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on Health Economics |
| By: | Xiuming Dong; Johanna Catherine Maclean; David Powell |
| Abstract: | Social insurance programs shield individuals from specific risks, but these programs are not necessarily independent of each other. The existence and scope of one program can potentially influence the use of others, especially when the risks covered by the programs are related. This study investigates the relationship between two mandated benefit programs in the United States: state paid sick leave (PSL) mandates and workers’ compensation. Unlike most developed countries, the U.S. lacks a federal PSL mandate; however, 15 states have implemented such policies. PSL mandates require firms to provide compensated time off for employee health-related needs, while workers’ compensation offers benefits to help workers recover from workplace injuries or illnesses. Using a difference-in-differences analysis, the study explores the impact of state PSL mandates on the usage of workers’ compensation benefits. The findings reveal meaningful spillover effects: when states adopt PSL requirements, there is a decrease in workers’ compensation benefit receipt. While some evidence suggests possible improvements in health, there are no observed reductions in workplace injury rates specifically, indicating that workers may substitute PSL benefits directly for workers’ compensation. |
| JEL: | I18 J28 J32 |
| Date: | 2024–07 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32751 |
| By: | Johanna Catherine Maclean; Sabrina Wulff Pabilonia |
| Abstract: | Unlike most developed countries, the U.S. lacks a federal paid sick leave policy. As a result, many workers must choose between losing earnings and attending to childcare responsibilities. To date, 14 states and the District of Columbia have adopted paid sick leave mandates that provide up to seven days of paid leave per year that can be used for family responsibilities and healthcare. In this study, we estimate the effects of state paid sick leave mandates on parents’ time spent providing childcare using time diaries from the 2004–2022 American Time Use Survey. Findings from difference-in-differences estimators suggest that post-mandate, parental time spent providing childcare increases by 4.9%. Effects are generally stronger among women and parents with younger children. Overall, our findings suggest that paid sick leave mandates allow parents to better balance work and family responsibilities. |
| JEL: | I18 J28 J33 |
| Date: | 2024–07 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32710 |
| By: | Gonçalves, Judite; Rocha-Gomes, João; Amorim-Lopes, Mário; Martins, Pedro S. |
| Abstract: | Women appear to take sick leave at a higher rate and for longer periods than men. However, the reasons for these differences are poorly understood. This study starts by outlining several channels (biological, psychological, socio-economic, and occupational) that may drive this gender gap. We then analyse rich individual longitudinal administrative data on employment and sickness benefits. We consider the case of Portugal, where sickness benefits are relatively generous, in contrast to other potentially related social support (such as childcare). We find that women's adjusted monthly odds of receiving sickness benefits are 1.66 times those of men. This ratio falls to 1.37 when considering only hospitalisation-initiated sickness benefits, which may be driven exclusively by health factors. Overall, our results suggest that biological factors, as well as work-related hazards and stressors, play a large role in the gender gap in sickness benefits; yet behavioural and socioeconomic factors are non-negligible. For example, more women may use sickness benefits to accommodate caregiving responsibilities, and more men may forgo statutory sick leave to provide for their family. Our findings underscore the importance of more evidence for the enhancement of health and equity at work. Improved social and workplace policies to mitigate the double burden of work and family responsibilities, laying mostly on (poorer) women, may be needed, also to increase fair use of sickness benefits. |
| Keywords: | Sick leave, Gender inequality, Hospitalisation, Diagnosis, Caregiving responsibilities |
| JEL: | I18 H55 J28 |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:glodps:1468 |
| By: | Damon Jones; David Molitor; Julian Reif |
| Abstract: | We study habit formation in annual biometric health screenings using a field experiment that randomly assigned financial incentives to 4, 799 employees over three years. Completing the first screening raised subsequent screenings by 32.4-36.0 percentage points (84%-90%) annually. Habit formation was similar whether employees were offered screenings as part of a comprehensive wellness program or just screenings alone, suggesting such habits can develop without frequent interactions. We rule out inattention as an explanation, using a subsample assigned more salient incentives. The long-run effect stems from the initial decision to participate, indicating a habit formation process with a one-shot mechanism. |
| JEL: | H0 I1 |
| Date: | 2024–07 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32745 |
| By: | Philipp Ager (University of Mannheim, CEPR); Viktor Malein (Lund University) |
| Abstract: | The paper evaluates the long-run impact of charity nurseries for disadvantaged children in early 20th-century New York. Access to charity nurseries with kindergarten instruction raised children’s years of education and reduced their likelihood of working in low-skilled jobs later in life. Instead, exposed children were more likely to work in jobs requiring higher cognitive and language skills. The effects were strongest for children from the most disadvantaged immigrant groups at that time. Our findings suggest that kindergarten instruction in charity nurseries helped immigrant children better understand teachers’ instructions and learning materials which improved their economic outcomes in adulthood. |
| Keywords: | Age of Mass Migration, Charity Nurseries, Child Care, Disadvantaged Children, Kindergarten Instruction, New York City |
| JEL: | I21 I26 J13 J15 N31 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:hes:wpaper:0263 |
| By: | Esther Duflo; Pascaline Dupas; Elizabeth Spelke; Mark P. Walsh |
| Abstract: | We provide experimental evidence on the intergenerational impacts of secondary education subsidies in a low-income context, leveraging a randomized controlled trial and 15-year longitudinal follow-up. For young women, receiving a scholarship for secondary school delays childbearing and marriage, and reduces unwanted pregnancies. Female scholarship recipients are more likely to marry a partner with tertiary education and their children have better early childhood development outcomes. In particular, we document a 45% reduction in under-three mortality as well as cognitive development gains of 0.25 standard deviations of test scores once children are of school age. The primary mechanism seems to be that more-educated caregivers have the knowledge and skills to safeguard their children’s health and stimulate their cognitive development. In contrast, we find no evidence of a positive impact for the children of male scholarship recipients, who tend to marry less educated partners. Together, these results suggest a key role for maternal education in child outcomes. We also estimate the cost-benefit ratio for secondary school scholarships and find that the impact on child survival alone is sufficient to make them a highly cost-effective investment. |
| JEL: | I26 J13 O15 |
| Date: | 2024–07 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32742 |
| By: | Lacey, Lindsey (Allegheny County Department of Human Services); Mishra, Nirajana (Northeastern University); Mukherjee, Priya (University of Wisconsin-Madison); Prakash, Nikhilesh (Stockholm School of Economics); Prakash, Nishith (Northeastern University); Quinn, Diane (University of Connecticut); Sabarwal, Shwetlena (World Bank); Saraswat, Deepak (University of Connecticut) |
| Abstract: | We conducted a randomized control trial to study the impact of two information messages aimed at reducing the stigma associated with mental illness on the willingness to seek mental healthcare among adults in Nepal. The first intervention shares information about the prevalence of mental health issues and the efficacy of treatment. The second intervention shares information about the mental health struggles of a Nepali celebrity and how he benefited from treatment. We find three results. First, compared to a no-information control group, both interventions increase participants' stated willingness to seek mental health treatment. This effect is driven by participants with high personal and anticipated stigma, less severe symptoms of depression and anxiety, and who hold strong beliefs about conformity to masculinity. Second, the impact on participants' stated willingness to seek mental health treatment mirrors their willingness to pay for counseling. Third, participants are, on average, more likely to report willingness to seek help when the enumerator is female. |
| Keywords: | mental health, stigma, prejudice, seeking help, celebrity, Nepal |
| JEL: | I12 I15 |
| Date: | 2024–07 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17166 |
| By: | Natalie Bau; David J. Henning; Corinne Low; Bryce Steinberg |
| Abstract: | Early fertility is a key barrier to female human capital attainment in sub-Saharan Africa, yet contraceptive take-up remains puzzlingly low, even among educated populations with healthcare access. We study a barrier to hormonal contraceptive uptake that has not been causally tested: the persistent (incorrect) belief that these contraceptives cause later infertility. This belief creates a perceived tradeoff between current and future reproductive control. We use a randomized controlled trial with female undergraduates at the flagship university in Zambia to test two interventions to increase contraceptive use. Despite high rates of sexual activity, low rates of condom-use, and near zero desire for current pregnancy, only 5% of this population uses hormonal contraceptives at baseline. Providing a non-coercive conditional cash transfer to visit a local clinic only temporarily increases contraceptive use. However, pairing this transfer with information addressing fears that contraceptives cause infertility has a larger initial effect and persistently increases take-up over 6 months. This treatment reduces beliefs that contraceptives cause infertility and leads to the take-up of longer-lasting contraceptives. Compliers are more likely to cite fear of infertility as the reason for not using contraceptives at baseline. Eliminating the belief that contraceptives cause infertility would more than triple contraceptive use. |
| JEL: | I10 I12 J10 J13 O10 O12 |
| Date: | 2024–07 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32735 |
| By: | Blimpo, Moussa (University of Toronto); Carneiro, Pedro (University College London); Jervis Ortiz, Pamela (Universidad de Chile); Lahire, Nathalie (World Bank); Pugatch, Todd (Oregon State University) |
| Abstract: | We study two early childhood programs in The Gambia for children between 0 and 3 years of age. The basic version of the program, called Baby Friendly Community Initiative (BFCI), provides parents with child health and nutrition information delivered through home visits and community meetings. A second version, called BFCI+, is center-based and adds cognitive stimulation to the basic version of the program through activities with children. Villages were randomly assigned to one of two versions of the program or to a control group that received neither. The BFCI+ program had moderate impacts on parental investments in children in terms of resources and time. Child language development improved for well-off parents or parents in the more well-off region. Poorer parents invested more in time spent with the children, whereas those who were more materially well-off spent more financial resources on the children. The basic version of the program, the BFCI, had no detectable impacts. |
| Keywords: | early childhood development, cognitive stimulation, teacher training, The Gambia, randomized controlled trials, Malawi Developmental Assessment Tool |
| JEL: | I25 I38 O15 O22 |
| Date: | 2024–07 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17133 |
| By: | Vasishth, Mahima (Bocconi University) |
| Abstract: | In this paper, I estimate the inter-generational health impact of maternal employment opportunities using evidence from the ready-made garment industry in Bangladesh. This industry was exposed to a trade liberalization policy in 2005, which generated spatial and temporal variation in the establishment of garment factories and therefore, potential employment opportunities for women. Using a difference-in-difference strategy, I find that the expansion of this sector improved the probability of neonatal survival for children who are born in areas that experience higher growth in employment opportunities post trade liberalization. This is driven by the improved labor market participation by mothers, enabling them to delay childbirth and improve their intra-household bargaining power. |
| Keywords: | neonatal mortality, female labor force participation, ready-made garment sector |
| JEL: | J21 I15 I12 |
| Date: | 2024–06 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17106 |
| By: | Gabriella Conti (University College London); Sören Kliem (Institute for Applied Science Jena); Malte Sandner (Technical University Nürnberg) |
| Abstract: | We study the impacts of a prenatal and infancy home visiting program targeting disadvantaged families on mental health outcomes, assessed through diagnostic interviews. The program significantly reduced the prevalence of mental health conditions for both mothers and children, measured at primary-school age, and broke the intergenerational association of these conditions. The impacts are predominantly associated with a particular delivery model, wherein a single home visitor interacts with the family, as opposed to a model involving two home visitors. |
| Keywords: | diagnostic interviews |
| JEL: | I12 J21 J13 J16 |
| Date: | 2024–07 |
| URL: | https://d.repec.org/n?u=RePEc:hka:wpaper:2024-014 |
| By: | M. Kate Bundorf; Melissa McInerney; Kosali I. Simon; Ruth Winecoff |
| Abstract: | Enrollment in one public benefit program often affects enrollment in others. We study life-course spillovers by examining how access to publicly subsidized health insurance prior to age 65 affects public benefit choices at the age of Medicare eligibility. We use administrative data to examine several Medicare enrollment choices: the heavily under-subscribed Medicaid “dual” coverage as a supplement to Medicare; Medicare Part D; the Part D Low Income Subsidy (LIS); and Medicare Advantage. Focusing on people living in low-income zip codes, we find a large increase in dual Medicaid among new Medicare beneficiaries in Medicaid expansion states relative to non- expansion states, as well as corresponding increases in healthcare use and reductions in out-of-pocket spending. The dual Medicaid increase exerts a bonus effect: greater take-up of LIS and Part D programs, which we attribute to the accompanying automatic enrollment in these programs. Our results on Medicare Advantage enrollment are inconclusive. Overall, our results suggest that experience with Medicaid before age 65 causes meaningful behavioral responses among the lowest-income beneficiaries when they age into Medicare; this emphasizes the importance of longitudinal spillovers also present in other public programs with eligibility criteria that differ by applicant age (e.g., Supplemental Nutrition Assistance Program (SNAP) and Supplemental Security Income (SSI)). |
| JEL: | H0 H51 H75 I0 I13 |
| Date: | 2024–07 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32675 |
| By: | Christopher S. Carpenter; Lucas Goodman; Maxine J. Lee |
| Abstract: | We provide the first evidence on transgender earnings in the US using administrative data on over 55, 000 individuals who changed their gender marker with the Social Security Administration and had gender-congruent first name changes on tax records. We validate and describe this sample which exhibits positive selection likely associated with the ability to legally affirm gender. To address selection we estimate transgender earnings gaps using timing variation within-person and variation across siblings and coworkers. All three approaches return evidence of robust transgender earnings penalties of 6-13 log points driven by extensive and intensive margin differences. |
| JEL: | J0 J10 |
| Date: | 2024–07 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32691 |
| By: | Michael F. Lovenheim; Jun Hyun Yun |
| Abstract: | The U.S. healthcare system requires substantial out-of-pocket payments by most consumers, which can prevent some from receiving needed medical services. Recent policy proposals seek to address this problem by increasing government health care spending in order to reduce out-of-pocket costs. The social value of these policies rests in part on the extent to which consumers face credit constraints in financing medical spending. We present a novel analysis of whether elderly households face such credit constraints by estimating the effects of wealth variation from home price changes on out-of-pocket medical expenditures. Using data from the Health and Retirement Study and various measures of home price changes, we find no evidence that housing wealth impacts out-of-pocket medical spending. The estimates are universally small and precise, allowing us to rule out even modest-sized effects. Effects are zero across the expenditure distribution, for specific categories of expenditure, and for different types of consumers split by health insurance status and SES. Our results suggest that further subsidizing health care for elderly homeowners, the majority of older Americans, would increase moral hazard costs without increasing access to needed care. |
| JEL: | G51 I11 I14 |
| Date: | 2024–07 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32729 |
| By: | Iris Kesternich; Bettina Siflinger; James P. Smith; Franziska Valder |
| Abstract: | Based on a sample of elderly individuals from the Survey of Health, Ageing, and Retirement in Europe, we investigate the relationship between job and marital stability over the life cycle. We argue that an unobserved, time-varying social skill affects stability in both markets. Using a grouped fixed-effects estimator, we show that unobserved relationship stability in both markets is significantly and positively associated. Instability in both markets is associated with lower levels of trust and conscientiousness and higher levels of extraversion and neuroticism. The absence of the father during childhood perpetuates higher instability later in life. Higher instability is also costly since it is associated with lower levels of late-life well-being. |
| Keywords: | relationship stability, marriage dissolution, job turnover, social skills, non-cognitive skills, grouped fixed-effect estimator, survey of health, ageing and retirement in Europe |
| JEL: | J12 J24 J63 I31 C33 |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:ces:ceswps:_11198 |
| By: | Davillas, Apostolos (University of Macedonia); Jones, Andrew M. (University of York) |
| Abstract: | We explore the role of epigenetic biological age in predicting subsequent health care utilisation. We use longitudinal data from the UK Understanding Society panel, capitalizing on the availability of baseline epigenetic biological age measures along with data on general practitioner (GP) consultations, outpatient (OP) visits, and hospital inpatient (IP) care collected 5-12 years from baseline. Using least absolute shrinkage and selection operator (LASSO) regression analyses and accounting for participants' pre-existing health conditions, baseline biological underlying health, and socio-economic predictors we find that biological age predicts future GP consultations and IP care, while chronological rather than biological age matters for future OP visits. Post-selection prediction analysis and Shapley-Shorrocks decompositions, comparing our preferred prediction models to models that replace biological age with chronological age, suggest that biological ageing has a stronger role in the models predicting future IP care as opposed to "gatekeeping" GP consultations. |
| Keywords: | epigenetics, biological age, health care utilisation, red herring hypothesis, LASSO, supervised machine learning |
| JEL: | C5 C81 I10 I18 |
| Date: | 2024–07 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17159 |
| By: | Bergvall, Sanna (University of Gothenburg); Rodríguez-Planas, Núria (Queens College, CUNY) |
| Abstract: | Most empirical studies indicate that becoming a mother is an augmenting factor for the perpetration of intimate partner violence (IPV). Using rich population-wide hospital records data from Sweden, we conduct a stacked DiD analysis comparing the paths of women two years before and after the birth of their first child with same-age women who are several quarters older when giving birth to their first child and find that, in contrast to the consensus view, violence sharply decreases with pregnancy and motherhood. This decline has both a short-term and longer-term component, with the temporary decline in IPV covering most of the pregnancy until the child is 6 months old, mimicking a temporary decrease in hospital visits for alcohol abuse by the children's fathers. The more persistent decline is driven by women who leave the relationship after the birth of the child. Our evidence is not supportive of alternative mechanisms including suspicious hospitalizations, an overall reduction in hospital visits or selection in seeking medical care, mothers' added value as the main nurturer, or mothers' drop in relative earnings within the household. Our findings suggest the need to push for public health awareness campaigns underscoring the risk of victimization associated with substance abuse and to also provide women with more support to identify and leave a violent relationship. |
| Keywords: | motherhood, stacked difference-in-differences model, event study, individual fixed effects, administrative longitudinal records data, population-wide estimates |
| JEL: | J12 J13 |
| Date: | 2024–07 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17129 |
| By: | Shooshan Danagoulian; Owen Fleming; Daniel S. Grossman; David Slusky |
| Abstract: | Individuals of Middle Eastern and North African (MENA) ancestry in the US have been targeted by anti-immigrant and counterterrorism policies and have been the focus of vitriolic political rhetoric. Despite this, lack of data identifying MENA individuals has prevented systematic evaluation of the impact of these policies and rhetoric on MENA communities’ wellbeing, including investment in health capital. This paper begins to address this gap in knowledge using a large, longitudinal medical records database with expanded race and ethnicity measures to describe disparities and evaluate the impact of immigration policies and anti-MENA rhetoric on preventive care use among MENA children in the US. Specifically, we evaluate the election of Donald Trump, and find that the election decreased MENA children’s utilization of vaccinations and well visits. Documenting MENA health and outcomes following official US policy and rhetoric is paramount for understanding the full consequences of policies that target underrepresented groups. |
| JEL: | H12 I14 I18 J15 |
| Date: | 2024–07 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32676 |
| By: | Brian Anderson; Eric Sutherland |
| Abstract: | Artificial intelligence will have profound impacts across health systems, transforming health care, public health, and research. Responsible AI can accelerate efforts toward health systems being more resilient, sustainable, equitable, and person-centred. This paper provides an overview of the background and current state of artificial intelligence in health, perspectives on opportunities, risks, and barriers to success. The paper proposes several areas to be explored for policy makers to advance the future of responsible AI in health that is adaptable to change, respects individuals, champions equity, and achieves better health outcomes for all. The areas to be explored relate to trust, capacity building, evaluation, and collaboration. This recognises that the primary forces that are needed to unlock the value from artificial intelligence are people-based and not technical. The OECD is ready to support efforts for co-operative learning and collective action to advance the use of responsible AI in health. |
| Date: | 2024–01–19 |
| URL: | https://d.repec.org/n?u=RePEc:oec:comaaa:10-en |
| By: | Jensen, Mathias Fjællegaard (University of Oxford); Zhang, Ning (Chinese University of Hong Kong) |
| Abstract: | Nearly everyone experiences the death of a parent in adulthood, but little is known about the effects of parental death on adult children's labor market outcomes and the underlying mechanisms. In this paper, we use Danish administrative data to examine the effects of losing a parent on individual labor market outcomes and its contribution to gender earnings inequalities. Our empirical design leverages the timing of sudden, first parental deaths, allowing us to focus on the health and family support channels. Our findings reveal enduring negative effects on the earnings of both adult sons and daughters: sons' earnings drop by 2% in the fifth year after parental death, while daughters' earnings drop by 3% during the same period. Exploring the underlying mechanisms, we observe that both women and men experience increased mental health issues after parental loss, albeit manifesting differently: women tend to seek psychological assistance more frequently, while men receive more mental health-related and opioid prescriptions. Furthermore, we find that women with young children experience a comparatively larger drop (around 4%) in earnings after parental death due to the loss of informal childcare, a factor that significantly contributes to the gender pay gap. Lastly, we show that women experience a greater decline in earnings if their surviving parent requires higher levels of eldercare. These findings collectively underscore a substantial labor market penalty for individuals who experience parental death and emphasize the role of informal care in contributing to gender pay disparities. |
| Keywords: | parental death, earnings, gender inequalities, mental health, family support |
| JEL: | D64 J10 J16 |
| Date: | 2024–07 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17127 |
| By: | Mari, Gabriele |
| Abstract: | After cutting social security in recent decades, the UK, Ireland, and Australia expanded income-support programs during the pandemic. Relatively overlooked, this paper investigates policy responses among younger generations, the socioeconomic disparities therein, and whether and which of these policies, now rolled back, were most beneficial. To answer these questions, I rely on longitudinal survey data on adolescents and their caregivers. In value-added regressions adjusting for pre-pandemic health reports, I find that children reported better average health in households with access to the relatively generous scheme adopted by Australia. Girls reported better health in households targeted by previous cutbacks, including those with lower incomes (UK, Ireland) or headed by a single parent (Australia). The more far-reaching programs in Ireland and Australia were associated with better health also among children in well-off households. On the other hand, some children reported worse mental health despite receipt of payments in all three countries and especially in the UK. Further distributional analyses suggest that programs might have reduced adolescent health disparities in Australia, whereas overall effects were negative or mixed in the UK and Ireland. Hence, policy changes during the pandemic did not equally fit the needs of all children. Nonetheless, drawing lessons from that period, changes to existing income-support programs hold some promise to temper distress and associated inequalities across generations. |
| Date: | 2024–07–15 |
| URL: | https://d.repec.org/n?u=RePEc:osf:socarx:pzr4k |
| By: | Silvia Castro; Kristina Czura |
| Abstract: | Every month, millions of women worldwide face challenges managing their menstrual hygiene, suffering negative impacts on their health, education, and productivity. Cultural taboos and social norms may contribute to harmful health behaviors and may also interfere with attempts to improve knowledge. Our study explores how deep-rooted cultural norms relate to, and potentially hinder, effective menstrual hygiene practices. We engaged with women in rural communities in Bangladesh to understand and quantify their well-being during menstruation and their perceptions on the prevailing social norms around menstrual health. With an educational intervention, we aim to disseminate crucial knowledge on menstrual hygiene practices. Our findings show that while the information intervention succeeded in reshaping certain misconceptions and menstrual practices, it was not enough to alter deep-seated norms regarding the washing and maintenance of menstrual cloth. |
| Keywords: | social norms, menstrual health management, menstrual hygiene, information, adverse health behavior |
| JEL: | I12 I15 D91 O12 |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:ces:ceswps:_11204 |
| By: | Antman, Francisca M. (University of Colorado, Boulder); Flynn, James (Miami University) |
| Abstract: | We investigate the impact of beer on mortality during the Industrial Revolution in 18th century England. Due to the brewing process, beer represented an improvement over available water sources during this period prior to the widespread understanding of the link between water quality and human health. Using a wide range of identification strategies to derive measures of beer scarcity driven by tax increases, weather events, and soil quality, we show that beer scarcity was associated with higher mortality, especially in the summer months when mortality was more likely to be driven by waterborne illnesses related to contaminated drinking water. We also leverage variation in inherent water quality across parishes using two proxies for water quality to show that beer scarcity resulted in greater deaths in areas with worse water quality. Together, the evidence indicates that beer had a major impact on human health during this important period in economic development. |
| Keywords: | beer, water quality, mortality, industrial revolution |
| JEL: | N33 I15 Q25 |
| Date: | 2024–07 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17164 |
| By: | Charles Yuji Horioka; Emin Gahramanov; Xueli Tang |
| Abstract: | The purpose of this paper is to conduct a theoretical and empirical analysis of the nexus between long-term care insurance (LTCI), formal care, informal (family) care, and bequests. In our empirical analysis, we use micro data from the Japan Household Panel Survey on Consumer Preferences and Satisfaction (JHPS-CPS), formerly known as the Preference Parameter Study, conducted by Osaka University. Japan is an interesting case to analyze because a public LTCI system was introduced there in 2000. Our analysis shows that, in the case of Japan, if parents are eligible for public LTCI benefits, their children will be less likely to be their primary caregiver and that this, in turn, will reduce their children’s perceived likelihood of receiving a bequest from them. This result implies that bequests are selfishly or strategically motivated (i.e., that parents leave bequests to their children in order to elicit care from them) and that the introduction of a public LTCI system will reduce the likelihood of children providing care to their parents and through this channel reduce their perceived likelihood of receiving a bequest from them. |
| JEL: | D11 D12 D15 D64 E21 I13 J14 |
| Date: | 2024–07 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32744 |
| By: | Johannes Geyer; Peter Haan; Mia Teschner |
| Abstract: | The price for institutional long-term care is a central determinant of the demand for formal and informal long-term care. In this paper, we show how macroeconomic conditions affect these prices. The analysis is based on administrative data that contains rich information on the universe of nursing homes and ambulatory care services and about all recipients of long-term care benefits in Germany. For identification, we exploit variation in macroeconomic conditions measured by the unemployment rate across districts and over time, applying a panel data approach with facility and time fixed effects. Our empirical results show that a higher unemployment rate increases prices for permanent long-term care as well as for prices of accommodation and meals in nursing homes. We provide empirical evidence for the mechanism of these price effects. While we find that employment, working hours, and quality of care in nursing homes are not significantly affected by macroeconomic conditions, our results show that a higher unemployment rate increases the price of nursing homes through a change in the composition of patients: it induces a shift from care recipients with a low degree of impairment to patients with high demands for labor-intensive care. We also document a substitution of low-impairment care from nursing homes toward ambulatory and informal home care. |
| Keywords: | Long-Term Care, Nursing home prices, Unemployment rate, Macroeconomic Conditions, Informal care |
| JEL: | E32 I11 J20 |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:diw:diwwpp:dp2096 |
| By: | A. Chung (Department of Economics, University of Reading); D S. Hamermesh (University of Texas at Austin, IZA, and NBER); C. Singleton (Economics Division, Stirling Management School, University of Stirling, and IZA); Z. Wang (School of Economics, Zhejiang University of Finance and Economics); J. Zhang (School of Economics, Zhejiang University, Department of Economics, The Chinese University of Hong Kong, and IZA) |
| Abstract: | We investigate the relationship between physical attractiveness and the time people devote to video/computer gaming. Average American teenagers spend 2.6% of their waking hours gaming, while for adults this figure is 2.7%. Using the American Add Health Study, we show that adults who are better-looking have more close friends. Arguably, gaming is costlier for them, and they thus engage in less of it. Physically attractive teens are less likely to engage in gaming at all, whereas unattractive teens who do game spend more time each week on it than other gamers. Attractive adults are also less likely than others to spend any time gaming; and if they do, they spend less time on it than less attractive adults. Using the longitudinal nature of the Add Health Study, we find supportive evidence that these relationships are causal for adults: good looks decrease gaming time, not vice-versa. |
| Keywords: | physical attractiveness, beauty, time allocation, social activity, teenage behavior |
| JEL: | J22 L82 L86 |
| Date: | 2024–08–13 |
| URL: | https://d.repec.org/n?u=RePEc:rdg:emxxdp:em-dp2024-04 |
| By: | Mendolia, Silvia (University of Torino); Stavrunova, Olena (University of Technology, Sydney); Vidal-Fernandez, Marian (University of Sydney) |
| Abstract: | Birth order effects in developed countries are consistently negative. That is, the later a child is born within a family, the worse their adult economic outcomes relative to their earlier-born siblings are. However, studies of birth order effects in emerging countries are scarcer and yield conflicting birth order effect signs. We study whether this divergence in results is due to within-country data idiosyncrasies or methods heterogeneity. We use almost 1.8 million observations gathered from the Demographic and Health Survey (DHS) to measure birth order effects on children's educational outcomes in 35 developing countries, between the mid-1980s and 2020. To the best of our knowledge, this is the first study analysing birth order effects in a comprehensive set of developing countries. In developing countries, families tend to be relatively large and within-family resources scarce. The DHS contains harmonised data and variables for all countries, providing a picture of birth order effects that is consistent across the developing world. Using mothers' fixed effects models, we estimate the impact of birth order on standardised years of schooling and school attendance, exploring non-linearities in birth order effects, as well as heterogeneous effects by gender, socio-economic characteristics and over time. Overall, we find negative birth order effects on educational attainment in 32 out of 35 countries. Consistent with this, we find that the probability of not being in school increases with birth order. We find that in most countries, overall birth order effects do not vary by gender, family wealth, location or over time. In countries where we do find differences in birth order across these dimensions of heterogeneity, the negative birth order effects are stronger for children from poorer households, and households in rural areas. |
| Keywords: | birth order, education, low income countries |
| JEL: | I10 I20 |
| Date: | 2024–07 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17131 |
| By: | Effrosyni Adamopoulou; Mattia Colombo; Eleftheria Triviza |
| Abstract: | This study examines how early-life exposure to food scarcity influences individuals’ long-term time preferences and savings behavior. To this end, we analyze hand-collected historical data on livestock availability during World War II at the provincial level, alongside detailed survey data on elicited time preferences and household savings. By leveraging differences across cohorts and provinces in a difference-in-differences framework, we find that individuals who experienced more severe scarcity during early childhood develop higher levels of patience later in life and tend to hold more (precautionary) savings, conditional on income. Our findings suggest that exposure to protein scarcity during the first years of life and in utero can instigate a lasting increase in prudent behavior in the form of a coping mechanism. |
| Keywords: | patience, precautionary savings, scarcity, early life experiences |
| JEL: | D14 N44 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:bon:boncrc:crctr224_2024_583 |
| By: | Huang, Junhua; Valizadeh, Pourya; Bryant, Henry; Priestley, Samuel |
| Abstract: | During the COVID-19 pandemic, the United States government introduced various pandemic-related relief measures to support low-income households participating in the Supplemental Nutrition Assistance Program (SNAP). Among these changes was the emergency allotment (EA), which provided additional benefits to help SNAP beneficiaries maintain access to essential food items during these challenging times. However, beginning in 2021, the expiration of EA, a temporary increase, led to a minimum reduction of $95 per month in benefits for program participants. This study estimates the impact of EA expiration on monthly fresh fruit and vegetable (FV) spending of SNAP households. Drawing on novel transaction-level food purchase data, we identify SNAP households based on method of payments, specifically Electronic Benefit Transfer (EBT) card usage, which is derived from uploaded food purchase receipts rather than self-reporting. Our general research design leverages variation across states and over time due to the staggered expiration of EA payments via difference-in-differences estimators. Our findings indicate a robust negative impact on fresh FV spending following the termination of EA, with a reduction of approximately 4%, translating into a decrease of roughly $8 per month for the average SNAP household, or $2.20 per person per month. This reduction suggests that, although statistically significant, the decrease is not substantial in terms of its impact on health. Indeed, we find that fresh FV spending is highly inelastic with respect to the SNAP benefit level, and simple changes to that level are unlikely to improve diet quality among poor households, if that is a policy goal. |
| Keywords: | Agribusiness, Consumer/Household Economics, Food Security and Poverty |
| Date: | 2024–07–23 |
| URL: | https://d.repec.org/n?u=RePEc:ags:aaea22:344186 |
| By: | Mahdinia, Iman PhD; Griswold, Julia B. PhD; Unda, Rafael; Sohrabi, Soheil PhD; Grembek, Offer PhD |
| Abstract: | The escalating number of injuries and fatalities among cyclists is a pressing safety concern. In the United States, communities are actively seeking strategies to boost cyclist safety, with some states implementing bike-specific policies, such as stop-as-yield laws, to support cyclists. Stop-as-yield laws allow cyclists to treat stop signs as yield signs. The laws are not yet widely implemented, and their potential safety impact is a subject of debate among transportation experts and advocates. This study investigates how stop-as-yield laws can positively or negatively affect safety and provides insights and guidelines for California policymakers and safety practitioners if the law passes in California. We collected cyclist data from five states that have enacted stop-as-yield laws—Idaho, Arkansas, Oregon, Washington and Delaware—and data from some of their contiguous states without such legislation. Using an observational before-after study with comparison groups at the state level, the research examined changes in cyclist crash frequencies after the laws were implemented. Additionally, a random-effects negative binomial regression model with panel data was employed to estimate a law’s overall impact. The results did not indicate a significant change in cyclist crashes among the states with stop-as-yield laws. |
| Keywords: | Engineering, Cyclists, highway safety, bicycle crashes, crash data, laws, yielding, stop signs |
| Date: | 2024–08–01 |
| URL: | https://d.repec.org/n?u=RePEc:cdl:itsrrp:qt64h2s9cj |