nep-hea New Economics Papers
on Health Economics
Issue of 2022‒07‒18
fifty-one papers chosen by
Nicolas R. Ziebarth
Cornell University

  1. Friday morning fever. Evidence from a randomized experiment on sick leave monitoring in the public sector By Tito Boeri; Paolo Naticchioni; Vincenzo Scrutinio; Edoardo di Porto
  2. Advantageous Selection Without Moral Hazard (with an Application to Life Care Annuities) By Philippe De Donder; Marie-Louise Leroux; François Salanié
  3. The Effect of Removing Early Retirement on Mortality By Cristina Belles; Sergi Jiménez; Han Ye
  4. The effects of financial incentives and disincentives on teachers' retirement decisions: Evidence from the 2003 French pension reform By Denis Fougère; Pierre Gouëdard
  5. Performance Pay in Insurance Markets: Evidence from Medicare By Michele Fioretti; Hongming Wang
  6. Does the Delivery of Primary Health Care Improve Birth Outcomes? Evidence from the Rollout of Community Health Centers By Esra Kose; Siobhan M. O'Keefe; Maria Rosales-Rueda
  7. Health Care Centralization: The Health Impacts of Obstetric Unit Closures in the US By Stefanie J. Fischer; Heather Royer; Corey D. White
  8. Days of Work Over a Half Century: The Rise of the Four-day Week By Daniel S. Hamermesh; Jeff Biddle
  9. Vaccination Policy, Delayed Care, and Health Expenditures By Erkmen G. Aslim; Wei Fu; Chia-Lun Liu; Erdal Tekin
  10. Sick and depressed? The causal impact of a diabetes diagnosis on depression By Gaggero, A.;; Gil, J.;; Jiménez-Rubio, D.;; Zucchelli, E.;
  11. Maternal Mortality and Women’s Political Power By Sonia R. Bhalotra; Damian Clarke; Joseph F. Gomes; Atheendar Venkataramani
  12. Does Public Policy Affect Attitudes? Evidence from Age-Based Health Insurance Coverage Policies in the United States By Yörük, Baris
  13. The Impact of Civil Conflict on Child Health: Evidence from Colombia By Noemi Kreif; Andrew Mirelman; Marc Suhrcke; Giancarlo Buitrago; Rodrigo Moreno Serra
  14. The Effects of Alcohol Excise Tax Increases by Drinking Level and by Income Level By Henry Saffer; Markus Gehrsitz; Michael Grossman
  15. Preterm births and educational disadvantage: heterogeneous effects By Baranowska-Rataj, Anna; Barclay, Kieron; Costa-Font, Joan; Myrskylä, Mikko; Özcan, Berkay
  16. Civil conflict, cash transfers, and child nutrition in Yemen By Olivier Ecker; Jean-François Maystadt
  17. Disclosing the 'Big C': What Does Cancer Survivorship Signal to Employers? By Sterkens, Philippe; Sharipova, Adelina; Baert, Stijn
  18. Loneliness and health of older adults: The role of cultural heritage and relationship quality By Casabianca, Elizabeth; Kovacic, Matija
  19. Trading Social Status for Genetics in Marriage Markets: Evidence from UK Biobank By Abdel Abdellaoui; Oana Borcan; Pierre Chiappori; David Hugh-Jones
  20. Enhancing the Utility of the Health and Retirement Study to Identify Drivers of Rising Mortality Rates in the United States By Monnat, Shannon M
  21. Health and ethnic inequalities in Mozambique with special reference to leprosy By Isabel Maria Casimiro; Júlio Machele
  22. 'Investing' in care for old age? An examination of long-term care expenditure dynamics and its spillovers By Costa-Font, Joan; Vilaplana-Prieto, Cristina
  23. Relative Income, the Breadwinner Norm, and Mental Health in Couples By Getik, Demid
  24. Addiction and Health: How Consumer Goods become Bads? By Yoshida, Ken; Ono-Yoshida, Rie
  25. Unpacking the Links between Conflict and Child Welfare: Evidence from a Foreign Insurgency By Heidi Kaila; Larissa Nawo; Hyuk Harry Son
  26. Longitudinal associations between different measures of socioeconomic status and health behavior among adolescents. Data from a wealthy Italian region By Belardinelli, Paolo; Torbica, Aleksandra; Fattore, Giovanni
  27. The Peace Baby Boom: Evidence from Colombia's peace agreement with the FARC By María Elvira Guerra-Cújar; Mounu Prem; Paul Rodríguez-Lesmes; Juan Fernando Vargas
  28. Opioid Use and Employment Outcomes: Evidence from the U.S. Military By Abby E. Alpert; Steve Schwab; Benjamin D. Ukert
  29. The Perceived Social Rejection of Sexual Minorities: Substance Use and Unprotected Sexual Intercourse By Drydakis, Nick
  30. Public healthcare financing during counterinsurgency efforts: Evidence from Colombia By Samuel Lordemus; Noemi Kreif; Rodrigo Moreno-Serra
  31. Conflict exposure and health: Evidence from the Gaza Strip By Michele Di Maio; Valerio Leone Sciabolazza
  32. Effect of Air Pollution on Cognitive Performance in India By Damini Singh; Indrani Gupta; Sagnik Dey
  33. QALYs, DALYs, and HALYs: A Unifying Framework for the Evaluation of Population Health By Moreno-Ternero, Juan D.; Platz, Trine Tornøe; Østerdal, Lars Peter
  34. Health Technology Assessment of Gene Therapies: Are Our Methods Fit for Purpose? By Besley, S.; Henderson, N.; Towse, A.; Cole, A.
  35. The Gray Zone By Mellace, Giovanni; Crudu, Frederico; Di Stefano, Roberta; Tiezzi, Silvia
  36. Non-Covid Excess Deaths, 2020-21: Collateral Damage of Policy Choices? By Casey B. Mulligan; Robert D. Arnott
  37. Causal Inference During a Pandemic: Evidence on the Effectiveness of Nebulized Ibuprofen as an Unproven Treatment for COVID-19 in Argentina By Sebastian Calonico; Rafael Di Tella; Juan Cruz Lopez Del Valle
  38. Does an effective government lower COVID-19's health impact?: Evidence from Viet Nam By Duc Anh Dang; Ngoc Anh Tran
  39. Growth, Lockdown and the Dynamics of the Covid-19 Pandemic By Luciana BARTOLINI; Francesco MAGRIS
  40. Close kin influence COVID-19 precautionary behaviors and vaccine acceptance of older individuals By Bruno Arpino; Valeria Bordone; Giorgio Di Gessa
  41. The Spread of COVID-19 in Belgium: a Municipality-Level Analysis By Philip Verwimp
  42. Covid or not Covid? Psychological Distress and Entrepreneurial Intentions among Canadian Workers during the Pandemic By Simon Coulombe; Marcus Dejardin; Sylvain Luc
  43. Recession and Recovery of the Pandemic By Lester C Hunt; Anqi Zhang; Shuonan Zhang
  44. Covid-19 pandemic in Brazil: Macroeconomic effects and policies By de Conti, Bruno
  45. Labour market shocks during the Covid-19 pandemic: inequalities and child outcomes By Claudia Hupkau; Ingo Isphording; Stephen Machin; Jenifer Ruiz-Valenzuela
  46. Producing Quality Adjusted Hospital Price Indexes By Brett Matsumoto
  47. The World Health Organization in a Post-COVID-19 Era: An Exploration of Public Engagement on Twitter By Thierry Warin
  48. Management of the COVID-19 pandemic in Kerala through the lens of state capacity and clientelism By Jos Chathukulam; Manasi Joseph
  49. Social distancing beliefs and human mobility: Evidence from Twitter By Simon Porcher; Thomas Renault
  50. The long echo of war. Early-life exposure to armed conflict and female experiences of intimate partner violence By Orsola Torrisi
  51. Make Every Bite Count with the Dietary Guidelines, 2020-2025: Start Simple with MyPlate! By Haven, Jackie

  1. By: Tito Boeri; Paolo Naticchioni; Vincenzo Scrutinio; Edoardo di Porto
    Abstract: Absent providers of key public services, such as schooling and health, are a major problem in both developed and developing countries. This paper provides the first analysis of a population-wide controlled field experiment for home visits checking on sick leave in the public sector. The experiment was carried out in Italy, a country with large absenteeism in the public sector, and it concerned the universe of public employees. We exploit unique administrative data from the Italian social security administration (INPS) on sick leave and work histories. We find that receiving a home visit reduces the number of days on sick leave in the following 16 months by about 12% (5.5 days). The effect is stronger for workers who are found irregularly on sick leave (-10.2 days). We interpret our findings as a deterrence effect of home visits: workers being found irregularly on sick leave experience a decline of about 2% of their wage in the following 12 months. Uncertainty aversion (there is no automatism in these sanctions) can play a role in these results. Our estimates suggest that home visits are cost-effective: every Euro spent for the visits involves up to 10 Euros reductions in sick benefits outlays. We estimate the marginal value of public funds (MVPF) spent on home visits at about 1.13, which is significantly lower than estimates of MVPF of income taxes in the US.
    Keywords: sick leave, absenteeism, randomized trial
    Date: 2021–05–21
  2. By: Philippe De Donder; Marie-Louise Leroux; François Salanié
    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.
    Keywords: propitious selection, positive or negative correlation property, contract bundling, long-term care insurance, annuity
    JEL: D82 I13
    Date: 2022
  3. By: Cristina Belles; Sergi Jiménez; Han Ye
    Abstract: This paper sheds new light on the mortality effect of delaying retirement by investigating the Spanish 1967 pension reform that exogenously changed the early retirement age depending on the date individuals started contributing to the social security system. Those that contributed before January 1st, 1967, maintained the right to voluntarily retire early at age 60, while individuals who started contributing after could not voluntarily claim pension until age 65. Using the Spanish administrative social security data, we find that the reform delayed labor market exit by around half a year and increased the probability that individuals take up disability pensions, partial pensions, and no pensions. We show evidence that delaying existing employment increases the harzard of dying between ages 60 and 69. Heterogeneous analysis indicates that the negative impact is driven by those employed in low-skill, physically and psychosocially demanding jobs. Moreover, we show that allowing for flexible retirement schemes, such as partial retirement, mitigates the negative effect of delaying retirement on mortality.
    Date: 2022–06
  4. By: Denis Fougère (OSC - Observatoire sociologique du changement (Sciences Po, CNRS) - Sciences Po - Sciences Po - CNRS - Centre National de la Recherche Scientifique, CNRS - Centre National de la Recherche Scientifique, LIEPP - Laboratoire interdisciplinaire d'évaluation des politiques publiques (Sciences Po) - Sciences Po - Sciences Po, CEPR - Center for Economic Policy Research - CEPR, IZA - Forschungsinstitut zur Zukunft der Arbeit - Institute of Labor Economics, ECON - Département d'économie (Sciences Po) - Sciences Po - Sciences Po - CNRS - Centre National de la Recherche Scientifique); Pierre Gouëdard (OCDE - Organisation de Coopération et de Développement Economiques = Organisation for Economic Co-operation and Development, LIEPP - Laboratoire interdisciplinaire d'évaluation des politiques publiques (Sciences Po) - Sciences Po - Sciences Po)
    Abstract: Using a sample of 12,463 high-school teachers, we evaluate the impact of the 2003 reform of the French national pension scheme. Considering the progressive implementation of the reform, we cannot use a reduced-form approach. Consequently, we estimate an option value modelà la Stock and Wise (Econometrica, 1990). Structural estimates suggest that teachers are slightly risk averse, that their quarterly discount factor is close to unity and that their preference for leisure is comparable to the one found by Stock and Wise (1990). Simulations imply that teachers respond significantly to monetary incentives offered to those who continue working after the legal retirement age. Our partial effectiveness analysis shows that the reform has progressively increased the average retirement age up to 61. This shift in the retirement age distribution should have resulted in year 2010 in a 6.37% decrease of public spendings associated with high-school teachers' pensions (except income taxes and other types of expenses, such as those relating to health, social security and widowhood).
    Keywords: option value model,pension reform,structural evaluation
    Date: 2021–10
  5. By: Michele Fioretti (ECON - Département d'économie (Sciences Po) - Sciences Po - Sciences Po - CNRS - Centre National de la Recherche Scientifique); Hongming Wang (Hitotsubashi University)
    Abstract: Public procurement bodies increasingly resort to pay-for-performance contracts to promote efficient spending. We show that firm responses to pay-for-performance can widen the inequality in accessing social services. Focusing on the quality bonus payment initiative in Medicare Advantage, we find that higher quality-rated insurers responded to bonus payments by selecting healthier enrollees with premium differences across counties. Selection is profitable because the quality rating fails to adjust for differences in enrollee health. Selection inflated the bonus payments and shifted the supply of high-rated insurance to the healthiest counties, reducing access to lower-priced, higher-rated insurance in the riskiest counties.
    Keywords: Pay-for-Performance,Medicare Advantage,Risk Selection,Quality Ratings,Health Insurance Access
    Date: 2021–05–01
  6. By: Esra Kose; Siobhan M. O'Keefe; Maria Rosales-Rueda
    Abstract: Introduced as part of the War on Poverty, Community Health Centers (CHCs) deliver primary care to underserved populations by locating sliding-scale clinics in economically disadvantaged areas. We investigate how this policy affected infant health using the rollout of CHCs and a flexible event study framework with Vital Statistics natality data. Our results show that average birth weight increased, and low birth weight incidence decreased after a CHC opened in the mother’s county of residence. These improvements in infant health can be explained by increased access to early prenatal care and reductions in maternal smoking.
    JEL: I38 J13 O15
    Date: 2022–05
  7. By: Stefanie J. Fischer; Heather Royer; Corey D. White
    Abstract: Over the last few decades, health care services in the United States have become more centralized. We study how the loss of hospital-based obstetric units in over 400 rural counties affect maternal and infant health via a difference-in-differences design. We find that closures lead to significant changes in obstetric practices such as inductions and C-sections. In contrast to concerns voiced in the public discourse, the effects on a range of maternal and infant health outcomes are negligible or slightly beneficial. While women travel farther to receive care, closures induce women to receive higher quality care.
    JEL: I18 I38 J08 J13 J18
    Date: 2022–06
  8. By: Daniel S. Hamermesh; Jeff Biddle
    Abstract: We examine patterns of work in the U.S. from 1973-2018 with the novel focus on days per week, using intermittent CPS samples and one ATUS sample. Among full-time workers the incidence of four-day work tripled during this period, with over 8 million more full-time workers on four-day weeks. The same growth occurred in the Netherlands, Germany, and South Korea. The rise was not due to changes in demographics or industrial structure. Four-day full-time work is more common among less educated, younger, and white non-Hispanic workers, among men, natives, and people with young children; and among police and firefighters, health-care workers, and in eating/drinking places. Based on an equilibrium model of its prevalence, we show that it results more from workers’ preferences and/or daily fixed costs of working than from employers' production costs. We verify the implication that the wage penalty for four-day work is greater where such work is more prevalent, and we show that the penalty has diminished over time.
    JEL: J11 J22
    Date: 2022–06
  9. By: Erkmen G. Aslim; Wei Fu; Chia-Lun Liu; Erdal Tekin
    Abstract: The COVID-19 pandemic has profoundly affected the United States healthcare system, resulting in major disruptions in the delivery of essential care and causing crippling financial losses that threaten the viability of millions of medical practices. There is little empirical evidence on the types of policies or innovations that are effective in shaping healthcare seeking behavior during a public health crisis. This paper evaluates the effect of COVID-19 vaccination on the individual propensity to delay or skip medical care. Our research design exploits the arguably exogenous variation in age-specific vaccine eligibility rollout across states and over time as an instrument for individual vaccination status. We find that receiving a COVID-19 vaccine reduces the likelihood of delaying care for any medical condition by 37 percent. Furthermore, our analysis reveals that children are significantly less likely to delay or skip healthcare delayed as a result of the availability of vaccines for their parents, indicating the presence of a positive health spillover within households that extends beyond protection against infection. We also find evidence to indicate that vaccination affects healthcare seeking behavior by easing concerns about contracting or spreading COVID-19. In supplementary analysis, we use novel data on debit and credit card spending to demonstrate that increased vaccine uptake has a positive, albeit statistically insignificant, effect on consumer healthcare spending in the short run. Our results highlight the important role that vaccines play in, not only protecting against coronavirus, but also safeguarding against the worsening of health due to delayed or foregone medical care. The decline in delayed or foregone care caused by vaccination is particularly strong among minorities and those with a low socioeconomic background, revealing an important role that vaccination efforts can play in narrowing inequities in health and healthcare. More broadly, our findings imply that advancements in vaccine development coupled with a regulatory process that accelerates the availability of vaccines to public in a safe manner can have the additional benefit of tackling unmet healthcare needs during a public health crisis.
    JEL: I1 I12 I18
    Date: 2022–06
  10. By: Gaggero, A.;; Gil, J.;; Jiménez-Rubio, D.;; Zucchelli, E.;
    Abstract: There is sparse evidence on the impact of health information on mental health as well as on the mechanisms governing this relationship. We estimate the causal impact of health information on mental health via the effect of a diabetes diagnosis on depression. We employ a fuzzy regression discontinuity design (RDD) exploiting the exogenous cut-off value in the diagnosis of type-2 diabetes provided by a biomarker (glycated haemoglobin) and information on diagnosed clinical depression drawn from rich administrative longitudinal data from Spain. We find that overall a type-2 diabetes diagnosis increases the probability of becoming depressed, however this effect appears to be driven mostly by women. Results also appear to differ by changes in lifestyle induced by the diabetes diagnosis: while women who did not lose weight are more likely to develop depression, men who did lose weight present a reduced probability of being depressed. Results are robust to alternative parametric and non-parametric specifications and placebo tests.
    Keywords: diabetes; depression; fuzzy regression discontinuity design; administrative longitudinal data; lifestyle changes;
    JEL: C21 I10 I12
    Date: 2022–06
  11. By: Sonia R. Bhalotra; Damian Clarke; Joseph F. Gomes; Atheendar Venkataramani
    Abstract: Millions of women continue to die during and soon after childbirth, even where the knowledge and resources to avoid this are available. We posit that raising the share of women in parliament can trigger action. Leveraging the timing of gender quota legislation across developing countries, we identify sharp sustained reductions of 8–12 percent in maternal mortality. Investigating mechanisms, we find that gender quotas lead to increases in percentage points of 5–8 in skilled birth attendance and 4–8 in prenatal care utilization, alongside a decline in fertility of 6–7 percent and an increase in the schooling of young women of about 0.5 years. The results are robust to numerous robustness checks. They suggest a new policy tool for tackling maternal mortality.
    JEL: I14 I15 O15
    Date: 2022–06
  12. By: Yörük, Baris (University at Albany, SUNY)
    Abstract: The existing literature provides evidence that public opinion and attitudes often affect public policy. However, little is known on how public policy might affect public attitudes and norms. I present new evidence on this topic by using age-based health insurance policies in the United States as natural experiments. I first exploit the discrete change in insurance coverage rates at age 26 due to the Affordable Care Act's dependent coverage mandate and show that this policy is associated with statistically significant deterioration in attitudes towards the necessity of health insurance among young adults who are affected by this policy the most. Next, I show that gaining health insurance at 65 due to the onset of Medicare does not have a significant impact on attitudes towards health insurance among the elderly. These findings are widespread across different demographic groups, robust under alternative model specifications, observed only after the policies are adopted, and highlight the importance of age in attitude formation.
    Keywords: attitudes, beliefs, health insurance coverage, public policy
    JEL: I12 I13 I18
    Date: 2022–06
  13. By: Noemi Kreif (Centre for Health Economics, University of York); Andrew Mirelman (Centre for Health Economics, University of York); Marc Suhrcke (Luxembourg Institute of Socio-economic Research); Giancarlo Buitrago (Clinical Research Institute, Universidad Nacional de Colombia, Hospital Universitario Nacional de Colombia); Rodrigo Moreno Serra (entre for Health Economics, University of York)
    Abstract: Internal armed conflicts have become more common and more physically destructive since the mid-20th century, with devastating consequences for health and development in low-and middle-income countries. This paper investigates the causal impacts of the long-term internal conflict on child health in Colombia, following an identification strategy based on the temporal and geographic variation of conflict intensity. We estimate the effect of different levels of conflict intensity on height-for-age (HAZ), weight-for-age (WAZ), and weight-for-height z-scoresamong children under five years old, and explore the underlying potential mechanisms, through maternal health behavior and health care utilization. We find a harmful effect of exposure to conflict violence during pregnancy for HAZ and WAZ, in the full sample and even more strongly in the rural sample, yet these estimates are smaller than those found for shorter term conflicts. The underlying pathways appear to operate around the time of the pregnancy and birth (in the form of maternal alcohol use, use of antenatal care and skilled birth attendance), rather than during the post-birth period (via breastfeeding or vaccination). The most adverse impacts of conflict violence on child health and utilization of maternal healthcare were observed in municipalities which suffered from intermittent presence of armed groups.
    Keywords: Conflict, Violence, Child health
    Date: 2020–10
  14. By: Henry Saffer; Markus Gehrsitz; Michael Grossman
    Abstract: The alcohol industry argues that alcohol excise taxes do not reduce heavy drinking because of substitutions to lower-cost products and that these taxes disproportionately burden low-income drinkers. Alternatively, some economists have argued that increases in alcohol excise taxes reduce heavy alcohol consumption. Using data from the Nielsen Homescan we investigate the effects of a large excise tax increase that raised alcohol prices. The results show that heavy drinkers reduce purchases, and this reduction is no different than the reductions by other drinkers. The results also show that only low-income drinkers pay more for ethanol after the tax increase.
    JEL: H20 I18
    Date: 2022–05
  15. By: Baranowska-Rataj, Anna; Barclay, Kieron; Costa-Font, Joan; Myrskylä, Mikko; Özcan, Berkay
    Abstract: Although preterm births are the leading cause of perinatal morbidity and mortality in advanced economies, evidence about the consequences of such births later in life is limited. Using Swedish register data on cohorts born 1982-1994 (N=1,087,750), we examine the effects of preterm births on school grades measured at age 16 using sibling fixed-effect models. We further examine how preterm births are affected by the degree of prematurity and the compensating role of family socioeconomic resources and characteristics of school districts. Our results show that the negative effects of preterm births are confined to children born extremely preterm (
    Keywords: premature births; school districts; educational disadvantage; parental effects
    JEL: N0
    Date: 2022–06–07
  16. By: Olivier Ecker (Development Strategy and Governance Division, International Food Policy Research Institute, United States); Jean-François Maystadt (Department of Economics, Lancaster University Management School, United Kingdom)
    Abstract: The most dramatic outcomes of protracted civil conflict include increased malnutrition among children and the resulting consequences for lifelong health and prosperity. Little is known about how to mitigate the nutritional impact of conflict. Knowing the potential of economic interventions is particularly important for post-conflict reconstruction, when the threat of violence resurgence is high. We use quarterly panel data from Yemen to estimate the impact of civil conflict on child nutrition in Yemen and the effects of unconditional cash transfers in mitigating the adverse nutritional impact. Our results show that a one-standard-deviation increase in armed conflict intensity reduces the weight-for-height z-scores (WHZ) of children by 9.6%, on average. We also find that the studied cash transfer program reduces the nutritional impact by 35.8% for WHZ. Our analysis suggests that if relative stability is restored, unconditional cash transfer programs can be an effective tool to curb rising acute child malnutrition in situations of complex emergencies.
    Keywords: Civil conflict, child nutrition, cash transfer, mitigation, Yemen
    JEL: D74 I15 O15
    Date: 2021–09
  17. By: Sterkens, Philippe (Ghent University); Sharipova, Adelina (Ghent University); Baert, Stijn (Ghent University)
    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: Casabianca, Elizabeth (European Commission); Kovacic, Matija (European Commission)
    Abstract: We estimate the direct causal effect of loneliness on a variety of health outcomes using a sample of second-generation immigrants among older adults drawn from the Survey of Health, Ageing and Retirement in Europe. In an effort to account for the endogeneity of self-declared loneliness, we explore the link between loneliness and a specific trait of maternal cultural background strongly associated with quality of relations and use the latter as an instrument for loneliness. We thus also assess the importance of cultural heritage in shaping individuals' perceptions of loneliness. Additionally, we investigate one pathway by which some specific ancestral factors may influence the formation of cultural traits in the modern era. Our results suggest that loneliness has a significant impact on health, both mental and physical. Notably, our identification strategy allows us to uncover a larger effect of loneliness on health than that found in an OLS setting. These findings are robust to a battery of sensitivity checks.
    Keywords: Loneliness, relationship quality, culture, mental health, physical health
    JEL: I12 I14 J14 D91 Z13
    Date: 2022–05
  19. By: Abdel Abdellaoui (Department of Psychiatry, Amsterdam UMC, University of Amsterdam); Oana Borcan (School of Economics, University of East Anglia); Pierre Chiappori (Department of Economics, University of Columbia); David Hugh-Jones (School of Economics, University of East Anglia)
    Abstract: If socio-economic status (SES) and genetic variants are both assets in marriage markets, then the two will become associated in spouse pairs, and will be passed on together to future generations. This process provides a new explanation for the surprising persistence of inequality across generations, and for the genes-SES gradient: the genetic differences we observe between high- and low-income people. The gradient includes differences related to human capital and to physical and mental health, so understanding its origins is important for understanding inequality in general, and health inequalities in particular. We model social-genetic assortative mating (SGAM) and test for its existence in a large genetically-informed survey. We compare spouses of individuals with different birth order, which is known to affect socio-economic status and which is exogenous to own genetic endowments among siblings. Spouses of earlier-born individuals have genetic variants that predict higher educational attainment. We provide evidence that this effect is mediated by individuals’ own educational attainment and income. Thus, environmental shocks to socio-economic status are reflected in the DNA of subsequent generations. Our work uncovers a new channel by which economic institutions can affect long-run inequality; suggests that genes-SES gradients may be historically widespread; and shows that genetic variation is endogenous to social institutions.
    Date: 2022–06–14
  20. By: Monnat, Shannon M
    Abstract: A recent report from the National Academies of Sciences, Engineering, and Medicine (NASEM) highlights rising rates of working-age mortality in the United States, portending troubling population health trends for this group as they age. The Health and Retirement Study (HRS) is an invaluable resource for researchers studying health and aging dynamics among Americans ages 50 and above and has strong potential to be used by researchers to provide insights about the drivers of rising U.S. mortality rates. This paper assesses the strengths and limitations of HRS data for identifying drivers of rising mortality rates in the U.S. and provides recommendations to enhance the utility of the HRS in this regard. Among our many recommendations, we encourage the HRS to prioritize the following: link cause of death information to respondents; reduce the age of eligibility for inclusion in the sample; increase the rural sample size; enhance the existing HRS Contextual Data Resource by incorporating longitudinal measures of structural determinants of health; develop additional data linkages to capture residential settings and characteristics across the life course; and add measures that capture drug use, gun ownership, and social media use.
    Date: 2022–04–07
  21. By: Isabel Maria Casimiro; Júlio Machele
    Abstract: The subject of this paper is health and ethnic inequalities in Mozambique, with special reference to leprosy. It is argued that the health policies and strategies adopted in the colonial and post-colonial periods led to an unequal distribution not only of certain diseases but also of health infrastructures. The colonial regime, by neglecting and creating ineffective leprosaria in central and northern Mozambique, 'ethnicized' Lazarus disease, a fact corroborated by its current unequal distribution.
    Keywords: Health, Ethnic inequality, Mozambique
    Date: 2022
  22. By: Costa-Font, Joan; Vilaplana-Prieto, Cristina
    Abstract: We first study the dynamic drivers of expenditure on long-term care (LTC) programs, and more specifically, the effects of labour market participation of traditional unpaid caregivers (women aged 40 and older) on LTC spending. Second, we examine spillover effects of a rise on LTC expenditure on health care expenditures (HCE) and the economy (GDP). Our estimates draw from a panel of more than a decade worth of expenditure data from a sample of OECD countries. We use a panel Vector Auto-regressive (panel-VAR) system that consider the dynamics between the dependent variables. We find that LTC expenditure increases with the rise of the labour market participation of the traditional unpaid caregiver (women over 40 years of age), and that such expenditures rise exerts large spillover effects on health spending components. We find that a 1% increase in female labour participation gives rise to a 1.48% increase in LTC expenditure and a 0.88% reduction in HCE. The effect of LTC spending over HCE is mainly driven by a reduction in inpatient and medicine expenditures, exhibiting large country heterogeneity. Finally, we document significant spillover effects of in LTC expenditures on per capita GDP.
    Keywords: long-term care spending; panel-VAR; dynamic panel data; female labour market participation; health spending; care spillovers; Springer deal
    JEL: I18 J10
    Date: 2022–05–27
  23. By: Getik, Demid (Department of Economics, Lund University)
    Abstract: The share of couples where the wife out-earns the husband is increasing in many countries. In this paper, I investigate how this income dynamic affects mental health. Using data on all Swedish couples who married in 2001, I show that mental health is positively associated with own and spousal income. However, it is negatively linked to the wife’s relative income. Crossing the threshold where the wife starts earning more increases the likelihood of a mental health diagnosis by 8-12 per cent. This effect does not appear driven by divorce or spouses being on different income trajectories.
    Keywords: gender; mental health; income; relative income
    JEL: I12 I19 I21 I31 J16 J24
    Date: 2022–06–15
  24. By: Yoshida, Ken; Ono-Yoshida, Rie
    Abstract: The purpose of this paper is to discuss addiction from the perspective of relationships between health and addictive behavior, by focusing on delayed symptoms (health effects). Some consumer goods are not simply "good," but have an aspect of "bad," which might cause damage to health a while after consumption. Our study deals with goods which turn into "bads" after a while. In this paper, we first assume that addictive goods can either be good or bad, depending on each individual's situation. Our results indicate that the intake of addictive goods will increase over time. They also imply that individuals who are cautious about the future are less prone to addiction problems, while short-sighted individuals are more likely to suffer from a serious addiction.
    Keywords: addiction, addictive goods, health, damage function, subjective discount rate
    JEL: D11 I12
    Date: 2022–06–14
  25. By: Heidi Kaila (World Bank); Larissa Nawo (University of Dschang, Dschang-Cameroon); Hyuk Harry Son (Cornell University)
    Abstract: Violent conflicts have enduring effects on child welfare, but little is understood about the mechanisms underlying these effects. Using data from Cameroon collected from a decade before to shortly after the eruption of the Boko Haram insurgency in the country, we study the immediate impacts of terrorist attacks on child welfare. We find that Boko Haram attacks lead to an immediate decrease in weight-for-height for children under five – an indicator of short-term health and nutrition. Furthermore, we find a reduction in health care service utilization which can prolong and aggravate fever and diarrhea. We do not find effects on dietary diversity. Our results are not driven by changes in the sample of children alive, as child mortality is un-affected by the conflict. The results underscore the importance of health care service provision in conflict-affected areas urgently after the eruption of violence to prevent irreversible impacts from taking place.
    Keywords: Terrorism, Boko Haram, Child health and nutrition, Child labor, Cameroon
    JEL: D74 I1 I32 J13 O15
    Date: 2021–10
  26. By: Belardinelli, Paolo; Torbica, Aleksandra; Fattore, Giovanni
    Abstract: We investigate the association between socio-economic status and unhealthy behaviors among adolescents. By using different measures of socio-economic status, we capture both subjective aspects, as operationalized by perceived family affluence, and objective aspects, such as parents' educational levels and family affluence scale. We use data from a sample of 11,623 adolescents who participated in the Health Behavior in School-aged Children (HBSC) study in 2007, 2010, and 2014 in the Lombardy region of Italy. Results show that all of our measures of socio-economic status are correlated with unhealthy behaviors among adolescents. In particular, perceiving a family affluence below average is significantly correlated with a higher probability of reporting all of the unhealthy behaviors included in our analysis. Having at least one parent with university education significantly decreases the odds of being obese or overweight, having an unbalance diet, being physically inactive, and reporting sedentary behaviors. However, adolescents with at least one university educated parent are more likely to make use of cannabis. When controlling for all of our SES measures simultaneously, we find that family affluence scale is no longer significant in determining adolescents' behaviors. Our findings suggest that, when focusing on health inequalities among adolescents, self-perceptions and non-material dimensions of SES have more explanatory power than its material dimensions.
    Keywords: adolescents; HBSC; health behavior; socio-economic status
    JEL: J1
    Date: 2022–07–01
  27. By: María Elvira Guerra-Cújar (School of Economics, Universidad del Rosario); Mounu Prem (School of Economics, Universidad del Rosario); Paul Rodríguez-Lesmes (School of Economics, Universidad del Rosario); Juan Fernando Vargas (School of Economics, Universidad del Rosario)
    Abstract: Violent environments are known to affect household fertility choices, demand for health services and health outcomes of newborns. Using administrative data with a difference-in-differences, we study how the end of the 50 years old Colombian conflict with FARC modified such decisions and outcomes in traditionally affected areas of the country. Results indicate that generalised reductions in total fertility rate were slowed down for municipalities traditionally affected by conflict as a result of the permanent ceasefire declared by the FARC insurgency. Total fertility rate observed a relative increase of 2.6% in the formerly conflict-affected areas, in all age groups. However, no impact was found for demand of health care services, neonatal and infant mortality rates, or birth outcomes such as the incidence of low weight at birth or the percentage of preterm births. Our evidence shows that municipalities with mines victims and expelled population by forced displacement before the ceasefire have significantly higher total fertility rate in the four years following the ceasefire. We argue that the mechanism behind this result is the optimism to raise the children in a better environment due to the reduction in victimisation in areas that experience FARC violence.
    Keywords: fertility, pregnancy, mortality, armed conflict, violence
    JEL: I12 I15
    Date: 2020–10
  28. By: Abby E. Alpert; Steve Schwab; Benjamin D. Ukert
    Abstract: There is significant interest in understanding the labor market consequences of the opioid epidemic, but little is known about how opioid use impacts on-the-job productivity. We analyze the impact of opioid initiation in the emergency department (ED) on workforce outcomes in the Military using linked medical and administrative personnel data for active duty service members from 2008 to 2017. Exploiting quasi-random assignment of patients to physicians in the ED, we find that assignment to a high-intensity opioid prescribing physician increases the probability of long-term opioid use and leads to subsequent negative effects on work capacity, job performance, and productivity. We also analyze the mechanisms underlying these negative workforce outcomes. While opioid use does not negatively affect measures of physical job performance, we find large increases in behavioral problems which lead to disciplinary actions and job separation.
    JEL: I1 I18 J21
    Date: 2022–06
  29. By: Drydakis, Nick (Anglia Ruskin University)
    Abstract: This study presents associations between the perceived social rejection of sexual minorities and tobacco, alcohol, and cannabis consumption and unprotected sexual intercourse in the capital of Greece, Athens. This is the first Greek study to evaluate the concept of the minority stress theory on sexual minorities' substance use and unprotected sexual intercourse. In addition, this is among the first international studies to examine whether periods of adverse economic conditions are associated with sexual minorities' substance use and unprotected sexual intercourse. Two panel datasets covering the periods 2013–2014 and 2018–2019 were used to determine the perceived social rejection, that is, whether sexual minorities have been rejected by friends, treated unfairly in educational and/or workplace environments, treated negatively in social situations and received poor health and public services due to their sexuality. The estimates indicate that perceived social rejection is associated with the increased consumption of tobacco (by 9.1%, P
    Keywords: sexual orientation, minority stress, smoking, drinking, cannabis, unprotected sexual intercourse, economic recession
    JEL: I12 I14 L66
    Date: 2022–06
  30. By: Samuel Lordemus; Noemi Kreif; Rodrigo Moreno-Serra (Centre for Health Economics, University of York)
    Abstract: How do government counterinsurgency efforts affect local public financing during civil conflicts? We investigate this question in the context of the protracted conflict in Colombia. Using data on antinarcotics operations and health transfers from the central government to municipal governments, we employ both panel estimations and instrumental variables to address concerns of endogeneity and omitted variables. We find no clear evidence that counterinsurgency operations causally affect health transfers to municipalities. However, we find indicative evidence that counterinsurgency operations affect the dynamics of local violence. Our findings suggest that armed counterinsurgency interventions by the State should be accompanied by renewed measures to support public healthcare financing for the affected local populations; otherwise, such interventions risk exacerbating the negative consequences of conflict exposure on population health.
    Keywords: Intergovernmental transfers, Armed conflict, Counterinsurgency, Public spending, Antidrug policy
    JEL: D74 F52 H51 H75 O15 O23
    Date: 2021–06
  31. By: Michele Di Maio (Department of Economics and Law, Sapienza University of Rome); Valerio Leone Sciabolazza (Department of Business and Economic Studies, University of Naples Parthenope)
    Abstract: Using individual-level longitudinal data and geo-localized information on conflict-related violent events, we study the impact of conflict on health in the Gaza Strip. Results show that individuals living in localities exposed to more conflict events have a higher probability of suffering from a physical impairment and a chronic disease. The effect is larger for men and older individuals. Two mechanisms contribute to explain why living in conflict-affected area increases the incidence of physical impairment: conflict increases the difficulty to reach health facilities and it decreases individual income. The conflict-induced increase in the probability of having high blood pressure is instead consistent with the development of Post-Traumatic Stress Disorder (PTSD) due to the exposure to conflict-related violent events.
    Keywords: Gaza Strip, conflict, violence, health, household income, health facilities
    JEL: C81 C83 C93 O10
    Date: 2020–11
  32. By: Damini Singh; Indrani Gupta (Institute of Economic Growth, Delhi University, Delhi); Sagnik Dey
    Abstract: This paper provides a causal estimate of the contemporaneous impact of outdoor air pollution on cognitive and academic performance of children aged 8-11 years in India by combining satellite PM2.5 data with the two rounds of Indian Human Development Survey. Our identification strategy relies on the use of thermal inversions as an instrument that generates exogenous variation in the pollution levels. Results show that exposure to average PM2.5 concentrations in the past 12 months prior to the month of test taken by the children has a significant detrimental impact on their cognitive ability in India. Specifically, a 1 µg/m3 increase in average PM2.5 concentrations in the past 12 months decreases the math performance by 10-16 percentage points and the reading performance by 7-9 percentage points. We also find that there is a significant fall in the combined agestandardised cognitive score. The results imply that the cost of air pollution in India is much higher than estimated, and a narrow focus on health-related outcomes understate the magnitude of negative impact of pollution, as mental acuity is essential for higher productivity of children.
    Keywords: Air pollution, Cognitive performance, Educational outcomes, Thermal inversions, India.
    JEL: O12 O13 I15 I24 I25 Q53 Q56
    Date: 2022–05–01
  33. By: Moreno-Ternero, Juan D. (Department of Economics, Universidad Pablo de Olavide); Platz, Trine Tornøe; Østerdal, Lars Peter (Department of Economics, Copenhagen Business School)
    Abstract: We provide a unifying framework for the evaluation of population health. We formalize several axioms for social preferences over distributions of health. We show that a specific combination of those axioms characterizes a large class of population health evaluation functions combining concerns for quality of life, quantity of life and health shortfalls. We refer to the class as (unweighted) aggregations of health-adjusted life years (HALYs). Two focal (and somewhat polar) members of this family are the (unweighted) aggregations of quality-adjusted life years (QALYs), and of disability-adjusted life years (DALYs). We also provide new characterization results for these focal members that enable us to scrutinize their normative foundations and shed new light on their similarities and differences.
    Keywords: Population health; QALYs; DALYs; HYEs; Axioms
    JEL: D63 I10
    Date: 2022–05–20
  34. By: Besley, S.; Henderson, N.; Towse, A.; Cole, A.
    Abstract: Gene therapies represent a new era of medicine, offering the potential for truly transformational health gains, and further benefits for society and health systems. Gene therapy is particularly relevant to rare disease patients, as more than 80 per cent of rare diseases have a known monogenic (single gene) cause. In contrast to traditional small molecule medicines, gene therapies have the potential to correct underlying genetic defects, offering the potential for transformational health gains rather than simply managing symptoms. Moreover, successful gene therapy may require only a single dose to confer lifelong improvement rather than requiring a lifetime of ongoing treatment, thereby dramatically reducing costs associated with years of chronic care management. Given the potential long-term nature of the health gains associated with gene therapies, there is often substantial uncertainty in outcomes which complicates the use of conventional health technology assessment (HTA) approaches. Furthermore, current HTA methods may not fully capture the potential broader value of gene therapies, such as decreased burden on the patient resulting from potentially one-time or short treatment regimen, value of hope and spillover effects on carers and family. As a result, it has been recognised that current HTA methods and evidence generation activities need to evolve in order to fully realise the potential of gene therapies and facilitate patient access. This report uses a mixed-methods approach to review and build on the appropriate path forward. Many of the challenges associated with the evaluation of gene therapies are not unique to these technologies, but it is well recognised that they face a high concentration of these challenges. Therefore, to unlock the potentially transformational promise of gene therapy for patients and society, overcoming them should be considered a priority. The recommendations provided in this report demonstrate the practical HTA tools available to work toward this goal.
    Keywords: Value, Affordability, and Decision Making
    JEL: I1
    Date: 2022–06–01
  35. By: Mellace, Giovanni (Department of Economics); Crudu, Frederico (Department of Economics and Statistics, University of Siena); Di Stefano, Roberta (Department of Statistical Sciences, Sapienza University of Rome); Tiezzi, Silvia (Department of Economics and Statistics, University of Siena)
    Abstract: On March 23, 2020, in response to the COVID-19 pandemic, Italy declared a nation-wide lockdown. A month earlier, on February 23, the Italian government ordered its military police to seal the borders and declared a Red Zone around 10 municipalities of the province of Lodi and in Vo’ Euganeo, a small town in Padua province. On the same day, Confindustria Bergamo, the province’s industrial association, posted a video on social media against having a lockdown in the area of Bergamo and was supported by key business leaders and local administrators. Despite having a similar infection rate to the Red Zone municipalities, the government decided not to extend the Red Zone to the municipalities of Bergamo province with high infection rates. Bergamo later became one of the deadliest outbreaks of the first wave of the virus in the Western world. What would have happened had the Red Zone been extended to that area? We use the Synthetic Control Method to estimate the causal effect of (not) declaring a Red Zone in the Bergamo area on daily excess mortality. We find that about two-thirds of the reported deaths could have been avoided had the Italian government declared the area a Red Zone.
    Keywords: COVID-19; causal impact; synthetic control method; Red Zone; Bergamo; non-pharmaceutical interventions
    JEL: C23 I18 O57
    Date: 2022–06–08
  36. By: Casey B. Mulligan; Robert D. Arnott
    Abstract: From April 2020 through at least the end of 2021, Americans died from non-Covid causes at an average annual rate 97,000 in excess of previous trends. Hypertension and heart disease deaths combined were elevated 32,000. Diabetes or obesity, drug-induced causes, and alcohol-induced causes were each elevated 12,000 to 15,000 above previous (upward) trends. Drug deaths especially followed an alarming trend, only to significantly exceed it during the pandemic to reach 108,000 for calendar year 2021. Homicide and motor-vehicle fatalities combined were elevated almost 10,000. Various other causes combined to add 18,000. While Covid deaths overwhelmingly afflict senior citizens, absolute numbers of non-Covid excess deaths are similar for each of the 18-44, 45-64, and over-65 age groups, with essentially no aggregate excess deaths of children. Mortality from all causes during the pandemic was elevated 26 percent for working-age adults (18-64), as compared to 18 percent for the elderly. Other data on drug addictions, non-fatal shootings, weight gain, and cancer screenings point to a historic, yet largely unacknowledged, health emergency.
    JEL: H22 I12 I18 J11
    Date: 2022–06
  37. By: Sebastian Calonico; Rafael Di Tella; Juan Cruz Lopez Del Valle
    Abstract: Many medical decisions during the pandemic were made without the support of causal evidence obtained in clinical trials. We study the case of nebulized ibuprofen (NaIHS), a drug that was extensively used on COVID-19 patients in Argentina amidst wild claims about its effectiveness and without regulatory approval. We study data on 5,146 patients hospitalized in 11 health centers spread over 4 provinces, of which a total of 1,019 (19.8%) received the treatment. We find a large, negative and statistically significant correlation between NaIHS treatment and mortality using inverse probability weighting estimators. We consider several threats to identification, including the selection of “low” risks into NaIHS, spillovers affecting patients in the control group, and differences in the quality of care in centers that use NaIHS. While the negative correlation appears to be, broadly, robust, our results are best interpreted as emphasizing the benefits of running a randomized controlled trial and the challenges of incorporating information produced in other, less rigorous circumstances.
    JEL: I1 I18 O3
    Date: 2022–05
  38. By: Duc Anh Dang; Ngoc Anh Tran
    Abstract: Government effectiveness has played an important role in tackling the crisis caused by the coronavirus (COVID-19) pandemic. This paper discusses the different aspects of government effectiveness in explaining the variation in the COVID-19 confirmed cases and death levels in Viet Nam. We use the Provincial Governance and Public Administration Performance Index in 2019 to measure the quality of government effectiveness at the local level. The findings show the importance of health system capacity in the battle against COVID-19.
    Keywords: COVID-19, Pandemic, State effectiveness, Viet Nam, healthcare capacity, Transparency, Political participation
    Date: 2022
  39. By: Luciana BARTOLINI; Francesco MAGRIS
    Keywords: , Growth, Lockdown, Public Health Policy, Reproduction Number
    Date: 2022
  40. By: Bruno Arpino (Dipartimento di Statistica, Informatica, Applicazioni "G. Parenti", Università di Firenze); Valeria Bordone (University of Vienna); Giorgio Di Gessa (University College London)
    Abstract: The family plays a central role in shaping health behaviors of its members through social control and support mechanisms. We investigate whether and to what extent close kin (i.e., partner and children) have mattered for older people in taking on precautionary behaviors (e.g., physical distancing) and vaccination during the COVID-19 pandemic in Europe. Drawing on data from the Survey of Health, Ageing and Retirement in Europe (SHARE), we combine its Corona Surveys (June-August 2020 and June-August 2021) with pre-COVID information (October 2019-March2020). We find that having close kin (especially a partner) is associated with a higher probability of both adopting precautionary behaviors and accepting a COVID-19 vaccine. Results are robust to controlling for other potential drivers of precautionary behaviors and vaccine acceptance, as well as to accounting for co-residence with kin. Our findings suggest that policy makers and practitioners may differently address kinless individuals when promoting public policy measures.
    Keywords: COVID-19; Coronavirus; Parenthood; Partnership; Precautionary behaviors; SARS-CoV-2; COVID-19 vaccine acceptance.
    Date: 2022–06
  41. By: Philip Verwimp (ECARES, ULB)
    Abstract: In this contributionI analyse socio-economic and demographic correlates of the spread of the COVID-19 epidemic across Belgian municipalities. I am interested in the onset of the epidemic, its intensity early on as well as the growth of contaminations in April. The paper usescontamination data from Sciensano, the Belgian health agency in charge of epidemiological information. In the period under investigation, March and April 2020, Belgium used a uniform and restrictive test policy for COVID-19, which changed on May 4th. The data are completed with socio-economic and demographic data published by governmental agencies. Employing linear and log-linear models I find that COVID-19 spread faster in larger, more densely populated, higher income municipalities with more elderly people and a larger share of the elderly population residing in care homes. Richer municipalities managed to slow down the epidemic in April more compared to poorer ones. Municipalities which were more exposed to migration, foreign travel for business, leisureor family affairs were affected earlier on in the epidemic. Income correlates with the contamination rate in particular in the Flemish Region whereas the share of foreign nationalities correlates with the contamination rate in particular in the Walloon Region.
    Keywords: COVID-19, Belgium, municipality, regression analysis
    Date: 2020–07
  42. By: Simon Coulombe (Département des relations industrielles - Université Laval (Québec), Canada); Marcus Dejardin (UNamur - Université de Namur [Namur], UCL - Université Catholique de Louvain = Catholic University of Louvain); Sylvain Luc (Département des relations industrielles - Université Laval (Québec), Canada)
    Abstract: Triggering events can be associated with entrepreneurial intentions. Using data from a survey on the mental health of Canadian workers carried out in the context of the COVID-19 pandemic crisis, we specifically test the association between entrepreneurial intentions and psychological distress, along with other individual demographic and personal-level measurements such as risk-aversion, and financial concern. Our results substantiate a positive relationship between entrepreneurial intention and individual psychological distress, as well as financial deterioration measured at the household level. Taken as a whole, our contribution helps to feed a discussion on the links between mental health and entrepreneurship in a process of personal resilience and, more generally, on well-being as a motivational factor in the entrepreneurial process.
    Keywords: well-being,psychological distress,entrepreneurial intention,COVID-19
    Date: 2022
  43. By: Lester C Hunt (University of Portsmouth); Anqi Zhang (Fudan University); Shuonan Zhang (University of Portsmouth)
    Abstract: We develop an SIR-macroeconomic model with virus detection and inequality to study their implications for economic and health consequences during a pandemic crisis. We find a two-way relationship between the pandemic recession and inequality that exacerbate each other although such a vicious circle could be broken by accurate and extensive testing. This mitigation effect can be improved given complementary arrangements such as social protection. The extensive virus detection could not only be a better alternative intervention to lock-down to break the “life-or-economy” trade-off, but also prevent the economy to be permanently damaged if there is reinfection.
    Keywords: COVID-19; SIR-macro model; testing; inequality
    JEL: E1 H0 I1
    Date: 2022–06–21
  44. By: de Conti, Bruno
    Abstract: The Covid-19 pandemic has had unequal effects around the world, not simply in terms of health prospects, but also in terms of economic and social consequences. In all these aspects, Brazil is among the most affected countries. This article aims to analyze the economic and social effects of the Covid-19 pandemic in Brazil, as well as the main macroeconomic policies that were implemented to face the crises. To understand it properly, we take into consideration three elements: i) the structural characteristics of the Brazilian economy; ii) the economic situation in Brazil when the pandemic broke out; iii) the inefficiencies and the negligence of Bolsonaro's government. The article argues that in the public health dimension, the denialist attitude of the president resulted in a lack of national policies for social distancing and a clear mismanagement of the vaccination process which contributed to the seriousness of the crisis. As for the economic and social dimensions, the national government - after some hesitation and under the pressure of the National Congress - implemented a set of policies which have irrefutably served as a cushion for the harms of the pandemic. Nonetheless, it is crucial to underline that these policies have been insufficient to cope with the concrete urgencies of more vulnerable populations in Brazil. The intermittence and the short-termism of the fiscal programs associated with the gradual (and untimely) reduction in the benefited population and in the amounts of the transfers limited the effectiveness of the policies.
    Keywords: COVID-19 pandemic,Brazil,macroeconomic policies,social policies,socioeconomic vulnerability
    JEL: E65 F62 I18
    Date: 2022
  45. By: Claudia Hupkau; Ingo Isphording; Stephen Machin; Jenifer Ruiz-Valenzuela
    Abstract: We study the effect of negative labour market shocks borne by parents during the Covid-19 crisis on resource and time investments in children and the channels through which negative labour market shocks experienced by parents might affect children. Using data collected in the UK before and during the pandemic, we show that fathers and mothers that were already disadvantaged were more likely to have suffered negative earnings and employment shocks. These shocks had an immediate intergenerational impact: Children whose fathers reported an earnings drop to zero are significantly less likely to have received additional paid learning resources compared to similar children whose fathers did not experience a drop in earnings. Potentially offsetting this, they received about 30 more mins of parental help with schoolwork per day. Parental mental health is negatively affected when they experience earnings losses, and fathers who experience a full loss in earnings were less likely to quarrel or talk about things that matter with their kids than fathers who did not suffer earnings drops. The interactions between labour market shocks, parental investments and school closures are likely to have important implications for future inequality.
    Keywords: covid-19,inequalities, labour markets, negative earnings
    Date: 2020–12–18
  46. By: Brett Matsumoto
    Abstract: This paper evaluates the relationship between hospital cost and quality and examines the impact of changing hospital quality on measures of hospital price inflation. To construct the official price indexes, government statistical agencies collect the prices of a fixed sample of goods over time. The price indexes can be biased if the quality of the goods is changing over time. In that case, the price index would reflect unobserved quality change in addition to pure price changes. Cost changes associated with the quality change can be used to quality adjust the price index. Measures of hospital quality are published by the Department of Health and Human Services through its Hospital Compare project. This paper estimates the causal relationship between the quality measures and hospital costs using the instrumental variable technique of Doyle et al. (2015), which is based on plausibly exogenous assignment to different ambulance companies. The relationship between cost and quality measures is then used to produce a cost-based quality adjustment for the inpatient hospital producer price index. The quality adjusted inpatient hospital price indexes increase at an average annual rate of 0.19 to 0.26 percentage points less than the unadjusted index from 2010-2016.
    Date: 2021
  47. By: Thierry Warin
    Abstract: This article analyses the conversations on Twitter related to the World Health Organization (WHO). We collect the text of the discussions as well as the metadata associated with each tweet. Our dataset is exhaustive as it includes all the tweets produced by WHO. Likes, retweets, and replies capture the level of engagement. The goal is to quantify the balance of likes, retweets, and replies, also known as “ratios”, and study their dynamics as proxy for the collective engagement in response to WHO’s communications. Our results demonstrate a higher engagement of the public receiving the information pushed by WHO. This engagement translates into a more balanced reaction with still a more likely favorable opinion vis-à-vis WHO, but with also more challenges. This protocol based on quantitative measures to serve as a proxy to the legitimacy concept seems to hold its promises. In particular, we also perform a simple sentiment analysis to check the robustness of our conclusions. Cet article analyse les conversations sur Twitter relatives à l'Organisation mondiale de la santé (OMS). Nous recueillons le texte des discussions ainsi que les métadonnées associées à chaque tweet. Notre ensemble de données est exhaustif puisqu'il comprend tous les tweets produits par l'OMS. Les mentions " j'aime ", " retweets " et " réponses " permettent de mesurer le niveau d'engagement. L'objectif est de quantifier l'équilibre entre les likes, les retweets et les réponses, également appelés "ratios", et d'étudier leur dynamique comme indicateur de l'engagement collectif en réponse aux communications de l'OMS. Nos résultats démontrent un plus grand engagement du public qui reçoit les informations diffusées par l'OMS. Cet engagement se traduit par une réaction plus équilibrée avec toujours une opinion plus probablement favorable vis-à-vis de l'OMS, mais avec également plus de défis. Ce protocole basé sur des mesures quantitatives pour servir de proxy au concept de légitimité semble tenir ses promesses. Nous effectuons également une analyse simple des émotions afin de vérifier la robustesse de nos conclusions.
    Keywords: Legitimacy,multilateralism,natural language processing,world health organization, Légitimité,multilatéralisme,traitement du langage naturel,organisation mondiale de la santé
    Date: 2022–06–15
  48. By: Jos Chathukulam; Manasi Joseph
    Abstract: During the first wave of COVID-19 infections, Kerala, a state in southern India, successfully managed to contain the pandemic. As a result, the Kerala model of managing the COVID-19 pandemic was celebrated as a success across the globe. However, at the time of writing, it looks like the celebrations were a bit premature and the failure to contain the spurt in COVID-19 infections in the state in a second wave also ascertains this fact. While the rest of India recovered from the second wave of COVID-19 infections, Kerala struggled to bring the pandemic under control.
    Keywords: COVID-19, Pandemic, State capacity, Clientelism
    Date: 2022
  49. By: Simon Porcher (IAE Paris - Sorbonne Business School); Thomas Renault (CES - Centre d'économie de la Sorbonne - UP1 - Université Paris 1 Panthéon-Sorbonne - CNRS - Centre National de la Recherche Scientifique)
    Abstract: We construct a novel database containing hundreds of thousands geotagged messages related to the COVID-19 pandemic sent on Twitter. We create a daily index of social distancing—at the state level—to capture social distancing beliefs by analyzing the number of tweets containing keywords such as "stay home", "stay safe", "wear mask", "wash hands" and "social distancing". We find that an increase in the Twitter index of social distancing on day t-1 is associated with a decrease in mobility on day t. We also find that state orders, an increase in the number of COVID-19 cases, precipitation and temperature contribute to reducing human mobility. Republican states are also less likely to enforce social distancing. Beliefs shared on social networks could both reveal the behavior of individuals and influence the behavior of others. Our findings suggest that policy makers can use geotagged Twitter data—in conjunction with mobility data—to better understand individual voluntary social distancing actions.
    Date: 2021
  50. By: Orsola Torrisi (The London School of Economics (LSE))
    Abstract: While there are reasons to expect a link between armed conflict and victimisation in intimate relationships, empirical evidence on the association is scant and rarely considers the age at exposure to war. This paper examines the legacy of experiencing armed violence in developmental ages on women's later risk of intimate partner violence (IPV) in four ex-Soviet countries (Armenia, Azerbaijan, Moldova, Tajikistan). I combine cross-national data on IPV from the Demographic and Health Survey and geo-referenced information from the Uppsala Conflict Data Program, and compare the IPV outcomes of cohorts who were exposed to conflict before the end of their teens with same-age non-exposed and older cohorts. Findings show that war in young ages is associated with greater risk of experiencing IPV later in life. Exposure in childhood ages (0-10) matters the most, and is particularly related to suffering physical forms of IPV. Results hold for both lifetime and past-year domestic abuse, and are not driven by migration. I explore some pathways and find that, while attitudes towards IPV are not associated with early-age experience of conflict in women, men exposed to war in late adolescence (16-19) are more likely to condone violence against female partners. Normalisation of the use of violence in future potential perpetrators rather than desensitisation to abuse in victims appears as one plausible mechanism through which armed conflict can have lasting consequences on intimate relationship quality.
    Date: 2021–11
  51. By: Haven, Jackie
    Keywords: Health Economics and Policy, Food Consumption/Nutrition/Food Safety
    Date: 2021–02

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