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on Health Economics |
| By: | Amy Finkelstein; Matthew J. Notowidigdo; Frank Schilbach; Jonathan Zhang |
| Abstract: | We leverage spatial variation in the severity of the Great Recession across the United States to examine its impact on mortality and to explore implications for the welfare consequences of recessions. We estimate that an increase in the unemployment rate of the magnitude of the Great Recession reduces the average, annual age-adjusted mortality rate by 2.3 percent, with effects persisting for at least 10 years. Mortality reductions appear across causes of death and are concentrated in the half of the population with a high school degree or less. We estimate similar percentage reductions in mortality at all ages, with declines in elderly mortality thus responsible for about three-quarters of the total mortality reduction. Recession-induced mortality declines are driven primarily by external effects of reduced aggregate economic activity on mortality, and recession-induced reductions in air pollution appear to be a quantitatively important mechanism. Incorporating our estimates of pro-cyclical mortality into a standard macroeconomics framework substantially reduces the welfare costs of recessions, particularly for people with less education, and at older ages where they may even be welfare-improving. |
| JEL: | E3 I1 |
| Date: | 2024–02 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:32110&r=hea |
| By: | Hilary Wething (Economic Policy Institute); Meredith Slopen (City University of New York) |
| Abstract: | We investigate the impact of Seattle’s Paid Sick and Safety Time (PSST) policy on workers’ quarterly hours worked and separation hazard. Using Unemployment Insurance records from before and after the implementation of PSST, we examine individual-level employment behavior at the extensive and intensive margins and compare Seattle workers to workers in Washington state using a difference-indifferences strategy. Importantly, we consider how impacts vary by employment characteristics, including worker wage rate and tenure, and by firm characteristics, including industry and firm size. We find that PSST increased workers’ quarterly hours by 4.42 hours per quarter, or around 18 hours per year. While there was no overall impact on workers’ separation hazard rates, we observed a 10 percent decrease in separations for workers in firms with more than 50 employees following PSST implementation. Our findings indicate that paid sick leave policies may support workers in increasing their hours and, to a lesser extent, may reduce turnover. |
| Keywords: | sick pay mandates, hours worked, low-wage employment |
| JEL: | I18 J08 J63 J68 |
| Date: | 2024–01 |
| URL: | http://d.repec.org/n?u=RePEc:upj:weupjo:24-396&r=hea |
| By: | Christopher Roth (University of Cologne, CEPR and ECONtribute, Max Planck Institute for Collective Goods); Peter Schwardmann (Carnegie Mellon University); Egon Tripodi (Hertie School of Government) |
| Abstract: | While psychotherapy has been shown to be effective in treating depression, take-up remains low. In a sample of 1, 843 depressed individuals, we document that concerns about effectiveness are top of mind when respondents consider the value of therapy. We then show that the average respondent underestimates the effectiveness of therapy and that an information treatment that corrects this misperception increases participants’ incentivized willingness to pay for therapy. Information affects therapy demand by changing beliefs rather than by shifting attention. Our results suggest that information interventions that target the perceived effectiveness of therapy are a potent tool in combating the ongoing mental health crisis. |
| Keywords: | Mental Health, Depression, Psychotherapy, Beliefs, Effectiveness, Information policy |
| Date: | 2024–02 |
| URL: | http://d.repec.org/n?u=RePEc:ajk:ajkdps:279&r=hea |
| By: | Lauren Hersch Nicholas; Kenneth M. Langa; Scott D. Halpern; Mario Macis |
| Abstract: | Despite the growing need for surrogate decision-making for older adults, little is known about how surrogates make decisions and whether advance directives would change decision-making. We conducted a nationally representative experimental survey that cross-randomized cognitive impairment, gender, and characteristics of advance care planning among hospitalized older adults through a series of vignettes. Our study yielded three main findings: first, respondents were much less likely to recommend life-sustaining treatments for patients with dementia, especially after personal exposure. Second, respondents were more likely to ignore patient preferences for life-extending treatment when the patient had dementia, and choose unwanted life-extending treatments for patients without dementia. Third, in scenarios where the patient's wishes were unclear, respondents were more likely to choose treatments that matched their own preferences. These findings underscore the need for improved communication and decision-making processes for patients with cognitive impairment and highlight the importance of choosing a surrogate decision-maker with similar treatment preferences. |
| JEL: | C99 I12 J14 |
| Date: | 2024–02 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:32116&r=hea |
| By: | French, Michael (University of Miami); Gumus, Gulcin (Florida Atlantic University) |
| Abstract: | Although they comprise a relatively small subset of all traffic deaths, hit-and-run fatalities are both contemptible and preventable. We analyze longitudinal data from 1982-2008 to examine the effects of blood alcohol concentration (BAC) laws on hit-and-run traffic fatalities. Our results suggest that lower BAC limits may have an unintended consequence of increasing hit-and-run fatalities, while a similar effect is absent for non-hit-and-run fatalities. Specifically, we find that adoption of a .08 BAC limit is associated with an 8.3% increase in hit-and-run fatalities. This unintended effect is more pronounced in urban areas and during weekends, which are typical settings for hit-and-run incidents. |
| Keywords: | traffic fatalities, hit-and-run, BAC, DUI, FARS |
| JEL: | H73 I12 I18 |
| Date: | 2024–01 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp16774&r=hea |
| By: | Michael D. Frakes; Melissa F. Wasserman |
| Abstract: | A quota system with an associated deadline may retain the possibility of worker procrastination and related deadline behaviors. A performance appraisal system based on continuous temporal incentives, on the other hand, has the potential to alleviate deadline effects but may lose some of the quality-related benefits associated with the flexibility of a quota/deadline system. We explore these tradeoffs by observing patent examiner behavior and examination quality outcomes surrounding a 2011 reform at the U.S. Patent and Trademark Office that built on its bi-weekly quota system by adding a set of bonuses tied to daily examination-pendency measures. We find a substantial reduction in deadline effects and near complete temporal smoothing in examiner behavior in connection with the reform, leading to large reductions in average examination pendency while resulting in no corresponding reductions in the accuracy of examinations. |
| JEL: | D03 J33 K0 O34 |
| Date: | 2024–01 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:32066&r=hea |
| By: | Guthmuller, Sophie; Heger, Dörte; Hollenbach, Johannes; Werbeck, Anna |
| Abstract: | We investigate the short- and long-term effects of retirement on loneliness using panel data from the Survey of Health, Aging, and Retirement in Europe. To estimate causal effects, we exploit differences in retirement eligibility rules across and within countries and use retirement thresholds in an instrumental variable setting. On average, we find that entering retirement leads to a significant reduction in loneliness in the long run, although our results show no clear effect in the short run. The reduction is driven by individuals being less likely to feel socially isolated and lacking companionship. Our results suggest that individuals adapt to retirement by increasing their activity levels and reap the benefits in terms of reduced loneliness and social isolation. Heterogeneity analysis by gender reveals that retirement increases feelings of loneliness for women in the short term, and that this effect appears to be driven by women lacking companionship when their partner is not yet retired. |
| Abstract: | Wir untersuchen die Auswirkungen von Renteneintritt auf Einsamkeit in der kurzen und langen Frist mit Hilfe von Fragebogendaten der Survey of Health, Aging, and Retirement in Europe. Um einen kausalen Zusammenhang aufzuzeigen, nutzen wir die Unterschiede in den Altersgrenzen der Rentenberechtigungsregelungen zwischen und innerhalb der Länder in einer Instrumentenvariablenschätzung. Kurzfristig zeigen unsere Analysen keine Auswirkungen. Langfristig reduziert der Renteneintritt aber das Einsamkeitsgefühl, da sich die Menschen weniger sozial isoliert fühlen und weniger enge Kontakte vermissen. Unsere Ergebnisse legen nahe, dass Menschen nach einer gewissen Zeit im Ruhestand ihr Aktivitätsniveau erhöhen, was Einsamkeit und sozialer Isolation entgegenwirkt. Unsere geschlechtsspezifische Analyse zeigt allerdings, dass Frauen sich nach Renteneintritt kurzfristig einsamer fühlen und enge Kontakte vermissen, wenn ihr Partner zu dem Zeitpunkt noch nicht im Ruhestand ist. |
| Keywords: | Loneliness, social isolation, retirement, instrumental variable, causal effect |
| JEL: | J26 J14 I10 |
| Date: | 2023 |
| URL: | http://d.repec.org/n?u=RePEc:zbw:rwirep:282008&r=hea |
| By: | Carneiro. Juliana (University of Warwick); Koppensteiner, Martin Foureaux (University of Surrey); Menezes, Livia (University of Birmingham) |
| Abstract: | In this paper, we estimate the causal effect of transitory individual-level health shocks on schooling outcomes in Brazil. We focus on dengue fever, which, despite putting half of the world’s population at risk, has received relatively little attention, possibly due to its low mortality. We link individual register data on dengue infections with detailed individual records from the Brazilian school census and use a fixed effects estimation strategy to estimate the effect of dengue infections on grade retention and dropout. We find that dengue infections during the school year have a substantial negative effect on measures of student success, with an increase in grade retention of 3.5 percent and an increase in dropout of 4.6 percent. Using information on monthly attendance from the monitoring system of conditionalities of the Brazilian cash transfer Bolsa Famılia, we provide evidence that infections reduce school attendance. |
| Keywords: | Health shocks ; dengue ; educational outcomes ; drop-out JEL Codes: I12 ; J13 ; K42 ; O12 |
| Date: | 2024 |
| URL: | http://d.repec.org/n?u=RePEc:wrk:warwec:1488&r=hea |
| By: | Costi, Chiara (University of Luxembourg); Migali, Giuseppe (Lancaster University); Zucchelli, Eugenio (Universidad Autónoma de Madrid) |
| Abstract: | The identification of factors affecting birth weight is a key issue in human development due to its established associations with long-term health, educational and labour-market outcomes. This paper exploits intergenerational information on three generations (grandparents-parents-children) to explore the effects of parental education and different parental smoking behaviours on birth weight. We use the intergenerational association between grandparents' education and smoking behaviour and the corresponding parental variables to aid the identification of parents' education and smoking on birth weight. We employ rich intergenerational data drawn from the US National Longitudinal Study of Adolescent to Adult Health and a flexible two-stage residual inclusion approach. We find that there is a strong intergenerational persistence of education levels and smoking behaviours across generations. Higher parental education reduces the likelihood of children's low birth weight, although the effect appears to be mainly driven by fathers. While maternal smoking during pregnancy increases the occurrence of low birth weight, especially among non-white parents, parental regular smoking (of either mothers or fathers) does not seem to greatly affect birth weight. Results are confirmed by robustness checks excluding direct effects of grandparents' smoking while in utero and using an instrumental variable for parental education. |
| Keywords: | parental education, prenatal smoking, birth weight, intergenerational persistence, Add Health |
| JEL: | I00 I12 I29 |
| Date: | 2024–01 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp16775&r=hea |
| By: | David G. Blanchflower; Alex Bryson |
| Abstract: | Using cross-sectional data files for the United States we show that difficulties experienced in childhood - so-called Adverse Child Experiences (ACE)s - are strongly and significantly associated with mental health in adulthood. Our evidence is taken from eight Behavioral Risk Factor Surveillance System (BRFSS) surveys from 2009-2023 which contain a special supplement asking respondents to recall abuse in their childhood. We find that poor mental health is on the rise in the United States, particularly among young women. This upward trend among the young is also apparent from the National Health Interview Surveys 1997-2021, the Healthy Minds surveys of 2007-2023 and the Youth Risk Behavior Surveillance System (YRBSS) for high school students. We find ACEs are strongly correlated with poor mental health among both the young and older people and the effect is additive. The impact of living with a household member with poor mental health is large relative to other ACEs and is particularly pronounced among younger people. Being bullied, including electronically, is also strongly negatively associated with the wellbeing of high school students. Time spent in front of a screen has been rising over time for the young and has an independent negative impact on their mental health over and above bullying, one which is more pronounced for young women. |
| JEL: | I1 I31 J16 |
| Date: | 2024–02 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:32119&r=hea |
| By: | Alexa Prettyman (Department of Economics, Towson University) |
| Abstract: | Over 20, 000 youth age out of foster care each year in the United States and face various hardships. Exploiting plausibly exogenous policy variation, I find that exposure to extended foster care reduces homelessness and incarceration by 29 and 38 percent, respectively. Outcomes from the National Youth in Transition Database, a longitudinal survey that collects information from foster youth at ages 17, 19, and 21, are linked to the Adoption and Foster Care Analysis and Reporting System, administrative data containing information about individuals' foster care history. Back-of-the-envelope calculations suggest that extended foster care yields a 4:1 return on investment. |
| Keywords: | Foster youth, Extended foster care, Transition to adulthood. |
| JEL: | I38 J13 |
| Date: | 2024–02 |
| URL: | http://d.repec.org/n?u=RePEc:tow:wpaper:2024-02&r=hea |
| By: | Lazuka, Volha (Lund University); Jensen, Peter S. (Linnaeus University) |
| Abstract: | Can the effect of a positive health shock, such as childhood vaccination, transmit across three generations? To answer this question, we estimate the impact of smallpox vaccination in childhood on the longevity and occupational achievements of three generations using unique individual-level data from Sweden, covering the last 250 years. We apply different estimation strategies based on linear and non-linear probability models. To address endogeneity concerns, we construct a shift-share instrumental variable, utilizing the fact that vaccination in Sweden was administered by the low-skilled clergy, who otherwise did not perform public health duties. Overall, our results show that a positive shock to the health of the first generation, such as smallpox vaccination, operating through various channels, enhances both health and socio-economic outcomes for at least two more generations. |
| Keywords: | intergenerational transmission of health, smallpox vaccination, shift-share instrumental-variables |
| JEL: | I18 J24 J62 |
| Date: | 2024–01 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp16765&r=hea |
| By: | McPake, Barbara; Dayal, Prarthna; Zimmermann, Julia; Williams, Gemma A. |
| Abstract: | Future global health security requires a health and care workforce (HCWF) that can respond effectively to health crises as well as to changing health needs with ageing populations, a rise in chronic conditions and growing inequality. COVID-19 has drawn attention to an impending HCWF crisis with a large projected shortfall in numbers against need. Addressing this requires countries to move beyond a focus on numbers of doctors, nurses and midwives to consider what kinds of healthcare workers can deliver the services needed; are more likely to stay in country, in rural and remote areas, and in health sector jobs; and what support they need to deliver high-quality services. In this paper, which draws on a Policy Brief prepared for the World Health Organization (WHO) Fifth Global Forum on Human Resources for Health, we review the global evidence on best practices in organising, training, deploying, and managing the HCWF to highlight areas for strategic investments. These include (1). Increasing HCWF diversity to improve the skill-mix and provide culturally competent care; (2). Introducing multidisciplinary teams in primary care; (3). Transforming health professional education with greater interprofessional education; (4). Re-thinking employment and deployment systems to address HCWF shortages; (5). Improving HCWF retention by supporting healthcare workers and addressing migration through destination country policies that limit draining resources from countries with greatest need. These approaches are departures from current norms and hold substantial potential for building a sustainable and responsive HCWF. |
| Keywords: | health care policy; health professional education; health security; health systems policy; healthcare workforce; human resources for health |
| JEL: | R14 J01 |
| Date: | 2024–01–26 |
| URL: | http://d.repec.org/n?u=RePEc:ehl:lserod:121977&r=hea |
| By: | Cuevas Ruiz, Pilar; Borra, Cristina; Sevilla Sanz, Maria Almudena |
| Abstract: | We provide the first causal evidence of the returns to maternal educational curricula on offspring's health at birth. Educational programs that aim to deliver more general knowledge may potentially improve women's earning potential and maternal prenatal investment by increasing the portability of skills across occupations and improving women's ability to make informed decisions about fertility options and health behavior. We study the impacts of a comprehensive educational reform that postponed students' curriculum choices and integrated more general education into the high school system on infant health outcomes. Using a dose-response difference-in-differences (DiD) model research design applied to linked population registries, we find that the reform led to a significant reduction in the incidence of very low birth weight (less than 1, 500 grams) and very preterm birth (less than 33 gestation weeks). Overall, the reform's positive effects on infant health at birth seem to be driven by increased mothers' labor market opportunities and better family planning, rather than increased ability to avoid risky behaviours or increased women's earnings via different occupational choices or assortative mating. |
| Keywords: | health at birth; educational curricula; vocational education; academic education; comprehensive educational reform; Consolidator Grant (CoG); SH3; ERC-2017- COG |
| JEL: | I28 J13 J16 I20 |
| Date: | 2023–04–18 |
| URL: | http://d.repec.org/n?u=RePEc:ehl:lserod:121334&r=hea |
| By: | Carolina Lopez; Anja Sautmann; Simone G. Schaner |
| Abstract: | Can information about the value of diagnostic tests improve provider practice and help patients recognize higher quality of care? In a randomized experiment at public clinics in Mali, health providers and patients received tailored information about the importance of rapid diagnostic tests (RDTs) for malaria. The provider training increased provider reliance on RDTs, improving the match between a patient's malaria status and treatment with antimalarials by 15-30 percent. Nonetheless, patients were significantly less satisfied with the care they received, driven by those whose prior beliefs did not match their true malaria status. The patient information intervention did not affect treatment outcomes or patient satisfaction and reduced malaria testing. These findings are consistent with highly persistent patient beliefs that translate into low demand for diagnostic testing and limit patients' ability to recognize improved quality of care. |
| JEL: | I11 I12 O15 |
| Date: | 2024–01 |
| URL: | http://d.repec.org/n?u=RePEc:nbr:nberwo:32075&r=hea |
| By: | Huo, Shutong (University of California, Irvine); Feng, Derek (Yale University); Gill, Thomas M. (Yale University); Chen, Xi (Yale University) |
| Abstract: | Childhood circumstances may impact senior health, prompting this study to introduce novel machine learning methods to assess their individual and collective contributions to health inequality in old age. Using the US Health and Retirement Study (HRS) and the China Health and Retirement Longitudinal Study (CHARLS), we analyzed health outcomes of American and Chinese participants aged 60 and above. Conditional inference trees and forest were employed to estimate the influence of childhood circumstances on self-rated health (SRH), comparing with the conventional parametric Roemer method. The conventional parametric Roemer method estimated higher IOP in health ( China: 0.039, 22.67% of the total Gini coefficient 0.172; US: 0.067, 35.08% of the total Gini coefficient 0.191) than conditional inference tree ( China: 0.022, 12.79% of 0.172; US: 0.044, 23.04% of 0.191) and forest ( China: 0.035, 20.35% of 0.172; US: 0.054, 28.27% of 0.191). Key determinants of health in old age were identified, including childhood health, family financial status, and regional differences. The conditional inference forest consistently outperformed other methods in predictive accuracy as measured by out-of-sample mean squared error (MSE). The findings demonstrate the importance of early-life circumstances in shaping later health outcomes and stress the early-life interventions for health equity in aging societies. Our methods highlight the utility of machine learning in public health to identify determinants of health inequality. |
| Keywords: | life course, inequality of opportunity, childhood circumstances, machine learning, conditional inference tree, random forest |
| JEL: | I14 J13 J14 O57 C53 |
| Date: | 2024–01 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp16764&r=hea |
| By: | Yinhe Liang; Xiaobo Peng; Meiping Aggie Sun |
| Abstract: | This paper examines the long-term impacts of growth and development monitoring in early childhood. For this purpose, we evaluate a pediatric healthcare program, the Systematic Management of Children (SMC), which offers growth and development monitoring through routine health checkups for all young children (0-6 years) in China. Using data on the program’s county-by-county rollout from 1950 to 2010, we find that full exposure to the SMC from birth increases lifetime income by 5%. We further provide evidence of several underlying mechanisms, including improved physical and mental health, better educational outcomes, increased cognitive skills, and sustained use of routine health checkups among adolescents. |
| Keywords: | growth and development monitoring, adult earnings, human capital, health, public goods |
| JEL: | H75 I15 I18 J24 N35 O12 O15 |
| Date: | 2024 |
| URL: | http://d.repec.org/n?u=RePEc:ces:ceswps:_10912&r=hea |
| By: | Serra-Sastre, Victoria |
| Abstract: | NHS job vacancies remain at record levels and an increasing number of staff are leaving the NHS. Work-related violence is an aspect that has received little attention as a possible driving force in dropout rates among NHS workforce. Recent figures indicate that approximately 15% of NHS staff had experienced physical violence while at work (NHS Staff Survey, 2022). Given the prevalence of abuse and the consequences it may have on staff wellbeing, we examine the impact of workplace violence on intention to quit the organisation. We employ data from the NHS Staff Survey, a rich dataset that records the experience and views of staff working in the NHS. We use data from 2018 to 2022 of NHS employees surveyed in all NHS acute hospitals, with a sample size of 1, 814, 120 observations. We study the impact of experiencing physical or verbal violence in the workplace on the intention to quit the organization, examining differences according to perpetrator type. Our analysis also sheds light on any aggravated effect the pandemic had on intention to leave for those exposed to violence. The results suggest that experiencing physical violence increases the intention to leave by 10 percentage points. The effect of verbal violence is quantitatively greater in magnitude, increasing intention to leave by 21 percentage points. Violence from managers has the largest detrimental effect, followed by exposure to violence from multiple perpetrators and violence from colleagues. Heterogeneous effects exist according to occupational group, gender, age and ethnicity. The pandemic only had a marginal contribution to these effects. Staff health, trust in management and quality of patient care are some of the possible mechanisms through which violence influences the intention to quit. Overall, the results suggest that targeted interventions are needed to improve retention after exposure to violence. |
| JEL: | R14 J01 |
| Date: | 2024–01–01 |
| URL: | http://d.repec.org/n?u=RePEc:ehl:lserod:121623&r=hea |
| By: | Donner, Herman (Department of Real Estate and Construction Management, Royal Institute of Technology); Kulander, Maria (University of Gävle) |
| Abstract: | Utilizing a large-scale public health survey in Sweden, this paper analyzes the relationship between the fraction of elderly above the age of 80 who live in various tenure forms, and their social engagement. Social engagement is a measure of both social interaction with others, and overall engagement in society. This measure has an established relationship with mental and physical health, even as the causal mechanism are still understudied. Across 130 municipalities, we find that a higher fraction of elderly living in elderly housing is associated with a lower fraction of elderly classified as having a low level of social engagement. We also find that a higher fraction of elderly living in single-family houses is associated with a higher fraction of elderly classified as having a low level of social engagement. The results support that closer proximity to neighbors, and potentially the engagement offered through services in elderly care, increases overall social engagement among the elderly, thereby also assumably promoting better mental and physical health. The findings can inform housing policies towards elderly populations. |
| Keywords: | Elderly; Housing; Mental Health; Social Engagement; Social Interactions; Well-Being |
| JEL: | I31 J14 J26 |
| Date: | 2024–02–04 |
| URL: | http://d.repec.org/n?u=RePEc:hhs:kthrec:2024_001&r=hea |
| By: | Richard Daramola; Md Shahadath Hossain; Harounan Kazianga; Karim Nchare |
| Abstract: | This study evaluates the long-term impacts of the National Vaccination Commando Program, an early childhood health intervention in Burkina Faso, during the 1980s. Using a difference-in-differences approach, we find significant reductions in child mortality and improvements in educational attainment, including increased primary school completion rates. We also find significant positive effects on adult employment and agricultural productivity, yielding a substantial rate of return on the initial health intervention. These findings underscore the lasting benefits of early childhood health interventions in low-income countries. |
| Keywords: | Early Childhood Interventions, Vaccination, Measles, Long-term Impacts, Economic Returns, Burkina Faso |
| JEL: | D61 I15 I25 O12 O15 |
| Date: | 2024–02–14 |
| URL: | http://d.repec.org/n?u=RePEc:csl:devewp:493&r=hea |
| By: | Sarah Louart (ALIMA - Alliance for International medical Action, CLERSÉ - Centre Lillois d’Études et de Recherches Sociologiques et Économiques - UMR 8019 - Université de Lille - CNRS - Centre National de la Recherche Scientifique); Gildas Boris Hedible (CERPOP - Centre d'Epidémiologie et de Recherche en santé des POPulations - UT3 - Université Toulouse III - Paul Sabatier - UT - Université de Toulouse - INSERM - Institut National de la Santé et de la Recherche Médicale); Valery Ridde (UCAD - Université Cheikh Anta Diop de Dakar [Sénégal], CEPED - UMR_D 196 - Centre population et développement - IRD - Institut de Recherche pour le Développement - UPD5 - Université Paris Descartes - Paris 5) |
| Abstract: | Acceptability is a key concept used to analyze the introduction of a health innovation in a specific setting. However, there seems to be a lack of clarity in this notion, both conceptually and practically. In low and middle-income countries, programs to support the diffusion of new technological tools are multiplying. They face challenges and difficulties that need to be understood with an in-depth analysis of the acceptability of these innovations. We performed a scoping review to explore the theories, methods and conceptual frameworks that have been used to measure and understand the acceptability of technological health innovations in sub-Saharan Africa. The review confirmed the lack of common definitions, conceptualizations and practical tools addressing the acceptability of health innovations. To synthesize and combine evidence, both theoretically and empirically, we then used the "best fit framework synthesis" method. Based on five conceptual and theoretical frameworks from scientific literature and evidence from 33 empirical studies, we built a conceptual framework in order to understand the acceptability of technological health innovations. This framework comprises 6 determinants (compatibility, social influence, personal emotions, perceived disadvantages, perceived advantages and perceived complexity) and two moderating factors (intervention and context). This knowledge synthesis work has also enabled us to propose a chronology of the different stages of acceptability. |
| Date: | 2023–08–31 |
| URL: | http://d.repec.org/n?u=RePEc:hal:journl:hal-04428148&r=hea |
| By: | Belloc, Ignacio; Gimenez-Nadal, José Ignacio; Molina, José Alberto |
| Abstract: | This study explores the link between daily weather conditions and individual engagement in physical activities within the context of the climate emergency. Using ATUS data from 2003-2022, alongside detailed daily-county weather data, the research investigates their correlations. Results highlight a significant positive relationship between extreme high temperatures and heightened participation in physical activities, coupled with increased time dedicated to such pursuits. Surprisingly, individuals in warmer regions exhibit no adaptation to higher temperatures, contradicting initial assumptions. Furthermore, this study discerns sustained effects over a week, with additional hot days positively impacting physical activity within the preceding seven days. These findings hold crucial implications, shedding light on voluntary responses to global warming. They provide essential insights for formulating effective mitigation and adaptive policies aimed at promoting physical activity across varying weather conditions amid the ongoing climate emergency. |
| Keywords: | Physical activity, weather, extreme temperatures, health, time use, ATUS |
| JEL: | I12 J22 Q54 |
| Date: | 2024 |
| URL: | http://d.repec.org/n?u=RePEc:zbw:glodps:1385&r=hea |
| By: | Heger, Dörte; Herr, Annika; Lückemann, Maximilian; Reichert, Arndt R.; Tycher, Leonie |
| Abstract: | Amidst demographic shifts, advanced economies are facing critical nursing shortages. This study analyzes strategies of German nursing care providers to address these shortages using administrative data for the period 2007 to 2017. Our analysis reveals that higher nursing shortages correlate with decreased nurseto-resident ratios, changes in the qualification mix of nurse personnel, and reduced care provision. These findings suggest that nurse shortages can be a threat to the quality of care and the financial sustainability of nursing homes at the margin of being profitable. |
| Abstract: | Aufgrund des demografischen Wandels sind viele Länder mit einem gravierenden Mangel an Pflegekräften konfrontiert. Diese Studie analysiert Strategien deutscher Pflegeheimbetreiber zur Bewältigung des Personalmangels anhand administrativer Daten für den Zeitraum von 2007 bis 2017. Unsere Analyse zeigt, dass ein höherer Personalmangel mit einem geringeren Pflegekräfte-Bewohner/in-Verhältnis, Veränderungen im Qualifikationsmix des Pflegepersonals sowie einem reduzierten Pflegeangebot korreliert. Diese Ergebnisse deuten darauf hin, dass der Mangel an Pflegekräften die Qualität der Pflege und die finanzielle Nachhaltigkeit von Pflegeheimen gefährden kann. |
| Keywords: | Nursing home care, personnel shortage, capacity, nursing management |
| JEL: | C90 I10 I11 I18 J01 |
| Date: | 2023 |
| URL: | http://d.repec.org/n?u=RePEc:zbw:rwirep:282009&r=hea |
| By: | Kämpfen, Fabrice (University College Dublin); Mosca, Irene (National University of Ireland, Maynooth) |
| Abstract: | This is the first study that investigates the heterogeneous effects of blood pressure (BP) screening on subsequent changes in BP in a high-income country. We use data from clinical health assessments carried out in 2010 (baseline) and 2014 (follow-up) as part of a nationally-representative longitudinal study on ageing in Ireland. We employ a Regression Discontinuity Design (RDD) by comparing outcomes at follow-up on either side of the BP cutoff that separates normal to abnormal BP at baseline. We find that the BP screening reduces BP at follow-up among those who at baseline do not report a previous hypertension diagnosis, with larger and more precisely estimated effects for males, middle-age individuals (as opposed to older individuals) and individuals without public health insurance coverage. However, we find no effects when we include in the analysis individuals who at baseline report a previous hypertension diagnosis. Overall, our analysis suggests that the effectiveness of the screening likely depends on whether the information on the outcome of the screening provided to individuals is new to them or not. |
| Keywords: | health screening, hypertension, blood pressure, undiagnosed individuals, non-communicable diseases, regression discontinuity design, ireland, high-income country |
| JEL: | C21 I12 I18 |
| Date: | 2024–01 |
| URL: | http://d.repec.org/n?u=RePEc:iza:izadps:dp16767&r=hea |
| By: | Maroto, Michelle Lee (University of Alberta); Pettinicchio, David; Chai, Lei; Holmes, Andy |
| Abstract: | Although social distancing measures enacted during COVID-19 prevented the spread of the virus and acted as important coping mechanisms during this stressful time, they also contributed to loneliness and anxiety. The pros and cons of social distancing measures were especially relevant among people with disabilities and chronic health conditions – a high-risk group concerned about infection through contact with non-household members and visiting public places like school, healthcare providers, and work. Drawing on data from a national online survey (N = 1, 027) and in-depth virtual interviews (N = 50) with Canadians with disabilities and chronic health conditions, we examine the positive and negative effects of three types of social distancing measures – avoiding public places, transitioning to remote work or school, and avoiding contact with non-household members – on perceptions of increases in anxiety and loneliness during the pandemic. We find that the relationships between engaging with social distancing measures and anxiety and loneliness could be positive or negative, with measures acting as both adaptive and maladaptive coping mechanisms. Although avoiding public places or non-household members and transitioning to remote work or school often resulted in increased anxiety and loneliness, respondents also described situations where these measures helped them cope with concerns about catching COVID-19. Our findings highlight potential implications for public health policy in allocating different coping resources among marginalized groups during times of crisis and demonstrate the importance of using a social model of stress, coping mechanisms, and mental health. |
| Date: | 2023–02–28 |
| URL: | http://d.repec.org/n?u=RePEc:osf:osfxxx:46hfd&r=hea |
| By: | Bustamante Izquierdo, Juana Paola; Cometto, Giorgio; Diallo, Khassoum; Zurn, Pascal; Campbell, Jim |
| Abstract: | This paper uses a health labor market lens to examine the impact of COVID-19 on health workers, as well as relevant policy levers. It compiles a collection of literature using a standardized measurement framework to determine the impact of COVID-19 on health workers. It examines the relevant issues under the lens of a health labor market. In particular, the paper interprets this information and knowledge by focusing on the supply, demand, and mismatches in a health labor market. Within this framework, it presents relevant issues on COVID-19 and its impact on health workers, as well as the ensuing policy response. Finally, the chapter presents key lessons learned from COVID-19 to inform future responses related to ensuring a sufficient workforce to tackle them. |
| Keywords: | labour market, employment, health, health workforce, supply, demand |
| JEL: | I11 I14 I18 J08 J21 J23 J49 |
| Date: | 2024 |
| URL: | http://d.repec.org/n?u=RePEc:zbw:glodps:1396&r=hea |