nep-hea New Economics Papers
on Health Economics
Issue of 2022‒09‒19
ten papers chosen by
Nicolas R. Ziebarth
Cornell University

  1. Overconfidence and Technology Adoption in Health Care By Diego A. Comin; Jonathan S. Skinner; Douglas O. Staiger
  2. Family Bargaining and the Gender Gap in Informal Care By Canta, Chiara; Cremer, Helmuth
  3. Timing Moral Hazard under Deductibles in Health Insurance By Zabrodina, V.;
  4. The impact of parents' health shocks on children's health behaviors By Jérémy Tanguy
  5. Gender preference at birth: A new measure for son preference based on stated preferences and observed measures of parents' fertility decisions By Mehwish Ghulam Ali; Ashton De Silva; Sarah Sinclair; Ankita Mishra
  6. Long-Term Services and Supports and Disease Management among Older Chinese Adults in Different Stages of Cognitive Impairment By Lin, Zhuoer; Chen, Xi
  7. Mental health effects of caregivers respite: subsidies or supports? By Costa-Font, Joan; Vilaplana-Prieto, Cristina
  8. Mental health concerns prelude the Great Resignation: Evidence from Social Media By R. Maria del Rio-Chanona; Alejandro Hermida-Carrillo; Melody Sepahpour-Fard; Luning Sun; Renata Topinkova; Ljubica Nedelkoska
  9. Drivers of COVID-19 deaths in the United States: A two-stage modeling approach By Christopher Baum; Andrés Garcia-Suaza; Miguel Henry; Jesús Otero
  10. COVID-19 Working Paper: Food Insecurity During the First Year of the COVID-19 Pandemic in Four African Countries By Bloem, Jeffrey; Michler, Jeffrey D.; Josephson, Anna; Rudin-Rush, Lorin

  1. By: Diego A. Comin; Jonathan S. Skinner; Douglas O. Staiger
    Abstract: Variation in technology adoption is a key driver of differences in productivity. Previous studies sought to explain variations in technology adoption by heterogeneity in profitability, costs of adoption, or other factors. Less is known about how adoption is affected by bias in the perceived skill to implement the technology. We develop a Bayesian framework in which the use of the technology depends on perceived skill, while the outcomes from using it depend on actual skill. We study the determinants of adoption in the case of implantable cardiac defibrillators (ICDs) for which we document large differences across hospitals in the rate of adoption between 2002-2006, and a strong reversal from 2006-2013. We find that perception bias explains two-thirds of the cross-hospital variation in ICD use. A dynamic version of the model with learning about bias predicts accurately the subsequent decline in ICD use between 2006-2013. These results suggest an important role for misperception in explaining the wide variation in the adoption of new technologies.
    JEL: I1 O3 O33
    Date: 2022–08
  2. By: Canta, Chiara (Toulouse Business School); Cremer, Helmuth (Toulouse School of Economics)
    Abstract: We study the optimal long-term care policy when informal care can be provided by children in exchange for monetary transfers by their elderly parents. We consider a bargaining model with single-child families. Daughters have a lower labor market wage and a lower bargaining power within the family with respect to sons. Consequently, they provide more informal care and have lower welfare in the laissez-faire (although not necessarily lower transfers). The first best involves redistribution from families with sons to families with daughters and can be implemented by a gender-specific schedule of public LTC benefits and transfers to working children. If the policy is restricted to be gender neutral, we find that the informal care provided by daughters should be distorted up to enhance redistribution from families with sons to families with daughters. Transfers within the family should be distorted in both types of families.
    Keywords: family bargaining, strategic bequests, informal care, long-term care, gender-neutrality
    JEL: D13 H23 H31 I19
    Date: 2022–08
  3. By: Zabrodina, V.;
    Abstract: This paper develops a new approach to identifying timing moral hazard in health insurance contracts when deductible choice is endogenous. I set up a dynamic model of healthcare consumption where individuals exceed a high deductible after a large health shock. I show that individuals either strategically prepone care from the year after the shock and keep a high deductible, or do not retime and switch to a low deductible the year after. The identification of timing moral hazard exploits the randomness of shock timing within a calendar year. Empirical results show quantitatively significant timing moral hazard responses, which decrease with the time left to the deductible reset. This pattern suggests that there are substantial frictions to preponing, and that dynamic changes in incentives matter in shaping strategic timing responses.
    Keywords: health insurance; strategic timing; moral hazard; insurance plan choice;
    JEL: D82 I11 I13
    Date: 2022–07
  4. By: Jérémy Tanguy (Université Savoie Mont Blanc)
    Abstract: I evaluate whether parents’ health shocks in early childhood, adolescence, or adulthood impact their children’s risky health behavior. I use a French epidemiological cohort. Two types of health shocks are considered: lung cancer and smoking-related cancer. First, I exploit heterogeneity in the age of the individual at the moment of the parent’s health shock to analyze the influence of the cancer diagnosis on the offspring's smoking behavior. Second, I propose a Cox proportional hazards model to study the impact of the age of the offspring at the date of the diagnosis on the probability of quitting smoking. Finally, I use the individual's smoking history to build a retrospective panel and estimate an individual fixed-effects model to identify the impact of the parent’s diagnosis on the probability of smoking. In line with the existing literature, I find in all cases very limited impact of the parent’s health shock on the offspring's behavior.
    Date: 2022–08–01
  5. By: Mehwish Ghulam Ali; Ashton De Silva; Sarah Sinclair; Ankita Mishra
    Abstract: Investigating preference for sons is a continuing focal area of development economics and demographic research. Son preference presents a challenge in achieving the United Nations Sustainable Development Goals of 'no poverty', 'good health and wellbeing', and 'gender equality' by 2030. It is thus important to investigate son preference to inform policy-makers of the potential challenges in achieving these goals. Inaccurate interpretation of the mechanisms of son preference could misinform policy analysis and result in unintended consequences.
    Keywords: Human fertility, Family planning, Welfare, Wellbeing
    Date: 2022
  6. By: Lin, Zhuoer (Yale University); Chen, Xi (Yale University)
    Abstract: Rapid population aging elevates burden of chronic and non-communicable diseases among older adults. Despite the critical role of self-management in disease prevention and control, effective management of diseases can be cognitively demanding and may require additional supports from family and social services. Using nationally representative data from China, this paper reveals great challenges in disease management and characterizes the differential effects of long-term care services and supports (LTSS) on disease management among older adults in different stages of cognitive impairment (CI). In specific, we use preventive care utilization and hypertension management as key indicators to assess the performance of disease management. We show that while access to LTSS from spouse or home-based services significantly facilitate active disease management behaviors, the effects are only evident among older adults with no CI. By contrast, access to LTSS has very modest effect for cognitively impaired individuals. In addition, older adults in more severe stages of CI perform worse in disease prevention, hypertension awareness and management. These findings reveal the vulnerability of older adults with CI in disease management and point to the importance of promoting targeted interventions to reduce barriers of accessing LTSS, especially among cognitively impaired population.
    Keywords: hypertension, aging, long-term services and supports, chronic disease management, cognitive impairment, disease awareness, preventive care utilization
    JEL: J14 I18 I38 D10 H41
    Date: 2022–08
  7. By: Costa-Font, Joan; Vilaplana-Prieto, Cristina
    Abstract: We study the effect the effect of a policy intervention that universalized previously means-tested subsidies in Spain, and document causal evidence of the effect of the receipt of caregiving supports and subsidies on unpaid spousal/partners caregivers mental health. Our estimates suggest that caregiving supports improve the mental health of caregivers among those providing more than 50 hours of care. In contrast, a subsidy gives rise to a reduction of 14.2pp. in the probability of depressive symptoms among individuals receiving less than 50 hours of care. Consistently, we find evidence of an increase in life satisfaction (15%) upon the receipt of subsidies and home supports (11%). We further document that evidence of a reduction in the probability of depression which is higher among part-time caregivers who spend between 20-50 caregiving hours/week compared to those providing more intensive care, which is explained by behavioural changes after the receipt of caregiving benefits. Finally, we estimate that a ‘hypothetical caregiving’ subsidy amount that would have fully compensated caregivers’ for their wellbeing losses (compared to non-caregivers) should lie between 800 and 850 euros/month, which is a magnitude well above the actual subsidy.
    Keywords: caregiving; long-term subsidies; long term care supports; mental health; caregiver's mental health; Spain; Elsevier deal
    JEL: I18 J22
    Date: 2022–10–01
  8. By: R. Maria del Rio-Chanona; Alejandro Hermida-Carrillo; Melody Sepahpour-Fard; Luning Sun; Renata Topinkova; Ljubica Nedelkoska
    Abstract: To study the causes of the 2021 Great Resignation, we use text analysis to investigate the changes in work- and quit-related posts between 2018 and 2021 on Reddit. We find that the Reddit discourse evolution resembles the dynamics of the U.S. quit and layoff rates. Furthermore, when the COVID-19 pandemic started, conversations related to working from home, switching jobs, work-related distress, and mental health increased. We distinguish between general work-related and specific quit-related discourse changes using a difference-in-differences method. Our main finding is that mental health and work-related distress topics disproportionally increased among quit-related posts since the onset of the pandemic, likely contributing to the Great Resignation. Along with better labor market conditions, some relief came beginning-to-mid-2021 when these concerns decreased. Our study validates the use of forums such as Reddit for studying emerging economic phenomena in real time, complementing traditional labor market surveys and administrative data.
    Date: 2022–08
  9. By: Christopher Baum (Boston College); Andrés Garcia-Suaza (Universidad del Rosario); Miguel Henry (Greylock McKinnon Associates); Jesús Otero (Universidad del Rosario)
    Abstract: We offer a two-stage (time-series and cross-section) econometric modeling approach to examine the drivers behind the spread of COVID-19 deaths across counties in the United States. Our empirical strategy exploits the availability of two years (January 2020 through January 2022) of daily data on the number of confirmed deaths and cases of COVID-19 in the 3,000 U.S. counties of the 48 contiguous states and the District of Columbia. In the first stage of the analysis, we use daily time-series data on COVID-19 cases and deaths to fit mixed models of deaths against lagged confirmed cases for each county. Because the resulting coefficients are county specific, they relax the homogeneity assumption that is implicit when the analysis is performed using geographically aggregated cross-section units. In the second stage of the analysis, we assume that these county estimates are a function of economic and sociodemographic factors that are taken as fixed over the course of the pandemic. Here we employ the novel one-covariate-at-a-time variable-selection algorithm proposed by Chudik et al. (Econometrica, 2018) to guide the choice of regressors.
    Date: 2022–08–11
  10. By: Bloem, Jeffrey; Michler, Jeffrey D.; Josephson, Anna; Rudin-Rush, Lorin
    Abstract: This report analyzes trends in food security up to one year after the onset of the Coronavirus (COVID-19) pandemic in four African countries. Using household-level data collected by the World Bank, this report shows differences in food security over time during the pandemic between rural and urban areas as well as between female- and male-headed households in Burkina Faso, Ethiopia, Malawi, and Nigeria. Analysis of data collected during the pandemic shows a sharp increase in food insecurity in the early months of the pandemic with a subsequent gradual decline. Additionally, this report finds that a larger increase in food insecurity occurred in rural areas relative to urban areas within each of these countries. Finally, the authors found no systemic difference in food insecurity between female-headed and male-headed households. These trends, documented amid the first year of the COVID-19 pandemic, complement previous microeconomic analyses studying short-term changes in food security associated with the pandemic and macroeconomic projections based on expected changes to income, prices, and food supply.
    Keywords: Consumer/Household Economics, Demand and Price Analysis, Financial Economics, Food Security and Poverty, International Development, International Relations/Trade, Public Economics, Research Methods/ Statistical Methods
    Date: 2022–07–07

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