nep-hea New Economics Papers
on Health Economics
Issue of 2022‒12‒19
thirty-six papers chosen by
Nicolas R. Ziebarth
Cornell University

  1. Maternal and Infant Health Inequality: New Evidence from Linked Administrative Data By Kate Kennedy-Moulton; Sarah Miller; Petra Persson; Maya Rossin-Slater; Laura Wherry; Gloria Aldana
  2. Public Childcare, Labor Market Outcomes of Caregivers, and Child Development: Experimental Evidence from Brazil By Orazio Attanasio; Ricardo Paes de Barros; Pedro Carneiro; David K. Evans; Lycia Lima; Pedro Olinto; Norbert Schady
  3. Paying Moms to Stay Home: Short and Long Run Effects on Parents and Children By Gruber, Jonathan; Huttunen, Kristiina; Kosonen, Tuomas
  4. Targeting Precision Medicine: Evidence from Prenatal Screening By Peter Conner; Liran Einav; Amy Finkelstein; Petra Persson; Heidi L. Williams
  5. Competing with precision: incentives for developing predictive biomarker tests By Kurt R. Brekke; Dag Morten Dalen; Odd Rune Straume
  6. The Effects of a Disability Employment Quota When Compliance Is Cheaper than Defiance By Krekó, Judit; Telegdy, Álmos
  7. Social Norms and Gendered Occupational Choices of Men and Women: Time to Turn the Tide? By Palffy, Patricia; Lehnert, Patrick; Backes-Gellner, Uschi
  8. Liberalizing the opening of new pharmacies and hospitalizations By Andrea Cintolesi; Andrea Riganti
  9. Why Some Acute Health Effects of Air Pollution Could Be Inflated By Bagilet, Vincent; Zabrocki-Hallak, Léo
  10. The Gift of a Lifetime: The Hospital, Modern Medicine, and Mortality By Alex Hollingsworth; Krzysztof Karbownik; Melissa A. Thomasson; Anthony Wray
  11. Activity based funding reform and the performance of public hospitals: The Case of Queensland, Australia By Bao Hoang Nguyen; Shawna Grosskopf; Jongsay Yong; Valentin Zelenyuk
  12. The Health-Consumption Effects of Increasing Retirement Age Late in the Game By Eve Caroli; Catherine Pollak; Muriel Roger
  14. Can Anti-Vaping Policies Curb Drinking Externalities? Evidence from E-Cigarette Taxation and Traffic Fatalities By Dhaval M. Dave; Yang Liang; Johanna Catherine Maclean; Joseph J. Sabia; Matthew Braaksma
  15. Inequalities in unpaid carer’s health, employment status and social isolation By Brimblecombe, Nicola; Cartagena Farias, Javiera
  16. Cognitive Decline and Dynamic Selection By Michael E. Darden
  17. Naturalization and Immigrants' Health By Aparicio Fenoll, Ainoa
  18. Does decriminalization cause more drug overdose deaths? Evidence from Oregon Measure 110 By Noah Spencer
  19. Opioid Mortality in the US: Quantifying the Impact of Key Determinants Using a Spatial Panel Data Approach By Gopal, Sucharita; Fischer, Manfred M.
  20. Keep calm and carry on: The short- vs. long-run effects of mindfulness meditation on (academic) performance By Cassar, Lea; Fischer, Mira; Valero, Vanessa
  21. PhD Studies Hurt Mental Health, But Less than You Think By Keloharju, Matti; Knüpfer, Samuli; Müller, Dagmar; Tåg, Joacim
  22. Information provision over the phone saves lives: An RCT to contain COVID-19 in rural Bangladesh at the pandemic's onset By Chowdbury, Shyamal; Schildberg-Hörisch, Hannah; Schneider, Sebastian O.; Sutter, Matthias
  23. Vaccine-Skeptic Physicians and COVID-19 Vaccination Rates By Steinmayr, Andreas; Rossi, Manuel
  24. Health Shocks and Overindebtedness: A Panel Data Analysis from Rural Viet Nam By Chhay, Panharoth; Rahut, Dil
  25. Counting Missing Women - A Reconciliation of the 'Flow Measure' and the 'Stock Measure' By Ebert, Cara; Klasen, Stephan; Vollmer, Sebastian
  26. Overcoming Behavioral Impediments to Maternal Care: Experimental Evidence on Domain Knowledge and Nudgeability from Recalcitrant Pakistan By Musharraf R. Cyan; Resul Cesur; Yasin Civelek; Bauyrzhan Yedgenov; Richard Rothenberg
  27. Analysis of modern organizational and information technologies in the management of professional health and professional longevity By Turzin Petr; Yashina Elena; Kovalev Sergey; Generalov Andrey; Evseev Alexandr; Lukichev Konstantin
  28. Strengthening the social safety net in Korea By Hyunjeong Hwang; Axel Purwin; Jon Pareliussen
  29. The demand side of Africa's demographic transition: desired fertility, wealth, and jobs By Céline Zipfel
  30. Mortalidad por covid-19 y otras causas durante la pandemia en Uruguay (Mortality from covid-19 and other causes during the pandemic in Uruguay) By DE ARMAS, GONZALO; Álvarez-Vaz, Ramón; Prieto, Victoria; Paredes, Mariana; POLLERO, RAQUEL
  31. Heterogeneity in Damages from A Pandemic By Amy Finkelstein; Geoffrey Kocks; Maria Polyakova; Victoria Udalova
  32. Severity of COVID-19 Infection and the Adoption of Contact-Confirming Application in Japan By Mitomo, Hitoshi; Otsuka, Tokio; Kamplean, Artima
  33. Effects of Covid-19 Pandemic on Online Shopping Behavior in Iran By Ghaffari, Reza; Cheng, Kequn
  34. Nonlinear control of Covid-19 pandemic based on the SIRD model By Rituraj, Rituraj; Ghadami, Seyyed Mostafa; Seyyedi, Seyyed Masoud
  35. Teleworking and Life Satisfaction during COVID-19: The Importance of Family Structure By Claudia Senik; Andrew E. Clark; Conchita d'Ambrosio; Anthony Lepinteur; Carsten Schröder
  36. Does Working from Home Work? A Natural Experiment From Lockdowns By Shen, Lucas

  1. By: Kate Kennedy-Moulton; Sarah Miller; Petra Persson; Maya Rossin-Slater; Laura Wherry; Gloria Aldana
    Abstract: We use linked administrative data that combines the universe of California birth records, hospitalizations, and death records with parental income from Internal Revenue Service tax records and the Longitudinal Employer-Household Dynamics file to provide novel evidence on economic inequality in infant and maternal health. We find that birth outcomes vary non-monotonically with parental income, and that children of parents in the top ventile of the income distribution have higher rates of low birth weight and preterm birth than those in the bottom ventile. However, unlike birth outcomes, infant mortality varies monotonically with income, and infants of parents in the top ventile of the income distribution---who have the worst birth outcomes---have a death rate that is half that of infants of parents in the bottom ventile. When studying maternal health, we find a similar pattern of non-monotonicity between income and severe maternal morbidity, and a monotonic and decreasing relationship between income and maternal mortality. At the same time, these disparities by parental income are small when compared to racial disparities, and we observe virtually no convergence in health outcomes across racial and ethnic groups as income rises. Indeed, infant and maternal health in Black families at the top of the income distribution is markedly worse than that of white families at the bottom of the income distribution. Lastly, we benchmark the health gradients in California to those in Sweden, finding that infant and maternal health is worse in California than in Sweden for most outcomes throughout the entire income distribution.
    JEL: I1 I14 I30
    Date: 2022–11
  2. By: Orazio Attanasio; Ricardo Paes de Barros; Pedro Carneiro; David K. Evans; Lycia Lima; Pedro Olinto; Norbert Schady
    Abstract: This study examines the impact of publicly provided daycare for children aged 0-3 on outcomes of children and their caregivers over the course of seven years after enrollment into daycare. At the end of 2007, the city of Rio de Janeiro in Brazil used a lottery to assign children to limited public daycare openings. Winning the lottery translated to a 34 percent increase in time in daycare during a child’s first four years of life. This allowed caregivers more time to work, resulting in higher incomes for beneficiary households in the first year of daycare attendance and 4 years later (but not after 7 years, by which time all children were eligible for universal schooling). The rise in labor force participation is driven primarily by grandparents and by adolescent siblings residing in the same household as (and possibly caring for) the child, and not by parents, most of whom were already working. Beneficiary children saw sustained gains in height-for-age and weight-for-age, due to better nutritional intake at school and at home. Gains in beneficiary children’s cognitive development were observed 4 years after enrolment but not later.
    JEL: I30 I31 I38
    Date: 2022–11
  3. By: Gruber, Jonathan; Huttunen, Kristiina; Kosonen, Tuomas
    Abstract: We study the impacts of a policy designed to reward mothers who stay at home rather than join the labor force when their children are under age three. We use regional and over time variation in child home care allowance to show that home care allowance decreases maternal employment in both the short and long term, with almost three-quarters of the supplement amount offset by lost labor income. The effects are large enough for the existence of home care benefit system to explain the higher child penalty in Finland than comparable nations. Home care benefits also negatively affect the early childhood cognitive test results of children at the age of five, increase the likelihood of choosing vocational rather than academic secondary education track, and increase youth crimes. We confirm that the mechanism of action is changing work/home care arrangements by studying a a day care fee (DCF) reform had the opposite effect of raising incentives to work. We find that this policy increased the labor force participation of mothers and participation of children to day care, and improved child early test and schooling outcomes. This parallel set of findings suggests that on average in Finland, shifting child care from the home to the market increases labor force participation and improves child outcomes.
    Keywords: home care allowance, employment, child development, schooling, Social security, taxation and inequality, J13, J21, J38, fi=Koulutus|sv=Utbildning|en=Education|, fi=Sosiaaliturva|sv=Social trygghet|en=Social security|, fi=Työmarkkinat|sv=Arbetsmarknad|en=Labour markets|,
    Date: 2022
  4. By: Peter Conner; Liran Einav; Amy Finkelstein; Petra Persson; Heidi L. Williams
    Abstract: Medical technologies can target care to patients identified through screening, raising questions of how broadly to screen for potential use. We explore this empirically in the context of a non-invasive prenatal screening, cfDNA, which is used to target a more costly invasive test that elevates miscarriage risk. Using Swedish administrative data on prenatal choices for pregnancies conceived between 2011 and 2019 – a period in which Swedish regions began providing coverage for the new screening – we document that coverage of cfDNA substantially increases cfDNA screening and reduces invasive testing. To assess the impact of counterfactual targeting of cfDNA coverage, we develop and estimate a stylized model of prenatal choices. We find that narrow targeting of cfDNA coverage can improve outcomes and reduce costs, while broader coverage also improves outcomes but with increased costs. These findings point to the potential gains from well-designed targeting of screening, but at the same time highlight the importance of the targeting design.
    JEL: H31 I12 I13 I18 J13
    Date: 2022–11
  5. By: Kurt R. Brekke (Norwegian School of Economics (NHH), Department of Economics); Dag Morten Dalen (BI Norwegian Business School); Odd Rune Straume (Department of Economics/NIPE, University of Minho)
    Abstract: We study the incentives of drug producers to develop predictive biomarkers, taking into account strategic interaction between drug producers and health plans. For this purpose we develop a two-dimensional spatial framework that allows us to capture the informational role of biomarkers and their effects on price competition and treatment choices. Although biomarkers increase the information available to prescribers, we identify an anticompetitive effect on the prices set by producers of therapeutically substitutable drugs. We also find that better information about each patient´s most therapeutically appropriate drug does not necessarily lead to more efficient treatment outcomes.
    Keywords: Pharmaceutical markets; Precision medicine; Therapeutic competition; Predictive biomarkers.
    JEL: I11 I18 L13 L65
    Date: 2022
  6. By: Krekó, Judit (Central European University); Telegdy, Álmos (Corvinus University of Budapest)
    Abstract: This paper evaluates the effects of the Hungarian disability employment quota, which requires firms over a certain size to employ people with disabilities or pay a noncompliance tax. We employ a regression discontinuity design on firm-level data to estimate the effect on the quota on the employment of persons with disabilities, when the tax increased from very low levels to 170 percent of the lowest wage cost required to meet the quota. We estimate a lower bound of the effect that takes into account the bias resulting from bunching of firms below the threshold. Firms hire 0.24–0.29 additional disabled workers on average when the tax increased, with a lower bound of 0.16. When the threshold is raised from 20 to 25 employees, bunching of firms and the estimated effect disappears around the old threshold. The policy effect is weaker in regions with few disabled individuals, implying that the policy outcomes are hampered by low labor supply, materializing in high fixed costs of hiring, as predicted by our model.
    Keywords: disability employment quota, labor demand, regression discontinuity, Hungary
    JEL: J14 H32 J23
    Date: 2022–11
  7. By: Palffy, Patricia (University of Zurich); Lehnert, Patrick (University of Zurich); Backes-Gellner, Uschi (University of Zurich)
    Abstract: We analyze the relationship between social gender norms and adolescents' occupational choices by combining regional votes on constitutional amendments on gender equality with job application data from a large job board for apprenticeships. Results show that adolescent males in regions with stronger traditional social gender norms are more likely to apply for typically male occupations. This finding does not hold for females, suggesting that incentivizing men to break the norms and choose gender-atypical occupations (e.g., in healthcare) can be even more effective in accelerating advancement toward gender equality in the labor market than incentivizing women to choose STEM occupations.
    Keywords: occupational gender segregation, social norms, occupational choice
    JEL: J24 J16 I24 M59
    Date: 2022–11
  8. By: Andrea Cintolesi (Bank of Italy); Andrea Riganti (University of Milan)
    Abstract: We study the impact of legal restrictions pertaining to pharmacy licences on hospitalizations. We use a reform approved in 2012 in Italy that increased the number of pharmacies allowed to operate in the national territory by 8%. We set up a regression discontinuity design exploiting monthly data on hospitalizations within Italian provinces. We find that an 8% increase in the number of pharmacies decreased medical hospitalizations by 1.1% and related expenditures by 1.3%. This drop is mainly driven by short hospitalizations of children and elderly individuals. On average, every new pharmacy prevents 17 medical hospitalizations every year. We do not find an impact on a control group of surgical hospitalizations, and we validate the results with a battery of placebo tests. Pharmacies appear to reduce hospitalizations by giving information to people who would otherwise be admitted to a hospital, and other mechanisms are not supported by the data.
    Keywords: regulation, pharmacies, license, healthcare expenditures, hospitalizations
    JEL: D45 H51 I10 K20
    Date: 2022–11
  9. By: Bagilet, Vincent; Zabrocki-Hallak, Léo
    Abstract: Hundreds of studies have shown that air pollution affects health in the very short-run. This played a key role in setting air quality standards. Yet, estimated effect sizes can vary widely across studies. Analyzing the results published in epidemiology and economics, we find that publication bias and a lack of statistical power could lead some estimates to be inflated. We then run real data simulations to identify the design parameters causing these issues. We show that this exaggeration may be driven by a small numbers of exogenous shocks, instruments with limited strength or sparse outcomes. Other literatures relying on comparable research design could also be affected by these issues. Our paper provides a principled workflow to evaluate and avoid the risk of exaggeration when conducting an observational study.
    Date: 2022
  10. By: Alex Hollingsworth; Krzysztof Karbownik; Melissa A. Thomasson; Anthony Wray
    Abstract: The past century witnessed a dramatic improvement in public health, the rise of modern medicine, and the transformation of the hospital from a fringe institution to one essential to the practice of medicine. In this paper, we explore how access to the hospital and modern medicine affects mortality. We do so by leveraging a combination of novel data and a unique quasi-experiment: a large-scale hospital modernization program introduced by The Duke Endowment in the early twentieth century. The Endowment helped communities build and expand hospitals, obtain state-of-the-art medical technology, attract qualified medical personnel, and refine management practices. We find that access to a Duke-supported hospital reduced infant mortality by 10%, saving one life for every $20,000 (2017 dollars) spent. Effects were larger for Black infants (16%) than for White infants (7%), implying a reduction in the Black-White infant mortality gap by one-third. We show that the effect of Duke support persisted into later life with a 9% reduction in mortality between the ages of 56 and 65. We further provide evidence on the mechanisms that enabled these effects, finding that Endowment-supported hospitals attracted higher-quality physicians and were better able to take advantage of new medical innovations.
    JEL: I14 J13 N32
    Date: 2022–11
  11. By: Bao Hoang Nguyen (School of Economics and Centre for Efficiency and Productivity Analysis (CEPA) at The University of Queensland, Australia); Shawna Grosskopf (Economics, School of Public Policy, Oregon State University, Corvallis, OR 97331, USA); Jongsay Yong (Melbourne Institute of Applied Economic and Social Research, The University of Melbourne, Parkville, Australia); Valentin Zelenyuk (School of Economics and Centre for Efficiency and Productivity Analysis (CEPA) at The University of Queensland, Australia)
    Abstract: This study investigates the impact of activity-based funding (ABF) on the performance of hospitals by exploiting a natural experiment that happened in the state of Queensland, Australia. To examine the outcome of the reform, we use both a simple measure of performance (the weighted average length of stay) and more sophisticated ones (the technical efficiency estimated from data envelopment analysis (DEA) models). We try to identify the causal effect of ABF on the technical efficiency of hospitals by incorporating difference-in-differences approach in the popular two-stage DEA framework. We find empirical evidence that ABF improves the technical efficiency of hospitals.
    Keywords: Hospital effciency, Activity based funding, Healthcare reform, DEA, Differencein- Differences, Truncated regression.
    JEL: C24 C61 I11 I18
    Date: 2022–11
  12. By: Eve Caroli (LEDa - Laboratoire d'Economie de Dauphine - IRD - Institut de Recherche pour le Développement - Université Paris Dauphine-PSL - PSL - Université Paris sciences et lettres - CNRS - Centre National de la Recherche Scientifique, IZA - Forschungsinstitut zur Zukunft der Arbeit - Institute of Labor Economics); Catherine Pollak (DREES - Centre de Recherche du DREES - Ministère de l'Emploi et de la Solidarité, LEDa - Laboratoire d'Economie de Dauphine - IRD - Institut de Recherche pour le Développement - Université Paris Dauphine-PSL - PSL - Université Paris sciences et lettres - CNRS - Centre National de la Recherche Scientifique); Muriel Roger (CES - Centre d'économie de la Sorbonne - UP1 - Université Paris 1 Panthéon-Sorbonne - CNRS - Centre National de la Recherche Scientifique, LIEPP - Laboratoire interdisciplinaire d'évaluation des politiques publiques (Sciences Po) - Sciences Po - Sciences Po)
    Abstract: Using the differentiated increase in retirement age across cohorts introduced by the 2010 French pension reform, we estimate the health-consumption effects of a 4-month increase in retirement age. We focus on individuals who were close to retirement age but not retired yet by the time the reform was passed. Using administrative data on individual sick-leave claims and nonhospital health-care expenses, we show that the probability of having at least one sickness absence increases for all treated groups, while the duration of sick leaves remains unchanged. Delaying retirement does not increase the probability of seeing a GP, except for men in the younger cohorts. In contrast, it raises the probability of having a visit with a specialist physician for all individuals, except men in the older cohorts. Delaying retirement also increases the probability of seeing a physiotherapist among women from the older cohorts. Overall, it increases health expense claims, in particular in the lower part of the expenditure distribution.
    Keywords: pension reform,retirement age,health,health-care consumption
    Date: 2022–10
  13. By: Mattia Filomena (Department of Economics and Social Sciences, Marche Polytechnic University); Matteo Picchio (Department of Economics and Social Sciences, Marche Polytechnic University)
    Abstract: We estimate the impact of temperatures on work related accident rates in Italy by using daily data on weather conditions matched to administrative daily data on work related accidents. The identification strategy of the causal effect relies on the plausible exogeneity of short-term daily temperature variations in a given spatial unit. We find that both high and cold temperatures impair occupational health by increasing workplace injury rates. The positive effect of warmer weather conditions on work related accident rates is larger for men, in manufacturing and service sectors, and for workplace injuries. Colder temperatures are particularly harmful for commuting accidents and in rainy days.
    Keywords: Climate change; temperatures; weather conditions; work related accidents; safety.
    JEL: J28 J81 Q52 Q54
    Date: 2022–11
  14. By: Dhaval M. Dave; Yang Liang; Johanna Catherine Maclean; Joseph J. Sabia; Matthew Braaksma
    Abstract: Teenage drinking is a top public health concern, generating social costs of over $28 billion per year, including substantial external costs associated with alcohol-related traffic fatalities. At the same time, the high rate of electronic cigarette (“e-cigarette”) use among teenagers has become a public health concern, with state and local policymakers turning to e-cigarette taxes as a tool to curb consumption. This paper is the first to explore the spillover effects of e-cigarette taxes on teenage drinking and alcohol-related traffic fatalities. Using data from five nationally representative datasets (the state and national Youth Risk Behavior Surveys, the Behavioral Risk Factor Surveillance Survey, the National Survey on Drug Use and Health, and the Fatality Analysis Reporting System) spanning the period 2003-2019, and a difference-in-differences approach, we find that a one-dollar increase in e-cigarette taxes is associated with a 1-to-2 percentage-point reduction in the probability of teenage binge drinking, and a 0.4 to 0.6 decline in the number of alcohol-related traffic fatalities per 100,000 16-to-20-year-olds in a treated state-year. A causal interpretation of our estimates is supported by (1) event-study analyses that account for heterogeneous and dynamic treatment effects, and (2) null effects of e-cigarette taxes on non-alcohol-related traffic fatalities.
    JEL: H71 I12
    Date: 2022–11
  15. By: Brimblecombe, Nicola; Cartagena Farias, Javiera
    Abstract: Providing higher-intensity unpaid care (higher care hours or care within the household) is associated with negative impacts on people's paid employment, mental health and well-being. The evidence of effects on physical health is mixed and carer's social and financial outcomes have been under-researched. The biggest evidence gap, however, is on how outcomes vary by factors other than type or level of care provision, in particular socio-demographic factors. Our study used two waves of data (2017/19 and 2018/2020) from the United Kingdom Household Longitudinal Study for people aged 16 and older. We investigated the effects of providing care for 10 or more hours a week or within the household in interaction with people's socio-demographic characteristics. Outcomes included mental and physical health, social isolation, employment status and earnings. We found that caring responsibilities interacted with gender, ethnicity, socio-economic status (as measured by highest educational qualification), or age to affect carers differentially in a number of areas of their lives leading to, and exacerbating, key disadvantages and inequalities.
    Keywords: employment and earnings; health; inequalities; social isolation; unpaid/informal care; R-PRU-1217-21101; Wiley deal
    JEL: R14 J01
    Date: 2022–11–12
  16. By: Michael E. Darden
    Abstract: Understanding cognitive health, its decline, and the investments that shape its age profile in later life are important in an aging society, and yet, estimating the cognitive health production function is complicated by non-random mortality and sample attrition. I study this dynamic selection problem in the context of education, race, and cigarette smoking, characteristics thought to affect the level, but not slope, of cognitive decline. I develop a general framework that involves estimation of a system of dynamic equations consistent with the Grossman (1972) model. Exploiting exciting longitudinal data from the National Health and Aging Trends Study (NHATS), I find substantially wider gaps in cognitive health by these characteristics relative to cross-sectional comparisons, in some cases by 100%. Furthermore, these gaps grow in age, which suggests that the bias generated by dynamic selection is not constant. The implication of these results is that theories of cognitive decline need to accommodate differential rates of change -- rather than just differences in levels -- in cognitive health by education and race. Connecting theory and empirical work offers an important tool for economists studying health investment and health in older populations.
    JEL: I10 I12 J24
    Date: 2022–11
  17. By: Aparicio Fenoll, Ainoa (University of Turin)
    Abstract: The "healthy immigrant effect" refers to the well-documented fact that immigrants are healthier than natives upon arrival, but their health level converges to that of natives over time. Unfortunately, little is known about whether environmental, institutional, or selective return migration mechanisms are behind the convergence. In this paper, I test whether immigrants' naturalization influences health convergence speed. Using restricted-access Spanish health data from the National and European Health Surveys, I estimate the impact of naturalization on health by exploiting that naturalization is possible after two years of residence for Latinoamerican immigrants and after ten years for all other immigrants. I find that naturalization worsens immigrants' health and thus accelerates the speed of convergence to natives' health. In particular, naturalization increases the propensity to suffer from varicose veins, cervical problems, lower back pain, constipation, depression, and anxiety. Changes in dietary habits and increases in employment are potential mechanisms behind these effects.
    Keywords: naturalization, immigrants' health, healthy immigrant effect
    JEL: J15 J61 I14
    Date: 2022–10
  18. By: Noah Spencer
    Abstract: This paper evaluates the causal effect of drug decriminalization on drug overdose deaths in a context where decriminalization was not accompanied by substantial public health investments. Using the synthetic control method, I find that when Oregon decriminalized small amounts of drugs in February 2021, it caused 181 additional drug overdose deaths during the remainder of 2021. This represents a 23% increase over the number of drug overdose deaths predicted if Oregon had not decriminalized drugs. My estimates suggest that decriminalization had similar effects on drug overdose deaths among men and women and among white and non-white people.
    Keywords: drug decriminalization, illicit drugs, synthetic control method
    JEL: D04 I18 K42
    Date: 2022–11–29
  19. By: Gopal, Sucharita; Fischer, Manfred M.
    Abstract: This paper employs a spatial Durbin panel data model, an extension of the cross-sectional spatial Durbin model to a panel data framework, to estimate the impact of a set of demographic and economic factors on state-level opioid-related mortalities in the US. The empirical model uses a pool of US states over six years from 2014 to 2019 and a nearest-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- related mortality in the states.
    Keywords: Spatial Durbin panel data model; Bayesian econometrics; Markov Chain Monte Carlo; direct (own state) effects; indirect (cross-state spatial spillover) effects; inferential statistics
    Date: 2022–12–01
  20. By: Cassar, Lea; Fischer, Mira; Valero, Vanessa
    Abstract: Mindfulness-based meditation practices are becoming increasingly popular in Western societies, including in the business world and in education. While the scientific literature has largely documented the benefits of mindfulness meditation for mental health, little is still known about potential spillovers of these practices on other important life outcomes, such as performance. We address this question through a field experiment in an educational setting. We study the causal impact of mindfulness meditation on academic performance through a randomized evaluation of a well-known 8-week mindfulness meditation training delivered to university students on campus. As expected, the intervention improves students' mental health and non-cognitive skills. However, it takes time before students' performance can benefit from mindfulness meditation: we find that, if anything, the intervention marginally decreases average grades in the short run, i.e., during the exam period right after the end of the intervention, whereas it significantly increases academic performance, by about 0.4 standard deviations, in the long run (ca. 6 months after the end of intervention). We investigate the underlying mechanisms and discuss the implications of our results.
    Keywords: performance,mental health,education,meditation,field experiment
    JEL: I21 C93 I12 I31
    Date: 2022
  21. By: Keloharju, Matti (Aalto University); Knüpfer, Samuli (Aalto U(niversity School of Business); Müller, Dagmar (Swedish Public Employment Service); Tåg, Joacim (Research Institute of Industrial Economics (IFN))
    Abstract: We study the mental health of PhD students in Sweden using comprehensive administrative data on prescriptions, specialist care visits, hospitalizations, and causes of death. We find about 7% (5%) of PhD students receive medication or diagnosis for depression (anxiety) in a given year. These prevalence rates are less than one-third of the corresponding survey-based prevalence rates reported in the literature, and even after adjusting for difference in methodology, 44% (72%) of the prevalence rates reported in the literature. We also document PhD students’ mental health significantly worsens relative to their peers after they have entered the program. This deterioration is consistent with doctoral studies having a negative causal effect on mental health.
    Keywords: Doctoral studies; Mental Health; Depression; Anxiety; Suicide
    JEL: A23 I10 I23 I29 I31
    Date: 2022–08–12
  22. By: Chowdbury, Shyamal; Schildberg-Hörisch, Hannah; Schneider, Sebastian O.; Sutter, Matthias
    Abstract: Lack of information about COVID-19 and its spread may have contributed to excess mortality at the pandemic's onset, In April and May 2020, we implemented a randomized controlled trial with more than 3,000 households in 150 Bangladeshi villages, Our one-to-one information campaign via phone stressed the importance of social distancing and hygiene measures, and illustrated the consequences of an exponential spread of COVID-19, We find that information provision improves knowledge about COVID-19 and induces significant behavioral changes. Information provision also yields considerably better health outcomes, most importantly by reducing the number of reported deaths by about 50% in treated villages.
    Keywords: Field experiment,COVID-19,Information intervention,Death rates
    JEL: C93 D01 D91 I12
    Date: 2022
  23. By: Steinmayr, Andreas (University of Innsbruck); Rossi, Manuel (University of Innsbruck)
    Abstract: What is the role of general practitioners (GPs) in supporting or hindering public health efforts? We investigate the influence of vaccine-skeptic GPs on their patients' decisions to get a COVID-19 vaccination. We identify vaccine-skeptic GPs from the signatories of an open letter in which 199 Austrian physicians expressed their skepticism about COVID-19 vaccines. We examine small rural municipalities where patients choose a GP primarily based on geographic proximity. These vaccine-skeptic GPs reduced the vaccination rate by 5.6 percentage points. This estimate implies that they discouraged 7.9% of the vaccinable population. The effect appears to stem from discouragement rather than from rationing access to the vaccine.
    Keywords: vaccine hesitancy, vaccination, COVID-19, health policy
    JEL: I12 I18
    Date: 2022–11
  24. By: Chhay, Panharoth (Asian Development Bank Institute); Rahut, Dil (Asian Development Bank Institute)
    Abstract: Rural households in developing countries have limited capacity to cope with and manage shocks, thereby resulting in chronic poverty, indebtedness, and a decline in overall well-being. We analyze the effects of health shocks on overindebtedness in rural Viet Nam using four rounds of a balanced panel data set of about 1,750 households observed over a decade (2007, 2010, 2013, 2016). Employing the household-level fixed-effect model, we find that health shocks reduce household income and increase health expenditure among rural Vietnamese households. We also find that households cope with health shocks mainly by borrowing from more sources. Households experiencing health shocks are 2.2 to 3.1 percentage points more likely to be overindebted, which occurs primarily among households without health insurance, suggesting that social health insurance can reduce households’ vulnerability to the consequences of health shocks. These findings strongly support efforts to expand access to social health insurance in rural Viet Nam.
    Keywords: health shocks; overindebtedness; social health insurance; household-level fixed effects; rural Viet Nam
    JEL: E21 E24 I13 I15
    Date: 2022–05
  25. By: Ebert, Cara; Klasen, Stephan; Vollmer, Sebastian
    Abstract: 'Stock estimates' of missing women suggest that the problem is concentrated in South and East Asia and among young children. In contrast, 'flow estimates' suggest that gender bias in mortality is much larger, is as severe among adults as it is among children in India and China, and is larger in Sub-Saharan Africa than in India and China. We show that the different stock and flow measure results rely on the choice of the reference standard for mortality and an incomplete correction for different disease environments in the flow measure. Alternative reference standards reconcile the results of the two measures.
    Keywords: Missing women,gender bias,mortality,disease,age,Sub-Saharan Africa,China,India
    JEL: J16 D63 I10
    Date: 2022
  26. By: Musharraf R. Cyan; Resul Cesur; Yasin Civelek; Bauyrzhan Yedgenov; Richard Rothenberg
    Abstract: We conducted a large-scale field experiment to calibrate phone messaging to its potential of overcoming behavioral barriers to maternal care uptake in the countryside of a developing country, where a significant share of women forgoes life-saving maternity-related care even when within reach. The high-arching goal of our intervention is to test if and to what extent filling out insufficient domain knowledge (i.e., childbearing-related health literacy) generates responsiveness to nudges for adopting maternal care among the rural poor of Pakistan. We find that informational nudges sent in a random order using the appropriate medium of communication, voice messages, during pregnancy significantly improve care-seeking behaviors, measured by antenatal care, postpartum checkup, and postnatal visits, through improved literacy. Importantly, we document that high-frequency voice calls timed to gestational age substantially increase the efficacy of informational nudges, including boosting facility deliveries, once domain knowledge is built and nudgeability established. Nevertheless, small financial incentives trump the productivity of informational voice calls in both improving health literacy and boosting care uptake, likely due to participants equating the intrinsic value of the intended behavioral change to the size of the monetary reward. These results are scalable to a large number of populations across developing nations.
    JEL: C93 D10 I12 I15
    Date: 2022–11
  27. By: Turzin Petr (Russian Presidential Academy of National Economy and Public Administration); Yashina Elena (Russian Presidential Academy of National Economy and Public Administration); Kovalev Sergey (Russian Presidential Academy of National Economy and Public Administration); Generalov Andrey (Russian Presidential Academy of National Economy and Public Administration); Evseev Alexandr (Russian Presidential Academy of National Economy and Public Administration); Lukichev Konstantin (Russian Presidential Academy of National Economy and Public Administration)
    Abstract: At present, great importance is attached to the problem of maintaining the professional health of the working-age population and prolonging professional longevity in the world and in the Russian Federation. This problem has become especially urgent in recent years, in connection with the change in the country's retirement age.
    Keywords: professional health, professional longevity
    Date: 2021–01
  28. By: Hyunjeong Hwang; Axel Purwin; Jon Pareliussen
    Abstract: Social protection in Korea is designed around traditional forms of employment and excludes a substantial share of workers in non-standard employment. The resulting social protection gaps compound income inequality and undermine financial sustainability as uninsured persons rely on tax-financed benefits. Besides, Korea’s tax and benefit system discourages taking up or returning to low-paid work from social assistance or unemployment benefits. Expanding the reach of employment insurance while redesigning the tax and benefit system could boost work incentives and reduce inequality and poverty. The elderly poverty rate is persistently high, partly because public pensions and social insurance were introduced relatively recently. Better targeting the means-tested Basic Pension could reduce elderly poverty considerably. Lengthening careers is essential to ensure pension sustainability and adequate retirement income for future retirees. Shifting from a severance pay system to a corporate pension would help improve retirement income and lower employers’ incentives to push for early retirements. Reducing inequalities in access to health and long-term care will require expansion of primary care and affordable quality home-based care. This will also help address the overreliance on hospitals and cope with rising demand.
    Keywords: health and inequality, retirement policies, safety, Social security and public pensions
    JEL: H55 I13 J28 J08
    Date: 2022–11–30
  29. By: Céline Zipfel
    Abstract: Sub-Saharan Africa (SSA) accounts for around 40% of projected global births over the next 80 years. To investigate the roots of persistently high fertility rates across the region, I assemble micro data from 192 Demographic and Health Surveys covering 66 low-and-middle-income countries and document three key facts. First, women's fertility ideals and intentions are, on average, substantially higher in SSA than other low-and-middle-income regions. This gap is particularly large among poorer households: the socioeconomic gradient in desired fertility is twice as steep (more negative) on the sub-continent. Second, poorer women are also significantly less likely to work for a wage in SSA, where there exists a robust negative relationship between female wage work prevalence and desired fertility across provinces. Third, exploiting within-SSA variation across 25 countries, I find that increases in female salaried employment opportunities at the province level are associated with a flattening of this gradient over time, conditional on a rich set of covariates. These findings provide suggestive evidence that the nature of SSA's occupational change process may be an important contributor to the region's distinct fertility transition.
    Date: 2022–12
  30. By: DE ARMAS, GONZALO; Álvarez-Vaz, Ramón (Universidad de la República); Prieto, Victoria; Paredes, Mariana; POLLERO, RAQUEL
    Abstract: From March 2020 to March 2022, more than 7,000 deaths from the COVID-19 disease were recorded in Uruguay, of which only 2% occurred in 2020. However, urban mobility made its greatest decrease in this first year of pandemic, falling to 57% in April 2020 from levels recorded before the virus arrived to Uruguay. These transformations affected the patterns of contagion of the SARs-COV-2 virus, maintaining levels of very low viral circulation for the international concert during 2020, but also affected the behavior of the other causes of death and the general health of the population. This paper analyzes the behavior of mortality by COVID-19 and other causes of death for 2020, the last year for which information is available published by the Ministry of Public Health for deaths by cause, age and sex. First, the potential years are estimated of life lost due to COVID-19 and other selected causes for the years 2019, 2020 and 2021. Second, it is break down by age and cause of death the gap in the values of life expectancy in 2020 and in previous years (2015-2019). This estimation makes it possible to identify which causes of death and age groups gained or lost years of life expectancy in this period. The results show that, unlike what happened in several countries in the region and the In the world, in Uruguay excess mortality was not recorded, but, on the contrary, years of life expectancy were gained compared to the pre-pandemic period. These gains were concentrated in the older age groups, in mortality from respiratory diseases, circulatory system and external causes, and were higher in men than in women
    Date: 2022–06–14
  31. By: Amy Finkelstein; Geoffrey Kocks; Maria Polyakova; Victoria Udalova
    Abstract: We use linked survey and administrative data to document and decompose the striking differences across demographic groups in both economic and health impacts of the first year of the COVID-19 pandemic in the United States. The impacts of the pandemic on all-cause mortality and on employment were concentrated in the same racial, ethnic, and education groups, with non-White individuals and those without a college degree experiencing higher excess all-cause mortality as well as a greater employment loss. Observable differences in living arrangements and the nature of work – which likely affected exposure to the virus and to economic contractions – can explain 15 percent of the Hispanic-White difference in excess mortality, almost one-quarter of the non- Hispanic Black-White difference, and almost half of the difference between those with and without a Bachelor’s degree; they can also explain 35 to 40 percent of the differences in economic damages between these groups. These findings underscore the importance of non-medical factors in contributing to the disparate impacts of public health shocks.
    JEL: I0
    Date: 2022–11
  32. By: Mitomo, Hitoshi; Otsuka, Tokio; Kamplean, Artima
    Abstract: This paper aims to analyze how the prevalence of COVID-19 infection has affected the adoption of the contact-confirming application in Japan and how network externalities have emerged in the diffusion process. Japan's COVID-19 contact-confirming application (COCOA), launched on June 19, 2020, was expected to be a digital platform to work against COVID-19 by notifying users of contact with a positive person, thereby encouraging them to change their behavior. However, the utilization of the app has not been advanced as expected. Given the app's purpose, the number of downloads must be influenced by the spread of infection. A synergetic effect caused by user interdependencies is expected to work for further utilization. In this sense, the effectiveness of the app should depend on the number of users and is therefore affected by network externalities. In addition, registration by positive patients is inevitable for the app to work. In Japan, it is left to the discretion of each infected person to register positive in the app. The number of positive registrations can represent how people are cooperative with the app and thus the Government policy. It would also be interesting to analyze how the spread of infection affects positive registrations. This paper investigates the influence of indices representing the seriousness of the disease on the number of app downloads and positive registrations. Data was collected from the open data published by the Ministry of Health, Labour and Welfare (MHLW). (...)
    Keywords: COVID-19,COCOA,Contact-confirming application,platform,ineffectiveness,network externality
    Date: 2022
  33. By: Ghaffari, Reza; Cheng, Kequn
    Abstract: Purpose - the main purpose of this study is to investigate the impact of Covid-19 pandemic on online shopping behavior in Iran. Design/methodology/approach - 484 customers of Digi Kala were selected by simple random sampling. The present study is applied objectively. The present study is a descriptive research in terms of how to collect data and it is a field research in terms of data collection. Structural equation modeling and SPSS 23 and SMARTPLS3 software were used to analyze the data. Findings - our results indicated that Covid-19 pandemic had a positive and significant effect on online shopping behavior in Iran. The level of health and economic fears during Covid-19 pandemic had a positive and significant effect on online shopping behavior in Iran. According to the moderating role of generational differences, Covid-19 pandemic and the level of health fears during the pandemic had a positive and significant effect on online shopping behavior in Iran. Nevertheless, the level of economic fears during Covid-19 pandemic had no significant effect on online shopping behavior in Iran according to the moderating role of generational differences. Originality/value - this work provides a guidance for the researchers and academicians in the field of marketing. Correspondingly, retailers and marketers should train themselves to survive during the global pandemics, and learn innovative approaches to supply the needs according to the changes in customers shopping behavior.
    Date: 2022–06–08
  34. By: Rituraj, Rituraj; Ghadami, Seyyed Mostafa; Seyyedi, Seyyed Masoud
    Abstract: In the last month of 2019, a new version of Corona disease was observed in Wuhan (China) which is known as Covid-19. Several models have been proposed to predict disease treatment. The SIR model is considered one of the simplest models for the prediction of pandemic disease. This means susceptible (S), infected (I), and recovered (R) populations. The SIRD model is yet another method that includes one more equation, i.e., the number of deaths (D). This paper proposed a control law for the first time to prevent the progression of the disease. The proposed control law is based on the SIRD model that is determined using two methods, i.e., the input-state feedback linearization method and the input-output feedback linearization method for the nonlinear modeling of Covid-19. The goal of control in this model is to reduce the percentage or number of infected people and the number of deaths due to Covid-19 disease. Simulation results show that the feedback linearization methods can have positive results in a significant reduction in unfurl of Covid-19. Delay in quarantine of infected people and constant percentage of people who should be quarantined are investigated as two important parameters. Results show that the percentage of infected people decreases 96.3 % and the percentage of deaths decreases 93.6 % when delay in quarantine equals 7 weeks.
    Date: 2022–06–16
  35. By: Claudia Senik (PSE - Paris School of Economics - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris sciences et lettres - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement, PJSE - Paris Jourdan Sciences Economiques - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris sciences et lettres - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement, SU - Sorbonne Université); Andrew E. Clark (PSE - Paris School of Economics - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris sciences et lettres - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement, PJSE - Paris Jourdan Sciences Economiques - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris sciences et lettres - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement); Conchita d'Ambrosio ( - Université du Luxembourg); Anthony Lepinteur ( - Université du Luxembourg); Carsten Schröder (DIW Berlin - Deutsches Institut für Wirtschaftsforschung)
    Abstract: We carry out a difference-indifferences analysis of a representative real-time survey conducted as part of the German SocioEconomic Panel (SOEP) study and show that teleworking had a negative average effect on life satisfaction over the first two years of the COVID-19 pandemic. This average effect hides considerable heterogeneity reflecting genderrole asymmetry: lower life satisfaction is only found for unmarried men and women with school-age children. The negative effect for women with school-age children disappears in 2021, suggesting adaptation to new constraints and/or the adoption of coping strategies.
    Keywords: Life Satisfaction,Teleworking,Work from Home,Gender,Childcare,COVID-19,SOEP
    Date: 2022–11
  36. By: Shen, Lucas
    Abstract: Using tracked changes from a large open-source software platform, this paper studies how working from home affected the output of individuals working in tech. The basis of the natural experiment comes from idiosyncratic and state-imposed workplace closures during the COVID-19 pandemic. I find a negative but almost-negligible change in individual-level output of 0.5 percent (standard error of 0.091 percent). Overall, and based on descriptive analyses of the timestamped data, tracked changes in software development cadences approximate regular work activity and provide a useful avenue for future studies of work.
    Keywords: Real-time data; Work from home; GitHub; Labor economics
    JEL: C81 J01 J24 M54 O3
    Date: 2022–11

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