nep-hea New Economics Papers
on Health Economics
Issue of 2022‒04‒18
27 papers chosen by
Nicolas R. Ziebarth
Cornell University

  1. Nurses without Borders: The Impact of Licensing Barriers on Employment By Anne Portlock
  2. Employee Health and Firm Performance By Rettl, Daniel A.; Schandlbauer, Alexander; Trandafir, Mircea
  3. Human-Capital Formation: The Importance of Endogenous Longevity By Titus Galama; Hans van Kippersluis
  4. The Longer-term Impact of Coinsurance for the Elderly - Evidence from High-access Case - By Norihiro Komura; Shun-ichiro Bessho
  5. Did the Medicaid Expansion Crowd Out Other Payment Sources for Medications for Opioid Use Disorder? Evidence from Rhode Island By Mary A. Burke; Riley Sullivan
  6. Universal Credit: Welfare Reform and Mental Health By Mike Brewer; Thang Dang; Emma Tominey
  7. More Than Shelter: The Effects of Rental Eviction Moratoria on Household Well-Being By Xudong An; Stuart A. Gabriel; Nitzan Tzur-Ilan
  8. Lasting Impact on Health from Natural Disasters, Potential Mechanisms and Mitigating Effects By Gaurav Dhamija; Gitanjali Sen
  9. Exposure or Income? The Unequal Effects of Pollution on Daily Labor Supply By Bridget Hoffmann; Juan Pablo Rud
  10. Forced Displacement, Mental Health, and Child Development: Evidence from the Rohingya Refugees By Siddique, Abu; Islam, Asad; Mozumder, Tanvir Ahmed; Rahman, Tabassum; Shatil, Tanvir
  11. The Impact of Cigarette Price Increases on the Prevalence of Daily Smoking and Initiation in Mexico By Martin González-Rozada; Fiona Franco Churruarin
  12. Tobacco control and optimal taxation in a changing European market landscape By Salvatore Barbaro; Nathalie Neu-Yanders
  13. Not so sweet: The impact of the Portuguese soda tax on producers By Goncalves, Judite; Merenda, Roxanne; dos Santos, João Pereira
  14. Religiosity, Smoking and Other Risky Behaviors By Roman, Monica; Zimmermann, Klaus F.; Plopeanu, Aurelian-Petruș
  15. The economics of long-term care. An overview By Klimaviciute, Justina; Pestieau, Pierre
  16. Perspectives on the economics and sociology of health. Contributions from the institutionalist approach of economics of convention -an introduction By Philippe Batifoulier; Rainer Diaz-Bone
  17. Voluntary health insurance markets in France: . Economic rationales and legal mechanisms By Philippe Batifoulier; Anne-Sophie Ginon
  18. Has COVID-19 Permanently Changed Online Consumption Behavior? By INOUE Hiroyasu; TODO Yasuyuki
  19. Hepatitis B in Senegal: A Successful Infant Vaccination Program but Urgent Need to Scale Up Screening and Treatment (ANRS 12356 AmBASS survey) By Lauren Périères; Aldiouma Diallo; Fabienne Marcellin; Marie Libérée Nishimwe; El Hadji Ba; Marion Coste; Gora Lo; Philippe Halfon; Coumba Touré Kane; Gwenaëlle Maradan; Patrizia Carrieri; Assane Diouf; Yusuke Shimakawa; Cheikh Sokhna; Sylvie Boyer; Cyril Bérenger; Marwan Al Qays Bousmah; Patrizia Carrieri; Maëlle de Seze; Tchadine Djaogol; Carole Treibich; Elhadji Ba; Fambaye Dièye; Elhadji Bilal Faye; Assane Ndiaye; Mouhamadou Baba Sow; Anna Julienne Selbé Ndiaye; Samba Ndiour; Sofiane Mohamed; Nicolas Rouveau; Maria‐camila Calvo Cortès; Gabrièle Laborde‐balen; Martine Audibert; Fatou Fall; Ibrahima Gueye; Karine Lacombe; Moussa Seydi; Edouard Tuaillon; Muriel Vray
  20. Nursing Homes and Mortality in Europe: Uncertain Causality By Flawinne, Xavier; Lefebvre, Mathieu; Perelman, Sergio; Pestieau, Pierre; Schoenmaeckers, Jerome
  21. Facing Displacement and a Global Pandemic: Evidence from a Fragile State By Di Maio, Michele; Fasani, Francesco; Sciabolazza, Valerio Leone; Molini, Vasco
  22. Understanding differences in vaccination uptake among OECD countries By David Turner; Nicolas Woloszko; Thomas Chalaux; Marnix Dek
  23. Making space for disability studies within a structurally competent medical curriculum: Reflections on Long Covid By Hunt, Joanne Elizabeth
  24. Exploring the Dynamic Relationship between Mobility and the Spread of COVID-19, and the Role of Vaccines By INOUE Tomoo; OKIMOTO Tatsuyoshi
  25. Understanding hesitancy with revealed preferences across COVID-19 vaccine types By Kutasi Kristóf; Koltai Júlia; Szabó-Morvai Ágnes; Röst Gergely; Karsai Márton; Biró Péter; Lengyel Balázs
  26. Violent Conflicts and Child Gender Preferences of Parents: Evidence from Nigeria By Ella Sargsyan
  27. Citizens' Opinions of and Experiences with Government Responses to COVID-19 Pandemic in Viet Nam By Do, Huyen Thanh; Nguyen, Cuong Viet; Nguyen, Long Thanh; Nguyen, Phuong Minh; Ngo, Quyen Ha; Phung, Tung Duc

  1. By: Anne Portlock (Department of Economics and Geosciences, US Air Force Academy)
    Abstract: The Nurse Licensure Compact forged an environment of multi-state professional licensing. Under the compact, registered nurses licensed in one of the now twenty-five party states may legally practice in the other participating states. This paper examines how mutual reciprocity of occupational licensing reduces barriers to employment. A sample of active duty military spouses, who do not have the luxury of making relocation decisions based on license transferability, was constructed using the American Communities Survey from 2001 to 2015 in order to identify effects on labor market participation. One would otherwise be confounded by the influence of employment opportunities on location selection. Both logistic regression and a linear probability model with state and year fixed effects are used to estimate the effect of multistate licensing. The treatment group consists of nurses whose military spouse was relocated from one party state to another participating state and consequently would be eligible for license reciprocity. The control group is composed of similar nurses whose spouse's military reassignment was not between compact states for whom re-entering the workforce would require certification in the new state. Results indicate significant reductions in departures from the labor force, identifying the labor market inefficiencies created by single-state professional licensing.
    Keywords: Occupational Licensing, Professional Licensing, Nurse Licensure Compact, License Reciprocity, Multi-state Licensing, Military Assignments, Military Spouses, Geographic Mobility in Health Professions
    JEL: J44 I18 J08
    Date: 2022–04
  2. By: Rettl, Daniel A. (University of Georgia); Schandlbauer, Alexander (University of Southern Denmark); Trandafir, Mircea (University of Southern Denmark)
    Abstract: When workers are in bad health, their productivity declines. We investigate whether the health of employees affects firm performance, taking advantage of the severity of the seasonal influenza seasons as a source of exogenous variation. We find that firms whose employees are particularly affected by influenza experience reductions in their return on assets and in net income. These results are not driven by firm-specific characteristics, as we find the same relationship between influenza severity and firm performance within firms, at the establishment level. We also document substantial heterogeneity in the effects, with small firms and labor-intensive firms driving our findings. This suggests that labor is an important driver of firm performance and that capital-intensive and larger firms are better able to shift resources in response to temporary shocks to their workforce. Back-of-the-envelope calculations suggest that smaller firms may be better off subsidizing vaccination programs for their employees.
    Keywords: seasonal influenza, health shock, firm performance
    JEL: L25 I12 G30 J31
    Date: 2022–03
  3. By: Titus Galama (University of Southern California); Hans van Kippersluis (Erasmus University)
    Abstract: We present a theory of human capital, with its two most essential components, health capital and, what we term, skill capital, endogenously determined within the model. Using the theory, and a calibrated version of it, we uncover and highlight an important economic mechanism driving human-capital formation, socio-economic and health disparities, human-capital based economic growth, and causal relations among the stocks of wealth, skill and health, namely whether individuals can influence their own length of life (endogenous longevity). Without the ability of individuals to influence their longevity, the effects of health, skill and wealth on later-life skill and health are muted. Any additional health, skill or wealth is not used for additional investment, but essentially consumed. These findings have important implications for the modeling of, and our understanding of, human-capital formation, disparities in human capital and health, and human-capital based economic growth.
    Keywords: health investment, education, human capital, health capital, dynamic optimal control, longevity
    JEL: D91 I10 I12 J00 J24
    Date: 2022–03
  4. By: Norihiro Komura (Institute of Economic Research, Kyoto University); Shun-ichiro Bessho (Faculty of Economics, University of Tokyo)
    Abstract: We estimate the longer-term impact of coinsurance for the elderly by RDD using administrative data, focusing on the increase in coinsurance in Japan, from 10% to 20%, for those aged 70-74, born after April 1944. The reduction of utilization in the longer term is similar to, or slightly larger than, in the short term. Patients reduce potentially wasteful care more; we do not find discernible impacts on health outcome and health-related behaviors. For the moderate change of prices for the elderly, distinctive characteristics associated with medical services, like behavioral hazard and ex-ante moral hazard, seem not largely affect consumer responsiveness.
    Keywords: Fiscal
    JEL: I11 I12 I13 I18 J14
    Date: 2022–02
  5. By: Mary A. Burke; Riley Sullivan
    Abstract: Using information from the all-payer claims database for Rhode Island covering more than three-quarters of health insurance enrollees in the state from April 2011 through May 2019, this paper offers new measures of the association between the Medicaid expansion and the rate of receipt of buprenorphine and methadone for opioid use disorder (OUD). These robust measures adjust for the extent to which new Medicaid payments for these medications that started in 2014 crowded out payments from either non-Medicaid insurance or from non-insurance subsidies for the treatment of opioid abuse. We find that crowding out was nontrivial but incomplete for either buprenorphine or methadone, such that the Medicaid expansion in Rhode Island appears to have enabled many patients to access medications for OUD for the first time. These findings offer support for the expansion of Medicaid in states that have not already done so.
    Keywords: opiod use disorder; Medicaid expansion; buprenorphine; methadone; crowding out; Rhode Island; all-payer claims database
    JEL: I12 I13 I14 I18
    Date: 2022–04–14
  6. By: Mike Brewer (Resolution Foundation); Thang Dang (Norwegian Institute of Public Health); Emma Tominey (University of York)
    Abstract: The UK Universal Credit (UC) welfare reform simplified the benefits system whilst strongly incentivising a return to sustainable employment. Exploiting a staggered roll-out, we estimate the differential effect of entering unemployment under UC versus the former system on mental health. Groups with fewer insurance possibilities - single adults and lone parents – experience a mental health deterioration of 8.4-13.9% sd. For couples, UC partially or fully mitigates mental health consequences of unemployment. Exploring mechanisms, for single adults and lone parents, reduced benefit income and strict job search requirements dominate any positive welfare effects of the reduced administrative burden of claiming benefits.
    Keywords: welfare reform, mental health, mediation, decomposition, universal credit
    JEL: D61 I10 I14 I38
    Date: 2022–03
  7. By: Xudong An; Stuart A. Gabriel; Nitzan Tzur-Ilan
    Abstract: We investigate the impact of 2020 COVID-19 rental eviction moratoria on household well-being. Analysis of new panel data indicates that eviction moratoria reduced evictions filings and resulted in redirection of scarce household financial resources to immediate consumption needs, notably including food and grocery spending. We also find that eviction moratoria reduced household food insecurity and mental stress, with larger effects evidenced among African American households. Findings suggest broad salutary effects of eviction moratoria during a period of widespread virus and economic distress.
    Keywords: Eviction moratorium; consumption; food security; mental health; COVID-19
    JEL: G28 R30 I38
    Date: 2022–04–05
  8. By: Gaurav Dhamija (Indian Institute of Technology, Hyderabad); Gitanjali Sen (Department Of Economics, Shiv Nadar University)
    Abstract: Exposure to extreme shocks in early life is found to have lasting impact in adulthood. Exploiting the variation in exposure measured by age and intensity of earthquake, we evaluate the impact of a 7.7 MW earthquake in Gujarat, India, on the health stock of children who were in utero or below three years. Using the India Human Development Survey (IHDS-1) data (2004-05) and earthquake intensity data, we find, an affected girl child to be shorter by at least 2.5 cm at the age of 3-6 years. The earthquake seems to have destroyed the household infrastructures and health facilities, affecting the expecting mothers and newborn children. The households using services to meet nutritional needs of children and pregnant women seem to be least affected. Our findings recommend faster reconstruction activities and highlight the importance of universal healthcare and nutritional delivery services to mitigate the impacts of early-life shocks.
    Keywords: Earthquake, child health, height, ZHFA, Shock, India.
    JEL: I1 I3 J1 O2
    Date: 2022–03–28
  9. By: Bridget Hoffmann (Inter-American Development Bank); Juan Pablo Rud ((Royal Holloway, University of London/IFS)
    Abstract: We use high-frequency data on fine particulate matter air pollution (PM 2.5) at the locality level to study the effects of high pollution on labor supply decisions and hospitalizations for respiratory disease in the metropolitan area of Mexico City. We document a negative, non-linear relationship between PM 2.5 and same-day labor supply, with strong effects on days with extremely high pollution levels. On these days, the average worker experiences a reduction of around 7.5% of working hours. Workers partially compensate for lost hours by increasing their labor supply on days that follow high-pollution days. Informal workers reduce their labor supply less than formal workers on high-pollution days and also compensate less on the following days. This suggests that informal workers may experience greater exposure to high pollution and greater reductions in labor supply and income. We provide evidence that reductions in labor supply due to high pollution are consistent with avoidance behavior and that income constraints may play an important role in workers’ labor supply decisions.
    Date: 2022–01
  10. By: Siddique, Abu; Islam, Asad; Mozumder, Tanvir Ahmed; Rahman, Tabassum; Shatil, Tanvir
    Abstract: Forced displacement is a major driver of mental disorders among refugees worldwide. Poor mental health of adult refugees, particularly mothers, is also considered a risk factor for the psychological well-being and development of their children. In this study, we experimentally examine the extent to which a multifaceted psychosocial program improves the mental well-being of refugee mothers, and facilitates growth and development among children under the age of two. In partnership with BRAC, we ran a cluster randomized controlled trial on 3,500 Rohingya mother-child dyads in refugee camps in Bangladesh. Participants were given weekly psychosocial support for a year that includes psychoeducation and parenting support for mothers and play activities for both mothers and children. The intervention was largely successful and led to: (i) reductions in the psychological trauma and depression severity of mothers and children, (ii) improvements in communication, gross-motor, problem-solving, and social skills of children, and (iii) reductions in stunting, underweight, and wasting among children in the treatment group. The intervention also caused the mental health of children to be more aligned with the mental health of their mothers, implying policies targeting the mental well-being of displaced mothers can be an important stepping stone to developing psychological resilience among their children, which can help them grow into well-rounded, healthy adults.
    Date: 2022–03–15
  11. By: Martin González-Rozada; Fiona Franco Churruarin
    Abstract: The main objective is to analyze the determinants of daily smoking prevalence and smoking initiation in Mexico with data from the Global Adult Tobacco Survey (GATS) 2015. We estimate the determinants of prevalence of daily smoking using a probit model and derive the price elasticity. Using two alternative price variables we find a prevalence price elasticity of around -0.40 suggesting that an increment of 10% in cigarette prices could reduce the daily smoking prevalence by 4.0%. Our results show that the participation demand elasticity (or prevalence price elasticity) is larger, in absolute value, for women than for men. An increase of 10% in price is associated with a 4.6% decrease in the probability of daily smoking among women versus a 3.5% decrease in the probability of daily smoking among men. Additionally, increases in prices affect Mexican youth and older people more than middle-aged people. A 10% increase in cigarette prices reduces the probability of daily smoking by 4.3% among youth between 15 and 24 years old, 3.9% for the middle-aged population, and 4.4% for those more than 65 years old. Smoking onset, or initiation, is modeled using a split-population model, allowing for the possibility that some individuals will never start smoking. At the mean risk age of 18 years, an increase of 10% in prices is expected to delay the onset of daily smoking by 1 year and 4 months. These findings suggest that a public policy of increasing excise taxes on cigarettes, with the objective of increasing prices, could be very effective to reduce daily smoking prevalence and smoking initiation. Moreover, increasing the excise tax would be an effective public policy because the poor, youth, and women would be among the groups to benefit most.
    Keywords: Daily smoking prevalence, smoking initiation, cigarette prices, smoking onset, split-population model.
    JEL: C41 I18
    Date: 2021–09
  12. By: Salvatore Barbaro (Johannes Gutenberg University Mainz); Nathalie Neu-Yanders (Institute for Policy Evaluation, Frankfurt)
    Abstract: A widely-supported aim of governments is to reduce the consumption of healthharming tobacco products and to increase their cessation. To reach this goal, the European Union is preparing a revision of its tobacco-related taxation. A crucial question in this revision is how to treat new (non-combustible) products like heated tobacco and e-cigarettes. The taxation of non-combustible products is two-fold: It can contribute to overall cessation since the entire market becomes less attractive or it can prevent traditional smokers from substituting for less harmful products. This paper provides evidence on European consumers’ perceptions of combustible and non-combustible products. First, we assess the reason for substituting for less harmful products. Second, we develop a theoretical framework to determine the optimal tax environment on the tobacco market. Lastly, we survey empirical evidence on US consumers’ responses to e-cigarette taxation and their impact on smoking prevalence. In addition, we apply price elasticity estimates from the US to European market data. Nearly all available data and studies indicate a positive cross-price elasticity, which has significant implications for tax policy. Our policy recommendation encourages price differentials between combustible and non-combustible products such as heated tobacco products and e-cigarettes. Additionally, we argue that smoking prevalence is not a sufficient measure for public health, since consumption of non-combustible alternatives is excluded. As an alternative, a measure for general harm level should be used.
    JEL: I18
    Date: 2022–03–30
  13. By: Goncalves, Judite; Merenda, Roxanne; dos Santos, João Pereira
    Abstract: In February 2017, Portugal implemented a tax on sugar-sweetened beverages (SSBs), under which producers were to be taxed according to the amount of sugar contained in the drinks they manufactured. We exploit administrative accounting data covering the universe of Portuguese firms between 2012 and 2019 to assess the causal impact of this tax on the behavior and performance of producers of SSBs. Our identification strategy relies on event study specifications, using producers of bottled water as counterfactual. Our findings indicate that SSBs producers became significantly less profitable in the post-tax period, vis-à-vis water bottlers, which was driven by a significant decrease in domestic sales. The soda tax hindered firms' capacity to convert receivables into cash and financial health deteriorated as liabilities grew. SSBs producers did not respond to this negative shock by cutting jobs or modifying their labor force towards relatively more skilled labor or higher R&D capacity.
    Keywords: Firm-level impacts,policy evaluation,Portugal,public health,sugar-sweetened beverages tax
    JEL: D22 H25 I18 L66
    Date: 2022
  14. By: Roman, Monica; Zimmermann, Klaus F.; Plopeanu, Aurelian-Petruș
    Abstract: While under communism the identity-providing religion was suppressed, religiosity is strong today even among the youth in post-communist countries. This provides an appropriate background to investigate how external and internal religiosity relates to risky behaviors like smoking, drinking, and drugs among the young. This study shows that not religion as such or internal religiosity, but largely observable (external) religiosity prevents them from wallowing in those vices. While this is found strongly for both males and females, those females doubting or reflecting religion show a somewhat smaller risky activity.
    Keywords: addictive behavior,Orthodox,external and internal religiosity,youth,smoking,drinking,drugs,Romania
    JEL: I12 N34 Z12
    Date: 2022
  15. By: Klimaviciute, Justina (Vilnius University); Pestieau, Pierre (Université catholique de Louvain, LIDAM/CORE, Belgium)
    Abstract: With the rapid increase in long-term care (LTC) needs, it is important to assess the expected contributions of the traditional providers of LTC: the state, the market and the family. We first survey the literature devoted to the family and the market. Then, given the declining role of family caregiving and the negligible role of the market, we look at a number of studies exploring the design of public policies in support of the dependent elderly, particularly those who cannot count on the assistance from their family and those who lack basic means. Those public policies are conceived in such a way that they also rely on both the market and the family.
    Keywords: Long-term care ; dependence ; social insurance ; family solidarity ; social norm
    JEL: I11 I12 I18 J14
    Date: 2022–01–22
  16. By: Philippe Batifoulier (CEPN - Centre d'Economie de l'Université Paris Nord - UP13 - Université Paris 13 - USPC - Université Sorbonne Paris Cité - CNRS - Centre National de la Recherche Scientifique); Rainer Diaz-Bone (University of Lucerne)
    Abstract: The article introduces the approach of economics and sociology of conventions (in short EC) as a neopragmatist institutionalism in the field of economics and sociology of health. For EC, conventions are regarded as institutional logics of valuation, valorization and coordination, and EC emphasizes the empirical plurality of orders of worth and values, actors rely on and institutions are built on. Especially health, health care and its institutions are closely linked to value issues and norms. Because of the pluralism of possible value systems and orders of worth, tensions and critiques are an important empirical phenomenon to be addressed in the health care system. The contribution sketches main positions and perspectives of EC in the analysis of values, medical professions and ethics, of datafication, quantification and classification (related to health and health care institutions), of social inequalities, as well as in the analysis of health policies and health capitalism. Also, the COVID-19 pandemic and its consequences are discussed from the standpoint of EC, finally social trends and perspectives in times of the pandemic are outlined.
    Abstract: Cet article est l'introduction du numéro spécial de la revue Historical Social Research (46, 2021) consacré aux apports du courant de l'Economie des conventions dans le domaine de la santé. L'article présente l'approche de l'économie et de la sociologie des conventions (en abrégé EC) comme un institutionnalisme néopragmatiste dans le domaine de l'économie et de la sociologie de la santé. Pour l'EC, les conventions sont considérées comme des logiques institutionnelles d'évaluation, de valorisation et de coordination et l'EC met l'accent sur la pluralité empirique des ordres de valeur sur lesquels les acteurs s'appuient et sur lesquels les institutions sont construites. En particulier, les soins de santé et leurs institutions sont étroitement liés aux questions de valeurs et aux normes. En raison du pluralisme des systèmes de valeurs et des ordres de valeur possibles, les tensions et les critiques sont un phénomène empirique important à prendre en compte dans le système de soins de santé. La contribution esquisse les principales positions et perspectives de l'EC dans l'analyse des valeurs, des professions médicales et de l'éthique, de la quantification et de la classification des données, des inégalités sociales, ainsi que dans l'analyse des politiques de santé et du capitalisme sanitaire. De plus, la pandémie COVID-19 et ses conséquences sont discutées du point de vue de l'EC.
    Keywords: Economis of convention,sociology of conventions,valorization,health economics,COVID-19 pandemic,quantification,social inequality,neopragmatism,health capitalism
    Date: 2022–02–22
  17. By: Philippe Batifoulier (CEPN - Centre d'Economie de l'Université Paris Nord - UP13 - Université Paris 13 - USPC - Université Sorbonne Paris Cité - CNRS - Centre National de la Recherche Scientifique); Anne-Sophie Ginon
    Abstract: In France, there are two types of health insurance: compulsory public health insurance and voluntary private health insurance which is organized as a market. This paper deals with private health insurance. We define the market place (position and scope) according to two criteria. On the one hand, the standardization or differentiation strategies of the insurance companies, which structure competition through quality and innovation. Secondly, the type of pooling (or mutualisation) at work in insurance contracts, distinguishing between commercial pooling and solidarity-based pooling. We draw up a typology of four "ideal-type" market configurations: residual market, educated market, polarized market and autonomous market.
    Date: 2022–02–22
  18. By: INOUE Hiroyasu; TODO Yasuyuki
    Abstract: This study examines how the COVID-19 pandemic has affected online consumption using data from a major online shopping platform in Japan. Our particular focus is the effect of two measures of the pandemic, i.e., the number of positive cases of COVID-19 and the declaration of states of emergency to mitigate the pandemic. We find that both measures promoted online consumption at the beginning of the pandemic, but their effect then faded in later periods. In addition, online consumption is found to have returned to normal after states of emergency ended, and the overall time trend in online consumption excluding the effects of the two measures was also stable during the first two years of the pandemic. These results suggest that the effect of the pandemic on online consumption is temporary and will not persist after the pandemic.
    Date: 2022–03
  19. By: Lauren Périères (VITROME - Vecteurs - Infections tropicales et méditerranéennes - IRBA - Institut de Recherche Biomédicale des Armées - IRD - Institut de Recherche pour le Développement - AMU - Aix Marseille Université); Aldiouma Diallo (VITROME - Vecteurs - Infections tropicales et méditerranéennes - IRBA - Institut de Recherche Biomédicale des Armées - IRD - Institut de Recherche pour le Développement - AMU - Aix Marseille Université); Fabienne Marcellin (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD - Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale - IRD - Institut de Recherche pour le Développement - AMU - Aix Marseille Université - INSERM - Institut National de la Santé et de la Recherche Médicale); Marie Libérée Nishimwe (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD - Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale - IRD - Institut de Recherche pour le Développement - AMU - Aix Marseille Université - INSERM - Institut National de la Santé et de la Recherche Médicale); El Hadji Ba (VITROME - Vecteurs - Infections tropicales et méditerranéennes - IRBA - Institut de Recherche Biomédicale des Armées - IRD - Institut de Recherche pour le Développement - AMU - Aix Marseille Université); Marion Coste (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); Gora Lo (IRESSEF - Institut de Recherche en Santé, de Surveillance Épidémiologique et de Formation [Dakar, Sénégal]); Philippe Halfon (ALPHABIO - Laboratoire de biologie médicale, Hôpital Européen [Fondation Ambroise Paré - Marseille]); Coumba Touré Kane (IRESSEF - Institut de Recherche en Santé, de Surveillance Épidémiologique et de Formation [Dakar, Sénégal]); Gwenaëlle Maradan (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD - Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale - IRD - Institut de Recherche pour le Développement - AMU - Aix Marseille Université - INSERM - Institut National de la Santé et de la Recherche Médicale, ORS PACA - Observatoire régional de la santé Provence-Alpes-Côte d'Azur [Marseille]); Patrizia Carrieri (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD - Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale - IRD - Institut de Recherche pour le Développement - AMU - Aix Marseille Université - INSERM - Institut National de la Santé et de la Recherche Médicale); Assane Diouf (VITROME - Vecteurs - Infections tropicales et méditerranéennes - IRBA - Institut de Recherche Biomédicale des Armées - IRD - Institut de Recherche pour le Développement - AMU - Aix Marseille Université); Yusuke Shimakawa (Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology - UPC - Université Paris Cité - PACRI - Pasteur-Cnam Risques infectieux et émergents - Institut Pasteur [Paris] - CNAM - Conservatoire National des Arts et Métiers [CNAM] - HESAM - HESAM Université - UPC - Université Paris Cité); Cheikh Sokhna (VITROME - Vecteurs - Infections tropicales et méditerranéennes - IRBA - Institut de Recherche Biomédicale des Armées - IRD - Institut de Recherche pour le Développement - AMU - Aix Marseille Université); Sylvie Boyer (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD - Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale - IRD - Institut de Recherche pour le Développement - AMU - Aix Marseille Université - INSERM - Institut National de la Santé et de la Recherche Médicale); Cyril Bérenger; Marwan Al Qays Bousmah; Patrizia Carrieri; Maëlle de Seze; Tchadine Djaogol; Carole Treibich; Elhadji Ba; Fambaye Dièye; Elhadji Bilal Faye; Assane Ndiaye; Mouhamadou Baba Sow; Anna Julienne Selbé Ndiaye; Samba Ndiour; Sofiane Mohamed; Nicolas Rouveau; Maria‐camila Calvo Cortès; Gabrièle Laborde‐balen; Martine Audibert; Fatou Fall; Ibrahima Gueye; Karine Lacombe; Moussa Seydi; Edouard Tuaillon (CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier], PCCEI - Pathogenesis and Control of Chronic and Emerging Infections - INSERM - Institut National de la Santé et de la Recherche Médicale - UM - Université de Montpellier - UA - Université des Antilles - Etablissement français du don du sang [Montpellier]); Muriel Vray
    Abstract: Senegal introduced the infant hepatitis B virus (HBV) vaccination in 2004 and recently committed to eliminating hepatitis B by 2030. Updated epidemiological data are needed to provide information on the progress being made and to develop new interventions. We estimated the prevalence of hepatitis B surface antigen (HBsAg) in children and adults living in rural Senegal and assessed hepatitis B treatment eligibility. A cross-sectional population-based serosurvey of HBsAg was conducted in 2018-2019 in a large sample (n = 3,118) of residents living in the Niakhar area (Fatick region, Senegal). Individuals positive for HBsAg subsequently underwent clinical and biological assessments. Data were weighted for age and sex and calibrated to be representative of the area's population. Among the 3,118 participants, 206 were HBsAg positive (prevalence, 6.9%; 95% confidence interval [CI], 5.6-8.1). Prevalence varied markedly according to age group in individuals aged 0-4, 5-14, 15-34, and >= 35 years as follows: 0.0% (95% CI, 0.00-0.01); 1.5% (95% CI, 0.0-2.3); 12.4% (95% CI, 9.1-15.6); and 8.8% (95% CI, 6.1-11.5), respectively. Of those subsequently assessed, 50.9% (95% CI, 41.8-60.0) had active HBV infection; 4 (2.9%; 95% CI, 0.9-9.4) were eligible for hepatitis B treatment. Conclusion: In this first population-based serosurvey targeting children and adults in rural Senegal, HBsAg prevalence was very low in the former, meeting the World Health Organization's (WHO)
    Date: 2022
  20. By: Flawinne, Xavier; Lefebvre, Mathieu; Perelman, Sergio; Pestieau, Pierre (Université catholique de Louvain, LIDAM/CORE, Belgium); Schoenmaeckers, Jerome
    Abstract: The current health crisis has particularly affected the elderly population. Nursing homes have unfortunately experienced a relatively large number of deaths. On the basis of this observation and working with European data (from SHARE), we want to check whether nursing homes were lending themselves to excess mortality even before the pandemic. Controlling for a number of important characteristics of the elderly population in and outside nursing homes, we conjecture that the difference in mortality between those two samples is to be attributed to the way nursing homes are designed and organised. Using matching methods, we observeexcess mortality in Belgium, France, Germany Luxembourg, Switzerland, Estonia and Czech Republic but no statistically significant excess mortality in Sweden, the Netherlands, Denmark, Austria, Italy or Spain. This raises the question of the organisation and management of these nursing homes, but also of their design and financing.
    Keywords: Nursing homes ; mortality ; propensity score matching ; SHARE
    JEL: C21 I10 J14
    Date: 2022–02–01
  21. By: Di Maio, Michele (Sapienza University of Rome); Fasani, Francesco (University of Milan); Sciabolazza, Valerio Leone (Sapienza University of Rome); Molini, Vasco (World Bank)
    Abstract: We use novel survey data to assess the impact of COVID-19 pandemic on the Libyan population. In our sample, 9.5% of respondents report that a household member has been infected by COVID-19, while 24.7% of them have suffered economic damages and 14.6% have experienced negative health effects due to the pandemic. Our analysis focuses on the differences between IDPs and non-displaced individuals, controlling for individuals and household characteristics, geo-localized measures of economic activity and conflict intensity. Displaced individuals do not experience higher incidence of COVID-19 relative to comparable non-displaced individuals, but are about 60% more likely than non-displaced respondents to report negative economic and health impacts caused by the pandemic. Our results suggest that the larger damages suffered by IDPs can be explained by their weaker economic status - which leads to more food insecurity and indebtedness - and by the discrimination they face in accessing health care.
    Keywords: internally displaced persons, COVID-19, debt, health, forced migration, conflict, Libya
    JEL: F22 J61 K37
    Date: 2022–03
  22. By: David Turner; Nicolas Woloszko; Thomas Chalaux; Marnix Dek
    Abstract: Resolving stark differences between rich and poor countries in vaccine coverage against COVID is a global policy priority for 2022. However, even among OECD countries, there currently remain surprisingly large differences in vaccine coverage and this paper attempts to explain these differences, including the role that policy has played. The main findings are: vaccination has had massive health and economic benefits; vaccine hesitancy can be overcome, although there remains a link with historical flu and MMR vaccination rates; well-designed vaccine passes can boost coverage; trust in government and other public institutions matter, although the link to vaccine coverage is not straight-forward; demographic structure and policy stances towards vaccinating children play a role in explaining differences in overall population vaccination rates; mandatory vaccination has been implemented or is being considered in a few OECD countries, although it is too early to assess the effects. Finally, case studies of the most successful vaccination campaigns provide additional illumination, which cannot easily be captured in multi-country correlations.
    Keywords: COVID, COVID certificates, Sars-Cov-2, vaccination rate, vaccine hesitancy, vaccine pass
    JEL: E61 I18
    Date: 2022–04–04
  23. By: Hunt, Joanne Elizabeth
    Abstract: Whilst critically informed approaches to medical education are increasingly advocated in literature, discussion of the potential role of disability studies in informing pedagogy and practice is largely lacking. The emergence of Long Covid, alongside the possibility of a wave of covid-related disability, underlines an urgent need for medicine to develop more contextualised, nuanced and structurally competent understandings of chronic illness and disability. This article argues that the integration of thinking from disability studies into medical curricula offers a pathway to such understanding, informing a more equitable, holistic and patient-centred approach to practice. Further, a structurally competent, anti-ableist approach positions clinicians and patients as allies, working together within a structural context that constrains both parties. Such positioning may mitigate tensions within the clinical encounter, tensions that are well-documented in the realm of marginalised chronic illness and disability. Whilst the possibilities arising from a partnership between disability studies and medicine are numerous, the foci here are the social relational model of disability and the concept of psycho-emotional disablism, within a broader paradigm of critical disability studies. It is argued that inadequate healthcare provision and policy in the realm of Long Covid can be understood as a form of structural and psycho-emotional disablism, arising from and reinforcing an ableist psychosocial imaginary permeated with neoliberal assumptions, and carrying a risk of furthering both disability and impairment. After considering Long Covid through these particular lenses, the article concludes with a discussion of how a partnership between disability studies and a structurally competent approach to medical education might translate into practice.
    Date: 2022–02–28
  24. By: INOUE Tomoo; OKIMOTO Tatsuyoshi
    Abstract: The novel coronavirus disease 2019 (COVID-19) outbreak has caused great turmoil around the world and is yet to be contained. Mitigating the number of people infected by COVID-19 remains a major policy goal for several countries. The purpose of this study is to analyze the dynamic relationship between mobility and the rate of change in the number of new infections in Japan. Another goal is to evaluate the effects of various policies, such as human mobility control and vaccination, as well as the impact of climate factors on the number of infections. The analysis reveals a strong positive relationship between the growth rate of the number of infections and mobility. Our results also indicate that the declaration of the state emergency effectively controlled the infection, although the effect seems to be weaker with additional declarations of a state of emergency. On the effect of vaccination, the results find little effect of vaccination on reducing the spread of infection through a reduction in susceptible population, but it has significantly weakened the mobility-spread relationship, suggesting that it may be useful in implementing economic revitalization policies.
    Date: 2022–02
  25. By: Kutasi Kristóf (Rice University, Department of Economics, Houston TX, 77005-1827, USA); Koltai Júlia (Centre for Social Sciences, Computational Social Science - Research Center for Educational and Network Studies, Budapest, 1097, HungaryEötvös Loránd University, Faculty of Social Sciences, Budapest, 1117, Hungary Central European University, Department of Network and Data Science, Vienna, 1100, Austria); Szabó-Morvai Ágnes (Eötvös Loránd Research Network, Centre for Economic and Regional Studies, Health and Population Lendület Research Group, Budapest, 1097, Hungary Debrecen University, Department of Economics, Debrecen, 4032, Hungary); Röst Gergely (University of Szeged, Bolyai Institute, Szeged, 6722, Hungary); Karsai Márton (Central European University, Department of Network and Data Science, Vienna, 1100, Austria Alfréd Rényi Institute of Mathematics, Budapest, 1053, Hungary); Biró Péter (Eötvös Loránd Research Network, Centre for Economic and Regional Studies, Mechanism Design Lendület Research Group, Budapest, 1097, Hungary Corvinus University of Budapest, Department of Operations Research and Actuarial Sciences, Budapest, 1093, Hungary); Lengyel Balázs (Eötvös Loránd Research Network, Centre for Economic and Regional Studies, Agglomeration and Social Networks Lendület Research Group, Budapest, 1097, HungaryCorvinus University of Budapest, Corvinus Institute for Advanced Studies, Budapest,)
    Abstract: Many countries have secured larger quantities of COVID-19 vaccines than their populace is willing to take. This abundance and variety of vaccines created a historical moment to understand vaccine hesitancy better. Never before were more types of vaccines available for an illness and the intensity of vaccine-related public discourse is unprecedented. Yet, the heterogeneity of hesitancy by vaccine types in certain segments of society has been neglected so far, even though factual or believed vaccine characteristics and patient attributes are known to influence acceptance. In this paper, we address this problem by analysing acceptance and assessment of five vaccine types using information collected with a nationally representative survey (N=1000) at the end of the third wave of the COVID-19 pandemic in Hungary, where a unique portfolio of vaccines were available to the public in large quantities. Our special case enables us to quantify revealed preferences across vaccine types since one could evaluate a vaccine unacceptable and even could reject an assigned vaccine to wait for another type. We find that the source of information that respondents trust characterizes their attitudes towards vaccine types differently and leads to divergent vaccine hesitancy. Believers of conspiracy theories were significantly more likely to evaluate the mRNA vaccines (Pfizer and Moderna) unacceptable while those who follow the advice of politicians evaluate vector-based (AstraZeneca and Sputnik) or whole-virus vaccines (Sinopharm) acceptable with higher likelihood. We illustrate that the rejection of non-desired and re-selection of preferred vaccines fragments the population by the mRNA versus other type of vaccines while it generally improves the assessment of the received vaccine. These results highlight that greater variance of available vaccine types and individual free choice are desirable conditions that can widen the acceptance of vaccines in societies.
    Keywords: vaccination, COVID-19, revealed preferences
    JEL: I12
    Date: 2022–03
  26. By: Ella Sargsyan
    Abstract: Identifying the impacts of conflicts and understanding the origins of gender gaps are both seemingly unrelated but crucial questions in the literature. Focusing on the gap at the intersection of these two branches of literature, this study explores whether and how longrun exposure to violent conflicts contributes to and shapes the child gender preferences of parents. I use temporal and spatial variations in conflicts in Nigeria and combine the Uppsala Conflict Data Program and the Demographic and Health Surveys Program to perform the analysis. The results show that the effect of long-run exposure to violent conflicts on stated preferences (attitudes) for boys is not homogeneous. While conflict events with low or no civilian death increase preferences for sons, violence targeted at civilians works in the opposite direction and decreases preferences for boys. I find no evidence of translating these preferences into behaviour via sex-selective abortions. Instead, evidence shows that parents use the stopping rule to achieve the desired gender composition of children. Further, analysis also indicates that, in the districts affected by conflict, parents have a positive bias towards boys in terms of their postnatal health investment.
    Keywords: gender preferences; son preference; violent conflicts; attitudes and behaviour;
    Date: 2022–03
  27. By: Do, Huyen Thanh; Nguyen, Cuong Viet; Nguyen, Long Thanh; Nguyen, Phuong Minh; Ngo, Quyen Ha; Phung, Tung Duc
    Abstract: This study explores the impact of COVID-19 and how Vietnamese citizens perceived and experienced measures adopted by central and local governments to contain the CVODI-19 pandemic in 2021. In general, the COVID-19 pandemic had a more severe impact in 2021 than in 2020. Citizens showed great concern about their children’s education (76 percent) and their personal health (68 percent). COVID-19 negatively impacted employment and income, with 77 percent of the respondents reporting income reduction due to the pandemic. The poor, ethnic minorities, unskilled, non-farm workers, and those working in the service sector or living in provinces with longer lockdowns were the most likely to suffer. Compared with 2020, in 2021, respondents showed a high but declining positive assessment of government performance in dealing with the pandemic, with 84 percent of the respondents rating the responses from the Central Government as good or very good (97 percent in 2020), 89 percent rating the response from their provincial governments’ responses as good or very good (94 percent in 2020). Only 13 percent of the respondents received support from the Government’s package. However, ethnic minorities, female, poorer and rural respondents were less likely to receive the support. For the support recipients, delivery was regarded as timely and transparent, but administrative procedures to get access to the package were not simple. Meanwhile, support from non-governmental organizations (NGOs), social organizations, charity foundations, and individuals was distributed more efficiently, with 25 percent of the respondents receiving support from these sources.
    Keywords: COVID-19,government policy,citizens' opinions,aid package,Vietnam
    Date: 2022

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