21-356&r= |
| By: | Mark Duggan; Irena Dushi; Sookyo Jeong; Gina Li |
| Abstract: | The delayed retirement credit (DRC) increases monthly OASI (Old Age and Survivors Insurance) benefits for primary beneficiaries who claim after their full retirement age (FRA). For many years, the DRC was set at 3.0 percent per year (0.25 percent monthly). The 1983 amendments to Social Security more than doubled this actuarial adjustment to 8.0 percent per year. These changes were phased in gradually, so that those born in 1924 or earlier retained a 3.0 percent DRC while those born in 1943 or later had an 8.0 percent DRC. In this paper, we use administrative data from the Social Security Administration (SSA) to estimate the effect of this policy change on individual claiming behavior. We focus on the first half of the DRC increase (from 3.0 to 5.5 percent) given changes in other SSA policies that coincided with the later increases. Our findings demonstrate that the increase in the DRC led to a significant increase in delayed claiming of social security benefits and strongly suggest that the effects were larger for those with higher lifetime incomes, who would have a greater financial incentive to delay given their longer life expectancies. |
| JEL: | H55 |
| Date: | 2021–06 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:28919&r= |
| By: | Mariacristina De Nardi; Eric French; John Bailey Jones; Rory McGee |
| Abstract: | While the savings of retired singles tend to fall with age, those of retired couples tend to rise. We estimate a rich model of retired singles and couples with bequest motives and uncertain longevity and medical expenses. Our estimates imply that while medical expenses are an important driver of the savings of middle-income singles, bequest motives matter for couples and high-income singles, and generate transfers to non-spousal heirs whenever a household member dies. The interaction of medical expenses and bequest motives is a crucial determinant of savings for all retirees. Hence, to understand savings, it is important to model household structure, medical expenses, and bequest motives. |
| Keywords: | Couples; Singles; Savings; Medical expenses; Bequest motives |
| JEL: | D15 D31 E21 H31 |
| Date: | 2021–05–25 |
| URL: | http://d.repec.org/n?u=RePEc:fip:fedmoi:92751&r= |
| By: | Myers, Caitlin Knowles (Middlebury College) |
| Abstract: | I implement event study and difference-in-differences research designs to measure the causal effects of mandatory waiting periods for abortions, distinguishing between "one- trip" waiting periods that allow counseling and information to be provided remotely and "two-trip" waiting periods that require two in-person appointments. The results suggest that one-trip waiting periods do not have substantial effects on abortions or births. Two-trip waiting periods are estimated to reduce abortions and delay those that still occur, increasing second trimester abortions by 19.1%, reducing resident abortion rates by 8.9%, and increasing births by 1.5%. These effects are larger for young women and for women of color. These effects also are larger in counties that are far from abortion providers and in counties with high poverty and unemployment. These findings support a "burden" rather than a "cooling-off period" interpretation of the findings. |
| Keywords: | mandatory waiting periods, abortions, births |
| JEL: | I11 I12 J13 |
| Date: | 2021–06 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp14434&r= |
| By: | Adriana Corredor-Waldron; Janet Currie |
| Abstract: | The continuing drug overdose crisis in the U.S. has highlighted the urgent need for greater access to treatment. This paper examines the impact of openings and closings of substance abuse treatment facilities in New Jersey on emergency room visits for substance abuse issues among nearby residents. We find that drug-related ER visits increase by 16.6% after a facility closure and decrease by 9.5% after an opening. The effects are largest in relatively under-served areas, among Black residents, and among males. They are smaller for the middle aged than for either younger or older people. The results suggest that expanding access to treatment results in significant reductions in morbidity related to drug abuse. |
| JEL: | I12 |
| Date: | 2021–05 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:28862&r= |
| By: | David M. Cutler; Edward L. Glaeser |
| Abstract: | The fivefold increase in opioid deaths between 2000 and 2017 rivals even the COVID-19 pandemic as a health crisis for America. Why did it happen? Measures of demand for pain relief – physical pain and despair – are high but largely unchanging. The primary shift is in supply, primarily of new forms of allegedly safer narcotics. These new pain relievers flowed mostly to areas with more pain, but since their apparent safety was an illusion, opioid deaths followed. By the end of the 2000s, restrictions on legal opioids led to further supply-side innovations which created the burgeoning illegal market that accounts for the bulk of opioid deaths today. Because opioid use is easier to start than end, America’s opioid epidemic is likely to persist for some time. |
| JEL: | I0 J1 |
| Date: | 2021–05 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:28873&r= |
| By: | Marcus Dillender |
| Abstract: | HIV/AIDS has been one of the largest public health crises in recent history, and the U.S. federal government has spent hundreds of billions of dollars fighting the disease. This study examines the impact of federal funding allocated to U.S. cities through the Ryan White CARE Act, which is the largest program for combating HIV/AIDS in the United States. The empirical approach identifies the impact of the funding by studying funding variation that comes from Ryan White policy features that resulted in large funding differences among cities that were originally on parallel HIV/AIDS trajectories and finds that Ryan White's city-level funding has improved HIV/AIDS outcomes in the cities receiving the funds. The estimates indicate that one HIV/AIDS death has been avoided for every $314,000 allocated through the program and that the program has saved approximately 60,000 lives through 2018. The estimates also indicate that funding differences across cities have contributed to the uneven progress in combating HIV/AIDS across the United States. |
| JEL: | H51 I14 I18 |
| Date: | 2021–05 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:28867&r= |
| By: | Ranasinghe, Ashantha (University of Alberta, Department of Economics); Su, Xuejuan (University of Alberta, Department of Economics) |
| Abstract: | We develop a mixed duopoly model with quality-differentiated products. The public firm chooses its product quality and offers it for free to eligible individuals as a form of social assistance to maximize consumer welfare, while the private firm chooses both the product quality and price to maximize profit. We first characterize the pattern of market segmentation for given product offerings, highlighting the non-monotonic relationship between market participation and individual income. We then calibrate the model to health insurance for the U.S. working-age population, with Medicaid acting as the public firm. We examine the distributional implications of policy changes, both actual and hypothetical, that lead to various degrees of public program expansion. Despite potentially significant inefficiency of the public firm, the overall effect of its expansion is welfare improving. Central to these findings is the significant market power enjoyed by the private firm that results in high profit margins if left unchecked. As more individuals become eligible for the public program, the resulting increase in competitive pressure disciplines the private firm’s ability to exercise market power. |
| Keywords: | mixed duopoly; quality differentiation; public provision of private goods; funding of public services; distribution |
| JEL: | D21 D43 H11 H42 H44 I00 L38 |
| Date: | 2021–06–23 |
| URL: | http://d.repec.org/n?u=RePEc:ris:albaec:2021_001&r= |
| By: | Krekel, Christian (London School of Economics); De Neve, Jan-Emmanuel (University of Oxford); Fancourt, Daisy (University College London); Layard, Richard (London School of Economics) |
| Abstract: | Despite a wealth of research on its correlates, relatively little is known about how to effectively raise wellbeing in local communities by means of intervention. Can we teach people to live happier lives, cost-effectively and at scale? We conducted a randomised controlled trial of a scalable social-psychological intervention rooted in self-determination theory and aimed at raising the wellbeing and pro-sociality of the general adult population. The manualised course ("Exploring What Matters") is run by non-expert volunteers (laypeople) in their local communities and to date has been conducted in more than 26 countries around the world. We found that it has strong, positive causal effects on participants' subjective wellbeing and pro-sociality (compassion and social trust) while lowering measures of mental ill health. The impacts of the course are sustained for at least two months post-treatment. We compare treatment to other wellbeing interventions and discuss limitations and implications for intervention design, as well as implications for the use of wellbeing as an outcome for public policy more generally. |
| Keywords: | wellbeing, pro-social behaviour, communities, intervention, RCT |
| JEL: | C93 I12 I31 |
| Date: | 2021–06 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp14447&r= |
| By: | Margaris, Panagiotis; Wallenius, Johanna |
| Abstract: | In this paper we develop and estimate a life cycle model that features pecuniary and non-pecuniary investments in health, along with a cognitive ability gradient associated with said investments, in order to rationalize the socioeconomic gradients in health and life expectancy in the United States. Agents accumulate health capital, which affects the level of utility, labor productivity, the distribution of medical spending shocks and life expectancy. We find that the cognitive ability gradient to health investments and the differences in lifetime income account for the lion's share of the observed life expectancy gap. Providing universal health insurance coverage has heterogeneous effects, depending on the progressivity of the financing mechanism, and at best results in a modest decrease in the life expectancy gap. |
| Keywords: | health; inequality; Life Cycle; time use |
| JEL: | D31 E21 I14 |
| Date: | 2020–05 |
| URL: | http://d.repec.org/n?u=RePEc:cpr:ceprdp:14796&r= |
| By: | Fink Simonsen, Nicolai (University of Southern Denmark, DaCHE - Danish Centre for Health Economics); Kjær, Trine (University of Southern Denmark, DaCHE - Danish Centre for Health Economics) |
| Abstract: | It is standard practice in the literature to assume that an individual’s marginal utility of consumption is independent of health status. If this assumption is not met, it could have important implications for welfare economic analyses. The aim of this paper is to provide new, more comprehensive empirical evidence of state dependence following the approach used by Finkelstein et al. (2013). We use a rich combination of longitudinal survey data and administrative register data. Survey data were obtained from the Survey of Health, Ageing and Retirement in Europe (SHARE) and combined with data from the comprehensive Danish registers, including individual income data and data on health care utilisation based on the universal ICD-10 classification system. Utility is measured in terms of subjective well-being attained from the SHARE survey. To further increase the power of our sample, we used a state-of-the-art prediction algorithm to enrich the register data with information on subjective well-being. With this approach, this paper also makes a general methodological contribution on the use of prediction models for data enrichment and imputation. We define a reduced form equation in which individual subjective well-being is regressed according to income and health with an interaction effect capturing state dependence. Our results show evidence of negative state dependence. From our baseline regression, the estimated magnitude suggests that marginal utility of consumption decreases by 14.6% when an individual becomes sick. The results are robust to different levels of risk aversion and to assumptions regarding the mapping of the latent utility onto observed utility. |
| Keywords: | utility; health risk; consumption |
| JEL: | C53 D12 I10 J14 |
| Date: | 2021–06–15 |
| URL: | http://d.repec.org/n?u=RePEc:hhs:sduhec:2021_002&r= |
| By: | Juan Pablo Atala; José Ignacio Cuesta; Felipe González; Cristóbal Otero |
| Abstract: | We study the economic and political effects of competition by state-owned firms, leveraging the decentralized entry of public pharmacies to local markets in Chile around local elections. Public pharmacies sell drugs at a third of private pharmacy prices, because of a stronger upstream bargaining position and downstream market power in the private sector, but are also of lower quality. Exploiting a field experiment and quasiexperimental variation, we show that public pharmacies affected consumer shopping behavior, inducing market segmentation and price increases in the private sector. This segmentation created winners and losers, as consumers who switched to public pharmacies benefited, whereas consumers who stayed with private pharmacies were harmed. The countrywide entry of public pharmacies would reduce yearly consumer drug expenditure by 1.6 percent, which outweighs the costs of the policy by 52 percent. Mayors that introduced public pharmacies received more votes in the subsequent election, particularly by the target population of the policy. |
| Date: | 2021 |
| URL: | http://d.repec.org/n?u=RePEc:ioe:doctra:561&r= |
| By: | Rena M. Conti; Brigham Frandsen; Michael L. Powell; James B. Rebitzer |
| Abstract: | In the U.S., pharmacy benefit managers (PBMs) manage prescription drug purchases for payers. Firms selling branded pharmaceuticals bid for preferred slots on the PBM's formulary by offering rebates off of list price. We find that PBMs enhance efficiency, but the gains do not accrue to consumers or drug makers. Our analysis offers insights into otherwise puzzling questions. Why do drug makers pay rebates to PBMs? Why do payers delegate formulary operations to a few large PBMs? Why are list prices so high? Why might PBMs vertically integrate with payers? Our framework also offers insights into proposals for market reform. |
| JEL: | I1 I11 L1 L14 |
| Date: | 2021–05 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:28866&r= |
| By: | Bratti, Massimiliano (University of Milan); Frimpong, Prince Boakye (Kwame Nkrumah University of Science and Technology); Russo, Simone (Central Bank of Malta) |
| Abstract: | This paper investigates the consequences of prenatal exposure to hot temperatures on child health in Sub-Saharan Africa (SSA) using a novel indicator of heat waves (the Heat Wave Magnitude Index daily). Leveraging several geo-referenced waves of the Demographic and Health Surveys merged with gridded data on the presence of heat waves and their magnitude since the 1980s, we investigate the effects of inutero exposure to heat waves on several birth and early childhood health outcomes (birth weight, low birth weight, weight-for-age and height-for-age z-scores, undernutrition, severe undernutrition, stunting, severe stunting, anemia). Our analysis demonstrates very robust negative effects on long-term child health, namely the probability that the child is severely stunted. Effects are larger for in-utero shocks experienced in the second and third trimesters of pregnancy and for heat waves of higher intensity. We further show that, at least in the SSA context, adaptation mechanisms such as access to improved water and sanitation, electricity, and improved housing do not appear to significantly attenuate the negative effects of heat waves. |
| Keywords: | Sub-Saharan Africa, child health, heat waves |
| JEL: | I14 I15 Q54 J13 |
| Date: | 2021–05 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp14424&r= |
| By: | Fletcher, Jason |
| Abstract: | A great deal of research demonstrates effects of access to contraception and abortion for women and their children, but much less research has considered the impacts of these developments for men. In this analysis, we leverage data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) to explore the possibility of “spillover” effects on male high school classmates related to women’s access to contraception during adolescence and young adulthood. We use school-based surveys of sexual activity and use of birth control pills to ask whether males who attend schools with higher proportions of contracepting young women classmates have different adult outcomes than those attending schools with lower proportions. We hypothesized that higher rates of birth control use would lower the likelihood of pregnancy during the adolescent years, which would in turn increase young men’s future education levels, income levels, and age at first birth. Our analyses did not reveal statistically significant associations between birth control use and young men's longer-term education, income, and family formation outcomes. However, we speculate that these null results are more likely to reflect low statistical power and data limitations than a true lack of association between these factors. Specifically, because surveys only gather information on birth control use when women report being sexually active, the measure may not fully reflect the range of contraceptive users. Additionally, findings of “spillover” effects are expected to be smaller than main effects of contraception for women, limiting our ability to uncover these effects in modest-sized samples. Future research should explore whether larger samples allow more precision in estimates, but most data may suffer from an inability to measure “peer” young women of men under study. Nonetheless, it is important to continue examining the role of contraceptive access in men’s lives as it is a potentially important element to understanding the full range of impacts of contraceptive access on people’s life outcomes. |
| Date: | 2021–06–11 |
| URL: | http://d.repec.org/n?u=RePEc:osf:socarx:4f26r&r= |
| By: | Auer, Daniel; Kunz, Johannes S. |
| Abstract: | This paper investigates the intergenerational effect of communication barriers on child health at birth using a natural experiment in Switzerland. We leverage the fact that refugees arriving in Switzerland originate from places that have large shares of French (or Italian) speakers for historical reasons and upon arrival are by law randomly allocated across states that are dominated by different languages but subject to the same jurisdiction. Our findings based on administrative records of all refugee arrivals and birth events between 2010 and 2017 show that children born to mothers who were exogenously allocated to an environment that matched their linguistic heritage are on average 72 gram heavier (or 2.2%) than those that were allocated to an unfamiliar language environment. The differences are driven by growth rather than gestation and manifest in a 2.9 percentage point difference in low birth weight incidence. We find substantial dose-response relationships in terms of language exposure in both, the origin country and the destination region. Moreover, French (Italian) exposed refugees only benefit from French-(Italian-) speaking destinations, but not vice versa. Contrasting the language match with co-ethnic networks, we find that high quality networks are acting as a substitute rather than a complement. |
| Keywords: | Infant health,Language Proffciency,Refugee allocation,Networks |
| JEL: | F22 I12 J13 J24 J61 J62 |
| Date: | 2021 |
| URL: | http://d.repec.org/n?u=RePEc:zbw:glodps:867&r= |
| By: | D. Susie Lee (Max Planck Institute for Demographic Research, Rostock, Germany); Natalie Nitsche (Max Planck Institute for Demographic Research, Rostock, Germany); Kieron J. Barclay (Max Planck Institute for Demographic Research, Rostock, Germany) |
| Abstract: | Demographic studies on childlessness have typically focused on the social underpinnings of fertility behaviors. However, growing evidence indicates that health during early adulthood, as measured by indicators including body mass index (BMI), predicts population level variation in lifetime fertility. Using the NLSY79 data, we examine the association between BMI during early adulthood and childlessness at age 40+ by race/ethnicity, a major social axis for differences in both BMI and childbearing contexts in the United States. We find that being obese or underweight was consistently linked to higher lifetime childlessness in both sexes, compared to their healthy BMI counterparts, and that this pattern was broadly similar across Hispanic, black and non-Hispanic and non-black groups. Among the obese, but not the underweight, much of the BMI-childlessness association was driven by lower chances to ever marry, and marrying at older ages if marriage occurred. Finally, obese women were more likely to deviate from the common preference for two children, but this difference in fertility preferences played a minor role in the early BMI differentials for childlessness. This study suggests that the influence of early life BMI on childlessness and fertility manifests itself through complex intersections of physiological, psychological, and social/behavioral mechanisms. |
| Keywords: | USA, body weight, completed fertility, desired family size, ethnicity, health, marital union, races, sex differentials |
| JEL: | J1 Z0 |
| Date: | 2021 |
| URL: | http://d.repec.org/n?u=RePEc:dem:wpaper:wp-2021-012&r= |
| By: | Cole, Tim J.; Ogasawara, Kota; Schneider, Eric |
| Abstract: | This paper analyses the influence of the Second World War on the long-run pattern of child growth in Japan. We construct a prefecture-level dataset of mean heights of boys and girls from ages six to nineteen from 1929 to 2015. Linking the heights recorded at different ages for the same birth cohort, we measure a counterfactual causal effect of the nutritional shock of rationing, food shortages and other health shocks during the Second World War on the growth pattern of children. We find that at adulthood, Japanese boys and girls were 3.0 and 1.7 cm shorter than they would have been if the war had never occurred. The war also led to a delay in the pubertal growth spurt of about 0.5 years and slower maturation of children. These effects were greatest for children who experienced the war in late childhood and early adolescence. However, there were not strong penalties for children exposed to the war in utero and in early life, suggesting that they experienced catch-up growth as health conditions improved after the war. These findings challenge the thousand-days consensus that children cannot recover from nutritional shocks in early life and indicate that adolescence can be a sensitive period for health shocks. |
| Keywords: | Catch-up growth; Child growth; Health shocks; Japan; nutrition; Second World War |
| JEL: | I15 J13 J16 N35 O15 |
| Date: | 2020–05 |
| URL: | http://d.repec.org/n?u=RePEc:cpr:ceprdp:14808&r= |
| By: | Alan Piper; David G. Blanchflower; Alex Bryson |
| Abstract: | The cross-sectional association between pain and unemployment is well-established. But the absence of panel data containing data on pain and labor market status has meant less is known about the direction of any causal linkage. Those longitudinal studies that do examine the link between pain and subsequent labor market transitions suggest results are sensitive to the measurement of pain and model specification. We contribute to this literature using large-scale panel data from the German Socio-Economic Panel (GSOEP) for the period 2002 to 2018. We show that pain leads to job loss. Workers suffering pain are more likely than others to leave their job for unemployment or economic inactivity. This probability rises with the frequency of the pain suffered in the previous month. The effect persists having accounted for fixed unobserved differences across workers, is apparent among those who otherwise report good general health and is robust to the inclusion of controls for mental health, life satisfaction and the employee’s occupation. |
| JEL: | J0 J64 |
| Date: | 2021–05 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:28863&r= |
| By: | Angelucci, Manuela (University of Texas at Austin); Chiapa, Carlos (Analysis Group); Prina, Silvia (Northwestern University); Rojas, Irvin (Centro de Investigación y Docencia Económicas) |
| Abstract: | We study how 3,534 beneficiaries of PROSPERA, Mexico's cash transfer program, smooth food consumption around the transfer payday, an anticipated and transitory income shock. We find that food consumption and food security do not change around the transfer payday, including for recipients with impatient or time-inconsistent preferences and households with higher than median transfer dependence. Conversely, health and employment shocks (unexpected and less transitory income changes) reduce food security. The transfer's relative illiquidity may act as a commitment device, helping time-inconsistent and less experienced debit card holders smooth consumption. |
| Keywords: | consumption smoothing, permanent income hypothesis, payday |
| JEL: | D12 D91 E21 I12 I38 |
| Date: | 2021–06 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp14452&r= |
| By: | Md Shahadath Hossain (State University of New York at Binghamton); Plamen Nikolov (State University of New York (at Binghamton)) |
| Abstract: | Child height is a significant predictor of human capital and economic status throughout adulthood. Moreover, non-unitary household models of family behavior posit that an increase in women’s bargaining power can influence child health. We study the effects of an inheritance law change, the Hindu Succession Act Amendment (HSAA), which conferred enhanced inheritance rights to unmarried women in India, on child height. We find robust evidence that the HSAA improved the height and weight of children. In addition, we find evidence consistent with a channel that the policy improved the women’s intrahousehold bargaining power within the household, leading to improved parental investments for children. These study findings are also compatible with the notion that children do better when their mothers control a more significant fraction of the family resources. Therefore, policies that empower women can have additional positive spillovers for children’s human capital. |
| Keywords: | human capital, height, bargaining, parental investments, developing countries |
| JEL: | D13 I12 J13 Z13 |
| Date: | 2021–06 |
| URL: | http://d.repec.org/n?u=RePEc:hka:wpaper:2021-030&r= |
| By: | Bongaerts, Dion; Mazzola, Francesco; Wagner, Wolf |
| Abstract: | We investigate the effectiveness of business shutdowns to contain the Covid-19 disease. In March 2020, Italy shut down operations in a number of sectors. Using a difference-in-difference approach, we find that municipalities with higher exposure to closed sectors experience subsequently lower mortality rates. We estimate the resulting life savings to exceed 12.000 people over less than a month. Using estimates of remaining life-years, this translates into monetary benefits of 12 billion Euros We also show that business shutdowns exhibit rapidly diminishing returns and have effects outside the closed sectors and in other municipalities. This suggests that effective containment policies require central coordination. |
| Keywords: | business shutdown; coordination; COVID-19; Pandemic |
| JEL: | H12 I18 |
| Date: | 2020–05 |
| URL: | http://d.repec.org/n?u=RePEc:cpr:ceprdp:14814&r= |
| By: | Ying Jiao (SAF - Laboratoire de Sciences Actuarielle et Financière - UCBL - Université Claude Bernard Lyon 1 - Université de Lyon); Yahia Salhi (SAF - Laboratoire de Sciences Actuarielle et Financière - UCBL - Université Claude Bernard Lyon 1 - Université de Lyon); Shihua Wang |
| Abstract: | The dependence structure of the life statuses plays an important role in the valuation of life insurance products involving multiple lives. Although the mortality of individuals is well studied in the literature, their dependence remains a challenging field. In this paper, the main objective is to introduce a new approach for analyzing the mortality dependence between two individuals in a couple. It is intended to describe in a dynamic framework the joint mortality of married couples in terms of marginal mortality rates. The proposed framework is general and aims to capture, by adjusting some parametric form, the desired effect such as the "broken-heart syndrome". To this end, we use a well-suited multiplicative decomposition, which will serve as a building block for the framework and thus will be used to separate the dependence structure from the marginals. We make the link with the existing practice of affine mortality models. Finally, given that the framework is general, we propose some illustrative examples and show how the underlying model captures the main stylized facts of bivariate mortality dynamics. |
| Keywords: | Bivariate Mortality,Dependence,Conditional Survival Probability,Copula,Broken-Heart Syndrome |
| Date: | 2021–06–01 |
| URL: | http://d.repec.org/n?u=RePEc:hal:wpaper:hal-03244324&r= |
| By: | Virat Agrawal; Jonathan H. Cantor; Neeraj Sood; Christopher M. Whaley |
| Abstract: | As a way of slowing COVID-19 transmission, many countries and U.S. states implemented shelter-in-place (SIP) policies. However, the effects of SIP policies on public health are a priori ambiguous as they might have unintended adverse effects on health. The effect of SIP policies on COVID-19 transmission and physical mobility is mixed. To understand the net effects of SIP policies, we measure the change in excess deaths following the implementation of SIP policies in 43 countries and all U.S. states. We use an event study framework to quantify changes in the number of excess deaths after the implementation of a SIP policy. We find that following the implementation of SIP policies, excess mortality increases. The increase in excess mortality is statistically significant in the immediate weeks following SIP implementation for the international comparison only and occurs despite the fact that there was a decline in the number of excess deaths prior to the implementation of the policy. At the U.S. state-level, excess mortality increases in the immediate weeks following SIP introduction and then trends below zero following 20 weeks of SIP implementation. We failed to find that countries or U.S. states that implemented SIP policies earlier, and in which SIP policies had longer to operate, had lower excess deaths than countries/U.S. states that were slower to implement SIP policies. We also failed to observe differences in excess death trends before and after the implementation of SIP policies based on pre-SIP COVID-19 death rates. |
| JEL: | I1 I12 I18 I28 |
| Date: | 2021–06 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:28930&r= |
| By: | Rodríguez-Pose, Andrés; Burlina, Chiara |
| Abstract: | This paper examines the uneven geography of COVID-19-related excess mortality during the first wave of the pandemic in Europe, before assessing the factors behind the geographical differences in impact. The analysis of 206 regions across 23 European countries reveals a distinct COVID-19 geography. Excess deaths were concentrated in a limited number of regions—expected deaths exceeded 20% in just 16 regions—with more than 40% of the regions considered experiencing no excess mortality during the first 6 months of 2020. Highly connected regions, in colder and dryer climates, with high air pollution levels, and relatively poorly endowed health systems witnessed the highest incidence of excess mortality. Institutional factors also played an important role. The first wave hit regions with a combination of weak and declining formal institutional quality and fragile informal institutions hardest. Low and declining national government effectiveness, together with a limited capacity to reach out across societal divides, and a frequent tendency to meet with friends and family were powerful drivers of regional excess mortality. |
| Keywords: | Covid-19; coronavirus; Europe; institutions; pandemic; regions |
| JEL: | H75 R58 |
| Date: | 2021–05–12 |
| URL: | http://d.repec.org/n?u=RePEc:ehl:lserod:110454&r= |
| By: | Lima, Everton E. C. Dr. (Unicamp); Soares, Camila Ferreira; Monteiro da Silva, José H C |
| Abstract: | Since the beginning of the pandemic of the new coronavirus, Brazil is a country that has been heavily affected by this new disease, and from March 2020 this country saw its death records increased as the number of Covid-19 infected got out of control. Consequently, many studies tried to explain the influence of this illness in the number of deaths and possible reductions in life expectancy. Until now, there were few empirical attempts to comprehend the effects of pandemic on birth reductions. In this work, we sought to analyze the influence of the pandemic Covid-19 on birth numbers of six major cities of Brazil. Using data from the Ministry of Health, we compared the number of monthly births from October-December 2020 and January-March 2021 with the amount of newborns in similar months and in years previous to the pandemic. Our results show a strong decline in the number of births in all cities analyzed, and most of the reductions occurred at mothers' age of 30 years old. Because of the uncertain scenario that the pandemic brought us, women are postponing their fertility intentions, causing a perhaps temporary baby bust in major cities of Brazil. |
| Date: | 2021–05–31 |
| URL: | http://d.repec.org/n?u=RePEc:osf:osfxxx:a3n6s&r= |
| By: | Sá, Filipa |
| Abstract: | I use simple correlations and regression analysis to study how the number of confirmed Covid-19 cases and the number of deaths with Covid-19 per 100,000 people is related with the socioeconomic characteristics of local areas in England and Wales. I find that local areas that have larger households, worse levels of self-reported health and a larger fraction of people using public transport have more Covid-19 infections per 100,000 people. For mortality, household size and use of public transport are less important, but there is a clear relation with age, ethnicity and self-reported health. Local areas with an older population, a larger share of black or Asian population and worse levels of self-reported health have more Covid-19 deaths per 100,000 people. To prevent the spread of infection and reduce mortality, policymakers should introduce measures to improve housing conditions and improve the health of the population. Also, as many countries now begin to relax lockdown measures, they should pay particular attention to reducing the risk of infection in public transport. |
| Date: | 2020–05 |
| URL: | http://d.repec.org/n?u=RePEc:cpr:ceprdp:14781&r= |
| By: | Egorov, Georgy; Enikolopov, Ruben; Makarin, Alexey; Petrova, Maria |
| Abstract: | Voluntary social distancing plays a vital role in containing the spread of the disease during a pandemic. As a public good, it should be more commonplace in more homogeneous and altruistic societies. However, for healthy people, observing social distancing has private benefits, too. If sick individuals are more likely to stay home, healthy ones have fewer incentives to do so, especially if the asymptomatic transmission is perceived to be unlikely. Theoretically, we show that this interplay may lead to a stricter observance of social distancing in more diverse and less altruistic societies. Empirically, we find that, consistent with the model, the reduction in mobility following the first local case of COVID-19 was stronger in Russian cities with higher ethnic fractionalization and cities with higher levels of xenophobia. For identification, we predict the timing of the first case using pre-existing patterns of internal migration to Moscow. Using SafeGraph data on mobility patterns, we confirm that mobility reduction in the United States was also higher in counties with higher ethnic fractionalization. Our findings highlight the importance of strategic incentives of different population groups for the effectiveness of public policy. |
| Keywords: | altruism; COVID-19; diversity; fractionalization; Pandemic; Quarantine; Russia; self-isolation; Social distancing; Xenophobia |
| JEL: | D64 D74 I12 |
| Date: | 2020–05 |
| URL: | http://d.repec.org/n?u=RePEc:cpr:ceprdp:14810&r= |
| By: | Bartos, Vojtech; Bauer, Michal; Cahlíková, Jana; Chytilova, Julie |
| Abstract: | Aggressive behavior against out-group members often rises during periods of economic hardship and health pandemics. Here, we test the widespread concern that the Covid-19 crisis may fuel hostility against people from other nations or ethnic minorities. Using a controlled money-burning task, we elicited hostile behavior among a nationally representative sample (n=2,186) in the Czech Republic, at a time when the entire population was under lockdown. We provide causal evidence that exogenously elevating salience of the Covid-19 crisis magnifies hostility against foreigners. This behavioral response is similar across various demographic sub-groups. The results underscore the importance of not inflaming anti-foreigner sentiments and suggest that efforts to restore international trade and cooperation will need to address both social and economic damage. |
| Keywords: | COVID-19; discrimination; Experiment; health and economic crisis; hostility; inter-group conflict |
| JEL: | C90 D01 D63 D91 J15 |
| Date: | 2020–05 |
| URL: | http://d.repec.org/n?u=RePEc:cpr:ceprdp:14821&r= |
| By: | Lin Ma; Gil Shapira; Damien de Walque; Quy-Toan Do; Jed Friedman; Andrei A. Levchenko |
| Abstract: | In lower-income countries, the economic contractions that accompany lockdowns to contain the spread of COVID-19 can increase child mortality, counteracting the mortality reductions achieved by the lockdown. To formalize and quantify this effect, we build a macro-susceptible-infected-recovered model that features heterogeneous agents and a country-group-specific relationship between economic downturns and child mortality, and calibrate it to data for 85 countries across all income levels. We find that in low-income countries, a lockdown can potentially lead to 1.76 children’s lives lost due to the economic contraction per COVID-19 fatality averted. The ratio stands at 0.59 and 0.06 in lower-middle and upper-middle income countries, respectively. As a result, in some countries lockdowns actually can produce net increases in mortality. The optimal lockdowns are shorter and milder in poorer countries than in rich ones, and never produce a net mortality increase. |
| JEL: | I15 I18 |
| Date: | 2021–06 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:28925&r= |
| By: | Ulugbek Aminjonov; Olivier Bargain; Tanguy Bernard |
| Abstract: | Strict containment limits the spread of pandemics but is difficult to achieve when people must continue to work to avoid poverty. A new role is emerging for income support: by enabling people to effectively stay home, it can produce substantial health externalities. We examine this issue using data on human mobility and poverty rates in 729 subnational regions of lowand middle-income countries during the first year of COVID-19. Shelter-in-place orders decrease work-related mobility in general, but much less so in the poorest regions. Emergency income support significantly mitigates this mobility gap between regions. It reduces by half the additional contagion caused, via the mobility channel, by regional poverty differences. |
| Keywords: | COVID-19, poverty, policy, lockdown, social protection, compliance, mobility |
| JEL: | H12 I12 I18 I38 O15 |
| Date: | 2021 |
| URL: | http://d.repec.org/n?u=RePEc:grt:bdxewp:2021-12&r= |
| By: | Gitmez, Arda; Sonin, Konstantin; Wright, Austin L. |
| Abstract: | We offer a model in which heterogeneous agents make individual decisions with negative external effects such as the extent of social distancing during pandemics. Because of the externality, the agents have different individual and political preferences over the policy response. Personally, they might prefer a low-level response, yet would vote for a higher one because it deters the others - even if simultaneously decreasing their personal benefits. The effect is even more pronounced in information acquisition: agents would want one level of slant in the information they base their actions on and a different level of slant in public announcements. The model accounts for numerous empirical regularities of the public response to COVID-19. |
| Keywords: | Bayesian persuasion; compliance; COVID-19; Income inequality; media slant; public health externality |
| JEL: | D72 H12 I18 L82 |
| Date: | 2020–05 |
| URL: | http://d.repec.org/n?u=RePEc:cpr:ceprdp:14778&r= |
| By: | Rufrancos, Héctor; Moro, Mirko; Moore, Eva |
| Abstract: | This paper estimates the impact of University reopenings in Scotland in Autumn 2020 on COVID-19 cases in Scottish neighbourhoods. We geolocate all student halls in Scotland, and merge this data with neighbourhood-level case data. We employ a local differences-indi fferences strategy and tackle two research questions. First, we ask what was the impact of the start of semester on cases in the student neighbourhoods? Next, we turn our attention to the spillover of cases in the nearby communities to student neighbourhoods. University semester start dates in Scotland are staggered over the month of September, and we deal with this by focusing on each start cluster, as well as implementing the Callaway and Sant'Anna (2020) estimator. We find a substantial and persistent increase in cases in areas containing halls and evidence of persistent spillovers. These effects are linked to the group of Universities that started on 14th September, which include large Universities located in the major urban areas. The cases began to rise on 21st September, with 100 extra cases per 100,000 per day, and peaked a week later with 400 additional cases per 100,000 per day, after which they started declining, but persist until the Autumn tightening of coronavirus restrictions bit in November, two months after the restrictions were enacted. Our results invite a re-think of how close contact activities may safely resume. |
| Keywords: | Covid Economics,University reopenings,cases,Public Health |
| JEL: | I10 I18 I28 |
| Date: | 2021 |
| URL: | http://d.repec.org/n?u=RePEc:zbw:glodps:868&r= |
| By: | Durante, Ruben; Guiso, Luigi; Gulino, Giorgio |
| Abstract: | Social distancing can slow the spread of COVID-19 if citizens comply with it and internalize the cost of their mobility on others. We study how civic values mediate this process using data on mobility across Italian provinces between January and May 2020. We find that after the virus outbreak mobility declined, but significantly more in areas with higher civic capital, both before and after a mandatory national lockdown. The effect is not driven by differences in the risk of contagion, health-care capacity, geographic socioeconomic and demographic factors, or by a general North-South divide. Simulating a SIR model calibrated on Italy, we estimate that if all provinces had the same civic capital as those in top-quartile, COVID-related deaths would have been about 60% lower. We find consistent results for Germany where the incidence of the pandemic and restrictions to mobility were milder. |
| Keywords: | Civic capital; COVID-19; Culture; Externalities; Social distancing |
| JEL: | D91 Z1 |
| Date: | 2020–05 |
| URL: | http://d.repec.org/n?u=RePEc:cpr:ceprdp:14820&r= |
| By: | Heap, Shaun Hargreaves; Koop, Christel; Matakos, Konstantinos; Unan, Asli; Weber, Nina Sophie |
| Abstract: | Do crises make people more prosocial? And what role does communication play in promoting such attitudes and behavior? These answers matter for post-crisis economic recovery as social capital has been linked to growth. We leverage the incidence of Covid-19 --a multifaceted global crisis-- and using a representative panel of US residents, surveyed in April and October 2020, we explore how a) pandemic-induced economic and health anxiety map to prosocial inclinations and behavior, and b) whether communication (and what types) can foster social capital formation. We find that individual exposure to the economic and health consequences of the pandemic had no effect on prosocial inclinations and social capital; but perceived economic vulnerability reduced trust in government and respect for authority and increased preferences for redistribution. Yet information about the aggregate economic consequences of Covid-19 fosters social capital build-up (e.g., altruism, giving, patience) and prosocial preferences. In contrast, information about the health costs of the pandemic has the opposite effect; it greatly reduces interpersonal trust. These information effects also map into policy preferences beyond the Covid-19 crisis. Our findings are consistent with cultural accounts on the determinants of Americans' prosocial inclinations and preferences. |
| Date: | 2021–06–03 |
| URL: | http://d.repec.org/n?u=RePEc:osf:osfxxx:evzbn&r= |
| By: | R. Jason Faberman; Daniel Hartley |
| Abstract: | This paper explores the relationship between Covid-19 infection rates, race, and type of work. We focus on three U.S. cities—Chicago, New York, and Philadelphia—allowing us to exploit zip code-level variation in infection rates and testing rates over time, while controlling for a variety of neighborhood demographic characteristics. We find that neighborhoods with higher Black and Hispanic population shares, and neighborhoods with higher shares of workers in high-social contact jobs within essential businesses, had disproportionately higher Covid-19 infection rates, even after applying our testing and demographic controls. These higher rates coincide with citywide peak infection rates, suggesting an amplified response for these groups. Local variation in type of work accounts for relatively little of the variation in infection rates by race. Additional evidence for Arizona, Florida, and Texas also shows amplified infection rates for these groups around statewide peak infection rates, despite their peaks occurring months after the cities in our main sample. Evidence from these states also shows higher infection rates among high-social contact workers in nonessential businesses that coincides with a more aggressive reopening of these businesses. |
| Keywords: | Covid-19 pandemic; infection rates; race; employment; social interaction |
| JEL: | H12 I12 J15 R12 |
| Date: | 2020–08–12 |
| URL: | http://d.repec.org/n?u=RePEc:fip:fedhwp:92697&r= |
| By: | David Desmarchelier; Magali Jaoul-Grammare; Guillaume Morel; Thi Kim Cuong Pham |
| Abstract: | This paper develops a competitive Ramsey-Cass-Koopmans framework in which an infectious disease evolves according to a simple SIS model. It aims at examining how the lockdown a§ects infectious disease persistence, individual welfare, and economic dynamics. In contrast to the existing literature, two types of infectives are introduced: (1) symptomatics and (2) asymptomatics. While the former is assumed to be too ill to work, the latter supply their labour and spread the disease. The government imposes a lockdown as an instrument to control the disease spread. In the long run, when the contamination rate of the disease is relatively high and the share of asymptomatics is low enough, the lockdown is welfare improving regardless of the degree of household empathy toward infectives. Moreover, a stable limit cycle can emerge near the endemic steady-state, through a Hopf bifurcation, when the share of infectives increases sufficiently the marginal utility of consumption. Particularly, we prove that it is possible to tune the lockdown to simultaneously obtain the limit cycle disappearance and the disease eradication (Bogdanov-Takens bifurcation). In this sense, the lockdown allows hitting two birds with one stone. |
| Keywords: | Bogdanov-Takens bifurcation, Hopf bifurcation, Lockdown, Ramsey model, SIS model. |
| JEL: | C61 E13 I18 O41 |
| Date: | 2021 |
| URL: | http://d.repec.org/n?u=RePEc:ulp:sbbeta:2021-23&r= |