nep-hea New Economics Papers
on Health Economics
Issue of 2022‒10‒24
twenty-one papers chosen by
Nicolas R. Ziebarth
Cornell University

  1. How should we fund end-of-life care in the USA? By Arapakis, K.; French, E.; Jones, J.; McCauley, J.
  2. Exposure to Past Immigration Waves and Attitudes toward Newcomers By Rania Gihleb; Osea Giuntella; Luca Stella
  3. Demand Stimulus as Social Policy By Alan J. Auerbach; Yuriy Gorodnichenko; Daniel Murphy
  4. Stress and Retirement By Raquel Fonseca; Hugo Morin; Ana I. Moro-Egido
  5. Model of Errors in BMI Based on Self‐reported and Measured Anthropometrics with Evidence from Brazilian Data By Davillas, Apostolos; de Oliveira, Victor Hugo; Jones, Andrew M.
  6. Disease Perception and Preventive Behavior: The Vaccination Response to Local Measles Outbreaks By Hofmann, Sarah
  7. The Health Burden of E-Waste: The Impact of E-Waste Dumping Sites on Child Mortality By Stefania Lovo; Samantha B. Rawlings
  8. Widening Health Gap in the U.S. Labor Force Participation at Older Ages By Tomaz Cajner; Javier Fernández-Blanco; Virginia Sánchez-Marcos
  9. The Underserved Have Less Access to Employer-Sponsored Telemedicine Coverage By Alice Zawacki; Thomas A. Hegland; G. Edward Miller
  10. The Allocation of Incentives in Multi-Layered Organizations By Erika Deserranno; Stefano Caria; Philipp Kastrau; Gianmarco León-Ciliotta
  11. Voting up? The effects of democracy and franchise extension on human stature By Batinti, Alberto; Costa-Font, Joan; J. Hatton, Timothy
  12. The Care-Dependent are Less Averse to Care Robots: Comparing Intuitions of the Affected and the Non-Affected By Manuela Schönmann; Anja Bodenschatz; Matthias Uhl; Gari Walkowitz
  13. A spatial panel data model for estimating the impact of social and economic determinants on opioid mortality rates in the US By Fischer, Manfred M.; Gopal, Sucharita
  14. The Lancet Commission on lessons for the future from the COVID-19 pandemic By Jeffrey D Sachs; Salim Abdool Karim; Lara Aknin; Joseph Allen; Kirsten Brosbol; Francesca Colombo; Gabriela Cuevas Barron; Maria Fernanda Espinosa; Vitor Gaspar; Alejandro Gaviria; Andy Haines; Peter Hotez; Phoebe Koundouri; Felipe Larrain Bascunan; Jong-Koo Lee; Muhammad Pate; Gabriela Ramos; Srinath Reddy; Ismail Serageldin; John Thwaites; Vaira Vike-Freiberga; Chen Wang; Miriam Khamadi Were; Lan Xue; Chandrika Bahadur; Maria Elena Bottazzi; Chris Bullen; George Laryea-Adjei; Yanis Ben Amor; Ozge Karadag; Guillaume Lafortune; Emma Torres; Lauren Barredo; Juliana G E Bartels; Neena Joshi; Margaret Hellard; Uyen Kim Huynh; Shweta Khandelwal; Jeffrey V Lazarus; Susan Michie
  15. Sleep quality and the evolution of the COVID-19 pandemic in five European countries By Jabakhanji, Samira; Lepinteur, Anthony; Menta, Giorgia; Piper, Alan T.; Vögele, Claus
  16. Has the COVID-19 pandemic affected public trust? Evidence for the US and the Netherlands By Carin van der Cruijsen; Jakob de Haan; Nicole Jonker
  17. A Game-Theoretic Analysis of Childhood Vaccination Behavior: Nash versus Kant By Philippe De Donder; Humberto Llavador; Stefan Penczynski; John E. Roemer; Roberto Vélez
  18. Profits, Pandemics, and Lockdown Effectiveness in Nursing Home Networks By Pongou, Roland; Sidie, Ghislain Junior; Tchuente, Guy; Tondji, Jean-Baptiste
  19. The backfiring effects of monetary and gift incentives on Covid-19 vaccination willingness By Xinrui Zhang; Tom Lane
  20. Experience of the COVID-19 Pandemic and Support for Safety-Net Expansion By Alex Rees-Jones; John D’Attoma; Amedeo Piolatto; Luca Salvadori
  21. The path towards herd immunity: Predicting COVID-19 vaccination uptake through results from a stated choice study across six continents By Stephane Hess; Emily Lancsar; Petr Mariel; Jürgen Meyerhoff; Fangqing Song; Eline van den Broek-Altenburg; Olufunke Alaba; Gloria Amaris; Julián Arellana; Leonardo Basso; Jamie Benson; Luis Bravo-Moncayo; Olivier Chanel; Syngjoo Choi; Romain Crastes Dit Sourd; Helena Bettella Cybis; Zack Dorner; Paolo Falco; Luis Garzón-Pérez; Kathryn Glass; Luis Guzman; Zhiran Huang; Elisabeth Huynh; Bongseop Kim; Abisai Konstantinus; Iyaloo Konstantinus; Ana Margarita Larranaga; Alberto Longo; Becky P.Y. Loo; Malte Oehlmann; Vikki O'Neill; Juan de Dios Ortúzar; María José Sanz; Olga Sarmiento; Hazvinei Tamuka Moyo; Steven Tucker; Yacan Wang; Yu Wang; Edward J.D. Webb; Junyi Zhang; Mark H.P. Zuidgeest

  1. By: Arapakis, K.; French, E.; Jones, J.; McCauley, J.
    Abstract: Dying is expensive in America. Healthcare expenditures from all payors (public and private) total $80,000 in the last 12 months of life and $155,000 in the last 3 years. Although most end-of-life expenses are paid by insurers such as Medicare and Medicaid, the amount households pay out-of-pocket is hardly trivial. Furthermore, some conditions, such as dementia, are not well insured, leaving families with potentially enormous liabilities. In this viewpoint, we discuss the current funding of end-of-life care in the US. We argue that long term care (LTC) expenses are underinsured relative too other types of late in life care, such as hospitals pending and doctor visits. We then discuss potential reforms that would better insure families against catastrophic expenses related to LTC.
    Keywords: medical spending, Medicaid, Medicare, long term care, policy reform
    JEL: I11 I13 I18 I38 J14
    Date: 2022–08–22
  2. By: Rania Gihleb; Osea Giuntella; Luca Stella
    Abstract: How does previous exposure to massive immigrant inflows affect concerns about current immigration and the integration of refugees? To answer this question, we investigate attitudes toward newcomers among natives and previous immigrants. In areas that in the 1990s received higher inflows of immigrants of German origin—so-called ethnic Germans—native Germans are more likely to believe that refugees are a resource for the economy and the culture, viewing them as an opportunity rather than a risk. Refugees living in these areas report better health and feel less exposed to xenophobia.
    JEL: I0 J15
    Date: 2022–09
  3. By: Alan J. Auerbach; Yuriy Gorodnichenko; Daniel Murphy
    Abstract: We exploit a panel of city-level data with rich demographic information to estimate the distributional effects of Department of Defense spending and its effects on a range of social outcomes. The income generated by defense spending accrues predominantly to households without a bachelor’s degree. These households as well as Black households tend to disproportionately benefit from this spending. Defense spending also promotes a range of beneficial social outcomes that are often targeted by government programs, including reductions in poverty, divorce rates, disability rates, and mortality rates, as well as increases in homeownership, health insurance rates, and occupational prestige. We compare the effects of defense spending with the effects of general demand shocks and explore reasons for the differential effects of the shocks.
    JEL: E6 H30 H50
    Date: 2022–09
  4. By: Raquel Fonseca (ESG-Université du Québec à Montréal & CIRANO.); Hugo Morin (ESG-Université du Québec à Montréal and HRSDC.); Ana I. Moro-Egido (Department of Economic Theory and Economic History, University of Granada.)
    Abstract: This paper investigates the bi-directional causal relationship between retirement and stress. We use PSID data for the period 2007-2015. Using a simultaneous equations approach, we find that a rise in stress increases the probability to retire by roughly 49.8 percentage points, while retirement decreases stress by 23.1 percentage points. We find the same results when we disaggregate by individuals’ characteristics such as gender, occupation, wealth and ethnicity. We show that official retirement ages are a strong instrument for actual retirement age, and that lagged physical activity levels are a non-linear instrument for perceived stress. We also confirm that objective measures of mental health are a strong instrument for perceived stress. Our result is especially interesting in terms of policy, and further research should be done to analyse the effects of physical activity on economic and well-being variables at older ages.
    Keywords: Stress, retirement, physical activity, simultaneous equation models.
    JEL: C30 I10 I12 J26
    Date: 2022–10–05
  5. By: Davillas, Apostolos; de Oliveira, Victor Hugo; Jones, Andrew M.
    Abstract: The economics of obesity literature implicitly assumes that measured anthropometrics are error‐free and they are often treated as a gold standard when compared to self‐reported data. We use factor mixture models to analyse and characterize measurement error in both self‐reported and measured anthropometrics with national representative data from the 2013 National Health Survey in Brazil. Indeed, a small but statistically significant fraction of measured anthropometrics are attributed to data‐recording errors. The estimated mean body weight (height) for those cases that are subject to error is 10% higher (2.9% lower) than the estimated mean of latent true body weight (height). As they are imprecisely measured and due to individual’s reporting behaviour, only between 10% and 24% of our self‐reported anthropometrics are free from any measurement error. Postestimation analysis allows us to calculate hybrid anthropometric predictions that best approximate the true body weight and height distribution. BMI distributions based on the hybrid measures are close to those based on measured data, while BMI based on self‐reported data under‐estimates the true BMI distribution. Analysis of regression models for health care utilization shows little differences between the relationship with BMI when it is based on measured data or on our hybrid BMI measure, however some differences are observed when both are compared to BMI based on self‐reported data.
    Keywords: Body mass index, Measurement error, Mixture models, Obesity
    Date: 2022–06–27
  6. By: Hofmann, Sarah
    Abstract: This paper examines the role of perceived disease risk for vaccination behavior. Using health insurance claims data, I estimate the effect of local measles outbreaks in Germany on first and second dose measles vaccinations in children as well as catch‐up vaccinations in adults. In my empirical strategy, I exploit the variation in timing and location of regional disease outbreaks and estimate a two‐way fixed effects model with birth cohort and region fixed effects. Basic underlying assumption is that measles outbreaks alter perceptions regarding the disease risk. The robustness of this approach with regard to possible bias due to heterogeneous treatment effects under differential treatment timing is assessed through the use of alternative estimators. The results show that measles outbreaks within a region increase the share of children who receive their vaccination on time by 0.8 percentage points for both the first and second vaccination. This corresponds to a reduction in the share of not timely vaccinated children of about 4.1% and 2.6% for the first and second dose, respectively. They further also increase the rate of monthly catch‐up vaccinations in adults by about 15% for the age group 20‐30 to up to 46% for those at ages 40‐50 in the first six months after an outbreak. One important finding is that regional outbreaks do not lead to increases in vaccinations in other regions even if public attention extends beyond the affected region. This suggests that behavioral responses are driven by affective rather than deliberative risk perception. Also, vaccination effects can be observed only in the few months following the outbreak, which indicates that changes in the perceived disease risk due to a local measles outbreak are short‐lived and fade away quickly once the disease outbreak is over.
    Keywords: Vaccinations, Immunizations, Measles, Public Health
    Date: 2022–06–07
  7. By: Stefania Lovo; Samantha B. Rawlings
    Abstract: This paper examines the effect of e-waste dumping sites on early child health. We focus on two major dumping sites in West Africa, in Ghana and Nigeria. We observe children born before and after the creation of these dumps, and estimate a difference-in-difference specification in which we compare outcomes of those born within the vicinity of the dump to those farther away, before and after e-waste sites were created. We find that the e-waste sites increase neonatal and infant mortality, for children living in the proximity of the site. Event studies suggest that the negative effects emerge 2-3 years after the existence of the sites, consistent with the gradual and systematic build up of contaminants in the environment. By exploring routes of exposure, we find that the contamination of water and urban farming produce are among the drivers of the observed effects.
    Keywords: E-waste, health, infant mortality, dumping sites, West Africa
    JEL: I10 Q53 Q56 O10
    Date: 2022
  8. By: Tomaz Cajner; Javier Fernández-Blanco; Virginia Sánchez-Marcos
    Abstract: Using micro data from the CPS and the HRS, we document changes in labor force participation at older ages in the U.S. since the mid 1990s. Our main finding is that the over two-decade increase in participation is solely driven by individuals in good health, and does not differ across either educational or occupational groups. This phenomenon may importantly affect the results of social security reforms aiming at rising the mandatory retirement age, and may exacerbate the health gap in lifetime earnings.
    Keywords: labor force participation, old ages, health
    JEL: J22 I14
    Date: 2021–11
  9. By: Alice Zawacki; Thomas A. Hegland; G. Edward Miller
    Abstract: Telemedicine has been proposed as one means of improving health care access for underserved communities, and information about insurance coverage for telemedicine (TMC) is important in understanding its utilization and provision. We use 2018-2019 Medical Expenditure Panel Survey-Insurance Component data on employer-sponsored coverage to examine pre-pandemic TMC relative to employer, worker, and health plan characteristics. We find that the share of employees in private sector establishments offering TMC was lower in the most rural counties, in smaller firms, in establishments without unionized employees, and in establishments where most workers were low wage, part-time and older when compared to other establishments. These findings reflect differences across establishments in insurance offers, as well as differences in TMC conditional on an insurance offer, which suggests that TMC may function as a premium plan feature with limited availability and potential support for improving healthcare access for the underserved.
    JEL: I13 J32
    Date: 2022–09
  10. By: Erika Deserranno; Stefano Caria; Philipp Kastrau; Gianmarco León-Ciliotta
    Abstract: A classic problem faced by organizations is to decide how to distribute incentives among their different layers. By means of a field experiment with a large public-health organization in Sierra Leone, we show that financial incentives maximize output when they are equally shared between frontline health workers and their supervisor. The impact of this intervention on completed health visits is 61% larger than the impact of incentive schemes that target exclusively the worker or the supervisor. Also, the shared incentives uniquely improve overall health-service provision and health outcomes. We use these experimental results to structurally estimate a model of service provision and find that shared incentives are effective because worker and supervisor effort are strong strategic complements, and because side payments across layers are limited. Through the use of counterfactual model experiments, we highlight the importance of effort complementarities across the different layers of an organization for optimal policy design.
    Keywords: Incentives, multi-layered organizations, effort complementarities, side payments, output
    JEL: O15 O55 I15 J31 M52
    Date: 2022–04
  11. By: Batinti, Alberto; Costa-Font, Joan; J. Hatton, Timothy
    Abstract: We study the effect of the spread of democracy on population health in 15 European countries since the middle of the 19th century, and more specifically the average height of adult males by five-year birth cohort, and we estimate the effect of transitions to democracy using within-country variation. We find that the advent of democracy increased average height by about 0.7 cm. When we also account for the extension of the franchise to women, this increases to 1 cm or about 9% of the total increase in height of birth cohorts from the 1870s to the 1970s. Intervening mechanisms include reduced inequality and increased expenditure on social and health services. Our results are robust to a wide range of econometric tests.
    Keywords: height; democracy; transition; voting rights; franchise; inequality; political contestation; health services
    JEL: H10 J18
    Date: 2022–01–01
  12. By: Manuela Schönmann (Faculty of Computer Science, Technische Hochschule Ingolstadt, Ingolstadt, Germany; TUM School of Social Sciences and Technology, Technical University of Munich, Munich, Germany); Anja Bodenschatz (Faculty of Computer Science, Technische Hochschule Ingolstadt, Ingolstadt, Germany; TUM School of Social Sciences and Technology, Technical University of Munich, Munich, Germany; Seminar for Corporate Development and Business Ethics, Faculty of Management, Economics and Social Sciences, University of Cologne, Cologne, Germany); Matthias Uhl (Faculty of Computer Science, Technische Hochschule Ingolstadt, Ingolstadt, Germany; TUM School of Social Sciences and Technology, Technical University of Munich, Munich, Germany); Gari Walkowitz (Faculty of Business Administration, Technische Universität Bergakademie Freiberg, Freiberg, Germany)
    Abstract: The world’s population will continue to age significantly in the near future. One strategy to address the growing gap between supply and demand of professional caregivers in many regions is the use of care robots. Although there have been numerous ethical debates about the use of robots in elderly care, the important question of how (potentially) affected people perceive situations with care robots compared to situations with human caregivers has not yet been systematically examined. Using a large-scale experimental vignette study, we investigated the influence of the nature of the caregiver on participants’ perceived well-being when confronted with different care situations in nursing homes. Our results show that the views of people already affected by care dependency regarding care robots differ substantially from the views of people not affected by care dependency. The non-affected strongly devalued care robots compared to human caregivers, especially in a service context. This devaluation was not found among those affected; their perceived well-being was not influenced by the nature of the caregiver. These findings also proved robust when controlling for people’s attitudes toward robots, gender, and age.
    Keywords: Care robots, Elderly nursing care, Robot aversion, Well-being, Vignette experiment
    JEL: C83 I12 I31
    Date: 2022–10
  13. By: Fischer, Manfred M.; Gopal, Sucharita
    Abstract: This paper employs a spatial Durbin panel data model, an extension of the crosssectional spatial Durbin model to a panel data framework, to estimate the impact of a set of social and economic determinants on opioid-induced mortality in the US. The empirical model uses a pool of US states over six years from 2014 to 2019 and a k=8 neighbor matrix that represents the topological structure between the states. Calculation of direct (own state) and indirect (cross-state spillovers) effects estimates – based on Bayesian estimation and inference – reflects a proper interpretation of the marginal effects for our nonlinear model that involves lags of the dependent variable vector. The study provides evidence for the existence of spatial effects working through the dependent variable vector and points to the importance of larger indirect effects of Asian and Hispanic/Latino minorities on the one side and the population age groups 35-44 years and 65 years and older on the other. This finding echoes the first law of geography that ”everything is related to everything else, but near things are more related than distant things” (Tobler 1970). Space – largely neglected in previous research – matters for gaining a valid and better understanding of why and how neighboring states contribute to opioid-induced mortality in the states.
    Date: 2022–08–01
  14. By: Jeffrey D Sachs; Salim Abdool Karim; Lara Aknin; Joseph Allen; Kirsten Brosbol; Francesca Colombo; Gabriela Cuevas Barron; Maria Fernanda Espinosa; Vitor Gaspar; Alejandro Gaviria; Andy Haines; Peter Hotez; Phoebe Koundouri; Felipe Larrain Bascunan; Jong-Koo Lee; Muhammad Pate; Gabriela Ramos; Srinath Reddy; Ismail Serageldin; John Thwaites; Vaira Vike-Freiberga; Chen Wang; Miriam Khamadi Were; Lan Xue; Chandrika Bahadur; Maria Elena Bottazzi; Chris Bullen; George Laryea-Adjei; Yanis Ben Amor; Ozge Karadag; Guillaume Lafortune; Emma Torres; Lauren Barredo; Juliana G E Bartels; Neena Joshi; Margaret Hellard; Uyen Kim Huynh; Shweta Khandelwal; Jeffrey V Lazarus; Susan Michie
    Abstract: As of May 31, 2022, there were 6.9 million reported deaths and 17.2 million estimated deaths from COVID-19, as reported by the Institute for Health Metrics and Evaluation (IHME; throughout the report, we rely on IHME estimates of infections and deaths; note that the IHME gives an estimated range, and we refer to the mean estimate). This staggering death toll is both a profound tragedy and a massive global failure at multiple levels. Too many governments have failed to adhere to basic norms of institutional rationality and transparency, too many people often influenced by misinformation-have disrespected and protested against basic public health precautions, and the world's major powers have failed to collaborate to control the pandemic. The multiple failures of international cooperation include (1) the lack of timely notification of the initial outbreak of COVID-19; (2) costly delays in acknowledging the crucial airborne exposure pathway of SARS-CoV-2, the virus that causes COVID-19, and in implementing appropriate measures at national and global levels to slow the spread of the virus; (3) the lack of coordination among countries regarding suppression strategies; (4) the failure of governments to examine evidence and adopt best practices for controlling the pandemic and managing economic and social spillovers from other countries; (5) the shortfall of global funding for low-income and middle-income countries (LMICs), as classified by the World Bank; (6) the failure to ensure adequate global supplies and equitable distribution of key commodities-including protective gear, diagnostics, medicines, medical devices, and vaccines-especially for LMICs; (7) the lack of timely, accurate, and systematic data on infections, deaths, viral variants, health system responses, and indirect health consequences; (8) the poor enforcement of appropriate levels of biosafety regulations in the lead-up to the pandemic, raising the possibility of a laboratory-related outbreak; (9) the failure to combat systematic disinformation; and (10) the lack of global and national safety nets to protect populations experiencing vulnerability. This Commission report aims to contribute to a new era of multilateral cooperation based on strong UN institutions to reduce the dangers of COVID-19, forestall the next pandemic, and enable the world to achieve the agreed goals of sustainable development, human rights, and peace that governments are committed to pursue as members of the UN. We address this Commission report to the UN member states, the UN agencies and multilateral institutions, and multilateral processes such as the G20 and the G7. Our aim is to propose guideposts for strengthening the multilateral system to address global emergencies and to achieve sustainable development. In issuing this report, we commend the excellent work of many important international studies that have preceded our own, most notably those from the Independent Panel for Pandemic Preparedness and Response and the G20 High-Level Independent Panel on Financing the Global Commons on Pandemic Preparedness and Response. Section 1 of this Commission report provides a conceptual framework for understanding pandemics. Section 2 provides an annotated chronology of the COVID-19 pandemic and thematic findings regarding several issues. Section 3 presents our policy recommendations, particularly around multilateral cooperation centred at WHO to address global health crises, and around investments in preparedness for future health crises through strong national health systems and international financing and technology cooperation with the world's lower-income regions.
    Date: 2022–10–08
  15. By: Jabakhanji, Samira; Lepinteur, Anthony; Menta, Giorgia; Piper, Alan T.; Vögele, Claus
    Abstract: The COVID-19 pandemic has led to lifestyle changes across Europe with a likely impact on sleep quality. This investigation considers sleep quality in relation to the evolution of the COVID-19 pandemic in five European countries. Using panel regressions and keeping policy responses to COVID-19 constant, we show that an increase in the four-week average daily COVID-19 deaths/100,000 inhabitants (our proxy for the evolution of the pandemic) significantly reduced sleep quality in France, Germany, Italy, Spain, and Sweden between April 2020 and June 2021. Our results are robust to a battery of sensitivity tests and are larger for women, parents and young adults. Additionally, we show that about half of the reduction in sleep quality caused by the evolution of the pandemic can be attributed to changes in lifestyles, worsened mental health and negative attitudes toward COVID-19 and its management (lower degree of confidence in government, greater fear of being infected). In contrast, changes in one's own infection-status from the SARS-CoV-2 virus or sleep duration are not significant mediators of the relationship between COVID-19-related deaths and sleep quality.
    Keywords: COVID-19,Sleep Quality,Mental Health,Public Policy,Coronaphobia
    JEL: I12 I18 J18
    Date: 2022
  16. By: Carin van der Cruijsen; Jakob de Haan; Nicole Jonker
    Abstract: Using two large-scale surveys among households, we examine the drivers of trust in banks, insurance companies, BigTechs, and other people in the United States and the Netherlands, and analyse whether the COVID-19 pandemic has affected public trust. Our results suggest that the COVID-19 pandemic did not have much effect on trust in financial institutions in the US and the Netherlands. However, trust in BigTechs and trust in other people declined in both countries, especially in the US. Our regression results show that the relationship between respondents’ characteristics and (changes in) trust differs across the US and the Netherlands, but for both countries we find evidence that individuals with poor health have lower levels of trust than healthy people, and that trust among poor-health respondents dropped more during the pandemic.
    Keywords: trust; COVID-19; financial institutions; BigTechs; health; consumer survey
    JEL: D12 D83 E58 G21 G22
    Date: 2021–08
  17. By: Philippe De Donder; Humberto Llavador; Stefan Penczynski; John E. Roemer; Roberto Vélez
    Abstract: Whether or not to vaccinate one's child is a decision that a parent may approach in several ways. The vaccination game, in which parents must choose whether to vaccinate a child against a disease, is one with positive externalities (herd immunity). In some societies, not vaccinating is an increasingly prevalent behavior, due to deleterious side effects that parents believe may accompany vaccination. The standard game-theoretic approach assumes that parents make decisions according to the Nash behavioral protocol, which is individualistic and non-cooperative. Because of the positive externality that each child’s vaccination generates for others, the Nash equilibrium suffers from a free-rider problem. However, in more solidaristic societies, parents may behave cooperatively –they may optimize according to the Kantian protocol, in which the equilibrium is efficient. We test, on a sample of six countries, whether childhood vaccination behavior conforms better to the individualistic or cooperative protocol. In order to do so, we conduct surveys of parents in these countries, to ascertain the distribution of beliefs concerning the subjective probability and severity of deleterious side effects of vaccination. We show that in all the countries of our sample the Kant model dominates the Nash model. We conjecture that, due to the free-rider problem inherent in the Nash equilibrium, a social norm has evolved, quite generally, inducing parents to vaccinate with higher probability than they would in the non-cooperative solution. Kantian equilibrium offers one precise version of such a social norm.
    Keywords: Kantian equilibrium, Nash equilibrium, vaccination, social norm
    JEL: C72 D62 D63 I12
    Date: 2021–12
  18. By: Pongou, Roland; Sidie, Ghislain Junior; Tchuente, Guy; Tondji, Jean-Baptiste
    Abstract: How do pandemics affect for-profit and not-for-profit organizations differently? To address this question, we analyse optimal lockdowns in a two-sector continuous-time individual-based mean-field epidemiological model. We uncover a unique solution that depends on network structure, lockdown effectiveness, and the planner's tolerable infection incidence. Using unique data on nursing home networks in the United States, we calibrate the model and jointly quantify state-level lockdown effectiveness and preference for enforcing stringent containment strategies during the COVID-19 pandemic. We also empirically validate simulation results derived from the theoretical analyses. We find that for-profit nursing homes experience higher COVID-19 death rates than not-for-profit nursing homes. In addition, this differential health effect increases with lockdown effectiveness.
    Keywords: Pandemics, Profits, Social networks, Lockdown effectiveness, Nursing Homes
    JEL: D85 E61 H12 I18 J14
    Date: 2022–09
  19. By: Xinrui Zhang (University of Nottingham Ningbo China); Tom Lane (University of Nottingham Ningbo China)
    Abstract: Policies offering material incentives for Covid-19 vaccination have been widely used around the world as countries pursue the pressing objective of boosting immunity. This paper reports an experiment in China aimed at testing the effects of such interventions on vaccination willingness. We provide the first Covid-19 vaccine study to separately consider and directly compare the effects of both monetary and gift-based incentives, both of which have been commonly employed in practice. Results from a sample of 1,365 individuals suggest that incentives in the range of 8-125 USD backfire, inducing lower vaccination willingness than simply offering vaccines for free. The effects of money and gifts of equivalent value do not significantly differ. We compare our results against the burgeoning literature on Covid-19 vaccine incentives, and demonstrate that the negative effects we identify are stronger than those observed to date in other populations.
    Keywords: Covid-19; Vaccine willingness; Incentives
    Date: 2022
  20. By: Alex Rees-Jones; John D’Attoma; Amedeo Piolatto; Luca Salvadori
    Abstract: Did individuals’ experiences with the harms of the COVID-19 pandemic influence their attitudes towards safety-net programs? To assess this question, we combine rich information about county-level impacts and individual-level perceptions of the early pandemic, repeated measurements of attitudes towards safety-net expansion, and prepandemic measurements of related political attitudes. Individuals facing higher county-level impact or greater perceived risks are more likely to support long-term expansions to unemployment insurance and government-provided healthcare when surveyed in June 2020. These differences persist across time, with experiences in the early months of the pandemic remaining strongly predictive of attitudes towards safety-net expansion in early 2021.
    Keywords: COVID-19, Unemployment Insurance, healthcare, safety net
    JEL: H2 H5
    Date: 2021–10
  21. By: Stephane Hess (University of Leeds); Emily Lancsar (ANU - Australian National University); Petr Mariel (UPV/EHU - University of the Basque Country [Bizkaia]); Jürgen Meyerhoff (TU - Technische Universität Berlin); Fangqing Song (University of Leeds, UCL - University College of London [London]); Eline van den Broek-Altenburg (University of Vermont [Burlington]); Olufunke Alaba (University of Cape Town); Gloria Amaris (University of Leeds, NTNU - Norwegian University of Science and Technology [Trondheim] - NTNU - Norwegian University of Science and Technology); Julián Arellana (Universidad del Norte, Barranquilla); Leonardo Basso (Universidad de Chile); Jamie Benson (University of Vermont [Burlington]); Luis Bravo-Moncayo (UDLA - Universidad de Las Américas [Ecuador], UTN - Universidad Técnica del Norte); Olivier Chanel (AMSE - Aix-Marseille Sciences Economiques - EHESS - École des hautes études en sciences sociales - AMU - Aix Marseille Université - ECM - École Centrale de Marseille - CNRS - Centre National de la Recherche Scientifique); Syngjoo Choi (SNU - Seoul National University [Seoul]); Romain Crastes Dit Sourd (University of Leeds); Helena Bettella Cybis (UFRGS - Universidade Federal do Rio Grande do Sul [Porto Alegre]); Zack Dorner (University of Waikato [Hamilton]); Paolo Falco (ITU - IT University of Copenhagen); Luis Garzón-Pérez (UTN - Universidad Técnica del Norte); Kathryn Glass (ANU - Australian National University); Luis Guzman (UNIANDES - Universidad de los Andes [Bogota]); Zhiran Huang (HKU - The University of Hong Kong); Elisabeth Huynh (ANU - Australian National University); Bongseop Kim (SNU - Seoul National University [Seoul]); Abisai Konstantinus (Ndatara surveys); Iyaloo Konstantinus (Namibia Institute of Pathology); Ana Margarita Larranaga (UFRGS - Universidade Federal do Rio Grande do Sul [Porto Alegre]); Alberto Longo (QUB - Queen's University [Belfast]); Becky P.Y. Loo (HKU - The University of Hong Kong); Malte Oehlmann (TUM - Technische Universität München = Technical University of Munich); Vikki O'Neill (QUB - Queen's University [Belfast]); Juan de Dios Ortúzar (UC - Pontificia Universidad Católica de Chile); María José Sanz (BC3 - Basque Centre for Climate Change, Ikerbasque - Basque Foundation for Science); Olga Sarmiento (UNIANDES - Universidad de los Andes [Bogota]); Hazvinei Tamuka Moyo (University of Cape Town); Steven Tucker (University of Waikato [Hamilton]); Yacan Wang (BJTU - Beijing Jiaotong University); Yu Wang (BJTU - Beijing Jiaotong University); Edward J.D. Webb (University of Leeds); Junyi Zhang (Hiroshima University); Mark H.P. Zuidgeest (University of Cape Town)
    Abstract: Despite unprecedented progress in developing COVID-19 vaccines, global vaccination levels needed to reach herd immunity remain a distant target, while new variants keep emerging. Obtaining near universal vaccine uptake relies on understanding and addressing vaccine resistance. Simple questions about vaccine acceptance however ignore that the vaccines being offered vary across countries and even population subgroups, and differ in terms of efficacy and side effects. By using advanced discrete choice models estimated on stated choice data collected in 18 countries/territories across six continents, we show a substantial influence of vaccine characteristics. Uptake increases if more efficacious vaccines (95% vs 60%) are offered (mean across study areas = 3.9%, range of 0.6%–8.1%) or if vaccines offer at least 12 months of protection (mean across study areas = 2.4%, range of 0.2%–5.8%), while an increase in severe side effects (from 0.001% to 0.01%) leads to reduced uptake (mean = −1.3%, range of −0.2% to −3.9%). Additionally, a large share of individuals (mean = 55.2%, range of 28%–75.8%) would delay vaccination by 3 months to obtain a more efficacious (95% vs 60%) vaccine, where this increases further if the low efficacy vaccine has a higher risk (0.01% instead of 0.001%) of severe side effects (mean = 65.9%, range of 41.4%–86.5%). Our work highlights that careful consideration of which vaccines to offer can be beneficial. In support of this, we provide an interactive tool to predict uptake in a country as a function of the vaccines being deployed, and also depending on the levels of infectiousness and severity of circulating variants of COVID-19.
    Date: 2022–04

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