nep-hea New Economics Papers
on Health Economics
Issue of 2023‒09‒25
24 papers chosen by
Nicolas R. Ziebarth, Cornell University

  1. Economics and dementia: challenges and responses By Knapp, Martin; Wong, Gloria
  2. Parental Health Penalty on Adult Children's Employment: Gender Difference and Long-Term Consequence By Jiayi Wen; Haili Huang
  3. The Effect of Child Endowment on Fertility Choices By Victor Lavy; Yeshaya Nussbaum
  4. Broadband Internet Access and Health Outcomes: Patient and Provider Responses in Medicare By Jessica Van Parys; Zach Y. Brown
  5. From Addiction to Aggression: The Spillover Effects of Opioid Policies on Intimate Partner Violence By Dhaval M. Dave; Bilge Erten; Pinar Keskin; Shuo Zhang
  6. The Effect of Universal Free School Meals on Child BMI By Davis, Will; Kreisman, Daniel; Musaddiq, Tareena
  7. Occupational Retirement and Pension Reform: The Roles of Physical and Cognitive Health By Jiayi Wen
  8. Running Up That Hill: Fitness in the Face of Recession By Papps, Kerry L.; Bryson, Alex; Reade, J. James
  9. Drinking Water Contaminant Concentrations and Birth Outcomes By Elaine L. Hill; Richard DiSalvo
  10. The Inheritance of Historical Trauma: Intergenerational Effects of Early-Life Exposure to Famine on Mental Health By Zhang, Zihan; Kim, Jun Hyung
  11. Dynamic, incentive-compatible contracting for health services By Levaggi, Rosella; Moretto, Michele; Pertile, Paolo
  12. The Growth of Disability Insurance in Belgium: Determinants and Policy Implications By De Brouwer, Octave; Tojerow, Ilan
  13. The impact of updating health benefits plans on health technologies usage and expenditures: the case of Colombia By Espinosa, Oscar; Rodríguez, Jhonathan; Ávila, Diego; Rodríguez-Lesmes, Paul; Basto, Sergio; Romano, Giancarlo; Mesa, Lorena; Enríquez, Hernán
  14. Patient engagement for patient safety: The why, what, and how of patient engagement for improving patient safety By Candan Kendir; Rie Fujisawa; Óscar Brito Fernandes; Katherine de Bienassis; Niek Klazinga
  15. Particulate Matter Pollution Remains a Threat for Cardiovascular Health: Findings From the Global Burden of Disease 2019 By Moradi, Mahsa; Behnoush, Amir Hossein; Abbasi‐Kangevari, Mohsen; Moghaddam, Sahar Saeedi; Soleimani, Zahra; Esfahani, Zahra; Naderian, Mohammadreza; Malekpour, Mohammad‐Reza; Rezaei, Nazila; Keykhaei, Mohammad; Khanmohammadi, Shaghayegh; Tavolinejad, Hamed; Rezaei, Negar; Larijani, Bagher; Farzadfar, Farshad
  16. Meeting Health Challenges in Developing Asia with Corrective Taxes on Alcohol, Tobacco, and Unhealthy Foods By Chris Lane
  17. The Growing Gap of Unmet Need: Assessing the Demand for, and Supply of, Home-Based Support for Older Adults with Disabilities in 31 Countries By Qian, Yuting; Chen, Shanquan; Lin, Zhuoer; Yu, Zexuan; Wang, Mengxiao; Hou, Xiaohui; Chen, Xi
  18. Subjective well-being measurement: Current practice and new frontiers By Jessica Mahoney
  19. Barriers to the Integration of Venezuelan Migrants and Refugees in Colombia By Dávalos, María Eugenia; Ardila Vargas, Luz Karine; Garcia-Suaza, Andres
  20. COVID-19 Vaccine Development and Rollout in Historical Perspective By Amanda Glassman; Charles Kenny; George Yang
  21. 'Ask not what your country can do for you': Legacies of the Great Recession and the consequences of the 'trust crisis' By Alia Aghajanian; Rute Martins Caeiro; Eva-Maria Egger; Patricia Justino; Maria C. Lo Bue
  22. Ethnic Inequality and Public Health By Sundar Ponnusamy; Mohammad Abbas Hakeem
  23. Teen Social Interactions and Well-being during the COVID-19 Pandemic By Kalenkoski, Charlene Marie; Wulff Pabilonia, Sabrina
  24. Gender and beyond. Employment patterns during the Covid-19 pandemic in Italy. By Brini, Elisa; Scherer, Stefani; Vitali, Agnese

  1. By: Knapp, Martin; Wong, Gloria
    Abstract: Economics and dementia are interconnected in many ways. There is, for example, accumulating evidence of the ways in which dementia impacts on the economic status of individuals and families, on health and social care system budgets, and on national economies. An individual’s economic status can affect their risk of dementia and their ability to respond to it. Governments and other strategic decision-makers are aware of the (growing, indeed urgent) need to take action – whether that is prevention, treatment or care – but also very aware of the limited resources available to them and to the general population. Research evidence can potentially inform the difficult decisions that government and others need to take. We briefly summarise some economic evaluation studies in the dementia area as a basis for identifying the main challenges of moving from evidence to better policy and practice. We then discuss some possible responses (from a range of stakeholders) to these challenges, and how the STRiDE study has sought to contribute to this fast-moving field.
    Keywords: cost-benefit analysis; cost-effectiveness analysis; cost-utility analysis; policy; STRiDE study
    JEL: J1
    Date: 2023–07–28
  2. By: Jiayi Wen; Haili Huang
    Abstract: This paper examines the long-term gender-specific impacts of parental health shocks on adult children's employment in China. We build up an inter-temporal cooperative framework to analyze household work decisions in response to parental health deterioration. Then employing an event-study approach, we establish a causal link between parental health shocks and a notable decline in female employment rates. Male employment, however, remains largely unaffected. This negative impact shows no abatement up to eight years that are observable by the sample. These findings indicate the consequence of "growing old before getting rich" for developing countries.
    Date: 2023–08
  3. By: Victor Lavy; Yeshaya Nussbaum
    Abstract: Does the intellectual endowment of children affect parents’ fertility choices? The quantity-quality model of fertility predicts that a positive (negative) shock to child endowment increases (decreases) parental demand for children. We test these predictions using Israeli data on intellectually gifted and intellectually disabled children. Because families with an exceptional-endowment child differ from those without, we propose quasi-experiments that exploit differences in the child’s birth order to estimate the effect of her birth on further fertility. We find that the birth of a gifted child increases family size. However, parents must recognize the endowment’s exceptionality for it to have an effect. Similarly, the birth of an intellectually disabled child negatively affects family size, but only when the child is of high birth order. Our results point to child endowment as an important factor in determining fertility choices.
    JEL: I0 J10
    Date: 2023–08
  4. By: Jessica Van Parys; Zach Y. Brown
    Abstract: High-speed internet has increased the amount of information available in health care markets. Online information may improve health outcomes if it reduces information frictions and helps patients choose higher quality providers or causes providers to improve quality. We examine how health outcomes for common procedures in Medicare changed after broadband internet rolled out across ZIP Codes from 1999 to 2008. Estimates imply that broadband expansion improved health outcomes by 5%. Broadband access primarily helped patients choose higher-quality providers; we find less evidence that broadband improved provider quality. We use a simple structural model to decompose the improvements in patient outcomes over time. Counterfactual simulations imply that broadband roll-out was responsible for about 12% of the improvement in outcomes by the end of the period.
    JEL: I10 L15 L86
    Date: 2023–08
  5. By: Dhaval M. Dave; Bilge Erten; Pinar Keskin; Shuo Zhang
    Abstract: Intimate partner violence (IPV) is the most common form of violence experienced by women, and imposes adverse health consequences for victims and their children. The annual economic burden of IPV amounts to over $4.1 trillion, a substantial share of which is borne by the public sector. Despite documented associations pointing to partner violence and substance abuse being intertwined public health issues, we know very little about this connection when it comes to opioids. We address this knowledge gap, and provide the first study of the downstream effects of a key supply-side intervention – the abuse-deterrent reformulation of one of the most widely diverted opioids, OxyContin – on intimate partner violence. Capitalizing on administrative data on reported incidents by female victims to law enforcement combined with a quasi-experimental research design, we find robust evidence that the reformulation led to a significant decline in IPV exposure by females. Heterogeneity analyses suggest that sub-populations (non-Hispanic Whites; younger adults) and localities (lower-educated; high poverty) which experienced higher rates of opioid prescribing and misuse at baseline, accrued the largest benefits in terms of lower IPV rates. The overall decline in IPV, however, masks a notable uptick in heroin-involved IPV, underscoring the importance of identifying populations at a higher risk of substitution to illicit opioids post-reformulation and mitigating this risk with evidence-based policies.
    JEL: H0 I12 I18 K0
    Date: 2023–08
  6. By: Davis, Will (Mississippi State University); Kreisman, Daniel (Georgia State University); Musaddiq, Tareena (Mathematica Policy Research)
    Abstract: We estimate the effect of universal free school meal access through the Community Eligibility Program (CEP) on child BMI. Through the CEP, schools with high percentages of students qualified for free or reduced-priced meals can offer free breakfast and lunch to all students. With administrative data from a large school district in Georgia, we use student-level BMI measures from the FitnessGram to compare within-student outcomes before and after CEP implementation across eligible and non-eligible schools. We find one year of CEP exposure increased expected BMI percentile by about 0.085 standard deviations, equivalent to a nearly 1.88-pound weight increase for a student of average height. We also find that the program led to a small increase in the likelihood of overweight and limited evidence of a small decrease in the likelihood of underweight. We do not find that the program increased student obesity risk. Examining the effects of CEP on child BMI by grade suggests that the overall effect is largely driven by students in middle schools, highlighting potential heterogeneity in the program's impact across grades. The findings of this paper are relevant for researchers and policymakers concerned with the effects of universal free school meals on student health.
    Keywords: school meals, child BMI, community eligibility provision, free lunch
    JEL: I10 I28
    Date: 2023–08
  7. By: Jiayi Wen
    Abstract: Despite increasing cognitive demands of jobs, knowledge about the role of health in retirement has centered on its physical dimensions. This paper estimates a dynamic programming model of retirement that incorporates multiple health dimensions, allowing differential effects on labor supply across occupations. Results show that the effect of cognitive health surges exponentially after age 65, and it explains a notable share of employment declines in cognitively demanding occupations. Under pension reforms, physical constraint mainly impedes manual workers from delaying retirement, whereas cognitive constraint dampens the response of clerical and professional workers. Multidimensional health thus unevenly exacerbate welfare losses across occupations.
    Date: 2023–08
  8. By: Papps, Kerry L. (University of Bradford); Bryson, Alex (University College London); Reade, J. James (University of Reading)
    Abstract: Drawing on 28 million observations on people's running times in a free weekly 5 kilometre running event, Parkrun, we examine whether labour market conditions affect fitness. Running times improve during recessions for men and women aged 50 and above but worsen for men aged 20-49 and women aged 20-29, suggesting that the fall in the opportunity costs of fitness during recessions is the dominant factor for elderly runners, whereas the income effect induced by unemployment dominates for prime age workers. Participation in Parkrun is not sensitive to the business cycle so our results are not driven by compositional changes.
    Keywords: business cycle, health, fitness, Parkrun
    JEL: I12 I30
    Date: 2023–08
  9. By: Elaine L. Hill; Richard DiSalvo
    Abstract: Previous research in the US has found negative health effects of contamination when it triggers regulatory violations. An important question is whether levels of contamination that do not trigger a health-based violation impact health. We study the impact of drinking water contamination in community water systems on birth outcomes using drinking water sampling results data in Pennsylvania. We create an overall water quality index and an index specific to reproductive health. We focus on the effects of water contamination for births not exposed to regulatory violations. Our most rigorous specification employs mother fixed effects and finds changing from the 10th to the 90th percentile of water contamination (among births not exposed to regulatory violations) increases low birth weight by 12% and preterm birth by 17%.
    JEL: I1 Q53
    Date: 2023–08
  10. By: Zhang, Zihan (Jinan University); Kim, Jun Hyung (Korea Advanced Institute of Science and Technology)
    Abstract: Can the effects of early childhood trauma persist across generations, impacting the long-run outcomes of their children? To answer this question, we exploit the geographic variation in the intensity of the Great Famine in China and distinguish the effects of exposures during four stages of childhood cognitive development between ages 0 to 15 as defined in the child development theory of Jean Piaget. We find that exposure to famine in childhood, especially in ages 0—2 and 3—7, negatively impacts the adult mental health of the survivors' children. We also find negative effects on parent's mental health and parent-child interaction frequency, consistent with the role of childhood home environments as transmission channels. Our findings show that the determinants of mental health problems can be traced back across a generation and demonstrate the persistent damage of early childhood trauma on the survivors and their children.
    Keywords: collective trauma, famine, mental health, intergenerational effects
    JEL: I14 I18 J13
    Date: 2023–08
  11. By: Levaggi, Rosella; Moretto, Michele; Pertile, Paolo
    Abstract: This paper aims to characterise a dynamic, incentive-compatible contract for the provision of health services, allowing for both moral hazard and adverse selection. Patients’ severity changes over time following a stochastic process and is private information of the provider. We characterise the optimal dynamic contract and show that it is made up of two components: a time-invariant payment, which depends on the structural characteristics of the provider, and a time-varying component, which is affected by both patient and hospital characteristics. To illustrate the characteristics of the dynamic contract and compare it with a more standard static contract, we provide a numerical exercise calibrated with data from hip replacement hospitalisations in Italy.
    Keywords: Health Economics and Policy, Research Methods/ Statistical Methods
    Date: 2023–09–06
  12. By: De Brouwer, Octave (Free University of Brussels); Tojerow, Ilan (Free University of Brussels)
    Abstract: Between 2005 and 2020, Belgium experienced a significant rise in the recipiency rate of long-term disability insurance (DI), rising from 3.5% to 6.8%. In this paper, we examine the potential factors driving this increase by exploiting administrative micro-level data covering the Belgian population from 2005 to 2015. Our analysis reveals that changes in observable characteristics, such as age, labor market participation among some groups of workers, and several job characteristics, can only marginally account for the increase in the long-term DI entry rate between 2005 and 2015. We also find evidence suggesting that reforms in unemployment insurance over the past two decades have contributed to the rise in the DI entry rate from unemployment. Finally, drawing on the literature on optimal DI policy, we discuss potential reforms aimed at decreasing the Belgian DI recipiency rate.
    Keywords: social insurance, disability insurance, unemployment insurance
    JEL: H53 H55 J65
    Date: 2023–08
  13. By: Espinosa, Oscar (Instituto de Evaluación Tecnológica en Salud; Universidad Nacional); Rodríguez, Jhonathan (Instituto de Evaluación Tecnológica en Salud); Ávila, Diego (Instituto de Evaluación Tecnológica en Salud); Rodríguez-Lesmes, Paul (Universidad del Rosario); Basto, Sergio (Instituto de Evaluación Tecnológica en Salud); Romano, Giancarlo (1 Instituto de Evaluación Tecnológica en Salud); Mesa, Lorena (Instituto de Evaluación Tecnológica en Salud); Enríquez, Hernán (Universidad Sergio Arboleda)
    Abstract: Using administrative data in 2012–2019, we estimate the impact of the inclusion of technology into the Colombian health benefits plan (HBP) charged to the capitation payment unit (CPU) on the usage, expenditures, and market conditions. Technologies (drugs and procedures) before and after their inclusion were compared using a Callaway-Sant’Anna’s difference-in-differences with multiple time period method and a synthetic control strategy. A substantial increase in the use and prescription of these technologies was noted. Expenditure levels per user slightly increased; however, the response varies over time. Annual expansion of HBP charged to CPU provided tacit benefits to the Colombian population.
    Keywords: Health benefits plan; universal health coverage; health expenditures; CallawaySant’Anna’s method; synthetic control
    JEL: C55 I13 I18
    Date: 2023–07–28
  14. By: Candan Kendir; Rie Fujisawa; Óscar Brito Fernandes; Katherine de Bienassis; Niek Klazinga
    Abstract: Patients’ and citizens’ perspectives and their active engagement are critical to make health systems safer and people-centred, and are key for co-designing health services and co-producing good health with healthcare professionals, and building trust in health systems. Patients, families, caregivers and citizens can contribute towards improving patient safety at all levels from clinical, local, institutional (e.g. hospital , nursing home), community (e.g. primary care, home care) and national levels of healthcare systems. This report, the sixth in the series on the Economics of Patient Safety, covers: (i) the economic impact of patient engagement for patient safety; (ii) the results of a pilot data collection to measure patient-reported experiences of safety and; (iii) the status of initiatives on patient engagement for patient safety taken in 21 countries, which responded to a snapshot survey. It also provides recommendations for countries to enhance patient engagement for patient safety.
    Date: 2023–09–15
  15. By: Moradi, Mahsa; Behnoush, Amir Hossein; Abbasi‐Kangevari, Mohsen; Moghaddam, Sahar Saeedi; Soleimani, Zahra; Esfahani, Zahra; Naderian, Mohammadreza; Malekpour, Mohammad‐Reza; Rezaei, Nazila; Keykhaei, Mohammad; Khanmohammadi, Shaghayegh; Tavolinejad, Hamed; Rezaei, Negar; Larijani, Bagher; Farzadfar, Farshad
    Abstract: Particulate matter (PM) pollution is a significant risk factor for cardiovascular diseases, causing substantial disease burden and deaths worldwide. This study aimed to investigate the global burden of cardiovascular diseases attributed to PM from 1990 to 2019. We used the GBD (Global Burden of Disease) study 2019 to investigate disability‐adjusted life‐years (DALYs), years of life lost (YLLs), years lived with disability (YLDs), and deaths attributed to PM as well as its subgroups. It was shown that all burden measures' age‐standardized rates for PM were in the same decreasing trend, with the highest decline recorded for deaths (−36.7%). However, the all‐age DALYs increased by 31%, reaching 8.9 million in 2019, to which YLLs contributed the most (8.2 million [95% uncertainty interval, 7.3 million–9.2 million]). Men had higher deaths, DALYs, and YLLs despite lower years lived with disability in 2019 compared with women. There was an 8.1% increase in the age‐standardized rate of DALYs for ambient PM; however, household air pollution from solid fuels decreased by 65.4% in the assessed period. Although higher in men, the low and high sociodemographic index regions had the highest and lowest attributed YLLs/YLDs ratio for PM pollution in 2019, respectively. Although the total age‐standardized rate of DALYs for PM‐attributed cardiovascular diseases diminished from 1990 to 2019, the global burden of PM on cardiovascular diseases has increased. The differences between men and women and between regions have clinical and policy implications in global health planning toward more exact funding and resource allocation, in addition to addressing inequity in health care access.
    Keywords: air pollution, cardiovascular diseases, global burden of disease, particulate matter, sociodemographic index
    Date: 2023
  16. By: Chris Lane (Center for Global Development)
    Abstract: In developing Asia there is potential for higher corrective taxes to help prevent many non-communicable diseases (NCDs) and contribute revenue. The productivity loss from death and disability from alcohol, tobacco and diets high in sugar-sweetened beverages in purchasing power parity dollars is PPP$ 879 billion (2 percent of Developing Asia GDP) with close to half these costs arising in China (PPP$ 431 billion), and another 20 percent in India (PPP$ 187 billion). Corrective taxes applied to these products can be a powerful tool to reduce harmful consumption. But effective implementation needs to consider tax design, demand responses, distributional consequences, and the use of corrective tax revenues including the costs and benefits of earmarking revenue to the health sector. It is estimated that corrective taxes, primarily on alcohol and tobacco, could raise an additional 0.6-0.7 percent of GDP in revenues, while improving health outcomes and cutting medical costs.
    Date: 2022–04–20
  17. By: Qian, Yuting (Yale University); Chen, Shanquan (University of Cambridge); Lin, Zhuoer (Yale University); Yu, Zexuan (Brown University); Wang, Mengxiao (World Bank); Hou, Xiaohui (World Bank); Chen, Xi (Yale University)
    Abstract: Providing support to older people with disabilities will increasingly challenge care systems in all countries. Accurately gauging the unmet need is a first step in response. Disability is commonly measured by documenting people's capacity to perform Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). This study assessed the prevalence and the extent (or severity) of ADL/IADL limitations in 31 countries from 2011 to 2018, together with the availability of support to manage them. The study identified a range of demographic, social, and policy factors that are associated with ADL/IADL limitations and the receipt of assistance among older adults. Results show substantial variation across countries in the prevalence and extent of ADL/IADL limitations and how both prevalence and extent have evolved over time. Country-level differences in socioeconomic conditions, health behaviors, chronic disease prevalence, and the strength of public safety nets are among the primary factors that may help explain these variations. Over the study period, most countries saw a decrease in the share of older adults with ADL/IADL limitations who received assistance, even as the prevalence of ADL/IADL limitations rose in many of those countries. This suggests considerable unmet need for ADL/IADL assistance among older adults in these countries. Specific groups, such as unpartnered males, were less likely to receive help. Countries may improve outcomes by targeting interventions to vulnerable groups. Comparative cross-country data on disability trends open new opportunities for countries to learn from each other's experiences in improving elder care.
    Keywords: global aging, disability, ADL/IADL limitations, unmet need, elder care
    JEL: J14 J18 I11 I18
    Date: 2023–08
  18. By: Jessica Mahoney
    Abstract: In the ten years since the OECD published its 2013 Guidelines on Measuring Subjective Well-being, the inclusion of evaluative, affective and eudaimonic indicators in national measurement frameworks and household surveys has grown. Country practice has converged around a standard measure of life satisfaction, however affective and eudaimonic measures remain less harmonised. This working paper combines findings from a stock take of OECD member state uptake of Guidelines recommendations with advances in the academic evidence base to highlight three focal areas for future work. Looking ahead, the OECD should prioritise (i) revisiting recommendations on affective indicators, particularly in light of recent OECD recommendations on measuring mental health; (ii) reviewing progress towards operationalising measures of eudaimonia; and (iii) creating new extended modules to measure the subjective well-being of children, to deepen advice on domain-specific life evaluation measures, and to further develop more globally inclusive measures, drawing on (for example) concepts of subjective well-being developed in Indigenous contexts and beyond western European/North American research literatures.
    Keywords: happiness, life satisfaction, mental health, subjective well-being
    JEL: I31 I38 D91
    Date: 2023–09–08
  19. By: Dávalos, María Eugenia (World Bank); Ardila Vargas, Luz Karine (World Bank); Garcia-Suaza, Andres (Universidad del Rosario)
    Abstract: Integration migrants has become a central challenge and opportunity for public policy in the medium term, to mitigate the impacts and maximize the benefits. This study explores the factors that enhance or reduce barriers to accessing opportunities. Based on data from the Migration Pulse (MP) survey, our analysis finds that access to information, contact networks, and documents for migratory status regularization play an important role in facilitating access to services and improving this group’s employability. Thus, the findings show the interrelationship between integration policies and their complementarity, such as those related to healthcare access and the regularization process. Overall, the results provide evidence supporting the convenience of place-based policies.
    Keywords: Migration; integration; regularization; Colombia
    JEL: F22 O15 R23
    Date: 2023–08–18
  20. By: Amanda Glassman (Center for Global Development); Charles Kenny (Center for Global Development); George Yang (Center for Global Development)
    Abstract: In mid-2022, profound inequities in the pace and level of coverage of COVID-19 vaccination persist, especially in the world’s poorest countries. Yet despite this inequity, we find that global COVID-19 vaccine development and diffusion has been the most rapid in history, everywhere. This paper explores the historical record in the development and deployment of vaccines globally, and puts the COVID-19 vaccine rollout in that context. Although far more can and should be done to drive higher coverage in the lowest-income countries, it is worth noting the revolutionary speed of both the vaccine development and diffusion process, and the potential good news that this signals for the future of pandemic preparedness and response.
    Keywords: Health care, Policy analysis, History
    JEL: I15 I18
    Date: 2022–02–09
  21. By: Alia Aghajanian; Rute Martins Caeiro; Eva-Maria Egger; Patricia Justino; Maria C. Lo Bue
    Abstract: This paper investigates how persistent changes in trust caused by the Great Recession have affected how governments and citizens across Europe responded to the next global crisis: the COVID-19 pandemic. We show that increases in individualism and mistrust towards institutions caused by individual exposure to the 2007-08 global financial crisis across European regions shaped citizens' responses to public health policies to curtail the spread of the COVID-19 pandemic almost 15 years later.
    Keywords: Trust, Social contract, Recession, Public health, COVID-19
    Date: 2023
  22. By: Sundar Ponnusamy (Monash University); Mohammad Abbas Hakeem (University of Adelaide)
    Abstract: We examine the association between ethnic inequality and various key health outcomes for a global set of developed and developing countries. Our results show that higher ethnic inequality is associated with a poor state of public health, such as higher child and maternal mortality, increased stillbirths and child stunting, and reduced life expectancy at birth. This set of effects is found to be predominant mainly in developing countries, and Sub-Saharan African countries. Results remain robust to the inclusion of various other measures of inequality, ethnic composition indices, geographic endowments, and other relevant controls. We argue that lower contraceptive usage and poor vaccination rates are potential mechanisms through which ethnic inequality affects health outcomes. Policies targeted at improving public health may need to focus more on these key intermediate channels in ethnic minority regions.
    Keywords: Inequality, child mortality, health
    JEL: I14 I18 J13
    Date: 2023–09
  23. By: Kalenkoski, Charlene Marie; Wulff Pabilonia, Sabrina
    Abstract: Adolescence is an important developmental period when teens begin spending less time with their parents and more time with friends and others outside their households as they transition into adulthood. Using the 2017-2021 American Time Use Surveys and the 2012, 2013, and 2021 Well-being Modules, we examine how the time teens spent alone and with parents, friends, and others changed during the COVID-19 pandemic, shedding light on how the social isolation of the pandemic disrupted this crucial development period. We also examine how time spent on various activities changed during the pandemic. Teens spent more time alone during the pandemic than before and spent more of their leisure time alone, with large increases in time spent playing computer games, on social media, and watching TV. Results suggest that socializing and communicating with others improves teens' well-being over other activities. Thus, teens' well-being was severely impacted by the pandemic.
    Keywords: teens, adolescents, COVID-19, well-being, time use, gaming
    JEL: J13 J22
    Date: 2023
  24. By: Brini, Elisa; Scherer, Stefani; Vitali, Agnese
    Abstract: This paper investigates employment changes during the pandemic for women and men in a country characterized by notoriously low female employment: Italy. In particular, the paper explores to what extent previously existing inequalities in employment were further exacerbated during the pandemic. Using data from Italian Labor Force Surveys for the years 2018 to 2020, we find evidence of a limited decline of employment, but a strong increase of persons working zero hours during the lockdown periods. This result holds for both men and women. The pandemic highlighted how gender inequalities in employment intersect with other socio-economic disadvantages: single mothers and low-educated women were more affected than their male counterparts, while single and foreign men were hit stronger than women with the same characteristics. The pandemic thus came with differentiated consequences for groups of persons, generally affecting harder those already in less advantaged situations. At the same time, results support the idea that women’s employment was relevant to counteract job-loss in the family, and some became the only breadwinner for their families – also exposing themselves to risks by working during the pandemic. All in all, the pandemic greatly accentuated pre-existing social inequalities in the Italian labor market, yet with apparently transitory effect at least regarding employment participation. We discuss reasons of why this was the case.
    Date: 2023–09–01

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