nep-hea New Economics Papers
on Health Economics
Issue of 2023‒04‒24
29 papers chosen by
Nicolas R. Ziebarth
Cornell University

  1. Longevity, Health and Housing Risks Management in Retirement By Pierre-Carl Michaud; Pascal St-Amour
  2. Can public policy increase paternity acknowledgement? Evidence from earnings-related parental leave By Anna Raute; Andrea Weber; Galina Zudenkova
  3. Public child care and mothers’ career trajectories By Katrin Huber; Geske Rolvering
  4. Maternal Mortality and Women's Political Voice: Historical Evidence from the U.S. By Sonia Bhalotra; Damian Clarke; Joseph F. Gomes; Atheendar Venkataramani
  5. The effects of social pensions on mortality among the extreme poor elderly By Jose Valderrama; Javier Olivera
  6. The impact of cold waves and heat waves on mortality: Evidence from a lower middle‐income country By Cuong Viet Nguyen; Manh Hung Nguyen; Toan Nguyen
  7. The long-run effects of war on health: Evidence from World War II in France By Olivier Allais; Guy Fagherazzi; Julia Mink
  8. Measuring Access to and Quality of Primary Care in Quebec: Insights from Research on Patient Enrolment Policies By Erin C. Strumpf; Laurie J. Goldsmith; Caroline E. King; Ruth Lavergne; Rita McCracken; Kimberlyn M. McGrail; Leora Simon
  9. Who gets injured at home? Evidence from older people in France By Liliane Bonnal; Greivis Buitrago Gámez; Pascal Favard; Cornel Oros
  10. The long term effects of a medical intervention: Determinants and implications of orthotic equipment failure By Aisha Abubakar; Sarah Bridges; Trudy Owens
  11. Decentralization, Ethnic Fractionalization, and Public Services: Evidence from Kenyan Healthcare By Hémet, Camille; Wren-Lewis, Liam; Mahoney, Jessica
  12. Elder care in Lebanon: An analysis of care workers and care recipients in the face of crisis By Nassif, Gabriella; Dakkak, Sabine
  13. Will working from home eventually work? Revisiting survey evidence with an information experiment By Patrick A. Puhani; Hamed Moghadam; Joanna Tyrowicz
  14. Child malnutrition in Nepal: Women’s empowerment or promotion of their socioeconomic status? By Elodie ROSSI
  15. BLM protests and racial hate crime in the United States By CARR, Joel
  16. Digitalization of the healthcare supply chain: A roadmap to generate benefits and effectively support healthcare delivery By Martin Beaulieu; Omar Bentahar
  17. Linkages Between Rural Community Capitals and Healthcare Provision: A Survey of Small Rural Towns in Three U.S. Regions By Pender, John; Kuhns, Maria; Yu, Cindy; Larson, Janice; Huck, Shirley
  18. Measuring maternal autonomy and its effect on child nutrition in rural India By Arulampalam, Wiji; Bhaskar, Anjor; Srivastava, Nisha
  19. Racial disparities in fetal and infant outcomes: a multiple-decrement life table approach By Alexander, Monica; Root, Leslie
  20. Cross-category spillovers in medical research By Aslan, Yasemin; Yaqub, Ohid; Rotolo, Daniele; Sampat, Bhaven N.
  21. Patient orientation in public hospitals: A marketing device as compromise between worlds By Patrick Gilbert; Marie-Eve Laporte
  22. Knowledge spillovers from HIV research-funding By Yaqub, Ohid; Coburn, Josie; Moore, Duncan A.Q.
  23. OSH and the COVID-19 pandemic a legal analysis By Cooney, Sean,; Pasqualeto, Olívia de Quintana Figueiredo,; Radoslavova, Tzvetomira,; Spieler, Emily,; Jiménez, Iván Williams,
  24. Racial Disparities in COVID-19 Experiences among Older Adults with Disabling Conditions By Marisa Shenk; Amal Harrati; Bernadette Hicks; Ana Quiñones
  25. The Risk-Benefit Balance in the COVID-19 “Vaccine Hesitancy” Literature: An Umbrella Review Protocol By Chaufan, Claudia; Hemsing, Natalie; McDonald, Jennifer; Heredia, Camila
  26. COVID-19 : Comprendre et agir sur lâacceptabilité sociale des mesures de santé publique By Roxane Borgès Da Silva
  27. Impacts of COVID-19 Pandemic on National Security Issues: Indonesia as a Case Study By Alam, Md. Mahmudul; Fawzi, Agung Masyad; Islam, Monirul; Said, Jamaliah
  28. Dietary Quality by Food Source and Demographics in the United States, 1977-2018 By Lin, Biing-Hwan; Guthrie, Joanne; Smith, Travis
  29. Two Approaches to Saving the Economy: Micro-Level Effects of Covid-19 Lockdowns in Italy By Cseres-Gergely, Zsombor; Kecht, Valentin; Le Blanc, Julia; Onorante, Luca

  1. By: Pierre-Carl Michaud; Pascal St-Amour
    Abstract: Annuities, long-term care insurance and reverse mortgages remain unpopular to manage longevity, medical and housing price risks after retirement. We analyze low demand using a life-cycle model structurally estimated with a unique stated-preference survey experiment of Canadian households. Low risk aversion, substitution between housing and consumption and low marginal utility when in poor health explain most of the reduced demand. Bequests motives are found to be a luxury good and play a limited role. The remaining disinterest is explained by information frictions and behavioural status-quo biases. We find evidence of strong spousal co-insurance motives motivating LTCI and of responsiveness to bundling with a near doubling of demand for annuities when reverse mortgages can be used to annuitize, instead of consuming home equity. Les rentes, l'assurance soins de longue durée (ASLD) et les prêts hypothécaires inversés restent impopulaires pour gérer les risques de longévité, les risques médicaux et les risques liés au prix du logement après la retraite. Nous analysons la faible demande à l'aide d'un modèle de cycle de vie estimé de manière structurelle avec une expérience par enquête unique de préférences déclarées auprès de ménages canadiens. Une faible aversion pour le risque, la substitution entre le logement et la consommation et une faible utilité marginale en cas de mauvaise santé expliquent principalement la faible demande. Les motifs de legs s'avèrent être un bien de luxe et ne jouent qu'un rôle limité. Le désintérêt restant s'explique par des frictions informationnelles et des biais comportementaux (inertie). Nous trouvons des preuves de l'existence d'une forte motivation de coassurance entre conjoints, qui motive l'achat d'ASLD; et de réactivité à l'offre groupée, avec un quasi-doublement de la demande de rentes lorsque les prêts hypothécaires inversés peuvent être utilisés pour constituer des rentes, au lieu de consommer la valeur nette du logement.
    Keywords: retirement wealth, insurance, health risk, housing risk, patrimoine retraite, assurance, risque santé, risque logement
    JEL: J14 G52 G53
    Date: 2023–03–13
  2. By: Anna Raute (Queen Mary University of London); Andrea Weber (Central European University); Galina Zudenkova (TU Dortmund University)
    Abstract: A child's family structure is a fundamental determinant of future well-being, making it essential to understand how public policies affect the involvement of fathers. In this paper, we exploit a reform of the German parental leave system which increased mother's income and reduced legal father's financial support burden to measure the impact on the relationship contract choices of parents who were unmarried at conception. Based on detailed birth record data, we demonstrate that short-run reform incentives during the first period after birth nudge unmarried fathers into the long-term commitment of acknowledging paternity. This shift reduces single motherhood by 6% but leaves the share of marriages at birth constant. Moreover, the change in relationship contract choices is mostly driven by parents of boys. These findings are compatible with predictions from a model where parents choose between three types of relationship contracts based on the mother's and father's incomes and support obligations. Our results highlight the necessity of studying intermediate relationship contracts (i.e., between the extremes of marriage and single motherhood) to improve our understanding of potential risk groups among the rising number of children growing up outside of marriage.
    Keywords: paid parental leave, family structure, paternity establishment
    JEL: I38 J12 J13 J16 J18
    Date: 2022–03–03
  3. By: Katrin Huber (University of Potsdam, CEPA, BSE); Geske Rolvering (University of Passau)
    Abstract: This paper studies the effect of public child care on mothers’ career trajectories. To this end, we combine county-level data on child care coverage with detailed individual-level information from the German social security records and exploit a set of German reforms leading to a substantial temporal and spatial variation in child care coverage for children under the age of three. We conduct an event study approach that investigates the labor market outcomes of mothers in the years around the birth of their first child. We thereby explore career trajectories, both in terms of quantity and quality of employment. We find that public child care improves maternal labor supply in the years immediately following childbirth. However, the results on quality-related outcomes suggest that the effect of child care provision does not reach far beyond pure employment effects. These results do not change for mothers with different ‘career costs of children’.
    Keywords: child care, maternal employment, career costs of children, women’s careers
    JEL: J08 J13 J22
    Date: 2023–04
  4. By: Sonia Bhalotra (University of Warwick); Damian Clarke (Universidad de Chile); Joseph F. Gomes (UNIVERSITE CATHOLIQUE DE LOUVAIN, Institut de Recherches Economiques et Sociales (IRES)); Atheendar Venkataramani (University of Pennsylvania)
    Abstract: We show that large declines in maternal mortality can be achieved by raising women's political voice. Using an event study approach, we show that the arrival of first antibiotics (sulfa drugs) in the U.S. in 1937, which were effective in treating peripartum bacterial infections, led to larger reductions in maternal mortality in states that extended suffrage to women prior to the 19th Constitutional Amendment of 1920, a national mandate that extended the franchise to all women. These findings suggest important complementarities between women's voice in politics and health-improving technologies. In terms of mechanisms, we argue that earlier suffrage and the longer history of women's political participation arising from it may have laid the groundwork for greater acceptability and quicker uptake of technologies that improved women's health. We also show that earlier suffrage led to a higher likelihood of women holding Senate seats, consistent with a channel where suffrage shaped policymaking through women leaders.
    Keywords: Maternal mortality, women's political representation, gender, suffrage, Sulfa
    JEL: I14 I15 O15
    Date: 2023–03–20
  5. By: Jose Valderrama; Javier Olivera
    Abstract: We study the effects of Peru’s social pension programme Pension 65 on mortality. The programme provides a lifetime pension equivalent to 32 US dollars per month to individuals aged 65 and older who do not have other pensions and are officially classified as extreme poor. The analysis relies on survey data obtained at the baseline, which we match to mortality records for the period 2012 to 2019. We exploit the discontinuity around the welfare index used by the programme to determine eligibility, and estimate intention-to-treat effects in a regression discontinuity setting. We find that after seven years, the programme can reduce mortality among eligible people by about 11.4 percentage points. The programme could also increase the life expectancy of eligible people by one year. The results and back-of-the-envelope calculations indicate that the policy is cost effective.
    Keywords: non-contributory pensions; mortality; regression discontinuity; old-age poverty
    JEL: H55 I38 J14
    Date: 2023–04
  6. By: Cuong Viet Nguyen (VNU - Vietnam National University [Hanoï]); Manh Hung Nguyen (TSE-R - Toulouse School of Economics - UT Capitole - Université Toulouse Capitole - Université Fédérale Toulouse Midi-Pyrénées - EHESS - École des hautes études en sciences sociales - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement); Toan Nguyen (ANU - Australian National University)
    Abstract: We estimate the impact of temperature extremes on mortality in Vietnam, using daily data on temperatures and monthly data on mortality during the 2000-2018 period. We find that both cold and heat waves cause higher mortality, particularly among older people and those living in the hot regions in Southern Vietnam. This effect on mortality tends to be smaller in provinces with higher rates of airconditioning and emigration, and provinces with higher public spending on health. Finally, we estimate economic cost of cold and heat waves using a framework of willingness to pay to avoid deaths, then project the cost to the year 2100 under different Representative Concentration Pathway scenarios.
    Keywords: Health, Mortality, Vietnam, Weather extremes
    Date: 2023–02–22
  7. By: Olivier Allais (ALISS - Alimentation et sciences sociales - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement); Guy Fagherazzi (LIH - Luxembourg Institute of Health); Julia Mink (ALISS - Alimentation et sciences sociales - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement, Sciences Po - Sciences Po)
    Abstract: We investigate the effects of early-life exposure to war on adult health outcomes including cancer, hypertension, angina, infarction, diabetes and obesity. We combine data from the French prospective cohort study E3N on women employed in the French National Education with historical data on World War II. To identify causal effects, we exploit exogenous spatial and temporal variation in war exposure related to the German invasion of France during the Battle of France. The number of French military casualties at the level of the postcode area serves as main measure of exposure. Our results suggest that exposure to the war during the first 5 years of life has significant adverse effects on health in adulthood. A 10 percent increase in the number of deaths per inhabitants in the individual's postcode area of birth increases the probability of suffering from any of the health conditions considered in this study by 0.08 percentage points. This is relative to a mean of 49 percent for the sample as a whole.
    Keywords: Early-life exposure, Developmental origins, World war II, Human capital development
    Date: 2021–05
  8. By: Erin C. Strumpf; Laurie J. Goldsmith; Caroline E. King; Ruth Lavergne; Rita McCracken; Kimberlyn M. McGrail; Leora Simon
    Abstract: More than one million “orphan” patients do not have a family physician in Quebec as revealed by the department of Health and Social Services scoreboard. This spring, Minister Dubé has launched several initiatives aimed at transforming the health system to facilitate access to high-quality and timely primary care services. These reforms focus primarily on the enrolment of patients with a family physician. Having access to a regular source of care is almost universally seen as a good thing. In this short note, Erin C. Strumpf, McGill University Professor and Fellow CIRANO, and her co-authors challenge this idea. They show that there is a tendency to confuse concepts and assume that repeated contact is evidence of a truly caring, trusting patient-physician relationship, which could ultimately lead to better health outcomes. If we want to effectively create and evaluate interventions aimed at improving primary care, it is essential to clearly identify the processes through which patient care can be improved and to identify the most relevant measures that actually capture the outcomes of interest such as affiliation and continuity of care. That is what the authors precisely do here. By being honest and clear about what we can actually measure and evaluate with the data we have, they argue that we create an opening for more creative approaches to health policy evaluation.
    Keywords: Family Physician, Access to Care, Health Policy, Primary Care,
    Date: 2022–06–06
  9. By: Liliane Bonnal (CRIEF - Centre de recherche sur l'intégration économique et financière - Université de Poitiers, TSE-R - Toulouse School of Economics - UT Capitole - Université Toulouse Capitole - Université Fédérale Toulouse Midi-Pyrénées - EHESS - École des hautes études en sciences sociales - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement); Greivis Buitrago Gámez (CRIEF - Centre de recherche sur l'intégration économique et financière - Université de Poitiers); Pascal Favard (IRJI - Institut de recherche juridique interdisciplinaire - UT - Université de Tours); Cornel Oros (LEO - Laboratoire d'Économie d'Orleans [2022-...] - UO - Université d'Orléans - UT - Université de Tours - UCA - Université Clermont Auvergne, CRIEF - Centre de recherche sur l'intégration économique et financière - Université de Poitiers)
    Abstract: The study analyses unintentional home and leisure injuries (HLIs) for the French senior population using data from the 2012 wave of the French health, health care and insurance survey. The results of our logit models reveal that health status, age, and risky attitudes are the main characteristics associated with HLIs for older people. When the severity of injuries is taken into consideration, the highest exposure to HLIs concerns the oldest seniors, aged 85 years old or older, with deteriorated health. This result is confirmed in the case of severe indoor HLIs, whereas for severe outdoor injuries, the most vulnerable individuals seem to be younger seniors, that is, 75–79 years old. Moreover, our findings suggest that HLIs, and mainly severe home HLIs, generate a short-term influence on a person's health.
    Keywords: Health problems, Home and leisure injuries, Logit models, Olderpeople
    Date: 2022–07–20
  10. By: Aisha Abubakar; Sarah Bridges; Trudy Owens
    Abstract: This paper tracks the outcomes of a medical intervention which provided lower limb orthosis to adults with disabilities between 2012 and 2018. Six years after the intervention, over one-third of the recipients were still using their orthotic devices. Using a discrete time hazard model, the analysis examines the speed at which the orthotic devices failed and evaluates how personal characteristics and clinical factors acted as potential risk markers of early equipment failure. The study finds that the peak time of failure lay between the fourth- and fifth-year post-fitting, with the probability of orthosis failure being significantly lower for women, the elderly and most importantly, those who had access to follow up care compared to their respective counterparts. The study also analysed the implications of orthotics failure on life satisfaction, health-related quality of life and severity of disability, which are designed to measure subjective wellbeing. Notably, the results indicate that access to follow up care improves functional efficiency, while failure of the orthosis consistently acts as a negative correlate of wellbeing.
    Keywords: disability; orthotic equipment; long-term outcomes; subjective wellbeing; Uganda
    Date: 2023
  11. By: Hémet, Camille; Wren-Lewis, Liam; Mahoney, Jessica
    Abstract: This paper examines how use of public services changed following a major constitutional reform in Kenya. Following an important period of inter-ethnic conflict, responsibility for local health services was decentralized to 47 newly created county governments. Using an event-study design, we find that use of public clinics for births increased significantly after the reform, but only in counties that were relatively ethnically homogeneous. We also find a significant increase in the correlation between county ethnic fractionalization and a range of other measures of public health service use. Results suggest that services in these counties are less likely to require payments after devolution. Additionally, using within-county variation, we find an increase in public service use among individuals that are of the same ethnicity as the members of the county government executive.
    Date: 2023–03–22
  12. By: Nassif, Gabriella; Dakkak, Sabine
    Abstract: The current socioeconomic and political crises plaguing Lebanon have exacerbated the ongoing care crisis, in particular for care workers and elderly care recipients. Over the past decade, non Arab migrant domestic workers have been, alongside family members, primarily responsible for providing privatized, in-home care for ageing Lebanese. This care, ranging from cooking and cleaning to administering medicines and providing care for people with disabilities, exists in the stark absence of substantive state-provided services for a rapidly ageing population. Under the pressures of the current economic crisis, however, the arrangements of this form of commodified care have come under particular strain, causing both care workers and care recipients to suffer. To better understand elderly care needs in Lebanon amidst the current, multi-faceted crisis, this report foregrounds the personal experiences and needs of both care workers, primarily non-Arab migrant domestic workers, and elderly care employers and recipients. Findings suggest that the most acute care needs for elderly Lebanese include long-term healthcare, emotional companionship, and domestic labor, at an affordable price. Workers highlighted the overwhelming nature of elderly work, their need for workplace support, and ultimately, their demands for a better legislative framework to protect them as migrant workers.
    Keywords: LEBANON; ASIA; crises; care work; migrant labour; domestic work; elderly; ageing; services; economic crises; healthcare; prices; legislation; women elderly care; women migrants;
    Date: 2023
  13. By: Patrick A. Puhani (Wirtschaftswissenschaftliche Fakultaet Leibniz Universität Hannover; Institute of Labor Economics (IZA)); Hamed Moghadam (Wirtschaftswissenschaftliche Fakultaet Leibniz Universität Hannover); Joanna Tyrowicz (Group for Research in Applied Economics (GRAPE); University of Warsaw; Institute of Labor Economics (IZA))
    Abstract: To determine how wives' and husbands' retirement options affect their spouses' (and their own) labor supply decisions, we exploit (early) retirement cutoffs by way of a regression discontinuity design. Several German pension reforms since the early 1990s have gradually raised women’s retirement age from 60 to 65, but also increased ages for several early retirement pathways affecting both sexes. We use German Socio-Economic Panel data for a sample of couples aged 50 to 69 whose retirement eligibility occurred (i) prior to the reforms, (ii) during the transition years, and (iii) after the major set of reforms. We find that, prior to the reforms, when several retirement options were available to both husbands and wives, both react almost symmetrically to their spouse reaching an early retirement age, that is both husband and wife decrease their labor supply by about 5 percentage points when the spouse reaches age 60). This speaks in favor of leisure complementarities. However, after the set of reforms, when retiring early was much more difficult, we find no more significant labor supply reaction to the spouse reaching a retirement age, whereas reaching one’s own retirement age still triggers a significant reaction in labor supply. Our results may explain some of the diverse findings in the literature on asymmetric reactions between husbands and wives to their spouse reaching a retirement age: such reactions may in large parts depend on how flexibly workers are able to retire.
    Keywords: retirement coordination; labor market participation; regression discontinuity design.
    JEL: J22
    Date: 2023
  14. By: Elodie ROSSI
    Abstract: After unsuccessful poverty alleviation policies to tackle the "Asian enigma, " women's empowerment (WE) is now promoted as another strategy. However, the concept is still debated between pioneers defending more power for women and international institutions promoting it through improvements in their socio-economic status (SES). This paper proposes to advance this way by examining the impact of WE in terms of power on children’s nutrition, also testing its interactive effects with the mothers’ SES. Using the 2016 Nepal Demographic and Health Survey, we account for two measures of children’s nutrition: height-for-age and dietary diversity scores. We use the multidimensional exploratory analysis to construct composite measures of WE and SES and tackle endogeneity issues through an instrumental variable approach. Our results demonstrate that the impact of WE is underestimated if endogeneity is not considered with a more positive effect on the fight against child malnutrition than women’s SES promotion. Interactive effects between WE and SES also suggest that the positive impact of WE exists regardless of mothers’ SES, mitigating the adverse effect of low maternal SES on children’s nutrition. Besides, we highlight that if women’s SES is a determinant in rural areas, promoting women’s education is desirable, while women's participation in the labor market has mixed consequences on maternal and child health. Finally, promoting WE appears crucial in breaking gender inequalities in child malnutrition locally.
    Keywords: Child undernutrition, Women's empowerment, Nepal, Socio-economic status, Multiple correspondence analysis, Instrumental variables.
    JEL: I14 I15
    Date: 2023
  15. By: CARR, Joel
    Abstract: We provide evidence of the impact of protests following the death of George Floyd on anti-Black and anti-White hate crimes in the US. Using a regression discontinuity in time model, difference-in-differences, and synthetic control methods we find that recorded anti-Black (-White) hate crime increased by up to 15 (4) incidents per day or 259 (165) percent in June 2020. To account for changes in incentives to commit hate crimes during the coronavirus pandemic we control for other hate crime biases. We find that changes in unemployment due to the pandemic is a significant mediating factor in the hate crime shock against both groups and a larger shock in the first weeks of the protests in counties with a first BLM protest after Floyd’s death. In addition, we test for mechanisms driving the changes, including retaliation, protectionism, and changes in victim reporting. Anti-Black hate crime is more sensitive to saliency of opposition to protests, “White genocide”, and Derek Chauvin measured by tweets but less sensitive to cable news reporting. Using crime victimization survey we find that White hate crime victims were more likely to report victimization during the protests and evidence that police reduced effort toward Black hate crime victims and increased arrests of anti-White hate crime offenders. The results suggest that large scale protests or conflict between two groups during periods of increase in unemployment can lead to a substantial increase in expressed xenophobia.
    Keywords: Racism, Hate crime, Crime
    JEL: J15 K14 D74
    Date: 2022–12
  16. By: Martin Beaulieu (HEC Montréal - HEC Montréal); Omar Bentahar (CEREFIGE - Centre Européen de Recherche en Economie Financière et Gestion des Entreprises - UL - Université de Lorraine)
    Abstract: The healthcare supply chain lags far behind supply chains in other industries in terms of performance and the deployment of best practices. Managers could bridge this gap and improve the performance of the healthcare supply chain by implementing digitalization initiatives. However, the erratic, disconnected digitalization of practices already deployed in the healthcare sector makes it difficult to maximize the potential of these initiatives. In order to generate the greatest benefits from digitalization while improving healthcare delivery, this article sets out a roadmap for implementing technologies. Unlike previous studies that focused on the entire supply chain or had been limited to patient flow, this study adopts the perspective of the hospital as a central launching point for digitalization initiatives. The roadmap, which involves both internal and external digitalization trajectories, is based on a research methodology that combines observations with an umbrella review of literature. This methodology enables us to capture the research challenges associated with the healthcare supply chain and show how digitalization initiatives can address them. The digitalization proposals put forward are structured in terms of priority and centered on hospitals. These proposals can help managers make improvements to the supply chain and also clinical flows
    Keywords: Digital, Supply chain, Healthcare, Technology
    Date: 2021–06–01
  17. By: Pender, John; Kuhns, Maria; Yu, Cindy; Larson, Janice; Huck, Shirley
    Abstract: This report identifies community-level factors affecting the recruitment and retention of rural healthcare professionals. The authors used key informant interviews and a survey of healthcare professionals in 150 small rural towns in 9 States, emphasizing a broad range of community assets and investments. Most participants perceived social capital (involving personal and professional relationships) to be important for the recruitment and retention of healthcare professionals. Human capital (resources inherent in people—such as their education, skills, and health) and physical capital (infrastructure, buildings, and equipment) were also important to most healthcare professionals but generally less so than social capital. Other types of community capital were important to a minority of health professionals. These findings suggest that rural communities can have a significant influence on attracting and retaining healthcare professionals through investments in social, human, and physical capital. The importance of many of these factors varies across the study regions and professional categories.
    Keywords: Community/Rural/Urban Development, Environmental Economics and Policy, Institutional and Behavioral Economics, Labor and Human Capital, Public Economics
    Date: 2023–03–16
  18. By: Arulampalam, Wiji (Department of Economics, University of Warwick); Bhaskar, Anjor (Azim Premji University, Bangalore); Srivastava, Nisha (nstitute for Human Development, Delhi)
    Abstract: We examine the link between a mother’s autonomy - the freedom and ability to think, express, make decisions, and act, independently - and the nutritional status of her children. We design a novel statistical framework that accounts for the cultural and traditional environment to create a measure of maternal autonomy treating this as a latent characteristic that is fixed in the short term. Using data from India, we deal with two econometric challenges : (i) creation and measurement of the ‘autonomy’ index, and (ii) endogeneity caused by selection due to son preference. We find : (i) one standard deviation (SD) higher autonomy score is associated with a 0.16 SD higher Height-for-Age Z-scores (HAZ) ; and an (ii)10% lower prevalence of stunting (HAZ
    Keywords: Child Nutrition ; Latent Factor Models ; Maternal Autonomy ; Endogenous selection ; Son preference JEL codes: I15 ; I14 ; C38
    Date: 2023
  19. By: Alexander, Monica; Root, Leslie
    Abstract: We discuss different frameworks to conceptualize age in the gestational period and in the first year of life, and then apply two conceptualizations to quantify racial/ethnic differences on a range of different fetal and infant outcomes in the United States. In particular, we focus on the extended approach, which combines gestational age and age in the first year of life onto a continuum of adjusted age since conception, and the gestational approach, which takes the viewpoint of gestation but considers both fetal outcomes and eventual outcomes in the first year of life. Both approaches use a multiple-decrement life table framework, accounting for decrements that related to all potential outcomes, including birth, fetal death, and infant death or survival. We find that the risks of both fetal and infant death are non-linear over the gestational age period and early weeks of life, with the highest risks at the beginning of the period (at 20 weeks) but also at around 37-40 weeks. The relative risks of different race/ethnic groups also change across age; in particular, the non-Hispanic Black population has a heightened risk of all adverse outcomes, but the magnitude of the difference in risk depends on gestational age, and in general, disparities are lowest in the mid-range of gestational ages.
    Date: 2023–03–26
  20. By: Aslan, Yasemin; Yaqub, Ohid; Rotolo, Daniele; Sampat, Bhaven N.
    Abstract: Whether research funding is targetable is one of the central unresolved questions of science policy. A particular question is how often research aimed at understanding one disease or problem spills over to others. This has been a perennial topic of debate at the world’s largest single funding body of biomedical research, the U.S. National Institutes of Health (NIH). Critics of the agency’s priority-setting process have repeatedly called for better alignment between funding and disease burden, and patient advocates for specific diseases for more funding for their causes. In response, opponents of planning have argued that research in one area frequently leads to advances in others. In this paper, we provide new evidence to inform these debates by examining the extent to which research funding (grants) in one scientific or disease area leads to research findings (publications) in another. We used the NIH’s Research, Condition, and Disease Categorization (RCDC) to identify categories for NIH grants awarded between 2008 and 2016. We applied machine-learning to map text to these categories and use this model to categorize publications resulting from these grants. We categorized over 1.2 million publications, resulting from over 90, 000 grants. We found that 70% of the publications have at least one RCDC category not in its grant, which we termed “unexpected” categories. On average, 40% of categories assigned to a publication were unexpected. After adjusting for similarity across some of the RCDC categories by empirically clustering the categories, we found 58% of the publications had at least one unexpected category and, on average, 33% of publication categories were unexpected. Our results suggest that disease-orientation and clinical research were less likely to be associated with spillovers. Grants resulting from targeted requests for applications were more likely to result in publications with unexpected categories, though the magnitude of the differences was relatively small.
    Date: 2023–03–23
  21. By: Patrick Gilbert (IAE Paris - Sorbonne Business School); Marie-Eve Laporte (IAE Paris - Sorbonne Business School)
    Abstract: The concept of patient centricity has spread for several years in hospitals where, under the expression patient-centered care (PCC), it contributes to introducing a marketing logic in a new environment. However, beyond the intention to transform the patient as an object into a patient as a subject, this concept remains difficult to define. A review of the literature shows a diversity of approaches that are echoed in practice. This article draws on the economies of worth to examine how these conceptions collide but also reconcile. It relies on the study of an emblematic case, the orthopedic surgery department of a large Parisian public hospital (3 weeks of observation and 43 interviews). The research shows that PCC is built sequentially in a shared experience involving patients, caregivers, and management. The article defines PCC as a marketing device resulting from compromises between different conventions and provides evolution scenarios.
    Keywords: conventions, customer centricity, economies of worth, hospitals, marketing device, patient centricity, patient-centered care
    Date: 2023
  22. By: Yaqub, Ohid; Coburn, Josie; Moore, Duncan A.Q.
    Abstract: HIV/AIDS has been a major focus for research funders. The US National Institutes of Health (NIH) alone has spent over $70bn on HIV/AIDS. Such investments ushered in antiviral drugs, helping to reverse a rapidly growing HIV/AIDS pandemic. However, the idea that research can deliver unexpected benefits beyond its targeted field, in fact, predates HIV/AIDS to at least Vannevar Bush’s influential 1945 report. Cross-disease spillovers – research investments that yield benefits beyond the target disease – remains unexplored, even though it could inform both priority-setting and calculations of returns on research investments. To this end, we took a sample of NIH’s HIV grants and examined their publications. We analyzed 118, 493 publications and found that 62% of these were spillovers. We used Medical Subject Headings (MeSH) terms assigned to publications to explore the content of these spillovers, as well as to corroborate non-spillovers. We located spillovers on a network of MeSH co-occurrence, drawn from the broader universe of medical publications, for comparison. We found that HIV spillovers were unevenly distributed across disease-space, and often in close proximity to HIV, which, when discounted, reduced our spillovers estimate to 40%. We further reviewed 1, 000 grant–publication pairs from a local sample and 1, 000 pairs from a remote sample. For local spillovers, a quarter seemed to be unexpected, on the basis of on their grant description; for remote spillovers, that proportion increased to one third. We also found that the NIH funding institutes whose remits were most closely related to HIV/AIDS were less likely to produce spillovers than others. We discuss implications for theory and policy.
    Date: 2023–03–20
  23. By: Cooney, Sean,; Pasqualeto, Olívia de Quintana Figueiredo,; Radoslavova, Tzvetomira,; Spieler, Emily,; Jiménez, Iván Williams,
    Abstract: This study provides an analysis of how occupational safety and health (OSH) regulation responded to the circumstances of key workers during the COVID-19 pandemic. It explains the objectives of OSH regulation, including its main elements and how it has evolved over time. It draws from national country studies to explain how different jurisdictions address safety and health in their regulatory frameworks and how these frameworks operate in practice, including during the COVID-19 pandemic.
    Keywords: occupational health, occupational safety, working conditions, COVID-19., labour inspection
    Date: 2023
  24. By: Marisa Shenk; Amal Harrati; Bernadette Hicks; Ana Quiñones
    Abstract: This paper examines the experiences of older adults with disabling conditions during the COVID-19 pandemic using data from the 2020 Health and Retirement Study. It documents the negative health, work, and financial experiences of older adults by disability status, race, and ethnicity. It also explores the intersectionality of race and ethnicity with disability and the role of contextual factors affecting the environments in which people live (e.g., health and economic conditions) using county- and state-level data.
    Date: 2022–11
  25. By: Chaufan, Claudia (York University); Hemsing, Natalie; McDonald, Jennifer; Heredia, Camila
    Abstract: “Vaccine hesitancy” has been described as a major public health problem, especially in the COVID-19 era. Identified factors driving “hesitancy” include the concerns of recipients with the safety, side effects, and risk-benefit ratio of COVID-19 vaccines1 — a proper assessment and disclosure of which are critical to the requisite process of informed consent. However, the expert literature has given little attention to the evidence informing these concerns, focusing instead on features of the recipients themselves to explain the phenomenon of so-called “hesitancy”. This umbrella review will expand the scope of research on “vaccine hesitancy” by examining how the safety, side effects, and risk-benefit ratio concerns of recipients of COVID-19 vaccines are addressed in the expert literature. We will include systematic reviews on COVID-19 “vaccine hesitancy” that examine hesitancy in any population involved with COVID-19 vaccination decisions for themselves or as caretakers (e.g., decisions about “vaccinating” their children) to capture the broadest possible range of perspectives on the phenomenon of interest. Only completed, published, and refereed systematic reviews in English will be included. We will search PubMed, the Epistemonikos COVID-19 platform (COVID-19 L·OVE), and the WHO Global Research on COVID-19 Database to locate quantitative, qualitative, and mixed methods studies reviews. Reviews that meet the inclusion criteria will undergo quality assessment (AMSTAR) and data extraction. Two reviewers will independently conduct title and abstract screening and extract and synthesize the data. Disagreements will be resolved through full team discussion. Subgroup analyses will be performed to compare findings according to social indicators of target populations, country location of the first author, and other contextual factors. Thematic analysis and synthesis will be used to “transform the data” into themes by applying a deductive-inductive approach. Frequency distributions will be calculated to assess the strength of support for each theme. Findings will be presented in tabular and narrative forms to facilitate their interpretation. Informed consent is a fundamental bioethical principle in medical research and practice. Insufficient attention to the concerns of vaccine recipients about these matters, compounded by a neglect to discuss the evidence-base informing these concerns, may contribute to the very problem that the COVID-19 “vaccine hesitancy” expert literature purports to address. This is especially true of an intervention based on novel technologies and intended to be delivered on a global scale. Identifying if and how the expert literature engages with these concerns is critical.
    Date: 2022–11–30
  26. By: Roxane Borgès Da Silva
    Abstract: As of May 14, masks will no longer be required to be worn in indoor public places such as businesses, schools and daycares. It will continue to be required in public transportation, hospitals, medical clinics and CHSLDs. A survey conducted by the Institut national de santé publique du Québec from April 15 to 27 shows that two-thirds of respondents still intend to continue wearing the mask. But in reality, how will Quebecers react? What will be their motivations? How can we ensure that they make informed choices based on their circumstances and the objective risk factors they - and those around them - face? And how do we avoid the ostracization of those who will continue to wear the mask? Research inspired by experimental economics provides insight into the role that awareness and improved knowledge of the real risks associated with COVID-19 can play in people's intentions and reactions following the implementation - or removal - of various measures. This short text presents the results of two experimental studies conducted in the specific context of the reopening of schools in September 2020. These studies allow us to draw two main conclusions about the social acceptability of health measures and individual choices in the face of the pandemic: It is essential to provide valid, accurate, and simple sources of information to inform and reassure the population about the risks of developing COVID-19, without causing "cognitive overload." Simple awareness tools, clear and evidence-based information can have an impact on people's perceptions and choices when it comes to their health or that of their loved ones. Dès le 14 mai, le port du masque ne sera plus obligatoire dans les lieux publics intérieurs comme les commerces, les écoles et les services de garde. Il continuera d’être exigé dans les transports en commun, les hôpitaux, les cliniques médicales et les CHSLD. Un sondage de l’Institut national de santé publique du Québec mené du 15 au 27 avril révèle que les deux tiers des personnes interrogées ont quand même l’intention de continuer de porter le masque. Mais dans les faits, comment les Québécoises et Québécois réagiront-ils ? Quelles seront leurs motivations ? Comment s’assurer qu’ils font des choix éclairés en fonction de leur situation et des facteurs de risque objectifs auxquels eux-mêmes — et les gens qui les entourent — font face ? Et comment éviter l’ostracisation de ceux et celles qui continueront de porter le masque ? La recherche inspirée de l’économie expérimentale permet de mieux comprendre le rôle que peuvent jouer la sensibilisation et l’amélioration des connaissances sur les risques réels reliés à la COVID-19 dans les intentions des gens et leurs réactions à la suite de la mise en place — ou le retrait — de diverses mesures. Ce court texte présente les résultats de deux études expérimentales réalisées dans le contexte particulier de la réouverture des écoles en septembre 2020. Ces études permettent de tirer deux principaux enseignements sur l’acceptabilité sociale des mesures sanitaires et des choix individuels face à la pandémie : Il est essentiel de proposer des sources d’informations valides, précises et simples pour informer et rassurer la population à propos des risques de développer la COVID-19, sans pour autant provoquer de « surcharge cognitive ». Des outils simples de sensibilisation, des informations claires et fondées sur des données probantes peuvent avoir un impact sur les perceptions et les choix des gens lorsqu’il est question de leur santé ou de celles de leurs proches.
    Keywords: Public health, Covid-19, reliable information, outreach, evidence, Santé publique, Covid-19, information fiable, vulgarisation, données probantes
    Date: 2022–05–11
  27. By: Alam, Md. Mahmudul (Universiti Utara Malaysia); Fawzi, Agung Masyad; Islam, Monirul; Said, Jamaliah
    Abstract: The national security issues in particular non-traditional security issues such as law enforcement, health, food, supply chain management, industry etc. are severely impacted by the COVID-19 outbreak in all countries of the world. As such, the developing country like Indonesia has largely been suffering from this epidemic. In this context, this paper attempts to analyse some national security issues that are affecting Indonesia, which is currently struggling with the COVID-19 pandemic. Proposed here are policy measures to combat both present and future challenges. The study uses secondary data collected from different sources concerning COVID-19 pandemic and security issues of Indonesia. The study analyses the data based on descriptive statistics, highlighting the impact of the COVID-19 pandemic on Indonesian law enforcement issues, and security of health, food, supply chain management, industrial and other economic sectors. The study argues that if the vulnerability continues in these security-related issues due to pandemic, the country will face a harsh reality to manage the state-affairs. Therefore, the policy options are mainly concerned with the COVID-19 issue. Indonesia’s government should identify what measures to take by conducting rapid diagnostics (RPD) and polymerase chain reaction (PCR) tests in the laboratory, respectively. Moreover, the government and relevant stakeholders need to develop strategies that break the stranglehold of COVID-19 transmission in order to resolve Indonesian national security concern.
    Date: 2022–03–08
  28. By: Lin, Biing-Hwan; Guthrie, Joanne; Smith, Travis
    Abstract: Food prepared away from home (FAFH) has become a mainstay in U.S. consumers’ diets, accounting for more than 50 percent of total food expenditures since 2009 and more than 30 percent of total food energy intake since 2011. This report analyzes data from nationally representative food consumption surveys conducted between 1977 and 2018 to examine U.S. consumers’ dietary quality relative to the Federal dietary guidance and how this varies by food source. The food sources this report examines include food at home, food purchased at restaurants, food purchased at fast-food establishments, food obtained at school among K–12 school and daycare children, and other food obtained away from home. Dietary quality is measured by nutrient and food-group density (i.e., intake amount per 1, 000 calories) for 12 nutrients and 35 food groups. All analyses are conducted for individuals aged 2 and above, both as a group and subdivided by demographics. In general, U.S. consumers make more nutritious choices when grocery shopping for foods than when obtaining food from commercial eating establishments. Compared with FAFH, food at home (FAH) is denser in underconsumed nutrients and food groups—e.g., fiber, iron, whole grains, fruits, dairy, and dark green vegetables—and lower in the density of over-consumed nutrients and food groups, including saturated fats, sodium, and refined grains. However, FAH has more added sugars in addition to a lower intake of seafood and most types of vegetables. In recent years, school foods have differed from other FAFH consumption due to a lower density of saturated fats and a higher density of whole grain, fiber, and fruit.
    Keywords: Community/Rural/Urban Development, Consumer/Household Economics, Food Consumption/Nutrition/Food Safety, Institutional and Behavioral Economics, Public Economics, Research Methods/ Statistical Methods
    Date: 2023–03–02
  29. By: Cseres-Gergely, Zsombor (European Commission); Kecht, Valentin (University of Bonn); Le Blanc, Julia (European Commission); Onorante, Luca (European Commission)
    Abstract: In response to the two waves of Covid-19 in 2020, the Italian government implemented a general lockdown in March, but geographically targeted policies during fall. We exploit this natural experiment to compare the effects of the two policies in a difference-in-differences design, leveraging a unique database combining traditional, municipality-level and big data at weekly frequency. We find that the general lockdown of the first wave strongly reduced mobility at a high price in terms of employment, while the targeted policies during the second wave induced a lower decrease in mobility and little additional economic cost. We also study the role of pre-existing municipality characteristics and labour market policies in shaping these responses. Our results suggest that working from home and short-term work schemes buffered the adverse consequences of the drop in economic activity on the labour market. Both mechanisms, however, acted more strongly in high-income areas and among white collar workers, exacerbating existing inequalities.
    Keywords: Covid-19, human mobility, lockdowns, big data, differences-in-differences
    JEL: I12 I18 H12 D04 C33 H51
    Date: 2023–02

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