nep-hea New Economics Papers
on Health Economics
Issue of 2023‒05‒01
twenty-six 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. The Health Wedge and Labor Market Inequality By Amy Finkelstein; Casey C. McQuillan; Owen M. Zidar; Eric Zwick
  3. Technology and Disability: The Relationship Between Broadband Access and Disability Insurance Awards By Barbara A. Butrica; Jonathan Schwabish
  4. Health, Disability, and the Evolving Nature of Work By Barbara A. Butrica; Stipica Mudrazija
  5. Pension Reforms and Couples' Labour Supply Decisions By Moghadam, Hamed Markazi; Puhani, Patrick A.; Tyrowicz, Joanna
  6. Air Quality, High-Skilled Worker Productivity and Adaptation: Evidence from GitHub By Felix Holub; Beate Thies
  7. What Matters for Annuity Demand: Objective Life Expectancy or Subjective Survival Pessimism? By Karolos Arapakis; Gal Wettstein
  8. Socio-behavioral factors contributing to recent mortality trends in the United States By Samuel H. Preston; Yana C. Vierboom; Mikko Myrskylä
  9. Put a Bet on It: Can Self-Funded Commitment Contracts Curb Fitness Procrastination? By Spika, Devon; Wickström Östervall, Linnea; Gerdtham, Ulf; Wengström, Erik
  10. Social Media Charity Campaigns and Pro-social Behaviour. Evidence from the Ice Bucket Challenge By Fazio, Andrea; Reggiani, Tommaso G.; Scervini, Francesco
  11. Effects of extending residencies on the supply of family medicine practitioners; difference-in-differences evidence from the implementation of mandatory family medicine residencies in Canada By Stephenson Strobel
  12. Excise Tax Incidence: The Inequity of Taxing Obesity and Beauty By Osaid Alshamleh; Glenn P. Jenkins; Tufan Ekici
  13. Broca Index: A Simple Tool to Measure Ideal Body Weight By Mohajan, Devajit; Mohajan, Haradhan
  14. Obesity and Its Related Diseases: A New Escalating Alarming in Global Health By Mohajan, Devajit; Mohajan, Haradhan
  15. Impacts of Interpersonal Continuity between General Practitioners (GPs) and Patients on Health Outcomes: A Systematic Review By Wu, Yansi
  16. Economic uncertainty and cardiovascular disease mortality By Kyriopoulos, Ilias-Ioannis
  17. A Case Study Analysis: Challenges in the NICE Evaluation of Multi-Indication Medicines for Rare and Ultra-Rare Diseases By Maria Errea;Nadine Henderson;Chris Skedgel;Mireia Jofre-Bonet
  18. Effects of Early Childhood Climate on Cognitive Development and Home Environment By Wu, Wenjie; Yang, Zhe; Kim, Jun Hyung; Yue, Ai
  19. Can Education Change Risk Preference? Evidence from Indonesia and Mexico By Zhou, Renee
  20. Modelling the impact of hybrid immunity on future COVID-19 epidemic waves By Thao P. Le; Isobel Abell; Eamon Conway; Patricia T. Campbell; Alexandra B. Hogan; Michael J. Lydeamore; Jodie McVernon; Ivo Mueller; Camelia R. Walker; Christopher M. Baker
  21. How Will COVID Affect the Completed Fertility Rate? By Anqi Chen; Nilufer Gok; Alicia H. Munnell
  22. Perception of COVID-19 and household behavior in Argentina By Pascale Phélinas; Valéria Hernández; Camille Ciriez
  23. How Does COVID-Induced Early Retirement Compare to the Great Recession? By Anqi Chen; Siyan Liu; Alicia H. Munnell
  24. Trusting the health system and COVID 19 restriction compliance By Costa-Font, Joan; Vilaplana-Prieto, Cristina
  25. Locking down vIolence: The covid-19 pandemic’s impact on non-state actor violence By Brancati, Dawn; Birnir, Johanna; Qutaiba Idlbi, Qutaiba Idlbi
  26. County-Level Drivers of Disability Benefit Claims in Times of COVID-19 By R. Vincent Pohl; David R. Mann

  1. By: Pierre-Carl Michaud (HEC Montreal); Pascal St-Amour (University of Lausanne - School of Economics and Business Administration (HEC-Lausanne); Swiss Finance Institute)
    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.
    Keywords: retirement wealth, insurance, health risk, housing risk
    JEL: J14 G52 G53
    Date: 2023–03
  2. By: Amy Finkelstein; Casey C. McQuillan; Owen M. Zidar; Eric Zwick
    Abstract: Over half of the U.S. population receives health insurance through an employer, with employer premium contributions creating a flat "head tax" per worker, independent of their earnings. This paper develops and calibrates a stylized model of the labor market to explore how this uniquely American approach to financing health insurance contributes to labor market inequality. We consider a partial-equilibrium counterfactual in which employer-provided health insurance is instead financed by a statutory payroll tax on firms. We find that, under this counterfactual financing, in 2019 the college wage premium would have been 11 percent lower, non-college annual earnings would have been $1, 700 (3 percent) higher, and non-college employment would have been nearly 500, 000 higher. These calibrated labor market effects of switching from head-tax to payroll-tax financing are in the same ballpark as estimates of the impact of other leading drivers of labor market inequality, including changes in outsourcing, robot adoption, rising trade, unionization, and the real minimum wage. We also consider a separate partial-equilibrium counterfactual in which the current head-tax financing is maintained, but 2019 U.S. health care spending as a share of GDP is reduced to the Canadian share; here, we estimate that the 2019 college wage premium would have been 5 percent lower and non-college annual earnings would have been 5 percent higher. These findings suggest that health care costs and the financing of health insurance warrant greater attention in both public policy and research on U.S. labor market inequality.
    JEL: H22 H24 I13 I14 J20 J31 J32 J38
    Date: 2023–03
  3. By: Barbara A. Butrica; Jonathan Schwabish
    Abstract: This paper examines the association between Social Security Disability Insurance (DI) awards, disability, and technology access. It uses multiple data sources, regression analyses, and geospatial analysis to document the geographic variation in these relationships. Our initial hypothesis was that any relationship between DI awards, disability, and technology access (e.g., computers, the internet, and broadband) would simply reflect the broadband gap between rural and non-rural, but we find that disparities hold even after taking into account these geographic differences.
    Date: 2022–10
  4. By: Barbara A. Butrica; Stipica Mudrazija
    Abstract: This paper explores whether the evolving nature of work has impacted the relationship between health and work-related disability and disability applications through its impact on job demands. Using data from the Health and Retirement Study, supplemented with data on job demands from the Occupational Requirement Survey and Occupational Information Network, we document trends in the association of health and functioning with the risk of experiencing a work-limiting health event and applying for or receiving disability benefits, and assess whether the changing composition of jobs and job demands impacts the strength of this relationship.
    Date: 2022–12
  5. By: Moghadam, Hamed Markazi (Leibniz Univeristät Hannover); Puhani, Patrick A. (Leibniz University of Hannover); Tyrowicz, Joanna (University of Warsaw)
    Abstract: To determine how wives' and husbands' retirement options affect their spouses' (and their own) labour 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 labour supply by about 5 percentage points when the spouse reaches age 60). This speaks in favour of leisure complementarities. However, after the set of reforms, when retiring early was much more difficult, we find no more significant labour supply reaction to the spouse reaching a retirement age, whereas reaching one's own retirement age still triggers a significant reaction in labour 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, labour market participation, household decisions, regression discontinuity design
    JEL: J22 J26
    Date: 2023–03
  6. By: Felix Holub; Beate Thies
    Abstract: Highly skilled knowledge workers are important drivers of innovation and long-run growth. We study how air quality affects productivity and work patterns among these workers, using data from GitHub, the world’s largest coding platform. We combine panel data on daily output, working hours, and task choices for a sample of 25, 000 software developers across four continents during the period 2014-2019 with information on concentrations of fine particulate matter (PM2.5). An increase in air pollution reduces output, measured by the number of total actions performed on GitHub per day, and induces developers to adapt by working on easier tasks and by ending work activity earlier. To compensate, they work more on weekends following high-pollution days, which suggests adverse impacts on their work-life-balance. The decline in output arises even at concentrations in line with current regulatory standards in the EU and US and is driven by a reduction in individual coding activity, while interactive activities are unaffected. Exposure to PM2.5 levels above the city-specific 75th percentile reduces daily output quantity by 4%, which translates into a loss in output value by approximately $11 per developer.
    Keywords: Air pollution, Productivity, High-skilled work, Adaptation, GitHub
    JEL: D24 J22 J24 L86 Q52 Q53
    Date: 2023–03
  7. By: Karolos Arapakis; Gal Wettstein
    Abstract: Since 1965, academics have argued that individuals should annuitize a large part of their wealth. However, for nearly as long, studies have documented that annuitization rates fall far short of what seem to be optimal levels. Researchers have proposed multiple explanations for this potentially sub-optimal outcome. This brief, based on a recent study, assesses the relative importance of two explanations of this outcome, called the annuity puzzle. The first explanation is that annuity prices are set to compensate insurers for the higher average life expectancy of those who voluntarily purchase annuities, thereby making the product less attractive to potential consumers. The second explanation is that individuals in their 50s and 60s subjectively underestimate their life expectancy, which makes them perceive annuities as less attractive. The discussion proceeds as follows. The first section provides a brief background. The second section describes the data and methodology. The third section presents the results: a one-year decrease in objective life expectancy is associated with a 0.20-percentage-point reduction in the chance of receiving income from a commercial annuity, which is nearly nine times larger than the association with an individual subjectively believing that he will live for one year less. The final section concludes that better understanding what drives annuitization is important for annuity providers and policymakers alike. If irrational subjective mortality pessimism were driving low annuitization rates, better informing the public about mortality rates could have reduced the problem. Given that objective life expectancy is the more important factor, a larger public role in the provision of annuities could be considered.
    Date: 2023–01
  8. By: Samuel H. Preston; Yana C. Vierboom (Max Planck Institute for Demographic Research, Rostock, Germany); Mikko Myrskylä (Max Planck Institute for Demographic Research, Rostock, Germany)
    Abstract: We investigate the contribution of socio-behavioral factors to changes in US adult mortality over the period 1997-2019, using National Health Interview Surveys (NHIS) for years 1997-2018 linked to death records through 2019. The variables studied include alcohol consumption, cigarette smoking, health insurance coverage, educational attainment, mental distress, obesity, and race/ethnicity. We evaluate the contribution of each socio-behavioral variable to mortality change by estimating the mortality risks associated with each variable in a hazards model and applying the risks to changes in the variable’s distribution. We find that reductions in cigarette smoking and increases in educational attainment are the largest contributors to recent mortality improvements, accounting between them for 67% of mortality improvements. In a secondary analysis, we compare two subperiods to investigate whether the variables can account for a widely-observed slowdown in the rate of mortality reduction that occurred within the period of study. Rising levels of psychological distress, combined with very high risks associated with distress, were responsible for 13% of the slowdown. However, most of the slowdown remains unaccounted for.
    JEL: J1 Z0
    Date: 2023
  9. By: Spika, Devon (Department of Economics, Lund University); Wickström Östervall, Linnea (Swedish Research Council); Gerdtham, Ulf (Department of Economics, Lund University); Wengström, Erik (Department of Economics, Lund University)
    Abstract: This paper investigates the use of self-funded commitment contracts to support individuals in achieving their goals of increased physical activity. We compare the effect of soft (non-incentivised) commitment contracts with hard (incentivised) contracts using a randomised experiment with 1629 members of a large gym in Stockholm, Sweden. We find a significant positive impact of being offered a hard contract on monthly visits to the gym and the probability of meeting one's contract goal. Hard and soft commitment contracts increase gym visits by 21% and 8%, respectively, relative to the control group. Trait self-control is negatively associated with the likelihood of accepting a contract and accepting to add stakes. The effect of soft and hard commitment contracts does not, however, differ by trait self-control. Importantly, we find that the effects of both hard and soft contracts were greatest among participants who reported exercising the least at baseline. Our experiment explores the use of a completely self-funded and highly scalable intervention. Our experimental design allows us to shed light on the importance of hard penalties in designing commitment contracts.
    Keywords: Incentives; Commitment contract; Self-control; Gym attendance
    JEL: C93 D03 I12
    Date: 2023–04–11
  10. By: Fazio, Andrea (Sapienza University of Rome); Reggiani, Tommaso G. (Cardiff University); Scervini, Francesco (University of Pavia)
    Abstract: Social media use plays an important role in shaping individuals' social attitudes and economic behaviours. One of the first well-known examples of social media campaigns is the Ice Bucket Challenge (IBC), a charity campaign that went viral on social media networks in August 2014, aiming to collect money for research on amyotrophic lateral sclerosis (ALS). We rely on UK longitudinal data to investigate the causal impact of the Ice Bucket Challenge on pro-social behaviours. In detail, this study shows that having been exposed to the IBC increases the probability of donating money, and it also increases the amount of money donated among those who donate at most £100. We also find that exposure to the IBC has increased the probability of volunteering and the level of interpersonal trust. However, all these results, except for the result on the intensive margins of donations, are of short duration and are limited to less than one year. This supports the prevalent consensus that social media campaigns may have only short-term eects.
    Keywords: donations, volunteering, altruism, social media campaigns, Ice Bucket Challenge
    JEL: D64 O35
    Date: 2023–03
  11. By: Stephenson Strobel
    Abstract: Background: There is currently interest in extending medical residency training in several countries including the United States and Canada. There is little evidence on what impacts extending medical residency has on supply of primary care practitioners. Methods: I leverage the province-by-province roll-out of mandatory family medicine residencies in Canada from 1976 to 1994. This mandated that practitioners had to complete a two year residency instead of a one year internship. I use annual Canadian Institute of Health Information data on supply of physicians by specialty and province. I employ a difference-in-differences estimation strategy comparing specialties impacted by the legislation to those that had no change in their residency length (first difference). I compare before and after legislation by province (second difference). Results: I find reductions in the supply of family medicine practitioners in the range of 5-10% of overall supply after implementation of a longer residency. This reduction is statistically significant lasting five years after mandate and point estimates of supply do not return to baseline until eight years after mandates. I find increases in the number of graduates of other programs that might plausibly substitute for family medicine suggestive that the policy drove medical students towards other residencies. Conclusion: Extending residency length has the potential to cause declines in physician supply over the short to medium run. There are both direct effects on physician supply through delays in cohorts as well as indirect effects through substitution away from family medicine residencies.
    Date: 2023–03
  12. By: Osaid Alshamleh (Department of Accounting and Finance, Cyprus International University, Hespolat, Mersin 10, Turkey); Glenn P. Jenkins (Department of Economics, Queens University, Kingston, Ontario, Canada and Cambridge Resources International Inc.); Tufan Ekici (Department of Economics, Ramapo College of New Jersey, Mahwah, N.J. USA)
    Abstract: The estimation and analysis of the distribution of the negative health impacts of certain commodities subject to excise taxes in Belize and the distribution of the burdens of the excise taxes across households of different income levels are the focus of this article. Particular attention is given to the taxation of soft drinks and cosmetics. We examine the income distribution and tax revenue impacts using the commodity data from the household expenditure survey by and the effective tax rates expressed as a percentage of the value of the final consumption of each item. As in many developing countries, taxes on alcoholic beverages and tobacco products are found to be regressive. The most regressive excise taxes are on soft drinks and cosmetics. Households across the economy pay more in excise taxes on cosmetics than they do on either alcoholic beverages or tobacco products. Relative to the level of household expenditures, the burden of the excise taxes on cosmetics is highest for households in the lowest quintile of total expenditures. The impact of soft drinks in creating obesity is likely to be much greater for high income households whose total consumption per household is twice that of low-income households.
    Keywords: excise tax, tax incidence, cosmetics, soft drinks, obesity, regressivity, Belize
    JEL: H22 L66
    Date: 2023–04–10
  13. By: Mohajan, Devajit; Mohajan, Haradhan
    Abstract: Proper measure of ideal body weight (IBW) is necessary in medical science. According to physicians, IBW is related to the lowest morbidity and mortality. Broca Index (BI) is a simple and effective tool to measure IBW; and general physicians, nutritionists, and Life Insurance Companies can use it confidently. In this mini review aspects of Broca Index (BI) are discussed for the calculation of ideal body weight (IBW) of health conscious people.
    Keywords: Broca Index, ideal body weight, BMI
    JEL: C3 C41 C43 I1 I13
    Date: 2023–01–16
  14. By: Mohajan, Devajit; Mohajan, Haradhan
    Abstract: At present rising of obesity becomes a principal public global health and economic concern. In 1997, the World Health Organization (WHO) has declared the obesity as global epidemic. About one-third of the world population is now suffering from overweight or obesity. It is estimated that some diseases, such as hypertension, cardiovascular diseases, Alzheimer disease, asthma, metabolic syndrome, liver steatosis, gallbladder disease, osteoarthritis, obstructive sleep apnea, certain types of cancer, hypercholesterolemia, metabolic syndrome, musculoskeletal disorders (joint and muscle pains), and type 2 diabetes are increased globally due to obesity. Obesity can affect nearly every organ system of human body and even may cause of total heart failure. On the other hand, obesity is incurring substantial costs for healthcare that are already affected the society. Obesity can be prevented, avoided, and cured. Prevention of obesity is the best policy, but proper treatment is necessary who are already affected with obesity. This article tries to discuss aspects of obesity, such as causes and prevention of obesity.
    Keywords: Overweight, obesity, body mass index, exercise, healthy balanced diet
    JEL: C2 I12 I14 I15
    Date: 2023–02–03
  15. By: Wu, Yansi (Department of Health Management and Health Economics)
    Abstract: Continuity of care is a long-standing, growing topic of healthcare, especially in primary care. Continuity between general practitioners and patients likely affects healthcare indicators, such as patient satisfaction, healthcare utilization, mortality, healthcare expenditure, etc. This review aims to examine the relationship between continuity and various healthcare indicators. A MEDLINE search covering 1966-2021 identified 10 systematic reviews and 26 relevant studies. There were 13 different continuity measures identified in these individual studies. Hospital admissions/re-admissions and emergency room visits are the most explored outcome measures, where significant negative effects were found to be consistent with higher continuity. More recent studies, especially in the Nordic countries, explored the impacts of discontinuity. Additionally, patients with chronic disease conditions were paid more attention to in recent studies. However, evidence in these two areas is limited and requires further research.
    Keywords: continuity of care; primary health care; patient-physician relationship; coordination of care; interpersonal continuity continuity; index; named GP; general practitioner; discontinuity of care; general practitioner discontinuity; patient satisfaction; quality of care
    JEL: H40 H51 H75 I11 I15 I18
    Date: 2023–04–12
  16. By: Kyriopoulos, Ilias-Ioannis
    Abstract: Previous studies have found a link between economic conditions, such as recessions and unemployment, and cardiovascular disease as well as other health outcomes. More recent research argues that economic uncertainty—independently of unemployment—can affect health outcomes. Using data from England and Wales, we study the association between fluctuations in economic uncertainty and cardiovascular disease mortality in the short term for the period 2001–2019. Controlling for several economic indicators (including unemployment), we find that economic uncertainty alone is strongly associated with deaths attributed to diseases of the circulatory system, ischemic heart disease and cerebrovascular disease. Our findings highlight the short-term link between economic conditions and cardiovascular health and reveal yet another health outcome that is associated with uncertainty.
    Keywords: cardiovascular disease; economic uncertainty; mortality; Wiley deal
    JEL: J1
    Date: 2023–03–23
  17. By: Maria Errea;Nadine Henderson;Chris Skedgel;Mireia Jofre-Bonet
    Abstract: Medicines for rare and ultra-rare conditions face distinct economic and ethical challenges compared to medicines for more common conditions. These challenges are implicitly acknowledged by the National Institute of Health and Care Excellence (NICE) by providing an auxiliary appraisal route for highly specialized technologies. However, concerns have been raised regarding the appraisals of medicines that don’t meet the strict criteria and are, therefore, evaluated via the standard appraisal route (STA). The STA pathway was not designed to consider the greater uncertainty associated with medicines for rare and ultra-rare conditions. In this report, we develop case studies to describe these challenges and how NICE approaches them in their assessment of these medicines. We conducted a series of stakeholder interviews to identify key perceived challenges, better understand the intricacies of the NICE appraisal process and the interplay with NHS England. The case studies include examples of cancer and non-cancer medicines, medicines with multiple indications, and those appraised by the STA and HST routes. In some cases, we find a flexible and pragmatic approach towards uncertainty; these positive examples include consideration of bespoke statistical modelling, expert testimony, and/or the use of real-world evidence. Less positive examples were also observed, especially around inflexible consideration of uncertainties inherent around ultra-rare conditions. NICE has recently proposed promising updates to their methods guidance, and NHS England has announced their intention to implement an Innovative Medicines Fund to fast-track new medicines, such as cutting-edge gene therapies. The authors believe these changes to be encouraging but draw attention to potential shortcomings and areas that may still require improvement to ensure that patients with rare and ultra-rare diseases are treated fairly, relative to patients with more common conditions.
    Keywords: A Case Study Analysis: Challenges in the NICE Evaluation of Multi-Indication Medicines for Rare and Ultra-Rare Diseases
    JEL: I1
    Date: 2021–09–01
  18. By: Wu, Wenjie (Jinan University); Yang, Zhe (Jinan University); Kim, Jun Hyung (Jinan University); Yue, Ai (Shaanxi Normal University)
    Abstract: Climate change poses a significant threat to the development of young children, but its impacts are not well known because of data and methodological limitations. Using a unique panel study in disadvantaged rural communities, we find that exposures to low temperatures undermine subsequent cognitive development before age 5, and reduce caregiver-child interactions and material investments. Results do not support income, health and temporary disruption in cognitive performance as potential channels. By undermining children's home environment, climate change may widen socioeconomic inequalities across households by their capacity to adapt, which is severely limited among disadvantaged households.
    Keywords: early childhood, cognitive skills, home environment, temperature, climate change, China
    JEL: I14 I18 J13 P25
    Date: 2023–03
  19. By: Zhou, Renee (University of Warwick)
    Abstract: To test whether education can change risk preference, I exploit the Indonesian school construction programme and the Mexican education reform in compulsory schooling as two separate natural experiments. Applying the instrumental variable approach, I do not find a causal effect of education on risk preference. The results are consistent in the two different settings, so my findings are externally valid. The results suggest that a change in risk preference may not be the channel via which the impact of education on risk-taking in real life. This paper contributes to the literature on the determinants of social preferences and the outcomes of education.
    Keywords: Risk preference ; risk aversion ; education JEL classifications: I25 ; D90
    Date: 2023
  20. By: Thao P. Le; Isobel Abell; Eamon Conway; Patricia T. Campbell; Alexandra B. Hogan; Michael J. Lydeamore; Jodie McVernon; Ivo Mueller; Camelia R. Walker; Christopher M. Baker
    Abstract: Since the emergence of SARS-CoV-2 (COVID-19), there have been multiple waves of infection and multiple rounds of vaccination rollouts. Both prior infection and vaccination can prevent future infection and reduce severity of outcomes, combining to form hybrid immunity against COVID-19 at the individual and population level. Here, we explore how different combinations of hybrid immunity affect the size and severity of near-future Omicron waves. To investigate the role of hybrid immunity, we use an agentbased model of COVID-19 transmission with waning immunity to simulate outbreaks in populations with varied past attack rates and past vaccine coverages, basing the demographics and past histories on the World Health Organization (WHO) Western Pacific Region (WPR). We find that if the past infection immunity is high but vaccination levels are low, then the secondary outbreak with the same variant can occur within a few months after the first outbreak; meanwhile, high vaccination levels can suppress near-term outbreaks and delay the second wave. Additionally, hybrid immunity has limited impact on future COVID-19 waves with immune-escape variants. Enhanced understanding of the interplay between infection and vaccine exposure can aid anticipation of future epidemic activity due to current and emergent variants, including the likely impact of responsive vaccine interventions.
    Keywords: epidemiology, mathematical modelling, vaccination, variants
    Date: 2023
  21. By: Anqi Chen; Nilufer Gok; Alicia H. Munnell
    Abstract: When COVID-19 brought on a health crisis and shut down many parts of the economy in 2020, many expected the fertility rate to plummet, even more than it had in recent years. While initially the severity of the public health and economic crises did result in large declines in fertility, the swift labor market recovery and income support for families led to a small rebound in fertility rates in 2021. The question is what happens next: is the uptick simply a temporary blip or a sign that the decade-long decline in fertility rates is over?
    Date: 2023–01
  22. By: Pascale Phélinas (CESSMA UMRD 245 - Centre d'études en sciences sociales sur les mondes africains, américains et asiatiques - IRD - Institut de Recherche pour le Développement - Inalco - Institut National des Langues et Civilisations Orientales - UPCité - Université Paris Cité, CERDI - Centre d'Études et de Recherches sur le Développement International - IRD - Institut de Recherche pour le Développement - CNRS - Centre National de la Recherche Scientifique - UCA - Université Clermont Auvergne); Valéria Hernández (CESSMA UMRD 245 - Centre d'études en sciences sociales sur les mondes africains, américains et asiatiques - IRD - Institut de Recherche pour le Développement - Inalco - Institut National des Langues et Civilisations Orientales - UPCité - Université Paris Cité); Camille Ciriez (CERDI - Centre d'Études et de Recherches sur le Développement International - IRD - Institut de Recherche pour le Développement - CNRS - Centre National de la Recherche Scientifique - UCA - Université Clermont Auvergne)
    Abstract: Based on a telephone survey conducted among a representative sample of one thousand respondents, this article analyzes the perceptions and attitudes of Argentinians toward the COVID-19 outbreak. The analysis shows that Argentinians overwhelmingly approved of the public health and economic policies pursued by their government and, as a result, changed their behavior. Among the many factors that influenced Argentinians' perceptions and attitudes, trust in institutions (president, governor, mayor) emerged as a major determinant. In terms of emotions, fear and a strong perception of the seriousness of the disease were also found to be powerful drivers of compliance with health regulations. The results also highlight the significance of economic and social measures that reduced the costs associated with precautionary behavior. These findings are robust to the inclusion of a wide range of sociodemographic control variables.
    Abstract: Fondé sur une enquête téléphonique menée auprès d'un échantillon représentatif de mille répondants, cet article analyse les perceptions et attitudes des Argentins face à l'épidémie de COVID-19. L'analyse montre que les argentins ont massivement approuvé la politique sanitaire et économique suivie par leur gouvernement, et, en conséquence, modifié leur comportement. Parmi les nombreux facteurs qui ont influencé l'adhésion des argentins à la politique suivie et le respect des consignes sanitaires, la confiance dans les institutions (président, gouverneur, maire) ressort comme un déterminant majeur. Parmi les émotions, la peur ainsi qu'une forte perception de la gravité de la maladie s'avèrent également de puissants moteurs du respect des consignes sanitaires. Les résultats soulignent également l'importance des mesures économiques et sociales qui ont permis de réduire les coûts associés aux comportements de précaution. Ces conclusions sont robustes à l'inclusion d'un vaste ensemble de variables de contrôle sociodémographiques.
    Keywords: Argentine, pandémie COVID-19, comportements, observance des consignes, politique sanitaire.
    Date: 2021–06
  23. By: Anqi Chen; Siyan Liu; Alicia H. Munnell
    Abstract: In early 2020, the COVID Recession seemed like it would result in an increase in early Social Security claiming, similar to the Great Recession. However, pretty quickly the COVID Recession turned out to be quite different. It was spurred by a health crisis, potentially increasing the likelihood of early claiming among older workers and accompanied by a quick recovery in the stock market followed by rapidly-rising prices that could enable many with assets to retire early. On the other hand, the unprecedented expansion and generosity of unemployment insurance (UI) offered a way for lower-paid workers to stay in the labor force. The following analysis, using data from the Health and Retirement Study (HRS), compares how the claiming pattern changed in the recession years 2008-2010 from the expansion years 2004-2006 with how the pattern changed in the recession year 2020 from the expansion years 2016-2018.
    Date: 2022–10
  24. By: Costa-Font, Joan; Vilaplana-Prieto, Cristina
    Abstract: We examine the extent to which exposure to higher relative COVID-19 mortality (RM), influences health system trust (HST), and whether changes in HST explain the perceived ease of compliance with pandemic restrictions during the COVID-19 pandemic. Drawing on evidence from two representative surveys covering all regions of 28 European countries before and after the first COVID-19 wave, and using a difference in differences strategy together with Coarsened Exact Matching (CEM), we document that living in a region with higher RM during the first wave of the pandemic increased HST. However, the positive effect of RM on HST is driven by individuals over 45 years of age, and the opposite effect is found among younger cohorts. Furthemore, we find that a higher HST reduces the costs of complying with COVID-19 restrictions, but only so long as excess mortality does not exceed the average by more than 20%, at which point the ease of complying with COVID-19 restrictions significantly declines, offsetting the positive effect of trust in the healthcare system. Our interpretation of these estimates is that a higher RM is interpreted as a risk signal among those over 45, and as a signal of health-care system failure among younger age individuals.
    Keywords: healthcare system trust; mortality; lockdown; Eurobarometer; difference in differences; Covid-19; coronavirus; Periscope H2020 GA 101016233; Elsevier deal
    JEL: I10 Z10
    Date: 2023–04–01
  25. By: Brancati, Dawn; Birnir, Johanna; Qutaiba Idlbi, Qutaiba Idlbi
    Abstract: Lockdown measures, widely used to stop the spread of disease in crises, we argue, are likely to reduce non-state actor violence, especially in urban and non-base areas. These measures deplete actors’ resources, reduce the number of high-value civilian targets, and make it logistically more difficult to conduct attacks. Using the example of the Islamic State of Iraq and Syria (ISIS), and taking advantage of the exogenous nature of COVID-19 lockdowns, we find that curfews and travel bans significantly reduce violence, especially in populated and non-base areas. These effects are most likely due to short-term changes in ISIS’s targets and logistics rather than its resources. These findings provide important insights into the security aspects of public health crises and offer novel findings into the general effectiveness of two common counterinsurgency tools.
    Keywords: COVID-19;pandemic;violence; terrorism; ISIS
    JEL: I0 I1
    Date: 2023–01–30
  26. By: R. Vincent Pohl; David R. Mann
    Abstract: The COVID-19 pandemic likely affected applications and awards for Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI). This paper uses Social Security Administration (SSA) administrative data on applications and awards, combined with county-level data on COVID-19 severity, unemployment, and proximity to an SSA field office, to understand drivers of application and award rates. Specifically, it examines how changes from 2019 to 2020 in SSI and SSDI application and award rates were related to county-level factors affected by the pandemic.
    Date: 2022–12

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