nep-hea New Economics Papers
on Health Economics
Issue of 2023‒10‒09
25 papers chosen by
Nicolas R. Ziebarth, Cornell University

  1. Health and labor market impacts of twin birth: Evidence from a Swedish IVF policy By Bhalotra, Sonia; Clarke, Damian; Mühlrad, Hanna; Palme, Mårten
  2. Externalities from Medical Innovation: Evidence from Organ Transplantation By Kevin Callison; Michael E. Darden; Keith F. Teltser
  3. Legal Representation in Disability Claims By Hoynes, Hilary; Maestas, Nicole; Strand, Alexander
  4. The Impact of High Temperatures on Performance in Work-Related Activities By Picchio, Matteo; van Ours, Jan C.
  5. Temperature exposure and sleep duration: Evidence from time use surveys By Hajdu, Tamás
  6. Mindfulness Training, Cognitive Performance and Stress Reduction By Gary Charness; Yves Le Bihan; Marie Claire Villeval
  7. Tax Credits for Clean Electricity: The Distributional Impacts of Supply-Push Policies in the Power Sector By Maxwell L. Brown; Jon M. Becker; Jared Carbone; Teagan Goforth; James McFarland; Destenie Nock; Kristina Pitman; Daniel C. Steinberg
  8. When State Becomes the Only Buyer: Effects of national volume-based procurement of cardiac stents in China By SUN Jessica Ya; YIN Ting; LIU Zhiyong
  9. Sex, Power, and Adolescence: Intimate Partner Violence and Sexual Behaviors By Manisha Shah; Jennifer Seager; Joao Montalvao; Markus Goldstein
  10. Gender Identity, Race, and Ethnicity-based Discrimination in Access to Mental Health Care: Evidence from an Audit Correspondence Field Experiment By Luca Fumarco; Benjamin Harrell; Patrick Button; David Schwegman; E Dils
  11. Graying and Staying on the Job: The Welfare Implications of Employment Protection for Older Workers By Morris, Todd; Dostie, Benoit
  12. Binge-Eating: A Life-Threatening Eating Disorder By Mohajan, Devajit
  13. The Impact of Maternal Education on Early Childhood Development: The Case of Turkey By : Deniz Karaoglan; : Serap Sagir; Meltem Dayioglu; Dürdane Sirin Saraçoglu
  14. Dynamics of life course family transitions in Germany: Exploring patterns, process and relationships By Maurer, Raimond; Usman, Sehrish
  15. How Much Would Reducing Lead Exposure Improve Children’s Learning in the Developing World? By Lee Crawfurd; Rory Todd; Susannah Hares; Justin Sandefur; Rachel Silverman Bonnifield
  16. Mortality Regressivity and Pension Design By Youngsoo Jang; Svetlana Pashchenko; Ponpoje Porapakkarm
  17. Encouraging Preventative Care to Manage Chronic Disease at Scale By Claire E. Boone; Pablo A. Celhay; Paul Gertler; Tadeja Gracner
  18. Rural Pensions, Intra-Household Bargaining, and Elderly Medical Expenditure in the People’s Republic of China By Chen, Zeyuan; Park, Albert
  19. Strategies for training laypeople to participate in health technology assessment: a scoping review protocol By Itaborahy, Alex; Frossard, Leny; Leite, Bianca Rosa; de Souza Matheus, Iandy Tarecone; Morais, Quenia Cristina Dias; Santos, Marisa
  20. COVID-19 Mortality Rates were Higher in States that Limited Governments from Enacting Public Health Orders By Xue Zhang; Mildred Warner; Gen Meredith
  21. The Impact of Vaccines and Behavior on U.S. Cumulative Deaths from COVID-19 By Andrew Atkeson
  22. Associations between anxiety and the willingness to be exposed to COVID-19 risk among French young adults during the first pandemic wave By Fabrice Etilé; Pierre-Yves Geoffard
  23. Economic Effects of Covid-19 and Non-Pharmaceutical Interventions: applying a SEIRD-Macro Model to Italy By Giuli, Francesco; Maugeri, Gabriele
  24. Historical Narratives about the COVID-19 Pandemic are Motivationally Biased By Philipp Sprengholz; Luca Henkel; Robert Böhm; Cornelia Betsch
  25. The Effects of COVID-19 Pandemic on (New) Life Insurances By Ropponen, Olli; Kuusi, Tero; Valkonen, Tarmo

  1. By: Bhalotra, Sonia (Department of Economics, University of Warwick, CEPR, IEA, IZA, CAGE, IFS); Clarke, Damian (bDepartment of Economics, University of Chile and IZA); Mühlrad, Hanna (IFAU - Institute for Evaluation of Labour Market and Education Policy); Palme, Mårten (Stockholm University)
    Abstract: In vitro fertilization (IVF) has allowed women to delay birth and pursue a career, but it massively increases the risk of twin birth. We investigate the extent to which having twins hampers women’s careers after birth. To do this, we leverage a single embryo transfer (SET) mandate for IVF procedures implemented in Sweden in 2003, following which the share of twin births showed a precipitous drop of 70%. Linking birth registers to hospitalization and earnings registers, we identify substantial improvements in women’s earnings following IVF birth, alongside improvements in maternal and child health and an increase in subsequent fertility. We provide the first comprehensive evaluation of SET. This is relevant given the secular rise in IVF births and the broader rise in the risk of twin birth.
    Keywords: twins; IVF; single embryo transfer; career costs of children; gender wage gap; fertility; maternal health; neonatal health; gender
    JEL: I11 I12 I38 J13 J24
    Date: 2023–08–10
  2. By: Kevin Callison; Michael E. Darden; Keith F. Teltser
    Abstract: We evaluate the introduction of direct-acting antiviral (DAA) therapy for Hepatitis C (HCV) on liver transplant allocation in the United States. We develop a model of listing and organ acceptance behavior for patients with both HCV-positive and HCV-negative end-stage liver disease. In the model, DAAs obviate the need for transplant for some HCV-positive patients, which shortens the waiting list, potentially benefiting HCV-negative registrants and inducing marginal HCV-negative patients to list. Using data from the universe of transplants between 2005 and 2019, we find that DAA availability resulted in an additional 5, 682 liver transplants to HCV-negative recipients between 2014 and 2019, driven in part by a 37% average annual increase in HCV-negative waiting list registrations. Our estimates imply that DAAs generated $7.52 billion in positive externalities for HCV-negative patients during this period.
    JEL: I10 I11 I14 O3
    Date: 2023–09
  3. By: Hoynes, Hilary (University of California Berkeley); Maestas, Nicole; Strand, Alexander
    Abstract: Legal representatives play a prominent role in the Social Security Disability Insurance adjudication process, earning fees totaling $1.2 billion in 2019. Long ubiquitous in appellate hearings, disability representatives—including attorneys and non-attorneys—have begun appearing more frequently at the beginning of cases, during the initial review. This development has raised questions about the motives of disability law firms, who are sometimes perceived to prioritize their own interests in response to incentives in the fee structure set by the Social Security Administration. At the same time, these concerns have revealed just how little is understood about the value of legal representation for claimants in disability cases. We provide the first estimates of the causal impact of legal representation on case outcomes when representatives are engaged from the initial stage. Our analysis is made possible by new administrative data identifying representatives appointed to disability claims at the initial and appellate levels. To address selection into representation, we instrument for initial representation using geographic and temporal variation in disability law firm market shares in the closely related but distinct appellate market. Among applicants on the margin of obtaining representation at the initial level, representation improves case outcomes and administrative efficiency across several metrics. Legal representation increases the probability of initial award by 23 percentage points, reduces the probability of appeal by 45 points, and induces no detectable change in the ultimate probability of award (including appeals). This pattern indicates that legal representation in the initial stage leads to earlier disability awards to individuals who would otherwise be awarded benefits only on appeal. Furthermore, by securing earlier awards and discouraging unsupported appeals, representation reduces total case processing time by nearly one year. Our analysis explores several mechanisms. (Stone Center on Socio-Economic Inequality Working Paper)
    Date: 2023–09–05
  4. By: Picchio, Matteo (Università Politecnica delle Marche, Ancona); van Ours, Jan C. (Erasmus University Rotterdam)
    Abstract: High temperatures can have a negative effect on work-related activities. Labor productivity may go down because mental health or physical health is worse when it is too warm. Workers may experience difficulties concentrating or they have to reduce effort in order to cope with heat. We investigate how temperature affects performance of male professional tennis players. We use data about outdoor singles matches from 2003 until 2021. Our identification strategy relies on the plausible exogeneity of short-term daily temperature variations in a given tournament from the average temperature over the same tournament. We find that performance significantly decreases with ambient temperature. The magnitude of the temperature effect is age-specific and skill-specific. Older and less-skilled players suffer more from high temperatures than younger and more skilled players do. The effect of temperature on performance is smaller when there is more at stake. Our findings also suggest that there is adaptation to high temperatures: the effects are smaller if the heat lasts for several days.
    Keywords: climate change, temperatures, tennis; performance, productivity
    JEL: J24 J81 Q51 Q54
    Date: 2023–09
  5. By: Hajdu, Tamás
    Abstract: The Earth's climate is projected to warm significantly in the 21st century, and this will affect human societies in many ways. Since sleep is a basic human need and part of everyone's life, the question of how temperature affects human sleep naturally arises. This paper examines the effect of daily mean temperature on sleep duration using nationally representative Hungarian time use surveys between 1976 and 2010. Compared to a mild temperature (5-10 °C), colder temperatures do not influence sleep duration. However, as daily mean temperatures rise, sleep duration starts to strongly decline. The effect of a hot (>25 °C) day is −12.4 minutes. The estimated sleep loss is especially large on weekends and public holidays, for older individuals, and for men. Combining the estimated effects with temperature projections of twenty-four climate models under four climate change scenarios shows that the warming climate will substantially decrease sleep duration. The projected impacts are especially large when taking into account of the effects of heatwave days. This study also shows that different groups in society are likely to be affected in significantly different ways by a warming climate.
    Keywords: temperature, climate change, sleep, time use survey, Hungary
    JEL: I12 Q54
    Date: 2023
  6. By: Gary Charness (Department of Economics, University of California at Santa Barbara, USA); Yves Le Bihan (Institut Français du Leadership Positif. 4 place Amédée Bonnet 69002 Lyon, France); Marie Claire Villeval (Univ Lyon, CNRS, GATE UMR 5824, F-69130 Ecully, France; IZA, Bonn, Germany)
    Abstract: Improving cognitive function and reducing stress may yield important benefits to individuals’ health and to society. We conduct an experiment involving a three-month within-firm training program based on the principles of mindfulness and positive psychology at three large companies. We find an improvement in the difference-in-differences across the training and control groups in all five non-incentivized measures and in seven of the eight incentivized tasks but only the non-incentivized measures and one of the incentivized measures reached a standard level of significance (above 5%), showing strong evidence of its impact on both reducing perceived stress and increasing self-reported cognitive flexibility and mindfulness. At the aggregate level, we identify an average treatment effect on the treated for the non-incentivized measures and some effect for the incentivized measures. Remarkably, the treatment effects persisted three months after the training sessions ended. Overall, mindfulness training seems to provide benefits for psychological and cognitive health in adults.
    Keywords: Mindfulness, Attention, Cognition, Stress, Lab-in-the-Field Experiment
    JEL: C91 I12
    Date: 2023
  7. By: Maxwell L. Brown; Jon M. Becker; Jared Carbone; Teagan Goforth; James McFarland; Destenie Nock; Kristina Pitman; Daniel C. Steinberg
    Abstract: We evaluate distributional and efficiency consequences of the bulk power clean electricity tax credits authorized by the 2022 Inflation Reduction Act. To do so, we link detailed electricity capacity expansion, computable general equilibrium, data-rich microsimulation, and air pollution models to estimate the policy incidence in terms of economic welfare and health impacts across a wide range of demographic groups. We evaluate the tradeoff between policy efficiency and income progressivity by comparing the tax credits to cap-and-trade policies that vary revenue recycling approaches. Under the scenarios analyzed the bulk power tax credits lead to increased clean electricity technology deployment resulting in a reallocation of capital from elsewhere in the economy, higher prices for capital and other goods, lower power prices, and lower emissions. The tax credits yield progressive outcomes for both economic welfare and health impacts. The health benefits exceed total policy costs and provide greater benefits for low-income and historically-marginalized households given the coincidence of household and emission source locations.
    JEL: Q43 Q48
    Date: 2023–08
  8. By: SUN Jessica Ya; YIN Ting; LIU Zhiyong
    Abstract: Medical device prices are a significant drivers of high healthcare spending in China; however, lowering prices remains an open question. We examine a unique solution for China as the central government acts as a single buyer for medical devices in the context of the national volume-based procurement (VBP) of cardiac stents. The tender held in November 2020 and reduced the average price of cardiac stents by 95%. Using detailed inpatient discharge record data, we found that the national VBP program increased patients’ total medical spending by 20%. The failure in reducing medical costs was due to physician-induced demand; the utilization of coronary stents and drug-eluting balloons increased by almost 10%. Distortionary effects were more prominent for patients with residential insurance and physicians with higher persuasion power.
    Date: 2023–09
  9. By: Manisha Shah; Jennifer Seager; Joao Montalvao; Markus Goldstein
    Abstract: Adolescents in Sub-Saharan Africa have some of the highest rates of intimate partner violence across the globe. This paper evaluates the impact of a randomized controlled trial that offers females a goal setting activity to improve their sexual and reproductive health outcomes and offers their male partners a soccer intervention, which educates and inspires young men to make better sexual and reproductive health choices. Both interventions reduce female reports of intimate partner violence. Impacts are larger among females who were already sexually active at baseline. We develop a model to understand the mechanisms at play. The soccer intervention improves male attitudes around violence and risky sexual behaviors. Females in the goal setting arm take more control of their sexual and reproductive health by exiting violent relationships. Both of these mechanisms drive reductions in IPV.
    JEL: I12 O10
    Date: 2023–08
  10. By: Luca Fumarco (Masaryk University, Czechia); Benjamin Harrell (Trinity University); Patrick Button (Tulane University); David Schwegman (American University); E Dils (YouthForce NOLA)
    Abstract: Racial, ethnic, and gender minorities face mental health disparities. While mental health care can help, minoritized groups could face discriminatory barriers in accessing it. Discrimination may be particularly pronounced in mental health care because providers have more discretion over accepting patients. Research documents discrimination broadly, including in access to health care, but there is limited empirical research on discrimination in access to mental health care. We provide the first experimental evidence, from a correspondence audit field experiment (“simulated patients” study), of the extent to which transgender and non-binary people, African Americans, and Hispanics face discrimination in access to mental health care appointments. We find significant discrimination against transgender or non-binary African Americans and Hispanics. We do not find evidence of discrimination against White transgender and non-binary prospective patients. We are mostly inconclusive as to if cisgender African Americans or Hispanics face discrimination, except we find evidence of discrimination against cisgender African American women.
    Keywords: mental health care, transgender, racial discrimination, audit, therapy
    JEL: C93 I14 J16 I11 I18 J15
    Date: 2023–09
  11. By: Morris, Todd (HEC Montreal); Dostie, Benoit (HEC Montreal)
    Abstract: We study the welfare implications of employment protection for older workers, exploiting recent bans on mandatory retirement across Canadian provinces. Using linked employer- employee tax data, we show that the bans cause large and similar reductions in job separation rates and retirement hazards at age 65, with further reductions at higher ages. The effects vary substantially across industries and firms, and around two-fifths of the adjustments occur between ban announcement and implementation dates. We find no evidence that the demand for older workers falls, but the welfare effects are mediated by spillovers on savings behavior, workplace injuries, and spousal retirement timing.
    Keywords: employment protection, retirement, welfare, active and passive savings responses, health effects, spousal spillovers
    JEL: J26 J78 H55
    Date: 2023–09
  12. By: Mohajan, Devajit
    Abstract: This study deals with binge-eating (BE) that is a deeper negative psychological problem and a severe life-threatening eating disorder, which is characterized by eating large quantities of food within a short period of time; with a feeling of a loss of control during the eating. Binge-eating is seen common among both genders of obese people; and also common among students and irrespective of smokers and non-smokers. A person of binge-eating faces difficulties in working life, social life, and relationships. S/he often feels guilty, also disgusted and embarrassed after eating. Actually binge-eating ultimately damages well-beings of sufferers. Early detection and evidence-based treatment can recover the binge-eating patients.
    Keywords: Binge-eating, eating disorders, depression, risk factors
    JEL: A1 A12 A13 A14 I1 I12 I14 I15 I18 I3 I31
    Date: 2023–05–07
  13. By: : Deniz Karaoglan (Gebze Technical University); : Serap Sagir (Middle East Technical University, Department of Economics); Meltem Dayioglu (Middle East Technical University, Department of Economics); Dürdane Sirin Saraçoglu (Middle East Technical University, Department of Economics)
    Abstract: In this paper, we investigate the relationship between mother’s education level and the development of young children in Turkey using representative microdata from the 2018 Turkey Demographic and Health Survey (TDHS). The data include detailed information about the developmental status of young children of 36-to-59 months old. We find that only when the mother has at least a high school level education, there is a positive impact on the child’s developmental status as summarized the Early Childhood Development (ECD) index, which is an index constructed based on the child’s four developmental domains. We also show that the household’s wealth is also positively associated with the child’s developmental status, particularly in the socioemotional and the learning readiness domains.
    Date: 2023–08–20
  14. By: Maurer, Raimond; Usman, Sehrish
    Abstract: This paper explores dynamics of family life events in Germany using discrete time event history analysis based on SOEP data. We find that higher educational attainment, better income level, and marriage emerge as salient protective factors mitigating the risk of mortality; better education also reduces the likelihood of first marriage whereas, lower educational attainment, protracted period, and presence of children act as protective factors against divorce. Our key finding shows that disparity in mean life expectancies between individuals from low- and high-income brackets is observed to be 9 years among males and 6 years among females, thereby illustrating the mortality inequality attributed to income disparities. Our estimates show that West Germans have low risk of death, less likelihood of first marriage, and they have a high risk of divorce and remarriage compared to East Germans.
    Keywords: Family dynamics, Life Events, Hazard estimation, Life course transitions
    JEL: C13 C34 J12
    Date: 2023
  15. By: Lee Crawfurd (Center for Global Development); Rory Todd (Center for Global Development); Susannah Hares (Center for Global Development); Justin Sandefur (Center for Global Development); Rachel Silverman Bonnifield (Center for Global Development)
    Abstract: Around half of children in low-income countries have elevated blood lead levels. What role does lead play in explaining low educational outcomes in these settings? We conduct a new systematic review and meta-analysis of observational studies on the relationship between lead exposure and learning outcomes. Adjusting for observable confounds and publication bias yields a benchmark estimate of a 0.12 standard deviation reduction in learning per natural log unit of blood lead. As all estimates are non-experimental, we present evidence on the likely magnitude of unobserved confounding, and summarize results from a smaller set of natural experiments. Our benchmark estimate accounts for over a fifth of the gap in learning outcomes between rich and poor countries, and implies moderate learning gains from targeted interventions for highly exposed groups (≈ 0.1 standard deviations) and modest learning gains (< 0.05 standard deviations) from broader public health campaigns.
    Date: 2023–07–30
  16. By: Youngsoo Jang (University of Queensland); Svetlana Pashchenko (University of Georgia); Ponpoje Porapakkarm (National Graduate Institute for Policy Studies)
    Abstract: How should we compare welfare across pension systems in presence of differential mortality? A commonly used standard utilitarian criterion implicitly favors the long-lived over the short-lived. We investigate under what conditions this ranking is reversed. We clearly distinguish between the redistribution along mortality and income dimensions, and thus between mortality and income progressivity. We show that when mortality is independent of income, mortality progressivity can be optimal only when (i) there is more aversion to inequality in lifetime utilities compared to aversion to consumption inequality, (ii) life is valuable. When the short-lived tend to have lower income, mortality progressivity can be also optimal when income redistribution tools are limited. In this case, mortality progressivity is used to substitute for income progressivity.
    Keywords: mortality-related redistribution, pensions, social security, annuities, life-cycle model
    JEL: G22 H21 H55 I38
    Date: 2023–09
  17. By: Claire E. Boone; Pablo A. Celhay; Paul Gertler; Tadeja Gracner
    Abstract: We study how reminding high-risk patients with chronic disease of their upcoming primary care appointments impacts their health care and behaviors. We leverage a natural experiment in Chile’s public healthcare system that sent reminders before preventative care appointments to over 300, 000 patients with type 2 diabetes and hypertension across 315 public primary care clinics between 2013 and 2018. Employing both a difference-in-differences and instrumental variables approach on national administrative patient-level data, we show that reminders increased preventative care visits, which led to more health screenings and improved medication adherence. In this at-scale program, we find substantial variation in implementation fidelity across clinics, which, once accounted for increases our estimates by over a third. Reminders also increased hospitalizations and reduced in-hospital mortality, suggesting an improvement in timely care-seeking behavior among high-risk patients. Our findings inform healthcare settings where patients must first visit their primary care provider for approval before undergoing tests, receiving medication prescriptions, or getting referrals to other specialists. Through intervening at the first step in the cascade of care, we find that a simple intervention like reminders can have large and meaningful downstream effects.
    JEL: I11 I12 I15
    Date: 2023–08
  18. By: Chen, Zeyuan (Southwestern University of Finance and Economics); Park, Albert (Asian Development Bank)
    Abstract: The rural elderly in the People’s Republic of China spend less on medical expenditures as they age despite declining health, which raises welfare concerns. This paper investigates the role of intra-household bargaining power on health expenditures of the elderly by evaluating the impact of cash transfers from a new social pension program. The program provided windfall payments to those above age 60, making it possible to employ a regression discontinuity design based on age of eligibility to estimate causal effects. Using data from the 2011 and 2013 waves of the China Health and Retirement Longitudinal Study, we find that receiving pension payments increases both the utilization of outpatient care and outpatient expenditures by the elderly who experienced illness. This result is robust to controlling for total household expenditures per capita, ruling out income effects as the main channel. Consistent with pensions increasing elderly bargaining power, we find that pensions significantly increase medical expenditures only for those elderly who co-reside with children or grandchildren but have no effect on those who live independently.
    Keywords: medical expenditures; pension; elderly; intra-household bargaining; regression discontinuity design; People’s Republic of China
    JEL: J14 J26
    Date: 2023–09–28
  19. By: Itaborahy, Alex (Instituto Nacional de Cardiologia); Frossard, Leny; Leite, Bianca Rosa; de Souza Matheus, Iandy Tarecone; Morais, Quenia Cristina Dias; Santos, Marisa
    Abstract: The objective of this study is to map the strategies that health technology assessment agencies use worldwide to educate laypeople about health technology assessment (HTA). The engagement of patients and the general public in the processes of HTA has garnered escalating support and endorsement from international networks of HTA agencies. Nonetheless, integrating the broader community into HTA procedures poses a multifaceted challenge. In order to render such participation efficacious, it is imperative to allocate substantial resources towards the dissemination of information and the educational empowerment of the community with respect to HTA. Furthermore, it is essential to furnish comprehensive training initiatives aimed at capacitating individuals to actively partake in the intricate web of HTA processes. This scoping review will consider studies addressing educative strategies to train laypeople on HTA. Additionally mapping and summarizing relevant methodological papers from any international HTA Agency regarding training laypeople to participate in HTA processes. Four databases will be searched for qualitative, quantitative, and mixed methods study designs. The gray literature search will include policy and practice documents from HTA and health organization websites. Two reviewers will independently complete title and abstract screening prior to the full-text review and data extraction.
    Date: 2023–08–28
  20. By: Xue Zhang (Center for Policy Research, Maxwell School, Syracuse University, 426 Eggers Hall, Syracuse, NY 13244); Mildred Warner (Cornell University); Gen Meredith (Cornell University)
    Abstract: State and local governments enacted various public health emergency policies during the COVID-19 pandemic that resulted in lower infection and death rates than would have occurred without these policies. However, some states limited emergency public health authority of state executives, state governors, and state and local officials during the pandemic. This brief summarizes the results of a study that used data from the Center for Public Health Law Research and Oxford COVID-19 Government Response Tracker to explore which states passed laws that limited emergency public health authority during the COVID-19 pandemic and the effects of those limitations on COVID-19 death rates. The study finds that states with unified Republican control were more likely to limit emergency authority during the COVID-19 pandemic and that limiting emergency public health authority was associated with higher COVID-19 death rates.
    Keywords: Public health policy, COVID-19, legislative professionalism
    Date: 2023–08
  21. By: Andrew Atkeson
    Abstract: The CDC reports that 1.13 million Americans have died of COVID-19 through June of 2023. I use a model of the impact over the past three years of vaccines and private and public behavior to mitigate disease transmission during the COVID-19 pandemic in the United States to address two questions. First, holding the strength of the response of behavior to the level of daily deaths from COVID-19 fixed, what was the impact of vaccines on cumulative mortality from COVID-19 up through June 2023? And second, holding the pace of deployment of vaccinations fixed, what would have been the impact of stricter or looser behavioral responses to COVID-19 deaths on cumulative mortality from COVID-19 over this same time period? In answering the first question, I find that vaccines saved 748, 600 lives through June 2023. That is, without vaccines, cumulative mortality from COVID-19 would have been closer to 1.91 million over this time period. In answering the second question, I find that behavioral efforts to slow the transmission of the virus before vaccines became widely administered were critical to this positive impact of vaccines on cumulative mortality. For example, with a complete relaxation of these mitigation efforts, vaccines would have come too late to have saved a significant number of lives. Earlier deployment of vaccines would have saved many lives. I find that marginal changes in the strength of the behavioral response to COVID-19 deaths within the range of those responses estimated with the model have a significantly smaller impact on cumulative COVID-19 mortality over this time period.
    Keywords: COVID-19 mortality; Vaccines; Behavior
    JEL: I0 I12
    Date: 2023–08–23
  22. By: Fabrice Etilé (PSE - Paris School of Economics - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris sciences et lettres - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement, PJSE - Paris Jourdan Sciences Economiques - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris sciences et lettres - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement); Pierre-Yves Geoffard (PSE - Paris School of Economics - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris sciences et lettres - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement, PJSE - Paris Jourdan Sciences Economiques - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris sciences et lettres - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement)
    Abstract: The COVID-19 outbreak has generated significant uncertainty about the future, especially for young adults. Health and economic threats, as well as more diffuse concerns about the consequences of COVID-19, can trigger feelings of anxiety, leading individuals to adopt uncertainty-reducing behaviours. We tested whether anxiety was associated with an increase in willingness to be exposed to the risk of COVID-19 infection (WiRE) using an online survey administered to 3, 110 French individuals aged between 18 and 35 years old during the first pandemic wave and lockdown period (April 2020). Overall, 56.5% of the sample declared a positive WiRE. A one standard deviation increase in psychological state anxiety raised the WiRE by +3.9 pp (95% CI [+1.6, 6.2]). Unemployment was associated with a higher WiRE (+8.2 percentage points (pp); 95% CI [+0.9, 15.4]). One standard deviation increases in perceived hospitalisation risk and in income (+1160€) were associated with a -4.1 pp (95% CI [-6.2, 2.1]) decrease in the WiRE and +2.7 pp increase (95% CI [+1.1, 4.4]), respectively. Overall, our results suggest that both psychological anxiety and the prospect of economic losses can undermine young adults' adherence to physical distancing recommendations. Public policies targeting young adults must consider both their economic situation and their mental health, and they must use uncertainty-reducing communication strategies.
    Date: 2022–01
  23. By: Giuli, Francesco; Maugeri, Gabriele
    Abstract: We study the economic effects generated by the proliferation of the Covid-19 epidemic and the implementation of non-pharmaceutical interventions by developing a SEIRD-Macro model, where the outbreak and policy interventions shape the labour input dynamic. We microfound an Epidemic-Macro model grounded on the Neo-Classical tradition, useful for epidemic and economic analysis at business cycle frequency, which is able to reproduce the highly debated health-output trade-off. Assuming a positive approach, we show the potential of our model by matching the epidemic and macroeconomic empirical evidence of the Italian case.
    Keywords: SIR-Macro models, Covid-19, Non-pharmaceutical interventions.
    JEL: E32
    Date: 2023–01–29
  24. By: Philipp Sprengholz (Institute of Psychology, University of Bamberg, Germany; Institute for Planetary Health Behaviour, University of Erfurt, Germany; Implementation Science, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany); Luca Henkel (Kenneth C. Griffin Department of Economics, University of Chicago, United States of America; Department of Economics, University of CEMA, Argentina); Robert Böhm (Faculty of Psychology, University of Vienna, Austria; Department of Psychology, University of Copenhagen, Denmark; Copenhagen Center for Social Data Science, University of Copenhagen, Denmark); Cornelia Betsch (Institute for Planetary Health Behaviour, University of Erfurt, Germany; Implementation Science, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany)
    Abstract: How people recall the SARS-CoV2 pandemic is likely to prove crucial in future societal debates on pandemic preparedness and appropriate political action. Beyond simple forgetting, previous research suggests that recall may be distorted by strong motivations and anchoring perceptions on the current situation. Here, based on four studies across 11 countries (total N = 10, 776), we show that recall of perceived risk, trust in institutions and protective behaviours depended strongly on current evaluations. While both vaccinated and unvaccinated individuals were affected by this bias, people who identified strongly with their vaccination status — whether vaccinated or unvaccinated — tended to exhibit greater and, importantly, opposite distortions of recall. Biased recall was not reduced by providing information about common recall errors or small monetary incentives for accurate recall, but partially by high incentives. Thus, it seems that motivation and identity influence the direction in which the recall of the past is distorted. Biased recall was further related to the evaluation of past political action and future behavioural intent, including adhering to regulations during a future pandemic or punishing politicians and scientists. Taken together, the findings indicate that historical narratives about the COVID-19 pandemic are motivationally biased, sustain societal polarization and affect preparation for future pandemics. Consequently, future measures must look beyond immediate public health implications to the longer-term consequences for societal cohesion and trust.
    Keywords: Memory, identity, polarization, motivated recall
    JEL: C91 D83 D91
    Date: 2023–09
  25. By: Ropponen, Olli; Kuusi, Tero; Valkonen, Tarmo
    Abstract: Abstract This paper studies the life insurance demand responses to Covid-19 pandemic. It employs the unique individual-level daily data on new term life insurances together with both geographical and timely variation in the severity of the pandemic in Finland. These data are merged with the high-quality register data on the background characteristics of the customers and other Finnish population. First, we observe that the take-out of new life insurances increased by 20 % in the first half of 2020 among individuals of ages 21–60, compared to the corresponding time periods in years 2018 and 2019. The average sum insured increased at the same time by 16 %. Second, we find that the life insurance demand responds heavily to all Covid-measures, each of which may be considered as reflecting the change in the perceived death risk. We also find that the responses are larger to the country-level measures compared to the hospital district level measures. An increase in each country-level Covid-measure by 10 % implies on average an increase in the number of new life insurances by roughly 1 % (elasticity e=0.1). We also find that highly educated people and people with high life insurance deficit levels responded to Covid-pandemic more often than other people.
    Keywords: COVID-19, Life insurances, Households
    JEL: G22 H31
    Date: 2023–09–19

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