nep-hea New Economics Papers
on Health Economics
Issue of 2023‒06‒12
fifteen papers chosen by
Nicolas R. Ziebarth
Cornell University

  1. Employing the Unemployed of Marienthal: Evaluation of a Guaranteed Job Program By Maximilian Kasy; Lukas Lehner
  2. Intergenerational scars: The impact of parental unemployment on individual health later in life By Ubaldi, Michele; Picchio, Matteo
  3. The Gender Well-being Gap By David G. Blanchflower; Alex Bryson
  4. Which income comparisons matter to people, and how? Evidence from a large field experiment By Xiaogeng Xu; Satu Metsälampi; Michael Kirchler; Kaisa Kotakorpi; Peter Hans Matthews; Topi Miettinen
  5. Nudging in complex environments By Alexander K. Koch; Dan Mønster; Julia Nafziger
  6. Persuading a Wishful Thinker By Victor Augias; Daniel M A Barreto
  7. Consistent Valuation of a Reduction in Mortality Risk using Values per Life, Life Year, and Quality-Adjusted Life Year By Hammitt, James K.
  8. Parental and Student Time Use around the Academic Year By Cowan, Benjamin; Jones, Todd R.; Swigert, Jeffrey
  9. Beauty, Underage Drinking, and Adolescent Risky Behaviours By Green, Colin P.; Wilson, Luke B.; Zhang, Anwen
  10. Asymmetric information, strategic transfers and the design of long-term care policies By Chiara Canta; Helmuth Cremer
  11. The Incidence of the Affordable Care Act’s Dependent Coverage Mandate By Sherry A. Glied; Hansoo Ko
  12. Financial Risk-Taking under Health Risk By Björn Bos; Moritz A. Drupp; Jasper N. Meya; Martin F. Quaas
  13. What Has Driven the Labor Force Participation Gap since February 2020? By Mary Amiti; Sebastian Heise; Giorgio Topa; Julia Wu
  14. Beyond the Storm: an Exploratory Survey on HR Managers' Representations of Epidemic-Induced Telework By Grégory Jemine
  15. The Heterogeneous Effects of Lockdown Policies on Air Pollution By Simon Briole; Augustin Colette; Emmanuelle Lavaine

  1. By: Maximilian Kasy; Lukas Lehner
    Abstract: We evaluate a guaranteed job program launched in 2020 in Austria. Our evaluation is based on three approaches, pairwise matched randomization, a pre-registered synthetic control at the municipality level, and a comparison to individuals in control municipalities. This allows us to estimate direct effects, anticipation effects, and spillover effects. We find positive impacts of program participation on economic and non-economic well-being, but not on physical health or preferences. At the municipality level, we find a large reduction of long-term unemployment, and no negative employment spillovers. There are positive anticipation effects on subjective well-being, status, and social inclusion for future participants.
    Keywords: job guarantee, pairwise matched randomization, synthetic control
    JEL: I38 J08 J45
    Date: 2023
  2. By: Ubaldi, Michele; Picchio, Matteo
    Abstract: This paper studies whether individuals that experienced parental unemployment during their childhood/early adolescence have poorer health once they reach the adulthood. We used data from the German Socio-Economic Panel from 2002 until 2018. Our identification strategy of the causal effect of parental unemployment relied on plant closures as exogenous variation of the individual labor market condition. We combined matching methods and parametric estimation to strengthen the causal interpretation of the estimates. On the one hand, we found a nil effect for parental unemployment on mental health. On the other hand, we detected a negative effect on physical health. The latter is stronger if parental unemployment occurred in early periods of the childhood, and it is heterogeneous across gender. The negative effect of parental unemployment on physical health may be explained by a higher alcohol and tobacco consumption later in life.
    Keywords: Parental unemployment, plant closure, mental health, physical health, health behaviors
    JEL: I14 J13 J62 J65
    Date: 2023
  3. By: David G. Blanchflower; Alex Bryson
    Abstract: Given recent controversies about the existence of a gender wellbeing gap we revisit the issue estimating gender differences across 55 subjective well-being metrics – 37 positive affect and 18 negative affect – contained in 8 cross-country surveys from 167 countries across the world, two US surveys covering multiple years and a survey for Canada. We find women score more highly than men on all negative affect measures and lower than men on all but three positive affect metrics, confirming a gender wellbeing gap. The gap is apparent across countries and time and is robust to the inclusion of exogenous covariates (age, age squared, time and location fixed effects). It is also robust to conditioning on a wider set of potentially endogenous variables. However, when one examines the three ‘global’ wellbeing metrics - happiness, life satisfaction and Cantril’s Ladder - women are either similar to or ‘happier’ than men. This finding is insensitive to which controls are included and varies little over time. The difference does not seem to arise from measurement or seasonality as the variables are taken from the same surveys and frequently measured in the same way. The concern here though is that this is inconsistent with objective data where men have lower life expectancy and are more likely to die from suicide, drug overdoses and other diseases. This is the true paradox – morbidity doesn’t match mortality by gender. Women say they are less cheerful and calm, more depressed, and lonely, but happier and more satisfied with their lives, than men.
    JEL: I30
    Date: 2023–05
  4. By: Xiaogeng Xu; Satu Metsälampi; Michael Kirchler; Kaisa Kotakorpi; Peter Hans Matthews; Topi Miettinen
    Abstract: Received wisdom holds that income rank matters for life satisfaction. In much of the literature, however, income comparisons are limited to the national population and evidence is correlational. In this paper, we investigate differences in the causal effects of rank information across reference groups. In a representative sample of mid-career Finns, we randomize individuals to receive personal rank information about educational, municipal, occupational, or age reference groups, and compare the effects, for a set of alternative welfare measures, to the standard national reference group and to a control group that receives no information. We also characterize the accuracy of rank beliefs across groups. Our data, which integrates experimental and register data, finds that rank information causes differences in satisfaction with disposable income, perceived fairness of own income, and wage satisfaction, but not life satisfaction. We also find substantial variation in the effects across reference groups, with those for the national reference group both weak and insignificant.
    Keywords: Relative position, individual welfare, fairness, comparison group, information provision
    JEL: D63 D8 D91 I31
    Date: 2023–05
  5. By: Alexander K. Koch (Department of Economics and Business Economics, Aarhus University); Dan Mønster (Department of Economics and Business Economics, Aarhus University); Julia Nafziger (Department of Economics and Business Economics, Aarhus University)
    Abstract: To study the effects of reminder nudges in complex environments, we apply a novel experimental approach based on a computer game in which decision makers have to pay attention to and perform multiple actions within a short period of time. The set-up allows us, first, to test the effect of reminders both on reminded and non-reminded actions and thus to observe whether reminders have (positive or negative) spillovers. Second, we investigate spillovers between multiple nudges by testing the effect of scaling up the number of reminded actions. Third, we study intertemporal spillovers by investigating whether the effects of having been exposed to reminders persist after reminders are withdrawn. We observe that reminders have positive effects in the short run - multiple reminders more so than single reminders: while reminders lead to crowding-out of non-reminded actions, the positive effect on the reminded actions dominates. After withdrawal of the reminders, the negative spillover effect persists, while the positive effect partially fades out so that, overall, reminders have no effect.
    Keywords: Nudging, spillover effects, attention, reminders, persistence, game-based experiments
    JEL: C9 D91
    Date: 2023–05–12
  6. By: Victor Augias (ECON - Département d'économie (Sciences Po) - Sciences Po - Sciences Po - CNRS - Centre National de la Recherche Scientifique); Daniel M A Barreto (Département d'économie - UPP - Université Pascal Paoli)
    Abstract: We analyze a model of persuasion in which Receiver forms wishful non-Bayesian beliefs. The effectiveness of persuasion depends on Receiver's material stakes: it is more effective when intended to encourage risky behavior that potentially lead to a high payoff and less effective when intended to encourage more cautious behavior. We illustrate this insight with applications showing why informational interventions are often ineffective in inducing greater investment in preventive health treatments, how financial advisors might take advantage of their clients overoptimistic beliefs and why strategic information disclosure to voters with different partisan preferences can lead to belief polarization in an electorate.
    Keywords: Non-Bayesian persuasion, Motivated thinking, Overoptimism, Optimal beliefs
    Date: 2022–02–15
  7. By: Hammitt, James K.
    Abstract: The monetary value of a reduction in mortality risk can be accurately characterized using the alternative concepts of value per statistical life (VSL), value per statistical life year (VSLY), and value per quality-adjusted life year (VQALY). Typically, each of these values depends on the age and other characteristics of the affected individual; at most one of the values can be independent of age. The common practice of valuing a transient or persistent risk reduction using a constant VSL, VSLY, or VQALY yields systematic differences in the calculated monetary value that depend on the age at which the risk reduction begins, its duration, time path, and whether future lives, life years, or quality-adjusted life years are discounted. Mutually consistent, age-dependent VSL, VSLY, and VQALY are derived and the large differences in valuation of illustrative transient and persistent risk reductions that can result from assuming age-independent values of each of the three concepts are illustrated.
    Date: 2023–05–03
  8. By: Cowan, Benjamin (Washington State University); Jones, Todd R. (Mississippi State University); Swigert, Jeffrey (Southern Utah University)
    Abstract: We demonstrate how mothers, fathers, and 15–17-year-old students alter their schedules around the K-12 academic year. Using regression discontinuity (RDD) methods, combined with dates on school year start and end dates by locality, we document several notable results. First, mothers are substantially more affected by the school year than are fathers. When school is in session, mothers sleep less, spend more time caring for family members and driving them around, and spend less time on eating, free time and exercise. Fathers see changes that are generally similar in sign but smaller in magnitude compared to mothers. 15–17-year-olds naturally reduce time spent in educational pursuits when school is out (a decrease of about 5.5 hours per day on weekdays), and most of that time is substituted toward free time (an additional 2+ hours per day) and sleep (1+ hours per day). Our results provide a holistic picture of how families build their days around the K-12 school calendar and have implications for policies targeted toward women's and teenage children's health and well-being.
    Keywords: parent time use, student time use, regression discontinuity
    JEL: I2 I1 J2 D1
    Date: 2023–04
  9. By: Green, Colin P.; Wilson, Luke B.; Zhang, Anwen
    Abstract: Physically attractive individuals experience a range of advantages in adulthood including higher earnings; yet, how attractiveness influences earlier consequential decisions is not well understood. This paper estimates the effect of attractiveness on engagement in risky behaviours in adolescence. We find marked effects across a range of risky behaviours with notable contrasts. Attractive adolescents are more likely to engage in drinking; the gap between attractive and unattractive adolescents in terms of propensity to drink constitutes about one fifth of the baseline mean. In contrast, more attractive adolescents are less likely to smoke, use drugs, or practice unprotected sex. Investigation into the underlying channels reveals that physically attractive adolescents are more popular, have higher self-esteem and personality attractiveness. Popularity leads to a higher likelihood of engagement in "cool" risky behaviours and a lower likelihood for "uncool" behaviours, while self-esteem and personality generally predict a lower likelihood in engaging in all risky behaviours. Our findings suggest physical attractiveness in adolescence carries long-lasting consequences over the life course.
    Keywords: beauty, risky behaviours, adolescent development
    JEL: I12 J10
    Date: 2023
  10. By: Chiara Canta (TBS - Toulouse Business School); Helmuth Cremer (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: We study the optimal design of social long-term care (LTC) insurance when the utility of informal caregivers is taken into account. Informal care is exchange-based. Children's cost of providing care is continuously distributed over some interval and is not observable. Parents choose a rule specifying transfers conditional on the level of informal care. We study first uniform provision of LTC and then a nonlinear policy depending on family transfers. In both cases, informal care increases with the children's welfare weight. Our theoretical analysis is completed by calibrated numerical solutions. Uniform public care should represent up to 40% of total care but its share decreases to about 30% as the weight of children increases. In the nonlinear case, public care increases with the children's cost of providing care at a faster rate when children's weight in social welfare is higher. It represents 100% of total care for families with high-cost children.
    Keywords: Long-term care, Informal care, Strategic bequests, Asymmetric information.
    Date: 2023–01
  11. By: Sherry A. Glied; Hansoo Ko
    Abstract: Economic theory and empirical studies conclude that the cost of voluntary employer-sponsored health insurance falls on employees. However, the distribution of incidence and the mechanism through which incidence occurs have not been well-established. We provide new evidence about incidence by examining the dependent coverage mandate in the ACA, which requires group insurance to allow adult children to age 26 to remain on their parents’ policies. We establish that the incidence of the mandate fell on covered employees as a group. We then consider three situations in which the benefits of this new coverage to an employee differ from the costs to an employer. First, we compare incidence where the young adult dependent is the youngest child in the family to the situation where the child is not the youngest (so the family could add a dependent to existing family coverage). We find that incidence falls mainly on households where the newly-eligible child is the youngest in the household. Second, higher-income households face a lower tax price of coverage than do lower-income households. We find that the incidence of the mandate falls mainly on the highest income households. Finally, we find that the mandate leads to increased commuting time for parents of newly-eligible dependents.
    JEL: H29 I13 J33
    Date: 2023–05
  12. By: Björn Bos; Moritz A. Drupp; Jasper N. Meya; Martin F. Quaas
    Abstract: We study how background health risk affects financial risk-taking. We elicit financial risk-taking behavior of a representative sample of more than 5, 000 Germans in five panel waves during the COVID-19 pandemic. Exploiting variation in local infections across time and space, we find that an increase in infections affecting background health risk translates into higher levels of self-reported fear and decreases financial investments in a risky asset. Once vaccines become available as a self-insurance device, the tempering effect on investments ceases. Our results provide evidence that non-financial background risks affect financial risk-taking, and for the alleviating effect of self-insurance devices.
    JEL: D14 D91 G11 G41 G51
    Date: 2023
  13. By: Mary Amiti; Sebastian Heise; Giorgio Topa; Julia Wu
    Abstract: The U.S. labor force participation rate (LFPR) currently stands at 62.5 percent, 0.8 percentage point below its level in February 2020. This “participation gap” translates into 2.1 million workers out of the labor force. In this post, we evaluate three potential drivers of the gap: First, population aging from the baby boomers reaching retirement age puts downward pressure on participation. Second, the share of individuals of retirement age that are actually retired has risen since the onset of the COVID-19 pandemic. Finally, long COVID and disability more generally may induce more people to leave the labor force. We find that nearly all of the participation gap can be explained by population aging, which caused a significant rise in the number of retirements. Higher retirement rates compared to pre-COVID have had only a modest effect, while disability has virtually no effect.
    Keywords: labor force participation; retirement; disability
    JEL: E2
    Date: 2023–03–30
  14. By: Grégory Jemine (HEC Liège, Management School of the University of Liège)
    Abstract: This paper sets out to provide insights into how HR managers experienced epidemic-induced telework, understood as an unprecedented form of telework due to its scale and effects on organizations and individuals. So far, scholars have mostly studied epidemic-induced telework through surveys and interviews conducted with teleworkers themselves. By contrast, the present paper investigates HR managers' representations of epidemic-induced telework. It is argued that the question is both timely and significant, since HR managers usually play important decisionmaking roles in the design of teleworking policies. Following an exploratory survey addressed to HR managers of Belgian firms conducted between April and May 2021, four ideal types of managerial reactions to epidemic-induced telework are developed: entrepreneurs, preservers, adapters, and questioners. These ideal types make it possible to better characterize the wide heterogeneity of HR managers' experiences of the pandemic and attitudes towards epidemicinduced telework.
    Keywords: telework, epidemic-induced telework, managerial representations, constrained telework, human resource managers, remote working, homeworking, exploratory survey, télétravail, covid
    Date: 2023
  15. 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

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