nep-hea New Economics Papers
on Health Economics
Issue of 2023‒05‒22
twenty-two papers chosen by
Nicolas R. Ziebarth
Cornell University

  1. Personalized Medicine and Prevention: Can Cross-Subsidies Survive in the Health Insurance Markets ? By David Bardey; Philippe de Donder
  2. The Institution of American Slavery, Current-Day Preference to Repeal the Affordable Care Act, and Efficacy of the Reform By Vinish Shrestha
  3. Nurse Practitioner Scope of Practice and Patient Harm: Evidence from Medical Malpractice Cases and Adverse Action Reports By Sara Markowitz; Andrew J.D. Smith
  4. The Labour Market Returns to Sleep By Joan Costa-Font; Sarah Fleche; Ricardo Pagan
  5. The Labor Market Effects of Place-Based Policies: Evidence from England’s Neighbourhood Renewal Fund By Robert Calvert Jump; Adam Scavette
  6. Pension Reforms and Couples' Labour Supply Decisions By Moghadam, Hamed Markazi; Puhani, Patrick; Tyrowicz, Joanna
  7. Exposure to collective gender-based violence causes intimate partner violence By Wolfgang Stojetz; Tilman Brück
  8. Examining the Value of Satellite Data in Halting Transmission of Polio in Nigeria: A Socioeconomic Analysis By Zhou, Janet; Azelton, Krystal; Nassar, Isabelle-Yara; Borowitz, Mariel
  9. The Unpredictability of Individual-Level Longevity By Breen, Casey; Seltzer, Nathan
  10. Mortality Comparisons 'At a Glance': A Mortality Concentration Curve and Decomposition Analysis for India By Creedy, John; Subramanian, S.
  11. Social inequities in neighborhood health amenities over time in the Wasatch Front Region of Utah: Historical inequities, population selection, or differential investment? By Curtis, David Stuart
  12. The relationship between quality of the working environment, workers’ health and well-being: Evidence from 28 OECD countries By Fabrice Murtin; Benoît Arnaud; Christine Le Thi; Agnès Parent-Thirion
  13. Synthetic Controls with Multiple Outcomes: Estimating the Effects of Non-Pharmaceutical Interventions in the COVID-19 Pandemic By Wei Tian; Seojeong Lee; Valentyn Panchenko
  14. Risk Compensation after COVID-19 Vaccination By Hwang, Jisoo; Hwang, Seung-sik; Kim, Hyuncheol Bryant; Lee, Jungmin; Lee, Junseok
  15. COVID-19-induced Human Capital Shocks, Lifetime Labor Productivity, and Inequality By Orbeta, Aniceto Jr. C.; Bayudan-Dacuycuy, Connie; Abrigo, Michael R.M.
  16. Homophily and Infections: Static and Dynamic Effects By Matteo Bizzarri; Fabrizio Panebianco; Paolo Pin
  17. Economic Costs of Distancing Policy Interventions By Rácz, Olivér Miklós
  18. Has COVID Reversed Gentrification in Major U.S. Cities? An Empirical Examination of Residential Mobility in Gentrifying Neighborhoods During the COVID-19 Crisis By Lei Ding; Jackelyn Hwang
  19. Covid and Cities, Thus Far By Gilles Duranton; Jessie Handbury
  20. The Effects of Differential Exposure to COVID-19 on Educational Outcomes in Guatemala By Andres Ham; Emmanuel Vazquez; Monica Yanez-Pagans
  21. The Heterogeneous Effects of Lockdown Policies on Air Pollution By Simon Briole; Augustin Colette; Emmanuelle Lavaine
  22. Overburdened Bureaucrats: Providing Equal Access to Public Services during COVID-19 By Kolstad, Karoline Larsen

  1. By: David Bardey (TSE-R - Toulouse School of Economics - UT Capitole - Université Toulouse Capitole - UT - Université de Toulouse - 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, UNIANDES - Universidad de los Andes [Bogota]); Philippe de Donder (TSE-R - Toulouse School of Economics - UT Capitole - Université Toulouse Capitole - UT - Université de Toulouse - 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)
    Abstract: Personalized medicine is still in its infancy, with costly genetic tests providing little actionable information in terms of efficient prevention decisions. As a consequence, few people undertake these tests currently, and health insurance contracts pool all agents irrespective of their genetic background. Cheaper and especially more informative tests will induce more people to undertake these tests and will impact not only the pricing but also the type of health insurance contracts. We develop a setting with endogenous prevention decisions and we study which contract type (pooling or separating) emerges at equilibrium as a function of the proportion of agents undertaking the genetic test as well as of the informativeness of this test. Starting from the current low take-up rate generating at equilibrium a pooling contract with no prevention effort, we obtain that an increase in the take-up rate has first an ambiguous impact on welfare, and then unambiguously decreases welfare as one moves from a pooling to a separating equilibrium. It is only once the take-up rate is large enough that the equilibrium is separating that any further increase in take-up rate increases aggregate welfare, by a composition effect. However, a better pooling contract in which policyholders undertake preventive actions (and lower their health risk) can also be attained if the informativeness of the genetic tests increases sufficiently.
    Keywords: discrimination risk, informational value of test, personalized medecine, pooling and separating equilibria.
    Date: 2023–04–22
  2. By: Vinish Shrestha (Department of Economics, Towson University)
    Abstract: This study investigates the relationship between the former slavery in the American South, current-day sentiments surrounding the Affordable Care Act (ACA), and its efficacy. We present three main findings. First, the preference to repeal ACA is discernably stronger among White Southerners in counties more dependent on the former slavery within the states that did not expand Medicaid. Second, Whites residing in low slavery dependent counties had higher pre-ACA uninsured rates compared to those living in counties with higher dependency on slavery. The ACA-related Medicaid expansions have closed this gap. The results for Black Southerners on this regard remain ambiguous. Third, the institution of Jim Crow that transcended slavery following the Emancipation and Reconstruction has impeded ACA's efficacy. Overall, the findings indicate that former institutions of racial oppression has affected the implementation of ACA in the American South.
    Keywords: The Patient Protection and Affordable Care Act (ACA), Slavery, Institution, ACA-related preferences, ACA efficacy, American South, Politics.
    JEL: I10 I14 D02 B15 D02
    Date: 2023–04
  3. By: Sara Markowitz; Andrew J.D. Smith
    Abstract: Many states have recently changed their scope of practice laws and granted full practice authority to nurse practitioners, allowing them to practice without oversight from physicians. Physician groups have argued against this change, citing patient safety concerns. In this paper, we use a ratio-in-ratio approach to evaluate whether the transition to full practice authority results in harm to patients as proxied by rates of malpractice payouts and adverse action reports against nurse practitioners. We find no evidence of such harm, and instead find that physicians may benefit from the law change in terms of reduced malpractice payouts against them.
    JEL: I1 K1
    Date: 2023–04
  4. By: Joan Costa-Font (LSE - London School of Economics and Political Science, IZA - Forschungsinstitut zur Zukunft der Arbeit - Institute of Labor Economics, CESifo - Center for Economic Studies and Ifo for Economic Research - CESifo Group Munich); Sarah Fleche (CES - Centre d'économie de la Sorbonne - UP1 - Université Paris 1 Panthéon-Sorbonne - CNRS - Centre National de la Recherche Scientifique, UP1 - Université Paris 1 Panthéon-Sorbonne, CEP - LSE - Centre for Economic Performance - LSE - London School of Economics and Political Science, LSE - London School of Economics and Political Science, CNRS - Centre National de la Recherche Scientifique); Ricardo Pagan (University of Málaga)
    Abstract: The proportion of people sleeping less than the daily-recommended hours has increased. Yet, we know little about the labour market returns to sleep. We use longitudinal data from Germany and exploit exogenous variation in sleep duration induced by time and local variations in sunset time. We find that a 1-hour increase in weekly sleep increases employment by 1.6 percentage points and weekly earnings by 3.4%. Most of this earnings effect comes from productivity improvements, while the number of working hours decreases with sleep time. We identify one mechanism driving these effects, namely the better mental health workers experience from sleeping more hours.
    Keywords: sleep, employment, productivity, mental health, sunset times
    Date: 2022–11
  5. By: Robert Calvert Jump; Adam Scavette
    Abstract: Neighborhood renewal programs are a type of place-based policy that aim to revive underperforming localities. The literature on place-based policies has found mixed results regarding their effects on local labor market outcomes, but there are relatively few studies of policies that aim to improve local labor supply. In this paper, we examine the labor market effects of the Neighbourhood Renewal Fund, which targeted eighty-eight of the most deprived areas in England during the early 2000s as part of the Labour Government's National Strategy for Neighbourhood Renewal. The fund disbursed almost £3 billion for spending on community safety, education, health care and worklessness, with supply-side interventions making up the bulk of the program's spending on worklessness. Using a difference-in-differences approach, we find statistically significant impacts on local employment and out-of-work benefit claimants. Our results suggest that policy interventions to improve local labor supply can be a successful strategy for neighborhood renewal.
    Keywords: Place-Based Policies; Urban Economics; Labor Supply; Employment
    JEL: J21 J22 J48 R10 R58
    Date: 2022–03–23
  6. By: Moghadam, Hamed Markazi; Puhani, Patrick; Tyrowicz, Joanna
    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: 2023–04
  7. By: Wolfgang Stojetz (ISDC – International Security and Development Center, Berlin, Germany; and Humboldt University Berlin, Germany); Tilman Brück (ISDC – International Security and Development Center, Berlin, Germany; Leibniz Institute of Vegetable and Ornamental Crops, Großbeeren, Germany; and Humboldt University Berlin, Germany)
    Abstract: Globally, one in three women experience intimate partner violence (IPV) over their lifetimes. Yet, the factors that cause men to commit IPV remain poorly understood. We propose and test a causal long-term link from past exposure to gender-based collective violence to violent behavior against an intimate partner. Combining novel survey data from Angolan war veteran families and a natural experiment, we find that exposure to sexual violence by armed groups against women makes male veterans about 30 percentage points more likely to commit physical – but not sexual – violence against a female intimate partner 18 years later (on average). Our results are not consistent with standard explanations of IPV based on group norms and intra-household bargaining. Instead, we attribute the effect to a lasting reduction in self-control skills. These findings challenge standard approaches to preventing IPV and emphasize the potential of working with men, especially after episodes of collective violence.
    Keywords: war, gender-based violence, intimate partner violence, wartime sexual violence, ex-combatants, demobilization
    JEL: D74 J12 J16
    Date: 2023–03
  8. By: Zhou, Janet; Azelton, Krystal; Nassar, Isabelle-Yara; Borowitz, Mariel
    Abstract: In 2014, Nigeria halted transmission of wild polio virus for the first time in its history. A critical enabling component in this historic achievement was the use of satellite data to produce more accurate maps and population estimates used in planning and implementing vaccination campaigns. This paper employs a value of information approach to estimate the net socioeconomic benefits associated with this use of satellite data. We calculate the increase in the likelihood of halting transmission of polio associated with the use of the satellite-based information compared to traditional data sources, and we consider the benefits associated with savings to the healthcare system as well as health benefits. Using a conservative approach focused on just one year of benefits, we estimate net socioeconomic benefits of between $46.0 million and $153.9 million. In addition to these quantified benefits, we also recognize qualitative benefits associated with improving human health, reaching marginalized communities, and building capacity among local populations. We also explore the substantial benefits associated with follow-on projects that have made use of the satellite-based data products and methodologies originally developed for the Nigeria polio eradication effort.
    Date: 2022–10–19
  9. By: Breen, Casey; Seltzer, Nathan (University of California, Berkeley)
    Abstract: How accurately can age of death be predicted using basic sociodemographic characteristics? We test this question using a large-scale administrative dataset combining the complete count 1940 Census with Social Security death records. We fit eight machine learning algorithms using 35 sociodemographic predictors to generate individual-level predictions of age of death for birth cohorts born at the beginning of the 20th century. We find that none of these algorithms are able to explain more than 1.5% of the variation in age of death. Our results suggest mortality is inherently unpredictable and underscore the challenges of using algorithms to predict major life outcomes.
    Date: 2023–04–08
  10. By: Creedy, John; Subramanian, S.
    Abstract: This paper uses the concept of the M-Curve, which plots the cumulative proportion of deaths against the corresponding cumulative proportion of the population (arranged in ascending order of age), and associated measures, to examine mortality experience in India. A feature of the M-curve is that it can be combined with an explicit value judgement (an aversion to early deaths) in order to make welfare-loss comparisons. Empirical comparisons over time, and between regions and genders, are made. Furthermore, in order to provide additional perspective, selective results for the UK and New Zealand are reported. It is also shown how the M-curve concept can be used to separate the contributions to overall mortality of changes over time (or differences between population groups) to the population age distribution and age-specific mortality rates.
    Keywords: Mortality Curve, Mortality-inefficiency measure, Crude Death Rate, Lorenz Curve, Age-distribution of population, Age-specific death rates, M-Curve comparisons, Decomposition, Age and fatality effects, Decomposition, Mean and dispersion effects,
    Date: 2022
  11. By: Curtis, David Stuart (University of Utah)
    Abstract: Socially disadvantaged groups generally are more likely to reside in areas with less desirable conditions. We examined longitudinal relationships between neighborhood resident characteristics and amenities from 1990 to 2010 in a four-county urban area of Utah, U.S. Four temporal patterns of social inequities are described using mixed-effects models: historical inequities in amenities; differential selection into amenity-rich tracts; differential investment in amenities; and simultaneous twenty-year change. Results indicate historical differences by nSES, with lower status tracts having fewer green/natural amenities and higher air pollution in 1990 but also greater walkability and more food stores. Differences widened over time as nSES disproportionately increased in tracts with more green/natural amenities, less air pollution, and lower walkability in 1990, consistent with differential selection. Tract percentage non-Hispanic White did not predict historical differences, but tracts that were less walkable and had fewer healthy food stores per capita in 1990 experienced larger subsequent increases in racial/ethnic diversity. Tracts with higher percentage non-Hispanic White in 1990 had larger decreases in air pollution but also declining green/natural amenities relative to more diverse tracts. This study shows how social inequities in neighborhood amenities change over time, providing strong evidence of historical socioeconomic differences that increased due to differential selection.
    Date: 2023–04–12
  12. By: Fabrice Murtin; Benoît Arnaud; Christine Le Thi; Agnès Parent-Thirion
    Abstract: This paper operationalises the OECD Guidelines for Measuring the Quality of the Working Environment (OECD, 2017) to describe job characteristics among European countries, the United States and Korea in 2010 and 2015. The analysis extends the range of aspects of quality of the working environment beyond those featuring in the Job Strain index presented by (Cazes, 2015), which is used to monitor implementation of the OECD Job Strategy, but at the cost of a more limited country coverage. While the two indices of job strain are largely consistent both across countries and over time, all of the job characteristics included in the “extended” index turns out to matter for workers’ well-being. The framework uses the job demands-resources model ( (Demerouti, 2001) that stresses the importance of balancing the demands of the job and the resources that are available to workers to meet those demands. Workers are classified as (heavily) strained when the number of job demands they face (largely) exceeds the number of job resources they benefit from, and conversely, they are classified as (very) well-resourced when their job resources (largely) exceed their job demands.On average among 28 OECD countries, about one third of employees are (moderately or heavily) strained at work, while one half are well-resourced. The share of employees that are heavily strained is close to 10%. Job strain is relatively more frequent among employees with low education and low occupational skills, and it is relatively less frequent in the service sector and in the public sector. Due to composition effects, women hold on average slightly less strained jobs than men. The share of strained workers has slightly declined on average over the 2010-2015 period, falling in a majority of countries. The improvement in working conditions is related to better prospects of career advancement, higher take-up of training, stronger social support and organisational participation at work, higher flexibility of working time, as well as lower exposure to physical risk factors, hard physical demands and unsocial work schedule. On the other hand, perceptions of job insecurity, intimidation and discrimination, as well as work intensity have been on the rise. Finally, quality of the working environment is strongly associated with workers’ well-being as measured by mental and physical health, days of sickness, job satisfaction as well as job motivation, and the associated effects are potentially large. For most outcomes, perceived intimidation and discrimination at work is one of the most powerful predictor of workers’ well-being.
    Keywords: job quality, quality of the working environment, well-being, workers' health
    JEL: J81 J88 J71 J58
    Date: 2022–01–31
  13. By: Wei Tian (School of Economics, UNSW Business School, UNSW); Seojeong Lee (Department of Economics, Seoul National University); Valentyn Panchenko (School of Economics, UNSW Business School, UNSW)
    Abstract: We propose a generalization of the synthetic control method to a multiple-outcome framework, which improves the reliability of treatment effect estimation. This is done by supplementing the conventional pre-treatment time dimension with the extra dimension of related outcomes in computing the synthetic control weights. Our generalization can be particularly useful for studies evaluating the effect of a treatment on multiple outcome variables. To illustrate our method, we estimate the effects of non-pharmaceutical interventions (NPIs) on various outcomes in Sweden in the first 3 quarters of 2020. Our results suggest that if Sweden had implemented stricter NPIs like the other European countries by March, then there would have been about 70% fewer cumulative COVID-19 infection cases and deaths by July, and 20% fewer deaths from all causes in early May, whereas the impacts of the NPIs were relatively mild on the labor market and economic outcomes.
    Keywords: Synthetic control, Policy evaluation, Causal inference, Public health
    JEL: C32 C54 I18
    Date: 2023–03
  14. By: Hwang, Jisoo (Harvard University); Hwang, Seung-sik (Seoul National University); Kim, Hyuncheol Bryant (Cornell University); Lee, Jungmin (Seoul National University); Lee, Junseok (UC Berkeley)
    Abstract: This paper studies the causal impacts of vaccine eligibility on social distancing behaviors (risk compensation). We apply a regression discontinuity design around the birth date cutoff of vaccine eligibility using large, high-frequency data from credit card and airline companies as well as survey data. We find no evidence of risk compensation although vaccine take-up increases substantially with eligibility. We find some evidence of self-selection into vaccine take-up based on perception towards vaccine effectiveness and side effects, but we do not find that the treatment effects differ between compliers and never-takers.
    Keywords: COVID-19, vaccine take-up, selection, risk compensation, social distancing
    JEL: I12 I18
    Date: 2023–04
  15. By: Orbeta, Aniceto Jr. C.; Bayudan-Dacuycuy, Connie; Abrigo, Michael R.M.
    Abstract: Using a human capital model with stochastic lifetimes, this study assesses the potential long-term impacts of human capital spending shocks in the early years of the COVID-19 pandemic on survival, lifetime income, and inequality. In the model, health and education spending separately affect survival rates and potential labor productivity, allowing the authors to trace how the pandemic’s effects may propagate through the economic lifecycle. Using recent National Transfer Account estimates for the Philippines, simulation results suggest that the COVID-19 pandemic is likely to negatively affect health and labor productivity, potentially worsening income inequality in the long run. These impacts appear to be more pronounced for some birth cohorts. Comments to this paper are welcome within 60 days from the date of posting. Email
    Keywords: COVID-19;National Transfer Accounts;human capital;health and labor productivity;income inequality
    Date: 2023
  16. By: Matteo Bizzarri (University of Naples Federico II and CSEF.); Fabrizio Panebianco (Università Cattolica di Milano.); Paolo Pin (Università di Siena and BIDSA.)
    Abstract: We analyze the effect of homophily in an epidemics between two groups of agents that differ in vaccination rates (“vaxxers" and “anti-vaxxers"). The steady state infection rate is hump-shaped in homophily, whereas the cumulative number of agents infected during an outbreak is u-shaped. If vaccination rates are endogenous, homophily has the opposite impact on the two groups, but the qualitative behavior of the aggregate is unchanged. However, the sign of the group-level impact is the opposite if vaccination is motivated by infection risk or by peer pressure. If motivations are group-specific, homophily can be harmful for both groups.
    Keywords: Homophily; seasonal diseases; vaccination; anti-vaccination movements; SIS-type model.
    JEL: D62 D85 I12 I18
    Date: 2023–04–26
  17. By: Rácz, Olivér Miklós
    Abstract: Distancing policy interventions (DPIs) were aimed at containing the COVID-19 pandemic, but they also likely affected economic activity. This paper estimates the effects of DPIs on selected indicators of monthly economic activity, such as industrial and manufacturing production, construction output, retail trade, inflation, and unemployment. The main contribution of this paper is the isolation of the causal effects of distancing interventions from the effects of voluntary distancing. I use mobility data as a measure of distancing to identify DPI effects on mobility in a regression discontinuity design, specifically as immediate changes in distancing right after the intervention. This strategy identifies the unobserved voluntary component of distancing as well, which is a key control variable in the identification of the economic effects of DPIs. I find significant output losses due to DPIs, but no evidence for inflationary or unemployment effects. Results also show that although voluntary distancing caused significant output losses, their effect was an order of magnitude smaller than that of DPIs.
    Keywords: COVID-19, non-pharmaceutical interventions, causal identification, regression-discontinuity-in-time
    JEL: C30 C33 C43 C54 E23 E24 E65 H10 H12 H30 H84 I10 I12 I18
    Date: 2023–05–05
  18. By: Lei Ding; Jackelyn Hwang
    Abstract: This paper examines whether neighborhoods that had been gentrifying lost their appeal during the pandemic because of COVID-induced health risks and increased work-from-home arrangements. By following the mobility pattern of residents in gentrifying neighborhoods in 39 major U.S. cities, we note a larger increase of 1.2 percentage points in the outmigration rate from gentrifying neighborhoods by the end of 2021, relative to nongentrifying ones, with out-of-city moves accounting for over 71 percent of the increased flight. The share of out-of-city moves into gentrifying neighborhoods also decreased significantly during the pandemic. Residents with high credit scores, younger residents, and probable homeowners were more likely to leave gentrifying neighborhoods and their respective cities. Gentrifying neighborhoods closer to city centers, with higher density or higher housing costs, or in cities that are more vulnerable to the pandemic were hit harder by COVID-induced adjustments. The results are consistent with the contention that the pandemic has slowed the pace of gentrification in many major U.S. cities. This slowed gentrification has important policy implications for local government public finance, as well as the long-term future of cities.
    Keywords: Gentrification; Mobility; COVID-19; Work-from-home; Spatial Dynamics
    JEL: R11 I18 H11 H2
    Date: 2022–08–17
  19. By: Gilles Duranton; Jessie Handbury
    Abstract: A key reason for the existence of cities are the externalities created when people cluster together in close proximity. During Covid, such interactions came with health risks and people found other ways to interact. We document how cities changed during Covid and consider how the persistence of new ways of interacting, particularly remote work, will shape the development of cities in the future. We first summarize evidence showing how residential and commercial prices and activity adjusted at different distances from dense city centers during and since the pandemic. We use a textbook monocentric city model to demonstrate that two adjustments associated with remote work—reduced commuting times and increased housing demand—generate the patterns observed in the data. We then consider how these effects might be magnified by changes in urban amenities and agglomeration forces, and what such forces might mean for the future of cities.
    JEL: R12 R21 R31
    Date: 2023–04
  20. By: Andres Ham (School of Government- Universidad de los Andes); Emmanuel Vazquez (CEDLAS-IIE-FCE-UNLP); Monica Yanez-Pagans (Education Global Practice. The World Bank)
    Abstract: This paper studies the effects of differential exposure to COVID-19 on educational outcomes in Guatemala. The government adopted a warning index (ranging from 0 to 10) to classify municipalities by infection rates in 2020, which was then used by the Ministry of Education in 2021 to establish a “stoplight” system for in-person instruction. Using administrative panel data for all students in Guatemala, the study employs a difference-in-differences strategy that leverages municipal differences over time in the warning index to estimate the effects of the pandemic on dropout, promotion, and school switching. The results show that municipalities with a higher warning index had significantly larger dropout, lower promotion rates, and a greater share of students switching from private to public schools. These effects were more pronounced during the first year of the pandemic. The findings show differential effects by the level of instruction, with greater losses for younger children in initial and primary education. The results are robust to specification choice, multiple hypothesis adjustments, and placebo experiments, suggesting that the pandemic has had heterogeneous consequences.
    JEL: H12 I21 I24 I25 I28
    Date: 2023–05
  21. By: Simon Briole (CEE-M - Centre d'Economie de l'Environnement - Montpellier - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement - Institut Agro Montpellier - Institut Agro - Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement - UM - Université de Montpellier); Augustin Colette (INERIS - Institut National de l'Environnement Industriel et des Risques); Emmanuelle Lavaine (CEE-M - Centre d'Economie de l'Environnement - Montpellier - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement - Institut Agro Montpellier - Institut Agro - Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement - UM - Université de Montpellier)
    Abstract: While a sharp decline in air pollution has been documented during early Covid-19 lockdown periods, the stability and homogeneity of this effect are still under debate. Building on pollution data with a very high level of resolution, this paper estimates the impact of lockdown policies on P M 2.5 exposure in France over the whole year 2020. Our analyses highlight a surprising and undocumented increase in exposure to particulate pollution during lockdown periods. This result is observed during both lockdown periods, in early spring and late fall, and is robust to several identification strategies and model specifications. Combining administrative datasets with machine learning techniques, this paper also highlights strong spatial heterogeneity in lockdown effects, especially according to long-term pollution exposure.
    Keywords: air pollution, P M 2.5, lockdown, spatial heterogeneity, machine learning, Covid-19
    Date: 2023–04–28
  22. By: Kolstad, Karoline Larsen
    Abstract: Discriminatory treatment of minorities by bureaucrats remains a serious challenge. A dominant explanation argues that bureaucrats discriminate because of high workloads in public organizations, but few empirical studies test this outside of the lab. In this study, I investigate whether workload matters for discrimination in a real-world public service context during the COVID-19 pandemic in Denmark in 2020. I document that unemployment services experienced a substantial increase in workload due to a 20% rise in unemployment and exploit the fact that the increase happened suddenly and spread asymmetrically. I use micro-level register data on bureaucrat-client interactions on more than 380, 000 unemployed and examine whether bureaucrats provided fewer services to citizens of non-Western descent. The finding reveals that the substantial workload associated with the COVID-19 pandemic did not lead to increased discrimination. I discuss the special circumstances associated with the COVID-19 pandemic and the possible role of organizational structure and professional norms.
    Date: 2023–04–21

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