nep-hea New Economics Papers
on Health Economics
Issue of 2022‒06‒20
34 papers chosen by
Nicolas R. Ziebarth
Cornell University

  1. The anatomy of a hospital system merger: the patient did not respond well to treatment By Martin Gaynor; Adam Sacarny; Raffaella Sadun; Chad Syverson; Shruthi Venkatesh
  2. The Return to Work in Disablity Programs: What Has Been Learned and Next Steps By Moffitt, Robert; Gregory, Jesse
  3. Beyond The Haze: Air Pollution and Student Absenteeism - Evidence from India By Singh, Tejendra Pratap
  4. Are women breaking the glass ceiling? A gendered analysis of the duration of sick leave in Spain By Martín-Román, Ángel L.; Moral, Alfonso; Pinillos-Franco, Sara
  5. Into the tropics: Temperature, mortality, and access to health care in Colombia By Juliana Helo Sarmiento
  6. Beyond Barker: Infant Mortality at Birth and Ischaemic Heart Disease in Older Age By Samuel Baker; Pietro Biroli; Hans van Kippersluis; Stephanie von Hinke
  7. When burnout tips the scales against you: An experimental investigation of employees’ burnout history in layoff decisions By Philippe Sterkens
  8. Does unemployment worsen babies’ health? A tale of siblings, maternal behaviour, and selection By De Cao, Elisabetta; McCormick, Barry; Nicodemo, Catia
  9. Regime and Treatment Effects in Duration Models: Decomposing Expectation and Transplant Effects on the Kidney Waitlist By Kastoryano, Stephen
  10. A flexible copula regression model with Bernoulli and Tweedie margins for estimating the effect of spending on mental health By Giampiero Marra; Matteo Fasiolo; Rosalba Radice; Rainer Winkelmann
  11. Locus of Control, Self-Control, and Health Outcomes By Botha, Ferdi; Dahmann, Sarah C.
  12. Advantageous selection without moral hazard (with an application to life care annuities) By Philippe De Donder; Marie-Louise Leroux
  13. The impact of healthcare IT on clinical quality, productivity and workers By Ari Bronsoler; Joseph Doyle; John Van Reenen
  14. Medical Device Companies and Doctors: Do their interactions affect medical treatments? By Amaral-Garcia, S.;
  15. "Better the devil you know": are stated preferences over health and happiness determined by how healthy and happy people are? By Matthew D. Adler; Paul Dolan; Amanda Henwood; Georgios Kavetsos
  16. Personalized Information Provision and the Take-Up of Emergency Government Benefits: Experimental Evidence from India By Amrit Amirapu; Irma Clots-Figueras; Bansi Malde; Anirban Mitra; Debayan Pakrashi; Zaki Wahhaj
  17. Disclosing the ‘Big C’: What Does Cancer Survivorship Signal to Employers? By Philippe Sterkens; Adelina Sharipova; Stijn Baert
  18. Scientific Advancements in Illegal Drugs Production and Institutional Responses: New Psychoactive Substances, Self-Harm, and Violence inside Prisons By D'Este, Rocco
  19. Filling in the gaps: Expanding social protection in Colombia By Paula Garda; Jens Matthias Arnold
  20. Online productivity and types of assignments in a Japanese workplace By Kostiantyn Ovsiannikov; Koji Kotani; Hodaka Morita
  21. Residual capacity and the political economy of pandemic response in Ghana By Kofi Takyi Asante
  22. Rational social distancing policy during epidemics with limited healthcare capacity By Simon K. Schnyder; John J. Molina; Ryoichi Yamamoto; Matthew S. Turner
  23. The Prevalence and Correlates of Prospective Vaccine Hesitancy Among Individuals who Received COVID-19 Vaccine Boosters. By Motta, Matt
  24. Spatial and Temporal Trends in Travel for COVID-19 Vaccinations By Cochran, Abigail L.; Wang, Jueyu; Wolfe, Mary; Iacobucci, Evan; Vinella-Brusher, Emma; McDonald, Noreen
  25. Prosocial motivation for vaccination By Reddinger, J. Lucas; Charness, Gary; Levine, David
  26. The impact of the Covid-19 pandemic and government intervention on active mobility By Alessa Möllers; Sebastian Specht; Jan Wessel
  27. Working from Home during a Pandemic – A Discrete Choice Experiment in Poland By Lewandowski, Piotr; Lipowska, Katarzyna; Smoter, Mateusz
  28. Dismissed and newly planned babies during the COVID-19 pandemic. A study of the motivations behind changes in fertility plans and behaviors in Italy By LUPPI, FRANCESCA; Arpino, Bruno; Rosina, Alessandro
  29. Social Distancing, Vaccination and Evolution of COVID-19 Transmission Rates in Europe By Chudik, A.; Pesaran, M. H.; Rebucci, A.
  30. What future for apprenticeships after coronavirus? By Guglielmo Ventura
  31. Short-time work policies during the COVID-19 pandemic By Julien Albertini; Xavier Fairise; Arthur Poirier; Anthony Terriau
  32. Geographies of grocery shopping in major Canadian cities: evidence from large-scale mobile app data By Smith, Lindsey Gail; Yifei, Maggie Ma; Widener, Michael; Farber, Steven
  33. COVID-19 and informal work: Degrees and pathways of impact in 11 cities around the world By Martha Alter Chen; Erofili Grapsa; Ghida Ismail; Sarah Orleans Reed; Michael Rogan; Marcela Valdivia
  34. Employer Reallocation During the COVID-19 Pandemic: Validation and Application of a Do-It-Yourself CPS By Alexander Bick; Adam Blandin

  1. By: Martin Gaynor; Adam Sacarny; Raffaella Sadun; Chad Syverson; Shruthi Venkatesh
    Abstract: Despite the continuing US hospital merger wave, it remains unclear how mergers change, or fail to change, hospital behavior and performance. We open the "black box" of hospital practices through a mega-merger between two for-profit chains. Benchmarking the merger's effects against the acquirer's stated aims, we show they achieved some of their goals, harmonizing electronic medical records and sending managers to target hospitals. Post-acquisition managerial processes were similar across the merged chain. However, these interventions failed to drive detectable gains in performance. Our findings demonstrate the importance of organizations for merger research in health care and the economy more generally.
    Date: 2022–12
  2. By: Moffitt, Robert (Johns Hopkins University, Department of Economics); Gregory, Jesse
    Abstract: We review a number of demonstrations conducted by the Social Security Administration which have attempted to improve labor market outcomes for disabled worker beneficiaries of the Social Security Disability Insurance program and disabled recipients of the Supplemental Security Income program. Based on our review, we draw lessons for the design of programs which improve work incentives and suggest possible elements of new demonstrations. *
    Keywords: Keywords, Disability, Work, Demonstrations
    JEL: I38 J14
    Date: 2022–01–24
  3. By: Singh, Tejendra Pratap
    Abstract: Air pollution remains one of the most challenging environmental phenomena. Despite its importance in impacting various facets of everyday life, there is a paucity of well-identified air pollution estimates on short-term outcomes for developing countries. Using novel data, I provide detailed empirical evidence on the direct effect of air pollution on student absenteeism in India by linking local exposure to fine particulate matter (PM2.5) to school attendance. I find a large negative effect of increased air pollution on school attendance. My results are robust to a host of specifications and a battery of robustness checks. Consistent with other works, I find that the effect is more pronounced for younger students and find evidence for differential impacts of air pollution on absenteeism by gender. Exploring the mechanisms behind increased absenteeism, I show that reduced school attendance might be resulting from increased incidence of respiratory ailments in the students exposed to air pollution.
    Date: 2022–05–11
  4. By: Martín-Román, Ángel L.; Moral, Alfonso; Pinillos-Franco, Sara
    Abstract: We study the gender gap in the duration of sick leave in Spain by splitting this duration into two types of days - those which are related to biological characteristics and those derived from behavioral reasons. Using the Statistics of Accidents at Work for 2011-2019, we found that women presented longer standard durations (i.e., purely attached to physiological reasons) compared to men. However, when estimating individuals' efficiency as the ratio between actual and standard durations, we found that women were more inefficient at lower levels of income, whereas in case of men, this occurred at higher levels of income. These results were reinforced when considering that men and women do not recover from the same injury at the same rate. Women were more efficient than men across all the compensation distribution, especially at higher income levels.
    Keywords: Moral hazard,Glass ceiling,Workplace injuries,Gender,Stochastic frontiers
    JEL: I12 I13 I18 J28
    Date: 2022
  5. By: Juliana Helo Sarmiento
    Abstract: This paper analyzes the relationship between temperature, mortality, and adaptation opportunities in a tropical country. Such countries host almost 40% of the world's population, and face inherently different environmental, demographic, and socio-economic conditions than their counterparts in temperate areas. Using detailed data from all Colombian municipalities, I show that even at narrow temper- ature ranges, which are characteristic of the tropics, anomalously hot or cold days increase mortality. An additional day with mean temperature above 27°C (80.6°F) increases mortality rates by approximately 0.24 deaths per 100,000, equivalent to 0.7% of monthly death rates. Unlike temperate locations, I find that deaths attributed to infectious diseases and respiratory illnesses drive this relationship in the hot part of the distribution, mainly affecting children aged 0-9. These findings uncover new factors and populations at risk, and imply that the average person who dies after a hot temperature shock loses approximately 30 years of life. I also provide evidence that access to health care and quality of services could serve as a mediating factor between temperature and mortality.
    Keywords: Weather, Temperature, Mortality
    JEL: I12 Q50 Q54
    Date: 2022–05–20
  6. By: Samuel Baker; Pietro Biroli; Hans van Kippersluis; Stephanie von Hinke
    Abstract: Adverse conditions in early life can have consequential impacts on individuals' health in older age. In one of the first papers on this topic, Barker and Osmond 1986 show a strong positive relationship between infant mortality rates in the 1920s and ischaemic heart disease in the 1970s. We go 'beyond Barker', first by showing that this relationship is robust to the inclusion of local geographic area fixed effects, but not family fixed effects. Second, we explore whether the average effects conceal underlying heterogeneity: we examine if the infant mortality effect offsets or reinforces one's genetic predisposition for heart disease. We find considerable heterogeneity that is robust to within-area as well as within-family analyses. Our findings show that the effects of one's early life environments mainly affect individuals with the highest genetic risk for developing heart disease. Put differently, in areas with the lowest infant mortality rates, the effect of one's genetic predisposition effectively vanishes. These findings suggest that advantageous environments can cushion one's genetic risk of developing heart disease.
    Date: 2022–05
  7. By: Philippe Sterkens (-)
    Abstract: Studies have shown that workers with a history of burnout are penalised in the labour market through lower hiring and promotion probabilities. The current study contributes to this body of literature by analysing how the formerly burned-out fare in the setting of a layoff. To do so, a vignette experiment is conducted among 197 managers who rated employees varying, amongst others characteristics, in their employment history at the organisation. Hence, I find that employees who have experienced burnout are more likely to be selected for a layoff than workers without an interruption in their working record, regardless of their current performance level and current health. In addition, the effect of burnout on the likeliness to be selected for layoff is more pronounced among older managers and varies by the respondents’ socially desirable response tendencies.
    Keywords: Burnout, Layoff, Vignette experiment, Social desirability
    Date: 2022–05
  8. By: De Cao, Elisabetta; McCormick, Barry; Nicodemo, Catia
    Abstract: We study in-utero exposure to economic fluctuations on birth outcomes by exploiting geographical variation in the unemployment rate across local areas in England, and by comparing siblings born to the same mother. Using rich individual data from hospital administrative records for 2003–2012, babies’ health is found to be strongly pro-cyclical. This overall result masks marked differences between babies born in the most affluent areas whose health at birth improves in a recession, and babies born in the average-to-lowest income deprived areas whose health deteriorates. Maternal alcohol consumption, smoking, and delay in the first antenatal care assessment - combined with parental income loss, are found to drive the results. While differences in maternal risky behaviours can explain the heterogenous effects.
    Keywords: unemployment rate; birth outcomes; birthweight; fertility; England; ES/T008415/1; NIHR Applied Research Collaboration Oxford and Thames Valley at Oxford Health NHS Foundation Trust
    JEL: E24 I10 I12 J13
    Date: 2022–05–01
  9. By: Kastoryano, Stephen (University of Reading)
    Abstract: This paper proposes a causal decomposition framework for settings in which an initial regime randomization influences the timing of a treatment duration. The initial randomization and treatment affect in turn a duration outcome of interest. Our empirical application considers the survival of individuals on the kidney transplant waitlist. Upon entering the waitlist, individuals with an AB blood type, who are universal recipients, are effectively randomized to a regime with a higher propensity to rapidly receive a kidney transplant. Our dynamic potential outcomes framework allows us to identify the pre-transplant effect of the blood type, and the transplant effects depending on blood type. We further develop dynamic assumptions which build on the LATE framework and allow researchers to separate effects for different population substrata. Our main empirical result is that AB blood type candidates display a higher pre-transplant mortality. We provide evidence that this effect is due to behavioural changes rather than biological differences.
    Keywords: dynamic treatment effects, survival models, expectation effects, kidney transplant
    JEL: C22 C41 I12
    Date: 2022–05
  10. By: Giampiero Marra; Matteo Fasiolo; Rosalba Radice; Rainer Winkelmann
    Abstract: Previous evidence shows that better insurance coverage increases medical expenditure. However, formal studies on the effect of spending on health outcomes, and especially mental health, are lacking. To fill this gap, we reanalyze data from the Rand Health Insurance Experiment and estimate a joint non-linear model of spending and mental health. We address the endogeneity of spending in a flexible copula regression model with Bernoulli and Tweedie margins and discuss its implementation in the freely available GJRM R package. Results confirm the importance of accounting for endogeneity: in the joint model, a $1000 spending in mental care is estimated to reduce the probability of low mental health by 1.3 percentage points, but this effect is not statistically significant. Ignoring endogeneity leads to a spurious (upwardly biased) estimate.
    Keywords: Binary response, co-payment, copula, health expenditures, penalized regression spline, Rand experiment, simultaneous estimation, Tweedie distribution
    JEL: I13 C31
    Date: 2022–05
  11. By: Botha, Ferdi (University of Melbourne); Dahmann, Sarah C. (University of Melbourne)
    Abstract: We provide the first empirical evidence on the direct link between locus of control and self-control, and how they interact in explaining a range of health outcomes. Using rich Australian survey data, we find that, while the two traits are distinct constructs, a greater internal locus of control is associated with higher self-control. The association between locus of control and health is reduced once we control for self-control, suggesting that self-control mediates at least part of this relationship. Finally, an internal locus of control amplifies the beneficial effects of self-control particularly for physical health.
    Keywords: locus of control, self-control, health, health behavior
    JEL: D91 I12 I31
    Date: 2022–05
  12. By: Philippe De Donder; Marie-Louise Leroux
    Abstract: Advantageous (or propitious) selection occurs when an increase in the premium of an insurance contract induces high-cost agents to quit, thereby reducing the average cost among remaining buyers. Hemenway (1990) and many subsequent contributions motivate its advent by differences in risk-aversion among agents, implying different prevention efforts. We argue that it may also appear in the absence of moral hazard, when agents only differ in riskiness and not in (risk) preferences. We first show that profit-maximization implies that advantageous selection is more likely when markup rates and the elasticity of insurance demand are high. We then move to standard settings satisfying the single-crossing property and show that advantageous selection may occur when several contracts are offered, when agents also face a non-insurable background risk, or when agents face two mutually exclusive risks that are bundled together in a single insurance contract. We exemplify this last case with life care annuities, a product which bundles long-term care insurance and annuities, and we use Canadian survey data to provide an example of a contract facing advantageous selection. To quote this document : De Donder P., Leroux M-L and Salanié F. (2022). Advantageous selection without moral hazard (with an application to life care annuities). (2022s-13, CIRANO). La sélection avantageuse (ou propice) se produit lorsqu'une augmentation de la prime d'un contrat d'assurance incite les acteurs à coût élevé à démissionner, réduisant ainsi le coût moyen parmi les acheteurs restants. Hemenway (1990) et de nombreuses contributions ultérieures motivent son apparition par des différences d'aversion au risque entre les acteurs, impliquant des efforts de prévention différents. Nous soutenons que la sélection avantageuse peut également apparaître en l'absence d'aléa moral, lorsque les agents ne diffèrent que par leur niveau de risque et non par leurs préférences (en matière de risque). Nous montrons d'abord que la maximisation du profit implique que la sélection avantageuse est plus probable lorsque les taux de marge et l'élasticité de la demande d'assurance sont élevés. Nous étudions ensuite des environnements économiques standard dans lesquels la propriété de croisement unique est satisfaite et montrons que la sélection avantageuse peut se produire lorsque plusieurs contrats sont proposés, lorsque les acteurs sont également confrontés à un risque [supp : de fond] non assurable, ou lorsque les acteurs sont confrontés à deux risques mutuellement exclusifs qui sont regroupés dans un seul contrat d'assurance. Nous illustrons ce dernier cas avec [supp : les rentes viagères,] un produit qui regroupe l'assurance soins de longue durée et les rentes, et nous utilisons des données d'enquête canadiennes pour fournir un exemple de contrat faisant l'objet de sélection avantageuse. Pour citer ce document : De Donder P., Leroux M-L and Salanié F. (2022). Advantageous selection without moral hazard (with an application to life care annuities). (2022s-13, CIRANO).
    Keywords: Propitious selection,positive or negative correlation property,contract bundling,long-term care insurance,annuity, Sélection propice,propriété de corrélation positive ou négative,regroupement de contrats,assurance soins de longue durée,rente
    JEL: D82 I13
    Date: 2022–05–26
  13. By: Ari Bronsoler; Joseph Doyle; John Van Reenen
    Abstract: Adoption of health information and communication technologies ('HICT') has surged over the past two decades. We survey the medical and economic literature on HICT adoption and its impact on clinical outcomes, productivity and labor. We find that HICT improves clinical outcomes and lowers healthcare costs, but (i) the effects are modest so far, (ii) it takes time for these effects to materialize, and (iii) there is much variation in the impact. More evidence on the causal effects of HICT on productivity is needed to guide further adoption. There is little econometric work directly investigating the impact of HICT on labor, but what there is suggests no substantial negative effects on employment and earnings. Overall, while healthcare is 'exceptional' in many ways, we are struck by the similarities to the wider findings on ICT and productivity stressing the importance of complementary factors (e.g. management and skills) in determining HICT impacts.
    Keywords: healthcare, technology, productivity, jobs
    Date: 2021–09–14
  14. By: Amaral-Garcia, S.;
    Abstract: Medical device companies may play a role in the type of treatments provided to patients, namely by influencing physicians to use their products. Physicians interact frequently with medical device representatives, which raises concerns that these relationships might bias healthcare providers. Using data on payments from medical device companies to physicians combined with hospital discharge datasets, I assess the impact of payments on medical treatments. The specific setting of this study is treatment provided to heart attack patients arriving at the Emergency Room (ER) in Florida hospitals. Using an instrumental variables approach, I find that patients treated by doctors who interact with the industry are more likely to receive an invasive procedure, stents or Coronary-Artery Bypass Graft (CABG). I find no significant impact on healthcare outcomes. However, interactions result in slightly higher medical costs. The results can have implications for the design of regulations on physician-industry interactions.
    Date: 2022–05
  15. By: Matthew D. Adler; Paul Dolan; Amanda Henwood; Georgios Kavetsos
    Abstract: Most people want to be both happy and healthy. But which matters most when there is a trade-off between them? This paper addresses this question by asking 4,000 members of the public in the UK and the US to make various trade-offs between being happy or being physically healthy. The results suggest that these trade-offs are determined in substantial part by the respondent's own levels of happiness and health, with happier people more likely to choose happy lives and healthier people more likely to choose healthy ones: "better the devil you know, than the devil you don't". Age also plays an important role, with older people much more likely to choose being healthy over being happy. We also test for the effect of information when a randomly chosen half of the sample are reminded that it is possible to be happy without being healthy. Information matters, but much less so than who we are. These results serve to further our understanding of the aetiology of people's preferences and have important implications for policymakers who are concerned with satisfying those preferences.
    Keywords: health, subjective well-being, happiness, preferences
    Date: 2021–11–01
  16. By: Amrit Amirapu; Irma Clots-Figueras; Bansi Malde; Anirban Mitra; Debayan Pakrashi; Zaki Wahhaj
    Abstract: The COVID-19 pandemic has adversely a ected the livelihoods of hundreds of millions of households, resulting in widespread poverty and food insecurity. To mitigate these e ects, many governments have introduced additionalbenefits as part of their existing welfare schemes. However, there is often a gap between the introduction of these programs and access to the benefits. To shed light on the source of these gaps, we conduct a field experiment with just over 1,000 slum-dwelling households in Uttar Pradesh, India during the COVID-19 pandemic. The intervention randomly exposed individuals to personalised information about government benefits via cell phones. We find that the simple and low-cost provision of personalised information i) increased the accuracy and precision of participants' knowledge about their entitled benefits, ii) increased access to and utilization of benefits, and iii) improved wellbeing (as measured through consumption, food insecurity and mental health). We do not find significant differences in effects based on whether males or females are targeted. Our findings show that there are large gaps in knowledge of and access to government benefits (despite widespread publicity about the programs) which can be reduced via a simple and low-cost information intervention.
    Keywords: COVID-19; Government Benefits; Emergency Aid; Information Intervention
    JEL: D10 H53 I38 O12
    Date: 2022–05
  17. By: Philippe Sterkens; Adelina Sharipova; Stijn Baert (-)
    Abstract: To study hiring discrimination against cancer survivors, we conduct a vignette experiment in which American and British recruiters evaluate fictitious job candidates. Candidates differed by periods of non-employment in their career, including non-employment due to suffering from cancer. We study the effect of cancer experiences on the recruiters’ hiring decisions, as well as its effect on underlying candidate perceptions, related to various potential forms of stigma identified in the literature. We find that employment opportunities are lower for candidates with a history of cancer, compared to candidates without such a gap. This penalty is particularly explained by perceptions that these candidates will have higher sick leave probabilities and create additional costs. However, relative to candidates with a comparable gap due to depression or personal reasons, former cancer patients are less stigmatised, with relatively favourable assessments of their emotional abilities, social abilities, motivation and positive impact on workplace culture.
    Keywords: Hiring discrimination, cancer, depression, signalling
    JEL: I10 I12 J70 J71
    Date: 2022–06
  18. By: D'Este, Rocco (University of Sussex)
    Abstract: Incarceration is a crucial part of the scholarly analysis of crime, but what happens inside penal institutions largely remains a 'black box' (Western, 2021). This paper studies the impact of the new psychoactive substances (NPS) epidemic within prisons. NPS are powerful addictive chemical compounds that mimic the pharmacological effects of conventional drugs of abuse (CDA) but avoid classification as illegal and detection in standard drug tests. To conduct the analysis, I have assembled a novel establishment-by-month database of all England and Wales prisons from 2007 to 2018 including information on drugs seizures, random mandatory drug test results, various measures of harm, violence, and causes of death. I first document a large increase in NPS availability and an alarming correlation with the steep rise in harm and violence behind bars. I then evaluate the impact of the Psychoactive Substances Act 2016, a supply-side intervention aimed at inhibiting the proliferation of NPS. The analysis exploits cross-prison variation in the initial size of the drug market and shows high-intensity NPS trafficking prisons experienced a sustained but partial reduction in NPS availability, limited substitution toward CDA, and a rise in violence, self-harm, and suicides following the law. Collectively, the findings suggest unwarranted responses to government interventions may be amplified within penal institutions and that new challenges stemming from scientific advances in illegal drugs production should be addressed through systemic interventions that also consider the demand for addictive substances.
    Keywords: illegal drugs, new psychoactive substances, prisons, violence, self-harm, supply-side intervention
    JEL: I18 K14 K42
    Date: 2022–04
  19. By: Paula Garda; Jens Matthias Arnold
    Abstract: The pandemic has highlighted significant gaps in social protection, in particularamong informal workers. With around 60% of workers in informal jobs, many of those most in need of social protection are left behind. The government has attempted to fill this gap with non-contributory benefits, but coverage and benefit levels are low. Better-off formal workers have access to a full range of social protection benefits, involving large-scale public subsidies that widen the gap. Labour informality and social protection coverage are interlinked, as high social contributions are one of the main barriers to formal job creation. Ensuring some universal basic social protection, while simultaneously lowering the cost of formal employment, would reduce labour informality, poverty and inequality and raise productivity, all of which are long-standing challenges in Colombia.
    Keywords: Colombia, employment, health, informality, pensions, public policy, social protection
    JEL: H51 H53 H55 I14 J32 J43 J65
    Date: 2022–05–19
  20. By: Kostiantyn Ovsiannikov (School of Economics and Management, Kochi University of Technology); Koji Kotani (School of Economics and Management, Kochi University of Technology); Hodaka Morita (Hitotsubashi University)
    Abstract: With the advance of the COVID-19 pandemic, many companies in the world have embraced telework. Despite the large volume of related studies, only few of them have addressed telework in relation to types of assignments and employment. In this context, we pose an open question of how productivity in an online environment depends on formats of work, remuneration systems and socioeconomic factors in comparison to a face-to-face environment. We collect the data of 500 Japanese employees through the stratified questionnaire survey, empirically examining and characterizing the perceived telework productivity for carrying out simple and creative tasks in individual and group formats as compared with face-to-face productivity. The three main findings are obtained. First, online productivity tends to be noticeably low for group format as compared to individual format, especially when carrying out creative tasks. Second, we find that managerial affiliation and sleeping hours tend to translate into, respectively, low group productivity and low individual productivity for both simple and creative tasks. Third, our study demonstrates that online productivity is unconditionally exacerbated under a seniority-based system as compared to a performance-based system. Overall, our findings reveal the difficulties faced by employees when performing group tasks remotely, pointing at the importance of professional incentives for increasing collective productivity of telework. The caveats we identified can thereby help companies to improve their transition from a face-to-face to an online environment.
    Keywords: Human resource management, Employee attitudes, Organizational culture, Institutions
    Date: 2022–05
  21. By: Kofi Takyi Asante
    Abstract: On the whole, poor countries in Africa and elsewhere seem to have weathered the coronavirus (SARS-CoV-2, or COVID-19) pandemic better than wealthier countries with superior healthcare systems. Using the Ghanaian case, this paper draws on newspaper articles, policy statements, and other secondary sources to explain how the country's competitive clientelist political settlement mediated the public health outcomes of the pandemic.
    Keywords: COVID-19, State capacity, Clientelism, Political settlements, Ghana, Public health
    Date: 2022
  22. By: Simon K. Schnyder; John J. Molina; Ryoichi Yamamoto; Matthew S. Turner
    Abstract: Epidemics of infectious diseases posing a serious risk to human health have occurred throughout history. During the ongoing SARS-CoV-2 epidemic there has been much debate about policy, including how and when to impose restrictions on behavior. Under such circumstances policymakers must balance a complex spectrum of objectives, suggesting a need for quantitative tools. Whether health services might be 'overwhelmed' has emerged as a key consideration yet formal modelling of optimal policy has so far largely ignored this. Here we show how costly interventions, such as taxes or subsidies on behaviour, can be used to exactly align individuals' decision making with government preferences even when these are not aligned. We assume that choices made by individuals give rise to Nash equilibrium behavior. We focus on a situation in which the capacity of the healthcare system to treat patients is limited and identify conditions under which the disease dynamics respect the capacity limit. In particular we find an extremely sharp drop in peak infections as the maximum infection cost in the government's objective function is increased. This is in marked contrast to the gradual reduction without government intervention. The infection costs at which this switch occurs depend on how costly the intervention is to the government. We find optimal interventions that are quite different to the case when interventions are cost-free. Finally, we identify a novel analytic solution for the Nash equilibrium behavior for constant infection cost.
    Date: 2022–05
  23. By: Motta, Matt (Oklahoma State University)
    Abstract: Objectives. Supplemental “booster” vaccines may prove vital in combating future, variant waves of COVID-19. Given relatively low levels of booster vaccine uptake, Americans’ willingness to receive a second booster shot are unclear. Consequently, I offer new insights into the (a) prevalence and (b) socio-political correlates of “boosted” Americans’ reluctance to receive an additional booster shot. Methods. In a demographically representative survey of N = 3,950 US adults, respondents reported their COVID-19 vaccination status, intentions to receive an additional booster, and reasons for potentially-foregoing vaccination. I provide both descriptive and multivariate analyses that assess both “boosted” Americans’ vaccination intentions, and their reasons for potentially-foregoing vaccination. Findings. While 49% [95% CI: 47, 51] of Americans report having received an initial booster shot, just 34% [33, 36] report that they would be “very likely” to do so again. In multivariate models, concerns about missing work to vaccinate (-10%; B = 0.53, p =0.05) and being unconvinced that additional boosters will be necessary (-47%; B = 2.24, p < 0.01) are significantly associated with being very likely to receive a second COVID-19 booster shot. Conclusions. Even among vaccine-accepting sub-populations, fears about side effects and seeing future vaccination as unnecessary motivate substantial vaccine hesitancy regarding additional booster vaccines. These findings can help public health practitioners better-preempt vaccine demand when responding to variant waves of COVID-19, and broaden our understanding of why even those who have positive views toward vaccination might, under some circumstances, opt to not do so.
    Date: 2022–04–28
  24. By: Cochran, Abigail L. (University of North Carolina at Chapel Hill); Wang, Jueyu; Wolfe, Mary; Iacobucci, Evan; Vinella-Brusher, Emma; McDonald, Noreen
    Abstract: Introduction: Understanding spatial and temporal trends in travel for COVID-19 vaccinations by key demographic characteristics (i.e., gender, race, age) is important for ensuring equitable access to and increasing distribution efficiency of vaccines and other health services. The aim of this study is to examine trends in travel distance for COVID-19 vaccinations over the course of the vaccination rollout in North Carolina. Methods: Data were collected using electronic medical records of individuals who had first- or single-dose COVID-19 vaccination appointments through UNC Health between December 15, 2020, and August 31, 2021 (N = 204,718). Travel distances to appointments were calculated using the Euclidean distance from individuals’ home ZIP code centroids to clinic addresses. Descriptive statistics and multivariate regression models with individuals’ home ZIP codes incorporated as fixed effects were used to examine differences in travel distances by gender, race, and age. Results: Males and White individuals traveled significantly farther for vaccination appointments throughout the vaccination rollout. On average, females traveled 3.5% shorter distances than males; Black individuals traveled 10.0% shorter distances than White individuals; and people aged 65 and older traveled 2.6% longer distances than younger people living in the same ZIP code. Conclusions: Controlling for neighborhood socioeconomic status and spatial proximity to vaccination clinics, males and White individuals traveled longer distances for vaccination appointments, demonstrating more ability to travel for vaccinations. Results indicate a need to consider differential ability to travel to vaccinations by key demographic characteristics in COVID-19 vaccination programs and future mass health service delivery efforts.
    Date: 2022–04–26
  25. By: Reddinger, J. Lucas (University of Wisconsin, La Crosse); Charness, Gary; Levine, David
    Abstract: Vaccination has both private and public benefits. We ask whether social preferences—concerns for the well-being of other people—influence one's decision regarding vaccination. We measure these social preferences for 549 online subjects: We give each subject \$4 to play a public-good game and make contributions to public welfare. To the extent that one gets vaccinated out of concern for the health of others, contribution in this game is analogous to an individual's decision to obtain vaccination. We collect COVID-19 vaccination history separately to avoid experimenter-demand effects. We find a strong result: Contribution in the public-good game is associated with greater demand to voluntarily receive a first dose, and thus also to vaccinate earlier. Compared to a subject who contributes nothing, one who contributes the maximum (\$4) is 48% more likely to obtain a first dose voluntarily in the four-month period that we study (April through August 2021). People who are more pro-social are indeed more likely to take a voluntary COVID-19 vaccination.
    Date: 2022–04–23
  26. By: Alessa Möllers (Institute of Transport Economics, Muenster); Sebastian Specht (Institute of Transport Economics, Muenster); Jan Wessel (Institute of Transport Economics, Muenster)
    Abstract: With data from automated counting stations and controlling for weather and calendar effects, we estimate the isolated impacts of the Covid-19 pandemic and subsequent government intervention (contact restrictions and business closures) on walking and cycling in 10 German cities. Pedestrian traffic in pedestrian zones decreases with higher local incidence values, and with stricter government intervention. There are ambiguous effects for cycling, which decreases in cities with a higher modal share of cycling, and increases in others. Moreover, we find impact heterogeneity with respect to different weekdays and hours of the day, both for cycling and walking. Additionally, we use data on overall mobility changes, which were derived from mobile phone data, in order to estimate the modal share changes of cycling. In almost all cities, the modal share of cycling increases during the pandemic, with higher increases in non-bicycle cities and during stronger lockdown interventions.
    Keywords: Covid-19 pandemic, before and during Covid-19 pandemic, active mobility, pedestrian, cycling, modal share
    JEL: R40 Q54
    Date: 2021–04
  27. By: Lewandowski, Piotr (Institute for Structural Research (IBS)); Lipowska, Katarzyna (Institute for Structural Research (IBS)); Smoter, Mateusz (Institute for Structural Research (IBS))
    Abstract: The COVID-19 pandemic has transformed working from home from a rarity to a widely adopted job amenity. We study workers' willingness to pay for working from home, and how it may be affected by subjective and objective assessments of COVID-19-related risks. We conducted a discrete choice experiment with more than 10,000 workers in Poland. We randomised wage differences between otherwise identical home- and office-based jobs. We also randomised an information provision treatment in which we informed 50% of workers about the level of exposure to contagion in their occupation, and how it may be reduced by working from home. We found that the demand for working from home was substantial – the majority of participants would prefer to work from home if they were offered the same wage for a home-based job as they would earn in an office-based job. On average, workers would sacrifice 5.1% of their earnings for the option to work from home, especially for 2-3 days a week (7.3%) rather than 5 days a week (2.8%). We also found that the perception of COVID-19 mattered, as workers who perceived it as a threat were willing to give up a much higher share of their earnings than those who did not. However, the willingness to pay did not differ significantly between individuals depending on whether their occupation had a high or a low level of exposure, or between individuals treated in the information experiment and those in the control group.
    Keywords: working from home, discrete choice, information provision experiment, occupational exposures, COVID-19
    JEL: J21 J44
    Date: 2022–04
  28. By: LUPPI, FRANCESCA; Arpino, Bruno; Rosina, Alessandro (Catholic University of the Sacred Heart)
    Abstract: While early evidence of the impact of the COVID-19 crisis on births has suggested a depressive effect on fertility intentions and behaviours, not all individuals have equally suffered the indirect consequences of the pandemic, and especially those related with the increased uncertainty brought by the economic recession. This study accounts for the heterogeneous consequences of the pandemic on fertility plans and behaviours, by focusing on the motivations for suspended pre-Covid fertility plans and on those for new fertility plans and conceptions that arose during the pandemic. The reasons for the latter are almost unexplored. To do that, we rely on unique data collected with a repeated cross-sectional survey conducted in April/May 2021 and October/November 2021 (2000 respondents each) on a quota sample of young Italians (aged 18 to 34). After exploring the main motivations for changing pre-COVID fertility plans or for intending to conceive a previously unplanned child during the pandemic, we estimate a set of multinomial and logit models to examine some correlates of fertility plans and behaviours. Finally, by interpreting these results in light of the reported motivations, we provide a more qualitative analysis that allows for a deeper interpretation of the reasons behind the patterns of associations. Potentially complex and non-unidirectional mechanisms, only partially related with reducing financial and occupational vulnerability, emerge as relevant for supporting fertility during the pandemic.
    Date: 2022–05–11
  29. By: Chudik, A.; Pesaran, M. H.; Rebucci, A.
    Abstract: This paper provides estimates of COVID-19 effective reproduction numbers and explains their evolution for selected European countries since the start of the pandemic taking account of changes in voluntary and government mandated social distancing, incentives to comply, vaccination and the emergence of new variants. Evidence based on panel data modeling indicates that the diversity of outcomes that we document may have resulted from the non-linear interaction of mandated and voluntary social distancing and the economic incentives that governments provided to support isolation. The importance of these factors declined over time, with vaccine uptake driving heterogeneity in country experiences in 2021. Our approach, also allows us to identify the basic reproduction number, R0. It is precisely estimated and differ little across countries.
    Keywords: COVID-19, multiplication factor, under-reporting, social distancing, self-isolation, SIR model, reproduction number, pandemics, vaccine
    JEL: D00 F60 C40 I12 E70
    Date: 2022–05–09
  30. By: Guglielmo Ventura
    Abstract: The Covid-19 pandemic outbreak and the ensuing economic uncertainty caused interruptions to apprenticeship training. This is putting the future of apprenticeships at risk just at the time when they will be most needed to protect employment and sustain the recovery. Apprenticeships offer a mix of training on the job and additional off-the-job training. This is generally a successful combination, but it has made apprenticeships particularly vulnerable during the current crisis. The purpose of this short briefing note is to present and discuss available evidence on the impact of the Covid-19 crisis on present and future apprenticeship provision as well as to set out a framework for policy interventions.
    Keywords: corona virus, COVID, pandemic, apprenticeship
    JEL: I28 J24
    Date: 2020–07–14
  31. By: Julien Albertini (Univ Lyon, Université Lumière Lyon 2, GATE UMR 5824, F-69130 Ecully, France); Xavier Fairise (GAINS, University of Le Mans); Arthur Poirier (LED, Paris 8 University Vincennes-Saint-Denis); Anthony Terriau (GAINS, University of Le Mans)
    Abstract: In this paper, we analyze the impact of short-time work programs on the French labor market during the COVID-19 pandemic. We develop a dynamic model with incomplete markets, search frictions, human capital, and aggregate and idiosyncratic productivity shocks. We calibrate our model and simulate what the labor market response to a lockdown shock would have been under various STW programs. We show that STW succeeded in stabilizing employment and consumption but generated substantial windfall effects characterized by an excessive reduction in hours worked.
    Keywords: COVID-19, matching frictions, short-time work policies, incomplete markets.
    JEL: E21 E24 J24 J38 J63 J65
    Date: 2022
  32. By: Smith, Lindsey Gail; Yifei, Maggie Ma; Widener, Michael; Farber, Steven
    Abstract: Socioeconomic and place-based factors contribute to grocery shopping patterns which may be important for diet and health. Big data provide the opportunity to explore behaviours at the population level. We used data collected from Flipp, a free all-in-one savings and deals content app, to identify visitation to grocery stores and estimate home-to-store distances, monthly frequencies, and number of unique stores visited in eight Canadian cities during 2020. Grocery shopping outcomes and associations with income, population density, and percentage of car commuters were explored using data aggregated at the Aggregate Dissemination Area (ADA) level in which app users lived. Changes in patterns of grocery shopping following restrictions implemented in response to the COVID-19 pandemic were also investigated. The median of average home-to-store distances ranged from 4-5 km across all cities throughout 2020. Shorter distances for grocery shopping were shown consistently for shoppers living in lower income, densely populated, and low-car commuting ADAs. A maximum of three unique supermarkets were visited on average each month. Decreases in the frequency and variability of grocery store visits were shown across all cities in April 2020 following the implementation of restrictions in response to COVID-19, and pre-pandemic levels of shopping were rarely achieved by the end of the year. Ultimately, these results provide much needed information regarding the characteristics of grocery shopping trips in a high-income country, as well as how food shopping was impacted by the onset of the COVID-19 pandemic. This information will be useful for a range of future studies seeking to characterise access to food retail.
    Date: 2022–04–26
  33. By: Martha Alter Chen; Erofili Grapsa; Ghida Ismail; Sarah Orleans Reed; Michael Rogan; Marcela Valdivia
    Abstract: This paper presents findings from two rounds (2020 and 2021) of a study on the impact of the COVID-19 crisis on informal workers in 11 cities across five regions of the world (Africa, Asia, Eastern Europe, Latin America, and North America). The study, carried out by the WIEGO network in partnership with local organizations of informal workers in each city, included a survey questionnaire and key informant interviews, both conducted by phone. The study findings confirm that the pandemic recession severely undermined the livelihoods of informal workers with limited recovery by mid-2021.
    Keywords: Informal economy, Economic impact, COVID-19, Recession, Work status, Earnings, Food security, Coping strategies
    Date: 2022
  34. By: Alexander Bick; Adam Blandin
    Abstract: Economists have recently begun using independent online surveys to collect national labor market data. Questions remain over the quality of such data. This paper provides an approach to address these concerns. Our case study is the Real-Time Population Survey (RPS), a novel online survey of the US built around the Current Population Survey (CPS). The RPS replicates core components of the CPS, ensuring comparable measures that allow us to weight and rigorously validate our results using a high-quality benchmark. At the same time, special questions in the RPS yield novel information regarding employer reallocation during the COVID-19 pandemic. We document that 26% of pre-pandemic workers were working for a new employer one year into the COVID-19 outbreak in the US, at least double the rate of any previous episode in the past quarter century. Our discussion contains practical suggestions for the design of novel labor market surveys and highlights other promising applications of our methodology.
    Keywords: Online Survey; Employment; Employer Separations; Employer Reallocation
    JEL: C81 C83 E24 J21 J63
    Date: 2022–05–03

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