nep-hea New Economics Papers
on Health Economics
Issue of 2021‒11‒01
24 papers chosen by
Nicolas R. Ziebarth
Cornell University

  1. The Effect of Medicaid on Care and Outcomes for Chronic Conditions: Evidence from the Oregon Health Insurance Experiment By Heidi Allen; Katherine Baicker
  2. Mental Health Therapy as a Core Strategy for Increasing Human Capital: Evidence from Ghana By Nathan Barker; Gharad T. Bryan; Dean Karlan; Angela Ofori-Atta; Christopher R. Udry
  3. Performance Pay in Insurance Markets: Evidence from Medicare By Michele Fioretti; Hongming Wang
  4. Market Segmentation and Competition in Health Insurance By Michael J. Dickstein; Kate Ho; Nathaniel D. Mark
  5. Effects of Opioid-Related Policies on Opioid Utilization, Nature of Medical Care, and Duration of Disability By David Neumark; Bogdan Savych
  6. How Communications that Portray Unhealthy Food Consumption Reduce Food Intake Among Dieters By Mia M. Birau; Diogo Hildebrand; Carolina O. C. Werle
  7. The Effect of Free School Meals on Household Food Purchases: Evidence from the Community Eligibility Provision By Michelle M. Marcus; Katherine G. Yewell
  8. School Food Policy Affects Everyone: Retail Responses to the National School Lunch Program By Jessie Handbury; Sarah Moshary
  9. Social Costs of Obesity in the Czech Republic By Petra Landovska
  10. Information, Belief, and Health Behavior: Evidence from China By Lei, Xiaoyan; Song, Guangxiang; Su, Xuejuan
  11. Public–private differentials in health care delivery: the case of cesarean deliveries in Algeria By Ahcène Zehnati; Marwân-Al-Qays Bousmah; Mohammad Abu-Zaineh
  12. Health Poverty By Bénédicte Apouey; David (David Patrick) Madden
  13. Risk aversion and the value of diagnostic tests By Hal Bleichrodt; David Crainich; Louis Eeckhoudt; Nicolas Treich
  14. Exposures and Behavioral Responses to Wildfire Smoke By Marshall Burke; Sam Heft-Neal; Jessica Li; Anne Driscoll; Patrick W. Baylis; Matthieu Stigler; Joakim Weill; Jennifer Burney; Jeff Wen; Marissa Childs; Carlos Gould
  15. Financial Incentives and Other Nudges Do Not Increase COVID-19 Vaccinations among the Vaccine Hesitant By Tom Chang; Mireille Jacobson; Manisha Shah; Rajiv Pramanik; Samir B. Shah
  16. The Effects of the Covid-19 Pandemic on the Mental Health and Subjective Wellbeing of Workers: An Event Study Based on High-Frequency Panel Data By Schmidtke, Julia; Hetschko, Clemens; Schöb, Ronnie; Stephan, Gesine; Eid, Michael; Lawes, Mario
  17. The Financial Fragility of For-profit Hospitals: Evidence from the COVID-19 Pandemic By Ge Bai; Daniel Jiménez; Phillip Phan; Luis E. Quintero; Alessandro Rebucci; Xian Sun
  18. COVID-19 Working Paper: Filling the Pandemic Meal Gap: Disruptions to Child Nutrition Programs and Expansion of Free Meal Sites in the Early Months of the Pandemic By Toossi, Saied
  19. COVID-19, Lockdowns and Well-Being: Evidence from Google Trends By Abel Brodeur; Andrew E. Clark; Sarah Flèche; Nattavudh Powdthavee
  20. COVID-19, stigma, and habituation: Theory and evidence from mobility data By Kurita, Kenichi; Katafuchi, Yuya
  21. The Impact of the Coronavirus Pandemic on New York City Real Estate: First Evidence By Jeffrey P. Cohen; Felix L. Friedt; Jackson P. Lautier
  22. COVID-19 Working Paper: Meatpacking Working Conditions and the Spread of COVID-19 By Krumel, Thomas; Goodrich, Corey
  23. Revenge of the experts: Will COVID-19 renew or diminish public trust in science? By Eichengreen, Barry; Aksoy, Cevat Giray; Saka, Orkun
  24. COVID-19 Vaccination Mandates and Vaccine Uptake By Alexander Karaivanov; Dongwoo Kim; Shih En Lu; Hitoshi Shigeoka

  1. By: Heidi Allen; Katherine Baicker
    Abstract: Health insurance may play an important role not only in immediate access to care but in the management of chronic disease, which would have implications for long-run care needs as well as health outcomes. Such causal connections are often difficult to establish, but we use Oregon’s 2008 Medicaid lottery to assess the management of diabetes and asthma, as well as several markers of physical health. This analysis complements several prior studies by introducing new data elements and by analyzing chronically ill subpopulations. While we had previously found that having insurance increases the diagnosis and use of medication for diabetes, we show here that it does not significantly increase the likelihood of diabetic patients receiving recommended care such as eye exams and regular blood sugar monitoring, nor does it improve the management of patients with asthma. We also find no effect on measures of physical health including pulse, obesity, or blood markers of chronic inflammation. Effects of Medicaid on health care utilization appear similar for those with and without pre-lottery diagnoses of chronic physical health conditions. Thus, while Medicaid is an important determinant of access to care overall, it does not appear that Medicaid alone has detectable effects on the management of several chronic physical health conditions, at least over the first two years in this setting. However, sample limitations highlight the value of additional research.
    JEL: I1 I13
    Date: 2021–10
  2. By: Nathan Barker; Gharad T. Bryan; Dean Karlan; Angela Ofori-Atta; Christopher R. Udry
    Abstract: We study the impact of cognitive behavioral therapy (CBT) for individuals selected from the general population of poor households in rural Ghana. Results from 2-3 months after a randomized intervention show strong impacts on mental and physical health, cognitive and socioemotional skills, and downstream economic outcomes. We find no evidence of heterogeneity by baseline mental distress; we argue that this is because CBT can improve human capital for a general population of poor individuals through two pathways. First, CBT reduces vulnerability to deteriorating mental health; and second, CBT directly improves bandwidth, increasing cognitive and socioemotional skills and hence economic outcomes.
    JEL: H0 H00 I0 I00 I3 J0 J01 J10 J21 J24 O0 O1 O10
    Date: 2021–10
  3. By: Michele Fioretti (ECON - Département d'économie (Sciences Po) - Sciences Po - Sciences Po - CNRS - Centre National de la Recherche Scientifique); Hongming Wang (Hitotsubashi University)
    Abstract: Public procurement bodies increasingly resort to pay-for-performance contracts to promote efficient spending. We show that firm responses to pay-for-performance can widen the inequality in accessing social services. Focusing on the quality bonus payment initiative in Medicare Advantage, we find that higher quality-rated insurers responded to bonus payments by selecting healthier enrollees with premium differences across counties. Selection is profitable because the quality rating fails to adjust for differences in enrollee health. Selection inflated the bonus payments and shifted the supply of high-rated insurance to the healthiest counties, reducing access to lower-priced, higher-rated insurance in the riskiest counties.
    Keywords: Pay-for-Performance,Medicare Advantage,Risk Selection,Quality Ratings,Health Insurance Access
    Date: 2021–05–01
  4. By: Michael J. Dickstein; Kate Ho; Nathaniel D. Mark
    Abstract: In the United States, households obtain health insurance through distinct market segments. We explore the economics of this segmentation by comparing coverage provided through small employers versus the individual marketplace. Using data from Oregon, we find households with group coverage spend 26% less on covered health care than households with individual coverage yet face higher markups. We develop a model of plan choice and health spending to estimate preferences in both markets and evaluate integration policies. In our setting, pooling can both mitigate adverse selection in the individual market and benefit small group households without raising taxpayer costs.
    JEL: I11 I13 I18 L0
    Date: 2021–10
  5. By: David Neumark; Bogdan Savych
    Abstract: We examine the effects of must-access prescription drug monitoring programs (PDMPs) and recent regulations limiting the duration of initial opioid prescriptions on care received by patients with work-related injuries, focusing on opioid utilization and medical care related to pain management. We find that must-access PDMPs contributed to declines in opioid utilization, while regulations limiting duration of initial opioid prescriptions had little effect on whether workers receive opioids, but reduced opioid use among those with prescriptions. We find limited evidence that must-access PDMPs affected utilization of other medical care related to pain management, and that must-access PDMPs and limits on initial prescriptions had little impact on the duration of temporary disability benefits captured at 12 months of maturity.
    JEL: I13 J28
    Date: 2021–10
  6. By: Mia M. Birau (emlyon business school); Diogo Hildebrand (Baruch College [CUNY] - CUNY - City University of New York [New York]); Carolina O. C. Werle (GEM - Grenoble Ecole de Management)
    Abstract: Both regulatory agencies and nonprofit organizations seek to understand how different tactics and appeals contained in food and public health advertisements might influence the food intake of an increasingly dieting-concerned population. This article addresses this important issue by examining how consumers who are concerned with their diets react to rich images of unhealthy food consumption. Results of two experiments show that exposure to food advertisements containing unhealthy food consumption imagery reduces food intake among consumers chronically concerned with dieting, whereas a third experiment shows a similar decrease in intended consumption when a public health advertisement portrays the consumption of unhealthy food. These findings in turn offer guidelines for maximizing the effectiveness of messages that attempt to promote healthy eating habits. Additionally, this research provides theoretical contributions to the self-control and mental imagery research domains which have public policy implications for regulatory agencies and nonprofit organizations.
    Keywords: counteractive control theory,health goal,consumption imagery,dieting concern
    Date: 2021
  7. By: Michelle M. Marcus; Katherine G. Yewell
    Abstract: We find evidence that exposure to universal free school meals through the Community Eligibility Provision (CEP) had a meaningful impact on grocery spending for households with children, with monthly food purchases declining by about $11, or 5 percent. For households in zip codes with higher exposure, the decline is as high as $39 per month, or 19 percent. We also show evidence that the composition of food purchases changes, with low income households experiencing an increase in the dietary quality of their food purchases by about 3 percent after CEP. Finally, we show CEP exposure is associated with an 11 percent decline in the percent of households that ran short of money or tried to make their food money go further, and an almost 5 percent decline in households classified as food insecure. Our results on the heterogeneous effects of CEP exposure by prior free/reduced price lunch eligibility reveal large benefits in terms of both spending, dietary composition, and food insecurity for previously eligible low-income families, suggesting that the stigma of free school meals may be declining after universal access.
    JEL: H51 I12 I38
    Date: 2021–10
  8. By: Jessie Handbury; Sarah Moshary
    Abstract: We study the private market response to the National School Lunch Program, documenting economically meaningful spillovers to non-recipients. We focus on the Community Eligibility Provision (CEP), an expansion of the lunch program under the 2010 Healthy, Hunger-Free Kids Act. Under the CEP, participating schools offer free lunch to all students. We leverage both the staggered roll-out and eligibility criterion for the CEP, which is limited to schools where at least 40% of students participate in other means-tested welfare programs. We find that local adoption of the CEP causes households with children to reduce their grocery purchases, leading to a 10% decline in grocery sales at large retail chains. Retailers respond with chain-level price adjustments: chains with the most exposure lower prices by 2.5% across all outlets in the years following adoption, so that the program's welfare benefits propagate spatially. Using a stylized model of grocery demand, we estimate that, by 2016, the indirect benefit had reduced grocery costs for the median household by approximately 4.5%.
    JEL: H42 I38 L11 R32
    Date: 2021–10
  9. By: Petra Landovska (Institute of Economic Studies, Faculty of Social Sciences, Charles University, Prague, Czech Republic)
    Abstract: Increasing prevalence of obesity is a pressing public health issue in the Czech Republic as well as world-wide, affecting up to 2.1 billion people. In the Czech Republic, 20-25% of adults and an increasing number of children are obese now. Given that obesity is a chronic disease which is associated with several serious comorbidities, it generates large social costs. The main aim of this study was to estimate both direct and indirect costs of obesity in the Czech Republic. Social costs of obesity are estimated using the cost-of-illness approach. Population attributable fractions (PAF) are computed based on prevalence of obesity in the Czech Republic and relative risks of 19 comorbidities. Direct costs (healthcare utilization costs and costs of pharmacotherapy) are estimated using the top-down approach, while indirect costs (absenteeism, presenteeism and premature mortality) are estimated using the human capital approach. In aggregate, the annual costs attributable to obesity in the Czech Republic in 2018 were 37.3 billion CZK (1.5 billion EUR). Direct costs were 13.1 billion CZK (0.5 billion EUR) and accounted for 3% of Czech healthcare expenditures. The highest healthcare utilization costs were attributable to type II diabetes (21.7%), ischemic heart disease (18.4%) and osteoarthritis (16.9%). The largest indirect costs were attributable to premature mortality (9.2 billion CZK/0.36 billion EUR), absenteeism (8.7 billion CZK/0.34 billion EUR) and presenteeism (6.3 billion CZK/0.25 billion EUR). This report demonstrates that obesity is a serious problem with considerable costs. Several preventive interventions should be applied in order to decrease the prevalence of obesity and achieve cost savings.
    Keywords: obesity, social costs, cost-of-illness study, Czech Republic
    JEL: I12 I18
    Date: 2021–10
  10. By: Lei, Xiaoyan (Peking University); Song, Guangxiang (Pennsylvania State University); Su, Xuejuan (University of Alberta, Department of Economics)
    Abstract: Individuals with imperfect information may make suboptimal choices, but providing more information may not effectively improve decision making if the information is not turned into updated belief. We build a Bayesian updating model to illustrate this phenomenon and use a unique Chinese survey that provides data on information shock, belief updating, and corresponding behaviors to test it. We find that when individuals receive signals about their hypertension status, behavioral changes, such as quitting smoking and take medication, are more likely if the new information leads to updated belief. Furthermore, we find heterogeneous effects across subgroups of individuals: Males are more likely to quit smoking and taking medication after belief updating; rural people are more likely to quit smoking but less likely to take medication, possibly due to lack of affordability or accessibility to medical services. We find no significant impacts on drinking.
    Keywords: Imperfect Information; Bayesian Updating; Belief; Health Behaviors
    JEL: D83 H12 J14
    Date: 2021–10–21
  11. By: Ahcène Zehnati (CREAD - Centre de recherches en économie appliquée au développement); Marwân-Al-Qays Bousmah (CEPED - UMR_D 196 - Centre population et développement - IRD - Institut de Recherche pour le Développement - UP - Université de Paris, IRD - Institut de Recherche pour le Développement, SAGESUD - ERL Inserm U1244 - Santé, vulnérabilités et relations de genre au sud - INSERM - Institut National de la Santé et de la Recherche Médicale - CEPED - UMR_D 196 - Centre population et développement - IRD - Institut de Recherche pour le Développement - UP - Université de Paris); Mohammad Abu-Zaineh (AMSE - Aix-Marseille Sciences Economiques - EHESS - École des hautes études en sciences sociales - ECM - École Centrale de Marseille - CNRS - Centre National de la Recherche Scientifique - AMU - Aix Marseille Université, IPED - Institute for Policy and Economic Development - UTEP - University of Texas [El Paso])
    Abstract: Akin to other developing countries, Algeria has witnessed an increasing role of the private health sector in the past two decades. Our study sheds light on the public–private overlap and the phenomenon of physician dual practice in the provision of health care services using the particular case of cesarean deliveries in Algeria. Existing studies have reported that, compared to the public sector, delivering in a private health facility increases the risk of enduring a cesarean section. While confirming this result for the case of Algeria, our study also reveals the existence of public–private differentials in the effect of medical variables on the probability of cesarean delivery. After controlling for selection in both sectors, we show that cesarean deliveries in the private sector tend to be less medically justified compared with those taking place in the public sector, thus, potentially leading to maternal and neonatal health problems. As elsewhere, the contribution of the private health sector to the unmet need for health care in Algeria hinges on an appropriate legal framework that better coordinates the activities of the two sectors and reinforces their complementarity.
    Keywords: public–private differentials,physician dual practice,Algeria,cesarean delivery
    Date: 2021–09
  12. By: Bénédicte Apouey; David (David Patrick) Madden
    Abstract: Poverty is typically measured with respect to some measure of individual or household resources, such as income or expenditure. However, there is no formal reason why poverty can not also be measured with respect to other important dimensions of the human condition, such as health or education. Here we review the analysis of health poverty. We predominantly focus on research which has appeared in the economics or health economics literature, and so much of our review will concentrate on the degree to which the methodology of poverty analysis as it stands for income poverty can also be applied in a health setting. We will see that this depends greatly upon the nature of the data available to the analyst, and in many cases the nature of health data will limit the range of poverty measures available.
    Keywords: Health; Poverty
    JEL: I14 I31 I32
    Date: 2021–07
  13. By: Hal Bleichrodt; David Crainich (LEM - Lille économie management - UMR 9221 - UA - Université d'Artois - UCL - Université catholique de Lille - Université de Lille - CNRS - Centre National de la Recherche Scientifique); Louis Eeckhoudt (IESEG School of Management Lille); Nicolas Treich (TSE - Toulouse School of Economics - UT1 - Université Toulouse 1 Capitole - Université Fédérale Toulouse Midi-Pyrénées - EHESS - École des hautes études en sciences sociales - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement)
    Abstract: Diagnostic tests allow better informed medical decisions when there is uncertainty about a patient's health status and, therefore, about the desirability to undertake treatment. This paper studies the relation between the expected value of diagnostic information and a patient's risk aversion. We show that the ex ante value of diagnostic information increases with risk aversion for diseases with low prevalence, but decreases with risk aversion for diseases with high prevalence. On the other hand, the ex post value of diagnostic information always increases with the patient's degree of risk aversion.
    Keywords: Diagnostic risks,Diagnostic tests,Value of information,Risk aversion
    Date: 2020–03
  14. By: Marshall Burke; Sam Heft-Neal; Jessica Li; Anne Driscoll; Patrick W. Baylis; Matthieu Stigler; Joakim Weill; Jennifer Burney; Jeff Wen; Marissa Childs; Carlos Gould
    Abstract: The impacts of environmental change on human outcomes often depend on local exposures and behavioral responses that are challenging to observe with traditional administrative or sensor data. We show how data from private pollution sensors, cell phones, social media posts, and internet search activity yield new insights on exposures and behavioral responses during large wildfire smoke events across the US, a rapidly-growing environmental stressor. Health-protective behavior, mobility, and sentiment all respond to increasing ambient wildfire smoke concentrations, but responses differ by income. Indoor pollution monitors provide starkly different estimates of likely personal exposure during smoke events than would be inferred from traditional ambient outdoor sensors, with similar outdoor pollution levels generating >20x differences in average indoor PM2.5 concentrations. Our results suggest that the current policy reliance on self protection to mitigate health risks in the face of rising smoke exposure will result in modest and unequal benefits.
    JEL: Q5 Q53
    Date: 2021–10
  15. By: Tom Chang; Mireille Jacobson; Manisha Shah; Rajiv Pramanik; Samir B. Shah
    Abstract: Can financial incentives, public health messages and other behavioral nudges –approaches deployed by state and local governments, employers, and health systems – increase SARS-CoV-2 vaccination rates among the vaccine hesitant in the US? In mid-2021, we randomly assigned unvaccinated members of a Medicaid managed care health plan to $10 or $50 financial incentives, different public health messages, a simple appointment scheduler, or control to assess impacts on SARS-CoV-2 vaccination intentions and vaccine uptake within 30 days of intervention. While messages increased vaccination intentions, none of the treatments increased overall vaccination rates. Consistent with backlash concerns, financial incentives and negative messages decreased vaccination rates for some subgroups. Financial incentives and other behavioral nudges do not meaningfully increase SARS-CoV-2 vaccination rates amongst the vaccine hesitant.
    JEL: I12 I18
    Date: 2021–10
  16. By: Schmidtke, Julia (Institute for Employment Research (IAB), Nuremberg, Germany); Hetschko, Clemens (University of Leeds); Schöb, Ronnie (FU Berlin); Stephan, Gesine (Institute for Employment Research (IAB), Nuremberg, Germany ; FAU); Eid, Michael (FU Berlin); Lawes, Mario (FU Berlin)
    Abstract: "Using individual monthly panel data from December 2018 to December 2020, we estimate the impact of the Covid-19 pandemic and two lockdowns on the mental health and subjective well-being of German workers. Employing an event-study design using individual-specific fixed effects, we find that the first and the second wave of the pandemic reduced workers’ mental health substantially. Momentary happiness and life satisfaction also decline in response to Covid-19, but to a smaller extent. We observe adaptation in our study outcomes between waves of the pandemic. This applies to a lesser extent to indicators of well-being in certain areas of life, such as satisfaction with the job and with leisure, which are negatively affected, too. Women do not seem to suffer greater well-being losses than men. However, workers in the German short-time work scheme are particularly negatively affected. Our results imply that increased anxiety about the future and restricted personal freedoms are among the drivers of the well-being impact of the pandemic." (Author's abstract, IAB-Doku) ((en))
    JEL: I19 I31
    Date: 2021–10–15
  17. By: Ge Bai; Daniel Jiménez; Phillip Phan; Luis E. Quintero; Alessandro Rebucci; Xian Sun
    Abstract: We estimate the likelihood of financial distress of U.S. hospitals in 2020 due to the COVID-19 pandemic using AHA Annual Survey data for 2011-2019 and smartphone mobility data for 2020. We find that while the average likelihood of distress across all hospitals is 28.53 % in 2020, slightly increasing from 2019, for-profit hospitals are much more likely to be distressed. Their average likelihood of financial distress is 39.13 %---a 6.93 percentage point increase from 2019. For-profit hospitals are the main providers of specialty health care services, such as psychiatric and acute long-term care, so their increased likelihood of distress poses a risk to service provision in these specialty areas, and particularly in rural communities. Our prediction model based on mobility data performs very well in sample against actual data and can potentially help policymakers and hospital administrators to monitor financial distress in real-time when case mixes change, or other large shocks materialize.
    JEL: G3 H51 I1 R51 Z21
    Date: 2021–10
  18. By: Toossi, Saied
    Abstract: Beginning in March 2020, the Coronavirus (COVID-19) pandemic struck the United States abruptly and unexpectedly, forcing the school and childcare center closures nationwide. These closures disrupted the provision of meals to children through the largest of the U.S. Department of Agriculture’s (USDA) child nutrition programs. In response, USDA issued a series of waivers to facilitate the continued provision of meals to children while prioritizing the health and safety of communities. This study assesses the extent to which the child nutrition infrastructure was able to rapidly adapt to meet the needs of children at the onset of the crisis. It documents disruptions in the provision of meals through the National School Lunch Program, School Breakfast Program, and Child and Adult Care Food Program from March through May 2020. In addition, this report examines the extent waivers allowed for greater flexibility in the implementation of these programs and the expansion of free meal sites helped to compensate for these disruptions.
    Keywords: Community/Rural/Urban Development, Consumer/Household Economics, Food Consumption/Nutrition/Food Safety, Food Security and Poverty, Public Economics
    Date: 2021–10–12
  19. By: Abel Brodeur (University of Ottawa [Ottawa], IZA - Forschungsinstitut zur Zukunft der Arbeit - Institute of Labor Economics); Andrew E. Clark (PSE - Paris School of Economics - ENPC - École des Ponts ParisTech - ENS Paris - École normale supérieure - Paris - PSL - Université Paris sciences et lettres - UP1 - Université Paris 1 Panthéon-Sorbonne - CNRS - Centre National de la Recherche Scientifique - EHESS - École des hautes études en sciences sociales - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement, PJSE - Paris Jourdan Sciences Economiques - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS Paris - École normale supérieure - Paris - PSL - Université Paris sciences et lettres - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement, IZA - Forschungsinstitut zur Zukunft der Arbeit - Institute of Labor Economics); Sarah Flèche (AMSE - Aix-Marseille Sciences Economiques - EHESS - École des hautes études en sciences sociales - ECM - École Centrale de Marseille - CNRS - Centre National de la Recherche Scientifique - AMU - Aix Marseille Université); Nattavudh Powdthavee (University of Warwick [Coventry])
    Abstract: The COVID-19 pandemic has led many governments to implement lockdowns. While lockdowns may help to contain the spread of the virus, they may result in substantial damage to population well-being. We use Google Trends data to test whether the lockdowns implemented in Europe and America led to changes in well-being related topic search terms. Using differences-in-differences and a regression discontinuity design to evaluate the causal effects of lockdown, we find a substantial increase in the search intensity for boredom in Europe and the US. We also found a significant increase in searches for loneliness, worry and sadness, while searches for stress, suicide and divorce on the contrary fell. Our results suggest that people's mental health may have been severely affected by the lockdown.
    Keywords: Loneliness,Well-being,Lockdown,COVID-19,Boredom
    Date: 2021–01
  20. By: Kurita, Kenichi; Katafuchi, Yuya
    Abstract: This paper introduces a habituation effect into the stigma model of self-restraint behavior under the pandemic. The theoretical result indicates that the state of emergency's self-restraint effects weaken with the number of times. In order to confirm whether the results of the theoretical analysis are consistent with the current situation, the empirical analysis examines the impact of emergency declarations on going-out behavior using a prefecture-level daily panel dataset that includes Google's going-out behavior data, the Japanese government's policy interventions based on emergency declarations, and covariates that affect going-out behavior such as precipitation and holidays. The results of the empirical analysis can be summarized in two points: First, for multiple emergency declarations from the beginning of the pandemic to 2021, the effect of refraining from going-out was confirmed under emergency declarations in a model that did not distinguish the number of emergency declarations. Second, in the model that considers the number of emergency declarations, the effect of voluntary restraint on going-out was found to decrease with the number of declarations. These empirical analyses are consistent with the results of theoretical analyses, which show that people become more habituated to a policy intervention as the number of the intervention increases.
    Keywords: COVID-19, Infection disease, Stigma, Self-restraint behavior, Non-pharmaceutical policy intervention, Mobility data
    JEL: D7 I18
    Date: 2021–10–17
  21. By: Jeffrey P. Cohen; Felix L. Friedt; Jackson P. Lautier
    Abstract: Concerns about the lingering novel Coronavirus may have led to long-term structural change in desired dwelling locations in some large U.S. cities, such as New York City. Densely concentrated neighborhoods may be at higher risk of virus contagion, giving more individuals incentives to move out. We investigate whether this pandemic-induced disamenity adversely affected real estate prices of one- or two-family owner-occupied properties across New York City. First, OLS hedonic results indicate that greater COVID case numbers are concentrated in neighborhoods with lower-valued properties. Second, we use a repeat-sales approach for the period 2003 to 2020, and we find that both the fear of contagion and pandemic-induced income effects adversely impacted home sale prices. Estimates suggest sale prices fell by roughly $60,000 or around 8% in response to both of the following: 1,000 additional infections per 100,000 residents; and a 10-percentage point increase in unemployment in a given MODZCTA. These price effects were more pronounced during the second wave of infections. Based on cumulative MODZCTA infection rates through 2020, the estimated COVID-19 price discount ranged from approximately 1% to 50% in the most affected neighborhoods, and averaged 14%. Interestingly, the fear of contagion effect intensified in the more affluent, but less densely populated NYC neighborhoods, while the income effect was more pronounced in the most densely populated neighborhoods with more rental properties and greater population shares of foreign-born residents. This disparity implies the pandemic led to inequality between homeowners in lower-priced and higher-priced neighborhoods.
    Date: 2021–10
  22. By: Krumel, Thomas; Goodrich, Corey
    Abstract: This preliminary analysis explores how working conditions in meatpacking plants might have contributed to the spread of the Coronavirus (COVID-19). Data from the Occupational Information Network (O*NET) was used to construct a set of industry-level working condition variables and compare meatpacking to the sample of other manufacturing industries in our comparison group. This novel approach showed that proximity to others in the meatpacking industry is likely the main factor that influenced the spread of COVID-19, nearly three standard deviations higher in meatpacking than our comparison sample of other manufacturing industries. Overall exposure to disease was also found to be 2.5 standard deviations higher in the meatpacking industry compared to other manufacturing industries. Subsequently, we performed a county-level analysis on COVID-19 spread, comparing rural counties that have a large number of meatpacking plants to other nonmetropolitan counties that were dependent on a single manufacturing industry, using the time frame of mid-March to mid-September of 2020. Data analysis begins in mid-March since confirmed cases became national in scope at this point. In mid-April 2020, COVID-19 cases in meatpacking-dependent rural counties rose to nearly 10 times the number in comparison to rural counties dependent on other single manufacturing industries. This difference disappears completely by mid-July, driven by a reduction in COVID-19 cases in the meatpacking industry rather than an increase in other industries, and holds steady through mid-September. The paper concludes by collating evidence from other studies to infer that the meatpacking industry's increased precautions to protect workers help explain why no difference was observed between meatpacking-dependent counties and our comparison group for the final 2 months of the study period. However, this inference should be viewed as suggestive since it cannot formally test using the data referenced in the working paper.
    Keywords: Agribusiness, Crop Production/Industries, Health Economics and Policy, Industrial Organization, Livestock Production/Industries
    Date: 2021–09–27
  23. By: Eichengreen, Barry; Aksoy, Cevat Giray; Saka, Orkun
    Abstract: It is sometimes said that an effect of the COVID-19 pandemic will be heightened appreciation of the importance of scientific research and expertise. We test this hypothesis by examining how exposure to previous epidemics affected trust in science and scientists. Building on the "impressionable years hypothesis" that attitudes are durably formed during the ages 18-25, we focus on individuals exposed to epidemics in their country of residence at this particular stage of the life course. Combining data from a 2018 Wellcome Trust survey of more than 75,000 individuals in 138 countries with data on global epidemics since 1970, we show that such exposure has no impact on views of science as an endeavor but that it significantly reduces trust in scientists and in the benefits of their work. We also illustrate that the decline in trust is driven by the individuals with little previous training in science subjects. Finally, our evidence suggests that epidemic-induced distrust translates into lower compliance with health-related policies in the form of negative views towards vaccines and lower rates of child vaccination.
    Keywords: Epidemics, Impressionable years, Scientists, Trust, Immunization, Vaccine Related, Clinical Research, Infection, COVID-19, epidemics, trust, science, scientist, Economics, Economic Theory, Applied Economics, Econometrics
    Date: 2021–01–01
  24. By: Alexander Karaivanov (Simon Fraser University); Dongwoo Kim (Simon Fraser University); Shih En Lu (Simon Fraser University); Hitoshi Shigeoka (Simon Fraser University)
    Abstract: We estimate the impact of government-mandated proof of vaccination requirements for access to public venues and non-essential businesses on COVID-19 vaccine uptake. We use event-study and difference-in-differences approaches exploiting the variation in the timing of these measures across Canadian provinces. We find that the announce- ment of a vaccination mandate is associated with large increase in new first-dose vaccinations in the first week (more than 50% on average) and the second week (more than 100%) immediately following the announcement. The estimated effect starts waning about six weeks past the announcement. Counterfactual simulations using our estimates suggest that these mandates have led to about 289,000 additional first-dose vaccinations in Canada as of September 30, 2021, which is 1 to 8 weeks after the policy announcements across the different provinces. Time-series analysis corroborates our results for Canada, and we further estimate that national vaccine mandates in three European countries also led to large gains in first-dose vaccinations (7+ mln in France, 4+ mln in Italy and 1+ mln in Germany, 7 to 12 weeks after the policy announcements).
    Date: 2021–10

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