nep-hea New Economics Papers
on Health Economics
Issue of 2023‒08‒21
35 papers chosen by
Nicolas R. Ziebarth
Cornell University

  1. Caregiving and Labor Supply: New Evidence from Administrative Data By Nicole Maestas; Matt Messel; Yulya Truskinovsky
  2. Unemployment, Alcohol and Tobacco Use: Separating State Dependence from Unobserved By Monica Deza
  3. Education and Later-life Mortality: Evidence from a School Reform in Japan By Kazuya Masuda; Hitoshi Shigeoka
  4. Accident-Induced Absence from Work and Wage Ladders By Biro, Aniko; Bisztray, Márta; da Fonseca, João G.; Molnár, Tímea Laura
  5. Value-based payment models in primary care: An assessment of the Menzis Shared Savings programme in the Netherlands By Luca Lindner; Arthur Hayen
  6. Welfare reform: Employment, mental health and intrahousehold insurance By Mike Brewer; Thang Dang; Emma Tominey
  7. Firms with Benefits? Nonwage Compensation and Implications for Firms and Labor Markets By Paige Ouimet; Geoffrey Tate
  8. Who Values Human Capitalists' Human Capital? The Earnings and Labor Supply of U.S. Physicians By Joshua D. Gottlieb; Maria Polyakova; Kevin Rinz; Hugh Shiplett; Victoria Udalova
  9. Nighttime light pollution and economic activities: A spatio-temporal model with common factors for US counties By Georges Bresson; Jean-Michel Etienne; Guy Lacroix
  10. Fatal Errors: The Mortality Value of Accurate Weather Forecasts By Jeffrey G. Shrader; Laura Bakkensen; Derek Lemoine
  11. The Rise in American Pain: The Importance of the Great Recession By Sneha Lamba; Robert A. Moffitt
  12. Antibiotic Demand in the Presence of Antimicrobial Resistance By Dubois, Pierre; Gokkoca, Gokce
  13. Assessing the Fertility Effects of Childcare Cost Subsidies: Evidence from the Child and Dependent Care Tax Credit By Averett, Susan L.; Wang, Yang
  14. Short-Term Labor Supply Response to the Timing of Transfer Payments: Evidence from the SNAP Program By Marks, Mindy; Prina, Silvia; Tahaj, Redina
  15. Does Adolescence Anemia Persist Over a Woman’s Life Cycle? Evidence from the Indonesian Family Life Survey By Satriawan, Elan; Shrestha, Ranjan; Witoelar, Firman; Yamano, Takashi
  16. Effect of Temperature on the Spread of Contagious Diseases: Evidence from over 2000 Years of Data By Mehmet Balcilar; Zinnia Mukherjee; Rangan Gupta; Sonali Das
  17. Do Primary Healthcare Facilities in More Remote Areas Provide More Medical Services? Spatial Evidence from Rural Western China By Shen, Chi; Lai, Sha; Deng, Qiwei; Cao, Dan; Zhao, Dantong; Zhao, Yaxin; Zhou, Zhongliang; Dong, Wanyue; Chen, Xi
  18. Hospital capacity reporting in Germany during COVID-19 By Reif, Simon; Schubert, Sabrina
  19. Can Self-affirmation Encourage HIV-Prevention? Evidence from Female Sex Workers in Senegal By Sara Haire; Aurélia Lépine; Daniel Effron; Carole Treibich
  20. Global Health Challenges and the World Economy: Assessing the Benefits of Fiscal Policy Cooperation By Pierre-Richard Agénor
  21. College Students' Social Capital and Their Perceptions of Local and National Cohesion By Rodríguez-Planas, Núria; Secor, Alan
  22. Healthy diets, costs and food policies in the Sahel and West Africa By Yan Bai; Jill Bouscarat; Kristina Sokourenko; Philipp Heinrigs; Koffi Zougbédé
  23. Forest Protection and Human Health: The Case of Malaria in the Brazilian Amazon By Luiza M Karpavicius; Ariaster Chimeli
  24. Updating the association between socioeconomic status and obesity in low‐income and lower‐middle‐income sub‐Saharan African countries: A literature review By Bertille Daran; Pierre Levasseur; Matthieu Clément
  25. Maternal Education and Early Child Development: The Roles of Parental Support for Learning, Learning Materials, and Father Characteristics By Yusuf Emre Akgunduz; Pelin Akyol; Abdurrahman B. Aydemir; Murat Demirci; Murat G. Kirdar
  26. How Pandemic Shock Affects Claim for Minimum Income Measures By Andrea Barigazzi; Giovanni Gallo
  27. Employee Performance and Mental Well-Being: The Mitigating Effects of Transformational Leadership during Crisis By Kristina Czura; Florian Englmaier; Hoa Ho; Lisa Spantig
  28. Remittances and Vaccine Hesitancy in the Punjab Province of Pakistan By Abbas, Faisal; Bang, James T.; Mitra, Aniruddha
  29. Pandemic effects: Do innovation activities of firms suffer from long-Covid? By Trunschke, Markus; Peters, Bettina; Czarnitzki, Dirk; Rammer, Christian
  30. The Forces Behind Social Unrest: Evidence from the Covid-19 Pandemic By Mario Lackner; Uwe Sunde; Rudolf Winter-Ebmer
  31. Give Me Your Best Shot! Diffusion of Complete versus Booster Covid-19 Vaccines across US Counties By Rajeev K. Goel; Michael A. Nelson
  32. COVID-19 anti-contagion policies and economic support measures in the USA By Dergiades, Theologos; Milas, Costas; Mossialos, Elias; Panagiotidis, Theodore
  33. Firm digitalisation and mobility - Do Covid-19-related changes persist? By Axenbeck, Janna; Bertschek, Irene; Breithaupt, Patrick; Erdsiek, Daniel
  34. Impact of the COVID-19 pandemic on employment: Findings from national labour surveys in five Latin American countries By Martha Alter Chen; Joann Vanek
  35. Social protection, the COVID-19 crisis, and the informal economy: Lessons from relief for comprehensive social protection By Laura Alfers; Florian Juergens-Grant

  1. By: Nicole Maestas; Matt Messel; Yulya Truskinovsky
    Abstract: A significant share of the rapidly growing demand for long-term care is met by family members, many of whom also work, and family caregiving has been shown to affect labor market outcomes. We use survey responses about family caregiving roles linked to administrative earnings records to estimate the employment trajectories of family caregivers over a 25 year period around the reported start of a caregiving episode. These trajectories vary significantly by gender. Relative to a matched comparison group, caregiving precipitates a drop in both earnings and employment for women, while men only enter caregiving after experiencing significant labor supply disruptions.
    JEL: J14 J16
    Date: 2023–07
  2. By: Monica Deza
    Abstract: Previous literature presents mixed evidence on the effect of alcohol consumption on labor market outcomes. On one hand, heavy alcohol consumption has been shown to have detrimental effects on labor market outcomes. On the other hand, moderate consumption is positively associated with wages and employment. Despite substantial reduced form evidence, previous literature has not been able to separately identify the causal pathways linking moderate versus heavy alcohol use to labor market performance due to the lack of natural experiments that only target moderate versus heavy drinking, as well as limitations of available structural methods that model state dependence and unobserved heterogeneity. This study develops a multiple-equation dynamic discrete choice ordered logit model, which allows separate identification of the contribution of state dependence (within and between outcomes) and unobserved heterogeneity. I apply this newly-developed model to differentiate the effects of moderate and heavy drinking, after accounting for other correlated unobserved heterogeneity. This study finds that moderate alcohol use increases employment, which is consistent with moderate alcohol consumption being a venue for social capital accumulation. Policies that target alcohol consumption separately by dosage level may be beneficial to employment in ways that have not previously been expected.
    JEL: I12 J01
    Date: 2023–07
  3. By: Kazuya Masuda; Hitoshi Shigeoka
    Abstract: We examine the mortality effects of a 1947 school reform in Japan, which extended compulsory schooling from primary to secondary school by as much as 3 years. The abolition of secondary school fees also indicates that those affected by the reform likely came from disadvantaged families who could have benefited the most from schooling. Even in this relatively favorable setting, we fail to find that the reform improved later-life mortality up to the age of 87 years, although it significantly increased years of schooling. This finding suggests limited health returns to schooling at the lower level of educational attainment.
    JEL: H52 I12 I21 I28
    Date: 2023–07
  4. By: Biro, Aniko (Centre for Economic and Regional Studies); Bisztray, Márta (KRTK KTI; Centre for Economic and Regional Studies, Institute of Economics); da Fonseca, João G. (University of Montreal); Molnár, Tímea Laura (Central European University)
    Abstract: How do temporary spells of absence from work affect individuals' labor trajectory? To answer this question, we augment a 'wage ladder' model, in which individuals receive alternative take-it-or-leave-it wage offers from firms and potentially suffer accidents which may push them into temporary absence from work. In such an environment, during absence, individuals do not have the opportunity to receive alternative wage offers that they would have received had they remained present. To test our model's predictions and to quantify the importance of foregone opportunities to climb the wage ladder, we use linked employer-employee administrative data from Hungary, that is linked to rich individual-level administrative health records. We use unexpected and mild accidents with arguably no permanent labor productivity losses, as exogenous drivers of short periods of absence. Difference-in-Differences results show that, relative to counterfactual outcomes in the case no accidents, (i) even short (3-12-months long) periods of absence due to accidents decrease individuals' wages for up to two years, by around 2.5 percent; and that (ii) individuals reallocate to lower-paying employers. The share of wage loss due to missed opportunities to switch employers is between 7-20 percent over a two-year period after returning to work, whereas at most 2 percent is due to occupation switches. Our results are robust to (a) instrumenting absence with having suffered an accident, (b) exploiting the random nature of the time of the accident, and (c) within-firm matching of individuals with and without an accident and subsequent absence spell.
    Keywords: wage ladder, accidents, health shocks, temporary absence from work
    JEL: J22 J23 I10
    Date: 2023–07
  5. By: Luca Lindner; Arthur Hayen
    Abstract: The Menzis Shared Savings Program was initiated in 2014 by the Dutch insurer Menzis and the national primary care organisation Arts en Zorg, and is among the first value-based payment models for primary care in Europe. It runs as a complement to the current – volume-driven – primary care payment system. This paper reviews the evidence of the impact of this programme against its stated objectives. The Menzis Shared Savings Program led to a lower volume of care, particularly in terms of referrals to specialist care, laboratory care and general practitioners care. Main facilitating factors were the advanced data infrastructure in place, communication and transparency about the programme’s parameters, and the programme’s focus on mitigating financial risk and uncertainty for providers. Shared savings models – even when added as a mere complement to existing volume-driven payment methods – could enhance value in health systems.
    Date: 2023–06–27
  6. By: Mike Brewer (Resolution Foundation); Thang Dang (Centre for Fertility and Health, Norwegian Insititute of Public Health); Emma Tominey (Department of Economics, University of York; HCEO; IZA)
    Abstract: The UK Universal Credit (UC) welfare reform simplified the benefits system, combining six benefit applications into one, whilst creating strict incentives for full-time employment. Exploiting a staggered roll-out, we analyse the impact of entering unemployment under UC compared to the former system on mental health, future employment transitions and intrahousehold labour supply reactions. Groups with fewer intrahousehold insurance possibilities - single adults and lone parents - experience a mental health deterioration of 8.4-13.9% sd. Whilst these groups experience an increase in employment transition, it is to part-time work. For couples UC creates an intrahousehold reaction, increasing partners' labour participation and UC partially or fully mitigates the mental health consequences of unemployment.
    Keywords: Welfare reform; Mental health; Employment transitions; Universal Credit; Intrahousehold insurance
    JEL: D13 D61 H53 I10 I14 I38 J2
    Date: 2023–07
  7. By: Paige Ouimet; Geoffrey Tate
    Abstract: Using administrative data on health insurance, retirement, and leave benefits, we find within-firm variation accounts for a dramatically lower percentage of total variation in benefits than in wages. We also document sharply higher between-firm variation in nonwage benefits than in wages. We argue that this pattern can be a consequence of nondiscrimination regulations, fairness concerns, and the high administrative burden of managing too many or complex plans. Consistent with this mechanism, we show that the presence of high-wage workers in unrelated divisions of a firm as well as workers hired in high-benefit local labor markets positively predicts their colleagues’ benefits, controlling for occupation, wages, state, and industry. We find that the resulting high benefits reduce turnover, particularly among low-wage workers, for whom the benefits comprise a larger percentage of total compensation. Moreover, firms with more generous benefits attract and retain more high-wage workers, but also reduce their reliance on low-wage workers more than low-benefit peers. Our results suggest that benefits disproportionately matter for worker-firm matching and, hence, compensation inequality.
    JEL: G32 J01 J23 J32 J63
    Date: 2023–07
  8. By: Joshua D. Gottlieb; Maria Polyakova; Kevin Rinz; Hugh Shiplett; Victoria Udalova
    Abstract: Is government guiding the invisible hand at the top of the labor market? We use new administrative data to measure physicians' earnings and estimate the influence of healthcare policies on these earnings, physicians' labor supply, and allocation of talent. Combining the administrative registry of U.S.~physicians with tax data, Medicare billing records, and survey responses, we find that physicians' annual earnings average $350, 000 and comprise 8.6% of national healthcare spending. The age-earnings profile is steep; business income comprises one-quarter of earnings and is systematically underreported in survey data. There are major differences in earnings across specialties, regions, and firm sizes, with an unusual geographic pattern compared with other workers. We show that health policy has a major impact on the margin: 25% of physician fee revenue driven by Medicare reimbursements accrues to physicians personally. Physicians earn 6% of public money spent on insurance expansions. We find that these policies in turn affect the type and quantity of medical care physicians supply in the short run; retirement timing in the medium run; and earnings affect specialty choice in the long run.
    JEL: I13 I18 J24 J31
    Date: 2023–07
  9. By: Georges Bresson; Jean-Michel Etienne; Guy Lacroix
    Abstract: Excessive nighttime light is known to have detrimental effects on health and on the environment (fauna and flora). The paper investigates the link between nighttime light pollution and economic growth, air pollution, and urban density. We propose a county model of consumption which accounts for spatial interactions. The model naturally leads to a dynamic general nesting spatial model with unknown common factors. The model is estimated with data for 3071 continental US counties from 2012–2019 using a quasi-maximum likelihood estimator. Short run and long run county marginal effects emphasize the importance of spillover effects on radiance levels. Counties with high levels of radiance are less sensitive to additional growth than low-level counties. This has implications for policies that have been proposed to curtail nighttime light pollution. L’éclairage nocturne de forte intensité est connu pour avoir des effets néfastes sur la santé et sur l'environnement (faune et flore). Cet article étudie le lien entre la pollution lumineuse nocturne et la croissance économique, la pollution de l'air et la densité urbaine. Nous proposons un modèle de consommation au niveau des comtés américains qui tient compte des interactions spatiales. Le modèle conduit naturellement à un modèle spatial dynamique général emboîté avec facteurs communs inconnus. Le modèle est estimé avec les données de 3 071 comtés continentaux américains de 2012 à 2019 à l'aide d'un estimateur de quasi-maximum de vraisemblance. Les effets marginaux des comtés à court et à long terme soulignent l'importance des effets de débordement sur la radiance locale. Les comtés caractérisés par de hauts niveaux de radiance sont moins sensibles à un accroissement de l’activité économique que ceux avec de faibles niveaux. Cela a des implications pour le design de politiques visant à réduire la pollution lumineuse nocturne.
    Keywords: Nighttime light pollution, air pollution, GDP, satellite data, space-time panel data model, Pollution lumineuse nocturne, pollution de lâair, PIB, données satellitaires, modèle panel spatio-temporel
    JEL: C23 Q53
    Date: 2023–07–24
  10. By: Jeffrey G. Shrader; Laura Bakkensen; Derek Lemoine
    Abstract: We provide the first revealed preference estimates of the benefits of routine weather forecasts. The benefits come from how people use advance information to reduce mor tality from heat and cold. Theoretically, more accurate forecasts reduce mortality if and only if mortality risk is convex in forecast errors. We test for such convexity using data on the universe of mortality events and weather forecasts for a twelve-year period in the U.S. Results show that erroneously mild forecasts increase mortality whereas erro neously extreme forecasts do not reduce mortality. Making forecasts 50% more accurate would save 2, 200 lives per year. The public would be willing to pay $112 billion to make forecasts 50% more accurate over the remainder of the century, of which $22 billion reflects how forecasts facilitate adaptation to climate change.
    JEL: D83 I12 Q51
    Date: 2023–06
  11. By: Sneha Lamba; Robert A. Moffitt
    Abstract: A significant literature has documented trend increases in pain among Americans over the last two or three decades. There is no single explanation seeming to work well for the increase. We show that, rather than resulting from a smooth upward trend, the increase was almost entirely concentrated in the 2007-2010 period, the time of the Great Recession, a result not uncovered in prior work. The disproportionate increase in pain among the less educated is also shown to have occurred primarily at the time of the Recession, with either little or no trend before or after. The Recession jump occurred only at older ages and, by cohort, primarily only at the ages when they experienced the Recession. However, the jump is difficult to explain, for while there was a temporary decline in employment during the Recession, it is unclear why there it should be followed by a permanent increase in pain. We assess a number of explanations related to family structure, the deterioration of family life, hysteresis, and biopsychosocial channels. While some factors have potential explanatory power, the rise in pain continues to be mysterious and deserves further research in light of our new findings.
    JEL: E32 I10
    Date: 2023–07
  12. By: Dubois, Pierre; Gokkoca, Gokce
    Abstract: Antimicrobial resistance (AMR) increases hospital stays, medical costs and mortality. Antibiotic consumption and resulting selective pressure on bacteria can create AMR. We study the role of AMR on changes in prescriptions of antibiotics in France for treating bladder inflammation (cystitis) using a representative sample of general practitioners between 2002 and 2019. Effects of resistance on demand and substitution behavior are identified via a random coefficient logit model, controlling for the endogeneity of resistance using antibiotics sales in veterinary medicine. As resistance increases, physicians substitute to other drugs, and we test whether physicians consider predictable resistance evolution in their decisions. We perform counterfactual analysis assessing the impact of decreasing veterinary use of antibiotics and limiting fluoroquinolone use to treat cystitis. Both policies reduce resistance against fluoroquinolones but have opposite effects on substitution behavior and consumer surplus. Finally, we propose a method for the optimal pricing of rapid bacterial detection and antibiotic susceptibility testing.
    JEL: I10 D12 L11 C25
    Date: 2023–07–25
  13. By: Averett, Susan L. (Lafayette College); Wang, Yang (University of Wisconsin-Madison)
    Abstract: We examine the impact of the Child and Dependent Care Tax Credit (CDCTC) on fertility and parental investment in children. The CDCTC aims to support working parents but its availability only to families with children incentivizing having more children or increasing investment in existing ones. Using the Panel Study of Income Dynamics and the National Center for Health Statistics' Natality data, we analyze the effects of state-level CDCTC policies on fertility and birth outcomes. Results indicate that the CDCTC increases labor force participation rates for married mothers, potentially suppressing fertility rates. Additionally, it has a positive effect on gestational age.
    Keywords: fertility, birth outcomes, child and dependent care tax credit
    JEL: I38 J13
    Date: 2023–06
  14. By: Marks, Mindy (Northeastern University); Prina, Silvia (Northeastern University); Tahaj, Redina (Northeastern University)
    Abstract: We study the effect of the timing of SNAP payments on weekly labor supply using data from the CPS. We rely on exogenous variation in the fielding of CPS interviews relative to benefit receipt to estimate labor supply of SNAP eligible individuals at the end of their SNAP benefit cycle (i.e. about to receive benefits) compared to individuals at the start of their cycle (i.e. just received benefits). We find that the timing of SNAP benefits impacts labor supply at the intensive margin, while the extensive margin is unaffected. Conditional on being employed, eligible individuals at the end of their SNAP cycle are more likely to be absent from work compared to individuals at the start of their SNAP cycle. They are also less likely to temporarily shift to full time work. Results are more pronounced for individuals with higher predicted benefit amounts. Our findings suggest that a worsening of individuals' status (e.g. health problems, child care issues) at the end of their SNAP cycle adversely impacts short-term work presence.
    Keywords: consumption cycles, SNAP benefits, labor supply
    JEL: J22 I38
    Date: 2023–07
  15. By: Satriawan, Elan (Universitas Gadjah Mada); Shrestha, Ranjan (William & Mary); Witoelar, Firman (Australian National University); Yamano, Takashi (Asian Development Bank)
    Abstract: We study the determinants of hemoglobin concentration in women throughout their life cycle and ask whether anemia during adolescence persists into adulthood. Using a panel of individuals from the Indonesian Family Life Survey (IFLS), we find that although about 30% of our sample was anemic during a given survey wave, 63% experienced anemia at least once over the four survey waves, suggesting a high burden of anemia among Indonesian women. Furthermore, the high prevalence of anemia is not limited to poor women but is also observed in the wealthier segments of the population. Using a dynamic panel framework, we find a significant relationship between current hemoglobin concentration and its measurement in the preceding survey wave, suggesting some persistence of anemia status across survey waves. However, a small autoregressive coefficient suggests that hemoglobin concentration and the likelihood of anemia converge across women over time. We find a few variables that are significant determinants of hemoglobin concentration. Among them, household socioeconomic status and wages of women compared with men in the community are positively associated with hemoglobin concentration.
    Keywords: anemia; hemoglobin concentration; Indonesian Family Life Survey; female adolescent health
    JEL: I15 I18
    Date: 2023–07–19
  16. By: Mehmet Balcilar (Department of Economics and Business Analytics, University of New Haven, 300 Boston Post Road, West Haven, CT 06516, USA; Department of Economics, Eastern Mediterranean University, Northern Cyprus, via Mersin 10, Turkey; Department of Economics, OSTIM Technical University, Ankara, Turkey); Zinnia Mukherjee (Department of Economics, Simmons University, Boston, MA 02115, U.S.A.); Rangan Gupta (Department of Economics, University of Pretoria, Private Bag X20, Hatfield 0028, South Africa); Sonali Das (Department of Economics, University of Pretoria, Private Bag X20, Hatfield 0028, South Africa)
    Abstract: The COVID-19 pandemic led to a surge in interest among scholars and public health professionals in identifying the predictors of health shocks and their transmission in the population. With temperature increase becoming a persistent climate stress, our aim is to evaluate how temperature specifically impacts the incidences of contagious disease. Using annual data from 1 AD to 2021 AD on incidence of contagious disease and temperature anomalies, we apply both parametric and non-parametric modelling techniques, and provide estimates on the contemporaneous, and as well as lagged effects, of temperature anomalies on the spread of contagious diseases. A non-homogeneous Hidden Markov Model is then applied to estimate the time-varying transition probabilities between hidden states where the transition probabilities are governed by covariates. For all empirical specifications, we find consistent evidence that temperature anomalies in fact have statistically significant effect of the incidence of the contagious disease in any given year covered in the sample period. The best fit model further indicates that the contemporaneous effect of a temperature anomaly on the response variable is the strongest, and that given temperature anomaly predictions are becoming very accurate, one can prepare effectively with necessary public health response for at least contagious diseases. These findings further have implications for designing cost effective infectious disease control policies for different regions of the world.
    Keywords: Temperature anomaly, contagious disease, General additive model, Nonhomogeneous Hidden Markov Model, climate change, public health
    JEL: C1 H1 Q0
    Date: 2023–07
  17. By: Shen, Chi; Lai, Sha; Deng, Qiwei; Cao, Dan; Zhao, Dantong; Zhao, Yaxin; Zhou, Zhongliang; Dong, Wanyue; Chen, Xi
    Abstract: Primary healthcare institutions (PHIs) in China have experienced a sizable decline in medical services in recent years. Despite the large regional disparities in China, there is a lack of evidence on the differential patterns of medical services offered by PHIs, especially from a spatial perspective. This study examines whether residents in more remote areas use more medical services offered by township healthcare centers (THCs), a main type of PHIs. Linking medical visits to 923 THCs in a western Chinese province in 2020 with the driving time and geographic coordinates from the Gaode map, a leading map navigation provider in China, we applied a multilevel linear model and a geographically weighted regression to examine spatial heterogeneity in medical service utilization. We showed that a one-hour increase in the shortest driving time between THCs and the local county hospitals was associated with an average 6% increase in THCs outpatient visits and a 0.6% increase in THCs inpatient visits. Our findings suggest that THCs located in more remote areas provided more medical services, especially outpatient services.
    Keywords: Primary healthcare institutions, Spatial remote, Medical Service, China
    Date: 2023
  18. By: Reif, Simon; Schubert, Sabrina
    Abstract: During the COVID-19 pandemic, hospitals faced a unique predicament. Hospital care was urgently needed and society took efforts to prevent overwhelming hospitals. However, hospitals in case-based reimbursement schemes faced financial problems because of cancelled elective care visits and government regulations to keep capacity free for Covid-19 patients. Therefore, emergency financing measures were implemented in many countries. We analyze how hospitals in Germany responded to a scheme that provided financial support if the intensive care unit (ICU) occupancy rate in a county exceeded 75%. The scheme distributed over seven billion euros to hospitals and was notable because financial support depended on a measure (ICU occupancy rate) that hospitals could directly influence. To analyze hospitals' reactions to this scheme, we employ event study analyses comparing ICU capacity before and after regions became eligible. We find no evidence of strategic reporting at an economically meaningful and hence empirically detectable scale.
    Keywords: Hospitals, Misreporting, Financial Support Programs, Covid
    JEL: I11 I18 H27
    Date: 2023
  19. By: Sara Haire (University of Miami); Aurélia Lépine (UCL - University College of London [London]); Daniel Effron (London Business School); Carole Treibich (GAEL - Laboratoire d'Economie Appliquée de Grenoble - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement - UGA - Université Grenoble Alpes - Grenoble INP - Institut polytechnique de Grenoble - Grenoble Institute of Technology - UGA - Université Grenoble Alpes)
    Abstract: We test an intervention aiming to increase condom usage and HIV testing in a stigmatized population at high risk of contracting HIV: female sex workers (FSWs) in Senegal. Some sex work is legal in Senegal, and condoms and HIV tests are freely available to registered FSWs—but FSWs may be reluctant to get tested and use condoms, in part because doing so would entail acknowledging their risk of contracting HIV and potentially expose them to stigma. Drawing on self-affirmation theory, we hypothesized that reflecting on a source of personal pride would help participants acknowledge their risk of HIV, intend to use condoms more frequently, and take an HIV test. Prior research suggests that similar self-affirmation interventions can help people acknowledge their health risks and improve their health behavior, especially when paired with information about effectively managing their health (i.e., self-efficacy information ). However, such interventions have primarily been tested in the United States and United Kingdom, and their generalizability outside of these contexts is unclear. Our high-powered experiment randomly assigned participants (N = 592 FSWs; N = 563 in the final analysis) to a self-affirmation condition or a control condition and measured their risk perceptions, whether they took condoms offered to them, and whether (after randomly receiving or not receiving self-efficacy information) they took an HIV test. We found no support for any of our hypotheses. We discuss several explanations for these null results based on the stigma attached to sex work and HIV, cross-cultural generalizability of self-affirmation interventions, and robustness of previous findings.
    Keywords: Self-affirmation, Self-efficacy, HIV, Stigma, Female sex work, Health
    Date: 2023–05–17
  20. By: Pierre-Richard Agénor (Université de Manchester, FERDI - Fondation pour les Etudes et Recherches sur le Développement International)
    Abstract: In the midst of the COVID-19 health crisis, many observers advocated the implementation of a global strategy to promote the production and equitable distribution of vaccines, prevent the emergence of infectious diseases, and reduce the risk of future pandemics. But what are the implications of this strategy for national tax and spending policies, and the world economy? What is the role, if any, of fiscal policy cooperation in that context? Dwelling on recent analytical research, it is argued that cooperation can be welfare-improving for the world at large, even when taxation is distortionary and governments face a trade-off between financing local public goods (such as infrastructure) and global public goods (vaccines).
    Date: 2023–06–28
  21. By: Rodríguez-Planas, Núria (Queens College, CUNY); Secor, Alan (City College of New York)
    Abstract: Using Queens College (a four-year college in NYC public system) students' survey data from 2022/23, we find that vulnerable students have less social capital in terms of physical order and social support in their neighborhoods. While social capital is directly related to self-reported neighborhood and national cohesion, resilience, and better mental health, different components of social capital matter for specific demographics. Physical order is more salient for less vulnerable students while social support is more salient for vulnerable students. Our findings underscore the need for policy action to be tailored to specific groups, rather than following a one-size-fits-all approach.
    Keywords: social cohesion, social capital, college students, mental health
    JEL: I24
    Date: 2023–07
  22. By: Yan Bai; Jill Bouscarat; Kristina Sokourenko; Philipp Heinrigs; Koffi Zougbédé
    Abstract: The Sahel and West Africa region is facing a serious food and nutrition security crisis with high rates of acute malnutrition, combined with high rates of malnourishment and over-nourishment – the “triple burden of malnutrition”. Poor-quality diets are the root of all forms of malnutrition, as well as common non-communicable diseases, and are responsible for an estimated one in five adult deaths globally. The high cost of food is a key barrier to accessing a healthy diet. Even before the recent global inflation in food prices, West Africa’s food prices were 30%-40% higher than other regions in the world of comparable income levels. The paper analyses the costs of healthy diets in 17 countries in the Sahel and West Africa and which food groups drive up costs. The observed high cross-country variability in costs and cost composition points to a need for more targeted and nutrition-sensitive food system policies as well as the need to invest in better food price data and monitoring capacities.
    Keywords: Cost of diet, Food prices, Food systems, Healthy diets, West Africa
    JEL: O55 Q11 Q13 Q18
    Date: 2023–07–31
  23. By: Luiza M Karpavicius; Ariaster Chimeli
    Abstract: Ecosystem degradation and contact with wildlife is often linked to infectious diseases such as COVID-19 and malaria, a major cause of death and incapacitation worldwide. This paper investigates a quasi-experiment involving two forest protection policies for the Brazilian Amazon region and their consequences to malaria incidence. The first inadvertently increased forest degradation in part of the Amazon, whereas the second curbed deforestation in the entire region. Using actual malaria case data distributed across space and over 17 years, we estimate the causal link between deforestation and malaria. The results imply that effective forest protection reduced malaria incidence by over 50%.
    Keywords: Malaria; Deforestation; Forest Protection Policies; Brazil
    JEL: D04 I18 Q23 Q56 Q57 Q58
    Date: 2023–07–20
  24. By: Bertille Daran (SADAPT - Sciences pour l'Action et le Développement : Activités, Produits, Territoires - AgroParisTech - Université Paris-Saclay - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement); Pierre Levasseur (SADAPT - Sciences pour l'Action et le Développement : Activités, Produits, Territoires - AgroParisTech - Université Paris-Saclay - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement); Matthieu Clément (BSE - Bordeaux Sciences Economiques - UB - Université de Bordeaux - CNRS - Centre National de la Recherche Scientifique)
    Abstract: Globally, the literature tends to emphasize negative associations between socioeconomic status (SES) and bodyweight in countries improving their economic development. However, little is known about the social distribution of obesity in sub-Saharan Africa (SSA) where economic growth has been highly heterogeneous the last decades. This paper reviews an exhaustive set of recent empirical studies examining its association in low-income and lower-middle-income countries in SSA. Although there is evidence of a positive association between SES and obesity in low-income countries, we found mixed associations in lower-middle-income countries, potentially providing evidence of a social reversal of the obesity burden.
    Keywords: nutrition transition obesity socioeconomic status sub-Saharan Africa, nutrition transition, obesity, socioeconomic status, sub-Saharan Africa
    Date: 2023–07–06
  25. By: Yusuf Emre Akgunduz (Sabanci University, Faculty of Arts and Social Sciences, Istanbul, Turkey); Pelin Akyol (Bilkent University, Department of Economics, Ankara, Turkey); Abdurrahman B. Aydemir (Sabanci University, Faculty of Arts and Social Sciences, Istanbul, Turkey); Murat Demirci (Koc University, Department of Economics, Istanbul, Turkey); Murat G. Kirdar (Bogazici University, Department of Economics, Istanbul, Turkey)
    Abstract: This paper explores the intergenerational effects of maternal education on the development outcomes of 24- to 59-month-old children in Turkey. As the source of exogenous variation in maternal schooling, we use mothers' exposure to the 1997 education reform in Turkey, which extended the duration of compulsory schooling from 5 to 8 years. The data come from the 2018 Turkey Demographic and Health Survey, which has a rich special module on early child development. We find a substantial increase in mothers' educational attainment and a rise in children's readiness to learn. Our finding is novel because it measures readiness to learn at a very young age rather than cognitive skills at later ages, as the previous studies do. We also find suggestive evidence of a positive impact on children's social-emotional development. Examining the channels, we find that both mothers and fathers, particularly fathers, spend more time with their children, and the variety of activities parents engage with them rises. In addition, learning materials at home, such as books, rise. Also, exploring father outcomes, we find evidence of reductions in the schooling and age gaps between partners, implying an increase in women's bargaining power, and suggestive evidence of a rise in fathers' schooling. These findings about father outcomes are consistent with the significant rise in fathers' involvement with children.
    Keywords: maternal education, early child development, parental support for learning.
    JEL: I26 J13 J24
    Date: 2023–07
  26. By: Andrea Barigazzi; Giovanni Gallo
    Abstract: Social transfers, and minimum income schemesin particular, are key toolsto support people’sincome and protect their living standards, especially in times of crisis. This paper aims to understand how the claiming of social benefits changed in response to the biggest crisis of recent years, i.e. the pandemic shock. In particular, we test whether the pandemic has reduced the transaction costs associated with claiming social transfers, increasing their spread across the population even controlling for recent recessive trends. We focus on Italy as an interesting case study, because it was the first Western country to be strongly affected by the Covid-19 pandemic and the latest EU country introducing a national minimum income scheme (the Reddito di Cittadinanza or RDC). Based on a rich dataset of statistics at NUTS-3 regional level, results show a significant and positive correlation between the spread of RDC recipients and the one of Covid-19 contagions, especially during the first stage of pandemic. This evidence confirms that lockdown measures strongly affected the economic wellbeing of households and, in turn, transaction costs associated with the RDC claim. Main results hold when relevant demographic and socioeconomic variables directly influencing the RDC claim are considered.
    Keywords: Minimum income schemes; transaction costs; Covid-19; social transfers; NUTS-3 regions
    JEL: I18 I31 I38
    Date: 2023–07
  27. By: Kristina Czura (University of Groningen); Florian Englmaier (LMU Munich); Hoa Ho (LMU Munich); Lisa Spantig (RWTH Aachen)
    Abstract: The positive role of transformational leadership on productivity and mental wellbeing has long been established. Transformational leadership behavior may be particularly suited to navigate times of crisis which are characterized by high levels of complexity and uncertainty. We exploit quasi-random assignment of employees to managers and study the role of frontline managers’ leadership styles on employees’ performance, work style, and mental well-being in times of crisis. Using longitudinal administrative data and panel survey data from before and during the Covid-19 pandemic, we find that frontline managers who were perceived as having a more transformational leadership style before the onset of the pandemic, lead employees to better performance and mental well-being during the pandemic.
    Keywords: leadership; frontline managers; labor-management relations; organizational behavior;
    JEL: M54 M12 J53
    Date: 2023–08–02
  28. By: Abbas, Faisal; Bang, James T.; Mitra, Aniruddha
    Abstract: Pakistan is one of only three countries that have failed to stop the transmission of poliovirus and experienced a surge of polio paralysis in 2019. Meanwhile, misconceptions persist about the safety and efficacy of vaccines in Pakistan and elsewhere. Our study investigates the effect of remittances on the likelihood a household vaccinate its children against polio and measles/mumps/rubella (MMR). Based on data from a Multiple Indicators Cluster Survey conducted in Punjab in 2014, we isolate the effect of receiving remittances using distance and exact matching. We find that access to remittances increases the likelihood of vaccinating male children against polio by about 11 percentage points and against MMR by about 12.5 percentage points. Unfortunately, remittances do not significantly improve vaccinations of girls. The results imply that vaccination campaigns - including campaigns to vaccinate against SARS-CoV-2 - should focus on communities without migration experience and vaccinating girls.
    Keywords: Remittances, Vaccines, Polio, Gender, Pakistan
    JEL: F24 O15 I15
    Date: 2023
  29. By: Trunschke, Markus; Peters, Bettina; Czarnitzki, Dirk; Rammer, Christian
    Abstract: The COVID-19 pandemic has affected firms in many economies. Exploiting treatment heterogeneity, we use a difference-in-differences design to causally identify the short-run impact of COVID-19 on innovation spending in 2020 and expected innovation spending in subsequent years. Based on a representative sample of German firms, we find that negatively affected firms substantially reduced innovation expenditure not only in the first year of the pandemic (2020) but also in the two subsequent years, indicating 'Long-Covid' effects on innovation. In 2020, innovation expenditure fell by 4.7 % due to the pandemic. In 2022, innovation spending was even 5.4 % lower compared to the counterfactual scenario without the pandemic. Firms with higher pre-treatment digital capabilities show higher innovation resilience during the pandemic. Moreover, COVID-19 leads to a decrease in innovation spending not only in firms that were strongly negatively affected by the pandemic, but also in those firms that experienced a positive demand shock from the pandemic, presumably to increase production capacity.
    Keywords: COVID-19, innovation, difference-in-differences, economic crisis, resilience
    JEL: O31 O33
    Date: 2023
  30. By: Mario Lackner; Uwe Sunde; Rudolf Winter-Ebmer
    Abstract: Despite growing concerns about the erosion of social cohesion and intensified social unrest as consequence of increasing economic and emotional stress, evidence for such a link is still lacking. We use a unique combination of nationally representative survey data, event data on social unrest, and data on Covid-19 fatalities and unemployment at a weekly resolution to investigate the emotional forces behind social unrest in the context of the pandemic in the USA. The results show that pandemic-related unemployment and Covid19 fatalities intensified negative emotional stress and led to a deterioration of economic confidence among individuals. The prevalence of negative emotional stress, particularly in economically strained and politically polarized environments, was, in turn, associated with intensified social unrest as measured by political protests. No such link is found for economic perceptions
    Keywords: economic shocks, Covid-19, civil unrest, emotional stress, party affiliation
    Date: 2023–07
  31. By: Rajeev K. Goel; Michael A. Nelson
    Abstract: This paper compares drivers of full COVID-19 vaccinations and booster doses across U.S. counties. Booster doses are contingent upon someone receiving the primary doses, and the risk attitudes and propensities to get vaccinated may be different across individuals, along with the supply chain differences across the primary and booster doses. Results show that new covid cases do not significantly impact vaccinations, while supply chain aspects via pharmacies had a positive impact. The effects of income, race, age, and education were largely consistent with intuition. Further, political ideologies mattered, while government decentralization did not. There were differences in the signs, magnitudes, and significance of the influence of some drivers across primary versus booster doses. Robustness checks include using alternative estimation techniques and examining differences across counties with low- and high vaccination rates. Policy implications are discussed.
    Keywords: Covid-19, vaccination, pandemic, booster, government, supply chain, pharmacies, political ideology, risk attitudes, county, United States
    JEL: I18 I11 H75 H11 D72
    Date: 2023
  32. By: Dergiades, Theologos; Milas, Costas; Mossialos, Elias; Panagiotidis, Theodore
    Abstract: Current literature assumes that non-pharmaceutical interventions (NPIs) reduce COVID-19 infections uniformly, that is, irrespectively of their strength. The role of economic support measures (ESM) in controlling the virus is also overlooked. Using a panel threshold model of COVID-19 cases in the US states, we identify three distinct regimes of ‘low’, ‘medium’, and ‘high’ severity interventions; the latter being more effective towards reducing infections growth. ESM increase the efficacy of NPIs through a behavioural channel that lowers the workplace hours supplied by individuals. Nonetheless, when containment policies are not very stringent (‘low’ regime) or are too draconian (‘high’ regime), ESM are less effective towards suppressing the pandemic. Finally, we find that the largest impact towards reducing the growth of infections comes jointly from school closures, workplace closures, cancelation of public events, and restrictions on internal movement, followed by the stay-at-home requirements, and the closure of public transport.
    JEL: C33 C51
    Date: 2023–07–21
  33. By: Axenbeck, Janna; Bertschek, Irene; Breithaupt, Patrick; Erdsiek, Daniel
    Abstract: The Covid-19 pandemic has sparked hope that firm digitalisation will result in long-lasting reductions in mobility and related carbon missions via the use of working from home and online services. In this study, we quantify the extent to which firm digitalisation can be associated with changes in mobility during the Covid-19 crisis in Germany, both when strong restrictions were in place and after the restrictions were lifted. To this end, we employ a novel text-mining approach to measure digitalisation based on firm websites. We aggregate our firm digitalisation indicator at the district level and link it to changes in mobility between January 2020 and December 2022. Our results indicate that districts with a higher level of firm digitalisation experienced a stronger reduction in mobility during the first two years of the pandemic. However, mobility almost came back to pre-crisis levels after most restrictions were lifted, suggesting that environmental improvements are not long-lasting.
    Keywords: Covid-19, digitalisation, mobility reductions, environmental improvements
    JEL: H12 I12 L96
    Date: 2023
  34. By: Martha Alter Chen; Joann Vanek
    Abstract: This paper provides a comparative summary of recent national statistics from five Latin American countries on employment losses and gains during the peak COVID-19 years compared with pre-pandemic levels. As part of its work on the impact of the pandemic on informal workers, the Women in Informal Employment: Globalizing and Organizing (WIEGO) network commissioned analyses of recent national labour force data in Brazil, Chile, El Salvador, Mexico, and Peru; and undertook a separate analysis of South African data on employment losses and gains during COVID-19 (see WIDER WP 2022/40 ).
    Keywords: Informal work, Employment, COVID-19, formal sector, Informal sector, Informal economy
    Date: 2023
  35. By: Laura Alfers; Florian Juergens-Grant
    Abstract: This paper considers the implications of COVID-19 relief measures for the building and extension of comprehensive and universal social protection systems. It highlights three key areas emerging from the crisis, which are likely to affect the shape of social protection systems moving forward. These include the contested meaning of universality, the digitization of social protection systems, and the possibilities for informal worker participation in building a more inclusive social protection.
    Keywords: Informal work, Universalism, Social protection, COVID-19
    Date: 2023

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