nep-hea New Economics Papers
on Health Economics
Issue of 2021‒07‒12
thirty-one papers chosen by
Nicolas R. Ziebarth
Cornell University

  1. The Impact of Free Secondary Education: Experimental Evidence from Ghana By Esther Duflo; Pascaline Dupas; Michael Kremer
  2. Equality of Opportunity and the Expansion of Higher Education in the UK By Carrieri, Vincenzo; Davillas, Apostolos; Jones, Andrew M.
  3. Unethical Decision Making and Sleep Restriction: Experimental Evidence By David L. Dickinson; David Masclet
  4. How hungry were the poor in late 1930s Britain? By Gazeley, Ian; Newell, Andrew; Reynolds, Kevin; Rufrancos, Hector
  5. Does Paid Family Leave Save Infant Lives? Evidence from United States By Chen, Feng
  6. Conspicuous leisure, time allocation, and obesity Kuznets curves By Nathalie Mathieu-Bolh; Ronald Wendner
  7. U.S. Cannabis Laws Projected to Cost Generic and Brand Pharmaceutical Firms Billions By Ziemowit Bednarek; Jacqueline Doremus; Sarah Stith
  8. Extending alcohol retailers' opening hours: Evidence from Sweden By Daniel Avdic; Stephanie von Hinke
  9. Education, dietary intakes and exercise By Stephanie von Hinke
  10. South Africa's Health Promotion Levy: excise tax findings and equity potential By Hofman, Karen J.; Stacey, Nicholas; Swart, Elizabeth C.; Popkin, Barry M.; Ng, Shu Wen
  11. The Risk of High Out-of-Pocket Health Spending among Older Americans By Helen Levy
  12. Incentives, Health, and Retirement: Evidence from a Finnish Pension Reform By Ollonqvist, Joonas; Kotakorpi, Kaisa; Laaksonen, Mikko; Martikainen, Pekka; Pirttilä, Jukka; Tarkiainen, Lasse
  13. Life Expectancy and Income Levels in Chile By Gonzalo Edwards; Raimundo Soto; Felipe Zurita
  14. Nursing Homes in Equilibrium: Implications for Long-term Care Policies By Tatyana Koreshkova; Minjoon Lee
  15. Entitled to Property: Inheritance Laws, Female Bargaining Power, and Child Health in India By Hossain, Md Shahadath; Nikolov, Plamen
  16. Key Considerations for Early Access Schemes for Single-Administration (One-Time) Therapies By Firth, I.; Schirrmacher, H.; Hampson, G.; Towse, A.
  17. The CoViD-19 pandemic and mental health: Disentangling crucial channels By Siflinger, Bettina; Paffenholz, Michaela; Seitz, Sebastian; Mendel, Moritz; von Gaudecker, Hans-Martin
  18. Mental health before and during the COVID-19 pandemic: the role of partnership and parenthood status in growing disparities between types of families. By Nicole Hiekel; Mine Kühn
  19. Doctors and Nurses Social Media Ads Reduced Holiday Travel and COVID-19 infections: A cluster randomized controlled trial in 13 States By Emily Breza; Fatima Cody Stanford; Marcela Alsan; M. D. Ph. D.; Burak Alsan; Abhijit Banerjee; Arun G. Chandrasekhar; Sarah Eichmeyer; Traci Glushko; Paul Goldsmith-Pinkham; Kelly Holland; Emily Hoppe; Mohit Karnani; Sarah Liegl; Tristan Loisel; Lucy Ogbu-Nwobodo; Benjamin A. Olken Carlos Torres; Pierre-Luc Vautrey; Erica Warner; Susan Wootton; Esther Duflo
  20. Willingness to pay for COVID-19 environmental health risk reductions in consumption: Evidence from U.S. professional sports By Brad R. Humphreys; Gary A. Wagner; John C. Whitehead; Pamela Wicker
  21. A Speeding Rate Starts to Slow: COVID-19 Mortality Rates by State By Joel Elvery
  22. Did COVID-19 Affect the Division of Labor within the Household? Evidence from Two Waves of the Pandemic in Italy By Del Boca, Daniela; Oggero, Noemi; Profeta, Paola; Rossi, Maria Cristina
  23. The Social Value of a SARS-CoV-2 Vaccine: Willingness to Pay Estimates from Four Western Countries By Costa-Font, Joan; Rudisill, Caroline; Harrison, Sayward; Salmasi, Luca
  24. Covid-19 contagion, economic activity and business reopening protocols By Alexandre Janiak; Caio Machado; Javier Turén
  25. A multiscale network-based model of contagion dynamics: heterogeneity, spatial distancing and vaccination By Maira Aguiar; Giovanni Dosi; Damian A. Knopoff; Maria Enrica Virgillito
  26. Pandemic perception and regulation effectiveness: Evidence from the COVID-19 By Luisa Loiacono; Riccardo Puglisi; Leonzio Rizzo; Riccardo Secomandi
  27. The Effectiveness of Strategies to Contain SARS-CoV-2: Testing, Vaccinations, and NPIs By Janos Gablera; Tobias Raabe; Klara Röhrl; Hans-Martin von Gaudecker
  28. Covid-19 vaccine efficacy and Russian public support for anti-pandemic measures By Borisova, Ekaterina; Ivanov, Denis
  29. Local inequalities of the COVID-19 crisis By Cerqua, Augusto; Letta, Marco
  30. The Heterogeneous Effects of COVID-19 on Labor Markets: People's Movement and Non-Pharmaceutical Interventions By HOSHI Kisho; KASAHARA Hiroyuki; MAKIOKA Ryo; SUZUKI Michio; TANAKA Satoshi
  31. Sharing the Caring? The Gender Division of Care Work during the COVID-19 Pandemic in Germany By Jessen, Jonas; Spiess, C. Katharina; Waights, Sevrin; Wrohlich, Katharina

  1. By: Esther Duflo; Pascaline Dupas; Michael Kremer
    Abstract: Following the widespread adoption of free primary education, African policymakers are now considering making secondary school free, but little is known about the private and social benefits of free secondary education. We exploit randomized assignment to secondary school scholarships among 2,064 youths in Ghana, combined with 12 years of data, to establish that scholarships increase educational attainment, knowledge, skills, and preventative health behaviors, while reducing female fertility. Eleven years after receipt of the scholarship, only female winners show private labor market gains, but those come primarily in the form of better access to jobs with rents (in particular rationed jobs in the public sector). We develop a simple model to interpret the labor market results and help think through the welfare impact of free secondary education.
    JEL: H52 I26 O12
    Date: 2021–06
  2. By: Carrieri, Vincenzo (Magna Graecia University); Davillas, Apostolos (University of East Anglia); Jones, Andrew M. (University of York)
    Abstract: Using nine waves of data from Understanding Society (UKHLS), we study the expansion of higher education in the UK, since the landmark Robbins Report in 1963, and its consequences for levels of and inequalities in household income, physical and mental health. We estimate fixed effects models accounting for both cohort and lifecycle effects and use entropy balancing to build a counterfactual scenario that fixes the opportunity set, in terms of the likelihood of being a graduate, at pre-Robbins levels. We confirm that the university expansion was characterised by a large increase in the proportion of graduates, with higher rates of graduation among individuals from more advantaged socioeconomic backgrounds. Having controlled for birth cohort and lifecycle effects, there is evidence of significant inequality of opportunity in the actual outcomes. However, comparing actual outcomes with counterfactual projections, we do not detect an impact of the expansion of higher education on inequality of opportunity (IOp) in income and only small reductions in IOp in physical and mental health.
    Keywords: equality of opportunity, higher education, entropy balancing, high dimensional fixed effects, health, income
    JEL: C1 D63 I12 I14
    Date: 2021–06
  3. By: David L. Dickinson; David Masclet
    Abstract: Recent examinations into the cognitive underpinnings of ethical decision making has focused on understanding whether honesty is more likely to result from deliberative or unconscious decision processes. We randomly assigned participants to a multi-night sleep manipulation, after which they completed 3 tasks of interest: imperfectly identifiable dishonesty (the Coin Flip task), identifiable dishonesty (the Matrix task), and anti-social allocation choices (the Money Burning game). We document the validity of the sleep protocol via significantly reduced nightly sleep levels (objectively measured using validated instrumentation) and significantly higher sleepiness ratings in the sleep-restricted (SR) group compared to the wellrested (WR) group. We report that money burning decisions are not statistically different between SR and WR participants. However, regarding honesty, we find significant and robust effects of SR on honesty. In total, given the connection between sleepiness and deliberation, these results add to the literature that has identified conditions under which deliberation impacts ethical choice. When dishonesty harms an abstract “other” person (e.g., the researcher’s budget), reduced deliberation more likely increases dishonesty compared to when harm is done to someone at closer social distance (e.g., another subject). Key Words: Ethical choice, dishonesty, antisocial behavior, sleep.
    JEL: C91 D91 D63
    Date: 2021
  4. By: Gazeley, Ian; Newell, Andrew; Reynolds, Kevin; Rufrancos, Hector
    Abstract: This article re-examines energy and nutrition available to British working-class households in the late 1930s using individual household expenditure and consumption data. We use these data to address a number of questions. First, what was the extent of malnutrition in late 1930s Britain? Second, how did the incidence change over time? Third, what were the nutritional consequences of the school meals and school milk schemes? We conclude that, for working households, energy and nutritional availability improved significantly compared with current estimates of availability before the First World War. These improvements were not equally shared, however. In the late 1930s, homes with an unemployed head of household had diets that provided around 20 per cent less energy than their working counterparts and female-headed households had diets that provided around 10 per cent fewer kcal per capita than the average male-headed household. The availability of most macro- and micronutrients showed similar relative reductions. State interventions designed to improve diet and nutrition, such as school meals and school milk, made children's diets significantly healthier, even if they did not eliminate macro- and micronutrient deficiencies completely. Not surprisingly, they made the greatest difference to children in households where the head of household was unemployed.
    Keywords: RES-062-23-2054; ES/L002523/1; Wiley deal
    JEL: N0
    Date: 2021–05–04
  5. By: Chen, Feng
    Abstract: One goal of the paid family leave (PFL) is to help working mothers balance their careers and family responsibilities and hence improve the well-being of their infants. However, most studies of PFL on early childhood outcomes have been based on the analyses of surviving infants. If PFL reduces infant deaths, such analyses would understate the effects. Using the linked birth and infant death data in the U.S. with a difference-in-differences framework, I find that the implementation of a six-week PFL in California reduced the post-neonatal mortality rate by 0.135, or it saved approximately 339 infant lives. The effects were driven by death from internal causes, and there were larger effects for infants with married mothers and infant boys. Additional robustness checks and placebo examinations indicate that the effect is not due to confounding factors or contemporary shocks but causal.
    Keywords: paid family leave,infant mortality,child development
    JEL: J13 J16 J18
    Date: 2021
  6. By: Nathalie Mathieu-Bolh (University of Vermont, USA); Ronald Wendner (University of Graz, Austria)
    Abstract: We build a theoretical model to explain the complex patterns of income and obesity, accounting for changes in behavior related to exercise. We combine the theory of time allocation with the theory of conspicuous leisure in a growth model, assuming that consumption expenditures connected to exercise time are conspicuous, and that conspicuous behavior changes with economic development. As a result, as economies develop, we show that there is a growing wedge between optimal exercise and consumption choices made by individuals with different income levels. We show that this pattern is connected to a dynamic Kuznets curve linking body weight to economic development over time, and a static Kuznets curve linking different steady state levels of income per worker to body weight. Thus, our model helps explain the rise and slowdown in obesity prevalence in the USA, as well as the positive correlation between obesity and income per worker in developing countries, and the negative correlation between obesity and income per worker in industrialized countries. We supplement our theoretical results with numerical simulations of the static and dynamic obesity Kuznets curves for the USA. We show that while exercise choices have contributed to a slowdown in the rise in obesity prevalence, there is to this date no dynamic Kuznets curve pattern for obesity in the USA. By contrast, we find the existence of a static Kuznets curve: the steady state level of average body weight increases with the per worker stock of capital up to a level of 186.5 pounds, corresponding to a capital stock 25% higher than the current steady state US capital stock, and decreases thereafter. We discuss policy implications of our findings.
    Keywords: Obesity; Status; Conspicuous leisure; Inequality; Kuznets Curve; Economic Development.
    JEL: D11 D30 H31 I15 O41
    Date: 2021–07
  7. By: Ziemowit Bednarek (Department of Finance California Polytechnic State University); Jacqueline Doremus (Department of Economics, California Polytechnic State University); Sarah Stith (Department of Economics, University of New Mexico)
    Abstract: Legalization of cannabis by U.S. states is likely increasing the use of cannabis as an alternative to conventional pharmaceutical drugs. We examined how cannabis legalization between 1996 and 2019 affected stock market returns for listed generic and brand pharmaceutical companies and found that returns were 1.5-2% lower at 10 days after legalization. Returns decreased in response to both medical and recreational legalization, for both generic and brand drugmakers. Investors anticipate a single legalization event to reduce drugmaker annual sales by $3B on average.
    Keywords: cannabis, marijuana, prescription drugs, stock market
    JEL: I11 I13 L10
    Date: 2021
  8. By: Daniel Avdic; Stephanie von Hinke
    Abstract: Excessive alcohol use is associated with a wide range of adverse outcomes that inflict large societal costs. This paper investigates the impacts of increases in regulated opening hours of Swedish alcohol retailers on alcohol purchases, health and crime outcomes by relating changes in these outcomes in municipalities that increased their retail opening hours to those in municipalities whose opening hours remained unchanged. We show that extended opening hours led to statistically and economically significant increases in alcohol purchases by around two percent per weekly opening hour, but find no corresponding increases in adverse outcomes related to the consumption of alcohol. We study potential mechanisms, such as consumption spillovers and on and off-premise substitution, and we discuss policy implications of our findings.
    Date: 2021–06–24
  9. By: Stephanie von Hinke
    Abstract: This paper examines the relationship between education and health behaviours, focusing on potential offsetting responses between calories "in" (i.e. dietary intakes) and calories "out" (i.e. physical activity). It exploits the 1972 British compulsory schooling law that raised the minimum school leaving age from 15 to 16 to estimate the effects of education on diet and exercise around middle age. Using a regression discontinuity design, the findings suggest that the reform led to a worsening of the quality of the diet, with increases in total calories, fats and animal proteins. However, I find that these changes are partially offset by a discontinuous increase in physical activity. Back-of-the-envelope calculations suggest little effect on the balance of calories. As such, the findings show that focusing on the two components of energy balance provides additional information that is concealed in analyses that only use a measure of obesity.
    Date: 2021–06–24
  10. By: Hofman, Karen J.; Stacey, Nicholas; Swart, Elizabeth C.; Popkin, Barry M.; Ng, Shu Wen
    Abstract: In 2016, the South African government proposed a 20% sugar-sweetened beverage (SSB) tax. Protracted consultations with beverage manufacturers and the sugar industry followed. This resulted in a lower sugar-based beverage tax, the Health Promotion Levy (HPL), of approximately 10% coming into effect in April 2018. We provide a synthesis of findings until April 2021. Studies show that despite the lower rate, purchases of unhealthy SSBs and sugar intake consumption from SSBs fell. There were greater reductions in SSB purchases among both lower socioeconomic groups and in subpopulations with higher SSB consumption. These subpopulations bear larger burdens from obesity and related diseases, suggesting that this policy improves health equity. The current COVID-19 pandemic has impacted food and nutritional security. Increased pandemic mortality among people with obesity, diabetes, and hypertension highlight the importance of intersectoral public health disease-prevention policies like the HPL, which should be strengthened.
    Keywords: equity; fiscal policy; health promotion; South Africa; 108424-001; P2CHD050924
    JEL: E6
    Date: 2021–05–31
  11. By: Helen Levy (University of Michigan and NBER)
    Abstract: Traditional Medicare imposes significant cost-sharing on beneficiaries. Most but not all beneficiaries obtain supplemental insurance through Medigap, Medicare Advantage, Medicaid, or employer-sponsored retiree coverage, which may vary in how well they protect against the risk of high spending. This paper uses data from the Health and Retirement Study for the years 2002 through 2016 to document how supplemental coverage for Medicare beneficiaries 65 and older has changed over time, and to estimate the distribution of out-of-pocket spending for enrollees with different coverage types. I find that the shares of beneficiaries with employer-sponsored supplemental coverage or Medigap declined between 2002 and 2016, whereas the shares with Medicare Advantage or no supplemental coverage for doctor and hospital bills have increased. The majority of those with no supplemental coverage for doctor and hospital bills have Medicare Part D, which covers prescription drug expenses. I find that all supplemental coverage types are associated with lower observed dispersion in out-of-pocket medical care spending, measuring dispersion as the ratio of the 90th to the 50th percentile or the standard deviation. All supplemental insurance types are associated with a lower probability that out-of-pocket medical care spending exceeds 10% of household income, while all but Medicaid are associated with a significantly higher probability that total out-of-pocket health spending (that is, medical care plus health insurance premiums) exceeds this threshold. Thus, all supplemental insurance forms effectively function as insurance, translating uncertain medical costs into more predictable — although still potentially burdensome — premiums.
    Date: 2020–09
  12. By: Ollonqvist, Joonas; Kotakorpi, Kaisa; Laaksonen, Mikko; Martikainen, Pekka; Pirttilä, Jukka; Tarkiainen, Lasse
    Abstract: We analyse the effects of changes in retirement incentives on retirement behaviour, and in particular whether individuals' health status modifes the effects of retirement incentives. We study these issues in the context of the Finnish pension reform of 2005, utilising detailed individual-level administrative data on health and retirement behaviour. Our results indicate that changes in economic incentives matter for retirement behaviour. Many types of individuals react to retirement incentives, and the reaction to economic incentives does not appear to vary according to the individuals' health status in a systematic way. Hence there does not seem to be a trade-off between providing incentives to postpone retirement and equal treatment of individuals with different health status.
    Keywords: pension reform, retirement incentives, health, Social security, taxation and inequality, H55, J26,
    Date: 2021
  13. By: Gonzalo Edwards; Raimundo Soto; Felipe Zurita
    Abstract: We document that life expectancies at the age of retirement differ significantly by income levels and gender in Chile. Using a sample of over 500 thousand workers that retired under the annuity system, we find that, conditional on reaching retirement age, there is a three-year difference in life expectancy between the lower and higher income groups. Differences are similar for men and women. We also find that as income per capita in Chile expanded over the past three decades, poverty levels have decreased quite markedly among pensioners. The evidence on income distribution is less clear cut. While income inequality is lower for the new generations, it increases after retirement within each generation as the poor die younger than the rich workers. Gender differences are also noteworthy. First, income among women is less unequal than that of men at retirement age and afterwards. Second, income inequality among retired men progressively worsens over time, while among women it remains stagnant over time. Our results have important implications for welfare projections, the allocation of health subsidies among pensioners, and the structure and management of the reserves required to life-insurance companies.
    Date: 2020
  14. By: Tatyana Koreshkova (Concordia University); Minjoon Lee (Carleton University)
    Abstract: We build an equilibrium model of the market for nursing home care with decision-makers on both sides of the market. The nursing home demand arises as a result of stochastic dynamic optimizations by households heterogeneous in age, health, wealth; and the cost of home-and-community-based care. On the supply side, locally competitive nursing homes decide prices and care intensity. The government pays for the long-term care of the poorest. We estimate the model parameters using Health and Retirement Survey and simulate the model to quantitatively evaluate the effects of long-term care policies on prices, intensities, care allocation, and welfare.
    Date: 2020–09
  15. By: Hossain, Md Shahadath (State University of New York); Nikolov, Plamen (State University of New York)
    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, India
    JEL: D13 I12 I13 J13 J16 J18 K13 O12 O15 Z12 Z13
    Date: 2021–06
  16. By: Firth, I.; Schirrmacher, H.; Hampson, G.; Towse, A.
    Abstract: Early access schemes (EASs) can enable access to medicines prior to completion of the regulatory process. EASs allow national regulators to issue an initial positive assessment of the balance between benefits and risks for groups of patients on the basis of early clinical trial data. The main aim is to meet the needs of patients facing exceptional challenges i.e., those with seriously debilitating or life-threatening diseases and no satisfactory treatment alternative. Single-administration (one-time) therapies present a challenge for EASs due to their one-off nature. In existing EASs, manufacturers are often required to provide the product free. For single-administration (one-time) therapies, where treatment is completed within the timeframe of the EAS, there is no prospect of reimbursement at that time or in the future for that patient. Hence, models of early access without reimbursement may not be financially sustainable for manufacturers of single-administration therapies, reducing investment into finding subsequent single administration therapies. In this paper, we present key considerations for the design of EASs for single-administration therapies based on a multi-stakeholder, expert roundtable. The roundtable was attended by 11 experts including current and former - payers, regulators, health technology assessment (HTA) body representatives, industry body representative, politicians, ethicists, government representatives and patient advisory groups. The experts included people with expertise at EU level as well as national level experts from Spain, France, UK, Poland, Italy and Germany. In this paper, we first set out the context for EASs based on a review of the literature. We then present the key considerations for EASs for single-administration therapies developed during the roundtable. Finally, we conclude with suggestions for further research on how to implement the key considerations in different national contexts.
    Keywords: Economics of Innovation
    JEL: I1
    Date: 2021–06–01
  17. By: Siflinger, Bettina; Paffenholz, Michaela; Seitz, Sebastian; Mendel, Moritz; von Gaudecker, Hans-Martin
    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 have 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,lockdown,child care
    JEL: I10 I18 I30 J22
    Date: 2021
  18. By: Nicole Hiekel (Max Planck Institute for Demographic Research, Rostock, Germany); Mine Kühn (Max Planck Institute for Demographic Research, Rostock, Germany)
    Abstract: This study set out to investigate mental health inequalities by family type and gender during the COVID-19 pandemic in Germany. We analyzed three dimensions of mental health (i.e., self-reported stress, exhaustion, and loneliness) one year before the pandemic and in spring 2020. First, two-parent families emerge as a vulnerable group, as they experienced the largest increases in levels of stress and exhaustion, converging with those experienced by single parents. Second, a gender gap emerges during this global health crisis, with women, and particularly mothers, carrying the heaviest burdens, and having the greatest mental health declines. The findings presented here underline the empirical and substantive value of studying mental health inequality from a multidimensional perspective and over time. Based on these findings, we urge policy-makers to consider more seriously the disproportionate burdens that members of families, and women in particular, have been carrying due to the pandemic, both directly and indirectly.
    JEL: J1 Z0
    Date: 2021
  19. By: Emily Breza; Fatima Cody Stanford; Marcela Alsan; M. D. Ph. D.; Burak Alsan; Abhijit Banerjee; Arun G. Chandrasekhar; Sarah Eichmeyer; Traci Glushko; Paul Goldsmith-Pinkham; Kelly Holland; Emily Hoppe; Mohit Karnani; Sarah Liegl; Tristan Loisel; Lucy Ogbu-Nwobodo; Benjamin A. Olken Carlos Torres; Pierre-Luc Vautrey; Erica Warner; Susan Wootton; Esther Duflo
    Abstract: During the COVID-19 epidemic, many health professionals started using mass communication on social media to relay critical information and persuade individuals to adopt preventative health behaviors. Our group of clinicians and nurses developed and recorded short video messages to encourage viewers to stay home for the Thanksgiving and Christmas Holidays. We then conducted a two-stage clustered randomized controlled trial in 820 counties (covering 13 States) in the United States of a large-scale Facebook ad campaign disseminating these messages. In the first level of randomization, we randomly divided the counties into two groups: high intensity and low intensity. In the second level, we randomly assigned zip codes to either treatment or control such that 75% of zip codes in high intensity counties received the treatment, while 25% of zip codes in low intensity counties received the treatment. In each treated zip code, we sent the ad to as many Facebook subscribers as possible (11,954,109 users received at least one ad at Thanksgiving and 23,302,290 users received at least one ad at Christmas). The first primary outcome was aggregate holiday travel, measured using mobile phone location data, available at the county level: we find that average distance travelled in high-intensity counties decreased by -0.993 percentage points (95% CI -1.616, -0.371, p-value 0.002) the three days before each holiday. The second primary outcome was COVID-19 infection at the zip-code level: COVID-19 infections recorded in the two-week period starting five days post-holiday declined by 3.5 percent (adjusted 95% CI [-6.2 percent, -0.7 percent], p-value 0.013) in intervention zip codes compared to control zip codes.
    Date: 2021–06
  20. By: Brad R. Humphreys; Gary A. Wagner; John C. Whitehead; Pamela Wicker
    Abstract: The COVID-19 pandemic caused substantial economic changes. The airborne transmission of the coronavirus increased the environmental health risks associated with many activities that entailed little risk in the pre-pandemic period, including workplace risks and risks faced by consumers. While a large literature estimates local tradeoffs between money and reduced risk of negative health outcomes in many settings, little empirical evidence addresses consumer willingness to pay for reduction in environmental health risks associated with coronavirus transmission. We estimate professional sports fans’ willingness to pay (WTP) for reduced likelihood of coronavirus infection through mask and social distancing policies at games using a stated preference approach. Regression results based on a latent class logit model using survey data collected from 1,391 fans of professional sports teams in five large U.S. metropolitan areas indicate increased attendance likelihood if the venue requires masks and limits attendance to below capacity. Latent class logit models indicate significant heterogeneity in WTP across risk scenarios and sports. We characterize the types of professional sports fan as casual fans who prefer a mask requirement but are indifferent to stadium and arena capacity, rabid fans who are anti-maskers and indifferent to capacity and fans who only have a positive WTP when there is a mask requirement and low stadium/arena capacity (i.e., opportunities for the greatest amount of social distancing). Key Words: Discrete choice experiment; Stated preferences; Willingness-to-pay; Environmental health risk
    Date: 2021
  21. By: Joel Elvery
    Abstract: The cumulative COVID-19 mortality rate of the United States has doubled or more each week between February 29, 2020 and April 12, 2020. Thankfully, doubling has stopped in several states as of April 12, 2020. One of these states, Louisiana, had the third-highest COVID-19 mortality rate in the country. In the Cleveland Fed’s District,1 the growth in mortality rates has continued to slow in Kentucky, Ohio, and West Virginia, but not in Pennsylvania. However, in most states mortality rates are still rising rapidly—mortality rates doubled or more between April 5, 2020 and April 12, 2020 in 37 states, including all four District states.
    Keywords: COVID-19
    Date: 2020–04–16
  22. By: Del Boca, Daniela (University of Turin); Oggero, Noemi (University of Turin); Profeta, Paola (Bocconi University); Rossi, Maria Cristina (University of Turin)
    Abstract: The COVID-19 pandemic has had a dramatic impact on families' lives, with parents all over the world struggling to meet the increased demands of housework, childcare and home-schooling. Much of the additional burden has been shouldered by women, particularly in countries with a traditionally uneven division of household labor. Yet the dramatic increase in remote work from home since the pandemic also has the potential to increase paternal involvement in family life and thus to redress persistent domestic gender role inequalities. This effect depends on the working arrangements of each partner, whether working remotely, working at their usual workplace or ceasing work altogether. We examine the role of working arrangements during the pandemic on the traditional division of household labor in Italy using survey data from interviews with a representative sample of working women conducted during the two waves of COVID-19 (April and November 2020). Our data show that the gender gap in household care related activities was widest during the first wave of the pandemic, and although it was less pronounced during the second wave, it was still higher than pre-COVID-19. The time spent by women on housework, childcare, and assisting their children with distance learning did not depend on their partners' working arrangements. Conversely, men spent fewer hours helping with the housework and distance learning when their partners were at home. It is interesting, however, that although men who worked remotely or not at all did devote more time to domestic chores and child care, the increased time they spent at home did not seem to lead to a reallocation of couples' roles in housework and child care. Finally, we find that working arrangements are linked to women's feelings of uncertainty, with heterogeneous effects by level of education.
    Keywords: COVID-19, work arrangements, housework, childcare, distance learning
    JEL: J13 J16 J21
    Date: 2021–06
  23. By: Costa-Font, Joan (London School of Economics); Rudisill, Caroline (University of South Carolina); Harrison, Sayward (University of South Carolina); Salmasi, Luca (Catholic University - Rome)
    Abstract: SARS-CoV-2 vaccines give rise to positive externalities on population health, society and the economy in addition to protecting the health of vaccinated individuals. Hence, the social value of such a vaccine exceeds its market value. This paper estimates the willingness to pay (WTP) for a hypothetical SARS-CoV-2 vaccine in four countries, namely the United States (US), the United Kingdom (UK), Spain and Italy during the first wave of the COVID-19 pandemic when no specific vaccine had been approved nor subsidised. WTP estimates are elicited using a payment card method to avoid 'yea saying' biases, and we study the effect of protest responses, sample selection bias, as well as the influence of trust in government and risk exposure when estimating the WTP. Our estimates suggest evidence of an average value of a hypothetical vaccine of 100-200 US dollars once adjusted by purchasing power parity (PPP). Estimates are robust to a number of checks.
    Keywords: social value, willingness to pay, vaccine value, vaccine attitudes, payment card, sample selection, protest responses, positive externalities, COVID-19
    JEL: H23 H42 I18
    Date: 2021–06
  24. By: Alexandre Janiak; Caio Machado; Javier Turén
    Abstract: This paper studies the impact of sanitary protocols aimed at reducing the contagion by Covid-19 during the production and consumption of goods and services. We augment a heterogeneous SIR model with a two-way feedback between contagion and economic activity, allowing for firm and sector heterogeneity. While protocols are a burden for firms (especially SMEs), they may enhance economic activity by avoiding infections that reduce the labor supply. Using Chilean data, we calibrate the model and assess the impact of recommended firm protocols on contagion and economic activity in the after-lockdown period. Our quantitative results suggest that: (i) A second wave of infections is likely in the absence of protocols; (ii) Protocols targeted at some sectors can reduce deaths while at the same time improving economic conditions; (iii) Protocols applied widely have a negative effect on the economy. We also find that applying strict protocols to a few sectors is generally preferable to applying milder protocols to a larger number of sectors, both in terms of health and economic benefits.
    Date: 2020
  25. By: Maira Aguiar; Giovanni Dosi; Damian A. Knopoff; Maria Enrica Virgillito
    Abstract: Lockdown and vaccination policies have been the major concern in the last year in order to contain the SARS-CoV-2 infection during the COVID-19 pandemic. In this paper we present a model able to evaluate alternative lockdown policies and vaccination strategies. Our approach integrates and refines the multiscale model proposed by Bellomo et al. , 2020, analyzing alternative network structures and bridging two perspectives to study complexity of living systems. Inside dierent matrices of contacts we explore the impact of closures of distinct nodes upon the overall contagion dynamics. Social distancing is shown to be more effective when targeting the reduction of contacts among and inside the most vulnerable nodes, namely hospitals/nursing homes. Moreover, our results suggest that school closures alone would not signicantly affect the infection dynamics and the number of deaths in the population. Finally, we investigate a scenario with immunization in order to understand the effectiveness of targeted vaccination policies towards the most vulnerable individuals. Our model agrees with the current proposed vaccination strategy prioritising the most vulnerable segment of the population to reduce deaths.
    Keywords: Pandemic; COVID-19; epidemiological models; kinetic theory; active particles; spatial patterns; networks; vaccination; health policies.
    Date: 2021–06–29
  26. By: Luisa Loiacono (Università di Parma e Università di Ferrara); Riccardo Puglisi (Università di Pavia); Leonzio Rizzo (Università di Ferrara e Institut d'Economia Barcelona); Riccardo Secomandi (Università di Ferrara)
    Abstract: The spread of COVID-19 led countries around the world to adopt lockdown measures of varying stringency to restrict movement of people. However, the effectiveness of these measures on mobility has been markedly different. Employing a difference-in-differences design and a set of robustness checks, we analyse the effectiveness of movement restrictions across different countries. We disentangle the role of regulation (stringency measures) from the role of people’s perception about the spread of COVID-19. We proxy the COVID-19 perception by using Google Trends data on the term “Covid”. We find that lockdown measures have a higher impact on mobility the more people perceive the severity of COVID-19 pandemic. This finding is driven by countries with low level of trust in institutions.
    Keywords: mobility, lockdown measures, COVID-19, stringency index, perception, public health, public policy
    JEL: D7 E7 I18
    Date: 2021–06
  27. By: Janos Gablera (Bonn Graduate School of Economics, IZA Institute of Labor Economics); Tobias Raabe (Private sector); Klara Röhrl (Bonn Graduate School of Economics); Hans-Martin von Gaudecker (IZA Institute of Labor Economics, Rheinische Friedrich-Wilhelms-Universität Bonn)
    Abstract: In order to slow the spread of the CoViD-19 pandemic, governments around the world have enacted a wide set of policies limiting the transmission of the disease. Initially, these focused on non-pharmaceutical interventions; more recently, vaccinations and large-scale rapid testing have started to play a major role. The objective of this study is to explain the quantitative effects of these policies on determining the course of the pandemic, allowing for factors like seasonality or virus strains with different transmission profiles. To do so, the study develops an agent-based simulation model, which is estimated using data for the second and the third wave of the CoViD-19 pandemic in Germany. The paper finds that during a period where vaccination rates rose from 5% to 40%, rapid testing had the largest effect on reducing infection numbers. Frequent large-scale rapid testing should remain part of strategies to contain CoViD-19; it can substitute for many non-pharmaceutical interventions that come at a much larger cost to individuals, society, and the economy.
    Keywords: CoViD-19, agent based simulation model, rapid testing, nonpharmaceutical interventions
    JEL: C63 I18
    Date: 2021–06
  28. By: Borisova, Ekaterina; Ivanov, Denis
    Abstract: In this study, we use random assignment of vignettes that feature optimistic and pessimistic scenarios with respect to vaccine safety and efficacy on a sample of roughly 1,600 Russians in order to gauge public support for anti-pandemic measures under various scenarios. Negative information on vaccine safety and efficacy reduces support for the anti-pandemic measures among individuals who fear Covid-19 and were initially supportive of government restrictions. These individuals tend to be old, and therefore vulnerable to Covid-19, and politically active. This loss of support is strongest for economically costly measures such as banning of large gatherings and the shuttering of non-essential businesses. Mask-wearing, which involves only minor costs, finds broad acceptance. We interpret the reactions in light of adaptation, fatigue over Covid-19 restrictions, and fatalism. The political consequences of non-pharmaceutical measures to deal with a pandemic include loss of public support over time, erosion of trust in government, and political backlash.
    JEL: I12 I18 C93
    Date: 2021–07–05
  29. By: Cerqua, Augusto; Letta, Marco
    Abstract: This paper assesses the impact of the first wave of the pandemic on the local economies of one of the hardest-hit countries, Italy. We combine quarterly local labor market data with the new machine learning control method for counterfactual building. Our results document that the economic effects of the COVID-19 shock are dramatically unbalanced across the Italian territory and spatially uncorrelated with the epidemiological pattern of the first wave. The heterogeneity of employment losses is associated with exposure to social aggregation risks and pre-existing labor market fragilities. Finally, we quantify the protective role played by the labor market interventions implemented by the government and show that, while effective, they disproportionately benefitted the most developed Italian regions. Such diverging trajectories and unequal policy effects call for a place-based policy approach that promptly addresses the uneven economic geography of the current crisis.
    Keywords: impact evaluation,counterfactual approach,machine learning,local labor markets,COVID-19,Italy
    JEL: C53 D22 E24 R12
    Date: 2021
  30. By: HOSHI Kisho; KASAHARA Hiroyuki; MAKIOKA Ryo; SUZUKI Michio; TANAKA Satoshi
    Abstract: The paper investigates the heterogeneous effect of a policy-induced decline in people's mobility on the Japanese labor market outcome during the early COVID-19 period. Regressing individual-level labor market outcomes on prefecture-level mobility changes using policy stringency index as an instrument, our two-stage least squares estimator presents the following findings. First, the number of people absent from work increased for all groups of individuals, but the magnitude was greater for workers with non-regular employment status, low-educated people, females, and those aged 31 to 45 years. Second, while work hours decreased for most groups, the magnitude was especially greater for business owners without employees and those aged 31 to 45. Third, the negative effect on unemployment was statistically significant for older males who worked as regular workers in the previous year. The impact was particularly considerable for those aged 60 and 65, thus suggesting that they lost their re-employment opportunity due to COVID-19. Fourth, all these adverse effects were greater for people working in service and sales occupations. Fifth, a counterfactual experiment of more stringent policies indicates that while an average worker would lose JPY 3,857 in weekly earnings by shortening their work hours, the weekly loss for those aged 31 to 45 years and working in service and sales occupations would be about JPY 13,842.
    Date: 2021–06
  31. By: Jessen, Jonas (DIW Berlin); Spiess, C. Katharina (DIW Berlin); Waights, Sevrin (DIW Berlin); Wrohlich, Katharina (DIW Berlin)
    Abstract: The COVID-19 pandemic and related closures of daycare centers and schools significantly increased the amount of care work done by parents. There is much speculation over whether the pandemic increased or decreased gender equality in parental care work. Based on representative data for Germany we present an empirical analysis that shows greater support for the latter rather than the former hypothesis. A key finding is that there is a significant increase in the number of couples where the mother is left completely or almost completely alone with the care work. We see only small increases in the prevalence of fathers doing more than mothers or in splitting these tasks 50:50. Additionally we find that the increase in mothers solely responsible for care work is greatest when the mother alone works from home. The division of care work is perceived very differently by mothers and fathers, a difference that also increased during the pandemic.
    Keywords: gender division, domestic work, child care, day care, COVID-19
    JEL: D13 J16 J22
    Date: 2021–06

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