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on Health Economics |
| By: | Shuo Feng; Ishani Ganguli; Youjin Lee; John Poe; Andrew Ryan; Alyssa Bilinski |
| Abstract: | Difference-in-differences (DiD) is the most popular observational causal inference method in health policy, employed to evaluate the real-world impact of policies and programs. To estimate treatment effects, DiD relies on the "parallel trends assumption", that on average treatment and comparison groups would have had parallel trajectories in the absence of an intervention. Historically, DiD has been considered broadly applicable and straightforward to implement, but recent years have seen rapid advancements in DiD methods. This paper reviews and synthesizes these innovations for medical and health policy researchers. We focus on four topics: (1) assessing the parallel trends assumption in health policy contexts; (2) relaxing the parallel trends assumption when appropriate; (3) employing estimators to account for staggered treatment timing; and (4) conducting robust inference for analyses in which normal-based clustered standard errors are inappropriate. For each, we explain challenges and common pitfalls in traditional DiD and modern methods available to address these issues. |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:arx:papers:2408.04617 |
| By: | R. Anton Braun; Karen A. Kopecky |
| Abstract: | Nursing home risk is significant and costly. Yet, most Americans pay for long-term care (LTC) expenses out-of-pocket. This chapter examines reforms to both public and private LTCI provision using a structural model of the US LTCI market. Three policies are considered: universal public LTCI, no public LTCI coverage, and a policy that exempts asset holdings from the public insurance asset test on a dollar-for-dollar basis with private LTCI coverage. We find that this third reform enhances social welfare and creates a vibrant private LTCI market while preserving the safety net provided by public insurance to low-income individuals. |
| Keywords: | Long-term care insurance; Medicaid; adverse selection; partnership program |
| JEL: | D82 D91 E62 G22 H30 I13 |
| Date: | 2024–08–14 |
| URL: | https://d.repec.org/n?u=RePEc:fip:fedcwq:98684 |
| By: | Naoki Aizawa; Hanming Fang; Katsuhiro Komatsu |
| Abstract: | The United States has experienced a significant decline in labor unions over the past half-century. We examine the aggregate labor market impact of labor unions, the causes of their decline, and their welfare and distributional consequences, accounting for unions’ effects on wages and employers’ insurance provisions. We first provide descriptive evidence that social insurance expansions contribute to the union’s decline. We then develop and estimate an equilibrium labor search model where unionization, wages, employers’ insurance provisions, and job security are endogenously determined. We find that, while skill-biased technological changes and Right-to-Work laws respectively explain 32% and 7% of the union decline from 1955 to 2019, social insurance expansions account for 15%. Our analysis also indicates that social insurance expansion can affect inequality through (de)unionization, and inequality may increase or decrease depending on how social insurance is targeted. Subsidizing unions lowers overall social welfare but increases the welfare of low-skilled workers. |
| JEL: | I13 J42 J51 J52 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32793 |
| By: | Margherita Borella; Francisco A. Bullano; Mariacristina De Nardi; Benjamin Krueger; Elena Manresa |
| Abstract: | While health affects many economic outcomes, its dynamics are still poorly understood. We use k means clustering, a machine learning technique, and data from the Health and Retirement Study to identify health types during middle and old age. We identify five health types: the vigorous resilient, the fair-health resilient, the fair-health vulnerable, the frail resilient, and the frail vulnerable. They are characterized by different starting health and health and mortality trajectories. Our five health types account for 84% of the variation in health trajectories and are not explained by observable characteristics, such as age, marital status, education, gender, race, health-related behaviors, and health insurance status, but rather, by one’s past health dynamics. We also show that health types are important drivers of health and mortality heterogeneity and dynamics. Our results underscore the importance of better understanding health type formation and of modeling it appropriately to properly evaluate the effects of health on people’s decisions and the implications of policy reforms. |
| JEL: | I1 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32799 |
| By: | Alexander Ahammer; Analisa Packham |
| Abstract: | Despite the fact that 30 percent of opioid overdoses also involve a benzodiazepine, there is little policy guidance on how to curb concurrent misuse and even less evidence on how changes to co-prescribing practices can affect patients' economic trajectories. In 2012, Austria restricted access to flunitrazepam, one of the most potent, and most heavily misused, benzodiazepines. We use linked individual-level data to identify opioid users and estimate the reform's impact on their health and labor market outcomes relative to a randomly selected comparison group of non-opioid users. Estimates indicate a 12.7 percent drop in employment, a 13.1 percent increase in unemployment insurance claims, and a 26.5 percent increase in overall healthcare expenditures. We provide suggestive evidence that these effects are due to incapacitating withdrawal symptoms, rather than substitution to other drugs, including heroin or alcohol. |
| JEL: | I18 I38 J18 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32804 |
| By: | Rose, C.;; Williams J.;; Bretteville-Jensen, , A.L.; |
| Abstract: | We study peer effects in recovery from substance use disorders. We focus on peers who share an inpatient treatment episode and who reside in the same county, reflecting the salience of geographic proximity for peer influence in risky behaviors, and examine peer effects on posttreatment mortality. We access linked administrative data on death for the universe of individuals who are admitted to inpatient treatment for a substance use disorder in Norway in 2009-2010. The impact of peers is identified using variation in the timing of admissions into treatment, which institutional factors ensure is conditionally exogenous. Patients exposed to a greater share of peers from their home-county have a lower mortality risk. A standard deviation increase in the share of home -county peers reduces mortality by 36% relative to the mean, with one additional peer leading to a 5% reduction. The peer-induced reduction in mortality is concentrated amongst individuals admitted for treatment for a drug use disorder (as opposed to an alcohol use disorder). This is driven by peers who themselves receive treatment for a drug use disorder, and is consistent with peer effects working through two potential channels; reduced illicit drug use and safer illicit drug use. Examining hospital episodes for intoxication and (nonfatal) overdose indicates a limited role for safer drug use, suggesting that peers primarily reduce mortality by reducing drug use. We conclude that peers from inpatient treatment episodes can be instrumental in supporting recovery outside of clinical settings. |
| Keywords: | peer effects; substance use treatment; mortality; |
| JEL: | I12 D85 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:yor:hectdg:24/18 |
| By: | Alexander W. Bartik; Elizabeth Rhodes; David E. Broockman; Patrick K. Krause; Sarah Miller; Eva Vivalt |
| Abstract: | We provide new evidence on the causal effect of unearned income on consumption, balance sheets, and financial outcomes by exploiting an experiment that randomly assigned 1000 individuals to receive $1000 per month and 2000 individuals to receive $50 per month for three years. The transfer increased measured household expenditures by at least $300 per month. The spending impact is positive in most categories, and is largest for housing, food, and car expenses. The treatment increases housing unit and neighborhood mobility. We find noisily estimated modest positive effects on asset values, driven by financial assets, but these gains are offset by higher debt, resulting in a near-zero effect on net worth. The transfer increased self-reported financial health and credit scores but did not affect credit limits, delinquencies, utilization, bankruptcies, or foreclosures. Adjusting for underreporting, we estimate marginal propensities to consume non-durables between 0.44 and 0.55, durables and semi-durables between 0.21 and 0.26, and marginal propensities to de-lever of near zero. These results suggest that large temporary transfers increase short-term consumption and improve financial health but may not cause persistent improvements in the financial position of young, low-income households. |
| JEL: | D14 E21 H53 G50 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32784 |
| By: | Matilde Giaccherini; Joanna Kopinska |
| Abstract: | This paper examines the impact of early-life radiation exposure on adult fertility using a dynamic difference-in-differences approach. Analyzing 18 cohorts of women born between 1976 and 1993 in Italian municipalities, we utilize a radiation exposure indicator and administrative datasets on hospitalizations (2004-2016) and birth certificates (2002-2019). Findings show increased rates of thyroid complications and cancer among women exposed in utero or up to five years old, along with higher incidences of spontaneous abortions and stillbirths. Finally, municipalities with high agricultural employment experienced more severe fallout effects, while political beliefs did not significantly influence adherence to protective measures. |
| Keywords: | fertility, radiation exposure, public health, health behaviors |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:ces:ceswps:_11260 |
| By: | Gabriella Conti; Sören Kliem; Malte Sandner |
| 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: | home visiting, mental health, diagnostic interviews |
| JEL: | I12 J21 J13 J16 |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:ces:ceswps:_11256 |
| By: | Erkmen G. Aslim; Wei Fu; Erdal Tekin |
| Abstract: | This study provides a comprehensive analysis of the relationship between the accessibility of abortion services and incidences of child maltreatment across the United States, using data from the National Incident-Based Reporting System (NIBRS) and the Myers abortion facility database from 2011 to 2018. The analysis reveals that a rise in travel distance to the nearest abortion facility significantly increases the incidence of child maltreatment. Specifically, we find that a 100-mile increase in travel distance was associated with a 21.7% increase in maltreatment reports. This effect is particularly pronounced for very young children, non-White children, and those living in economically disadvantaged, racially diverse, and rural areas. Furthermore, supplemental analyses using data from the National Child Abuse and Neglect Data System (NCANDS) and county-level eviction records for renting households reveal economic stability and housing security as significant mediators linking barriers to abortion services to an increased risk of maltreatment. These findings contribute to a deeper understanding of the complex interplay between reproductive health services access, socio-economic factors, and child welfare. |
| JEL: | I14 J13 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32771 |
| By: | Klein, T.J.;; Salm, M.;; Upadhyay, S.; |
| Abstract: | The Health insurance premiums often do not reflect individual health risks, implying redistribution from individuals with low health risks to individuals with high health risks. This paper studies whether more cost-sharing leads to less redistribution and to lower welfare of high-risk individuals. This could be the case because more cost-sharing increases outof-pocket payments especially for high-risk individuals. We estimate a structural model of healthcare consumption using administrative data from a Dutch health insurer. We use the model to simulate the effects of a host of counterfactual policies. The policy that was in place was a 350 euro deductible. Our counterfactual experiments show that redistribution would decrease when the deductible would increase. Nonetheless, high-risk individuals can benefit from higher levels of cost-sharing. The reason is that this leads to lower premiums because both high -risk and low-risk individuals strongly react to the financial incentives cost-sharing provides. |
| Keywords: | health insurance; moral hazard; patient cost-sharing; redistribution; |
| JEL: | I13 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:yor:hectdg:24/15 |
| By: | Cronin, C.J.;; Harris, M. C.;; Ziebarth, N. R.; |
| Abstract: | We study how public school teachers use paid leave. Most U.S. sick leave schemes operate as individualized credit accounts—paid leave is earned and unused leave accumulates, producing an employee-specific leave balance. We construct an administrative data set containing the daily balances and leave behavior of 982 teachers from 2010-2018. We find that ick leave use increases during flu season. We do not find evidence that the average teacher uses sick leave for leisure; however, there is evidence of such behavior among certain sub -sets of teachers (e.g., young, inexperienced teachers). Usage increases with leave balance; the elasticity is between 0.38-0.45. Further, higher balances reduce the likelihood that teachers work sick, particularly during flu season. |
| Keywords: | sick leave; teacher absence; presenteeism; moral hazard; labor supply ; |
| JEL: | I12 I13 I18 I28 J22 J28 J32 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:yor:hectdg:24/10 |
| By: | Bíró, A.;; Elek, P.; |
| Abstract: | We provide evidence on the impact of firm productivity on the health maintenance of employees. Using linked employer-employee administrative panel data supplemented with healthcare records from Hungary, we analyze the dynamics of healthcare use before and after moving to a new firm. We show that moving to a more productive firm leads to higher consumption of drugs for cardiovascular conditions and more physician visits, without evidence of deteriorating physical health, and, among older workers, to lower consumption of medications for mental health conditions. The results suggest that more productive firms have a beneficial effect on the detection of previously undiagnosed chronic illnesses and on the mental health of their employees. Plausible mechanisms include the higher quality of occupational health check-ups and less stressful job conditions. |
| Keywords: | firm productivity; healthcare use; mover identification; preventive care; |
| JEL: | I10 J32 J62 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:yor:hectdg:24/13 |
| By: | Tröster, Bernhard; Von Arnim, Rudiger; Raza, Werner |
| Abstract: | Even though trade negotiations have increasingly come to focus on regulatory issues, the full impacts, that is, both social costs and benefits of regulatory changes, often remain unexamined in trade impact assessments. To bridge this gap, we scrutinize the theoretical foundations, methodologies and policymaking applications of cost-benefit analysis (CBA) in the context of health and safety regulations. CBA has become the main approach in economics to quantify the social costs and benefits of regulation. Gaining a thorough understanding of CBA processes, their applications and their limitations provides a valuable foundation for our upcoming research, the integration of the broader impacts of regulations into a global trade model. |
| Keywords: | non-tariff barriers, globalisation, international treaties, free-trade agreeements |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:hbsfof:300714 |
| By: | Axel H. Börsch-Supan; Johannes Rausch; Luca Salerno |
| Abstract: | Germany, like many other countries, has undergone a series of pension reforms since the 1980s which generally decreased benefit generosity and increased the retirement age due to demographic pressures. This paper investigates whether these reforms have increased income and wealth inequality among retirees. In order to answer this question, we employed counterfactual simulations in which we predict how the income and social security wealth distributions would have developed if these reforms had not taken place, compared to the actual development of the income and social security wealth distributions. Our analysis reveals that the pension reforms has led to an increase in inequality in terms of social security wealth between the 1990s and 2000s and decreased inequality thereafter. The decrease in inequality is mainly driven by social assistance as it represents a lower bound for benefit size and thus mitigates the effect of benefit-reducing reforms for lower income groups. We further divided the total effect of the pension reforms into two components. The first component is the mechanical effect, which keeps retirement probabilities constant and only considers changes in benefit calculation. The second component is the behavioral effect, which describes how SSW differs because of altered retirement probabilities. Our findings indicate that in the German context the behavioral effect is statistically significant but economically small. |
| JEL: | H55 J23 J26 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32796 |
| By: | Cristina Belles-Obrero; Sergi Jiménez-Martín; Han Ye |
| Abstract: | This paper studies the mortality effect of delaying retirement by investigating the impacts of the 1967 Spanish pension reform, which affected the general population and exogenously changed the early retirement age, depending on the date individuals started contributing to the pension system. Using the Spanish administrative data, we find that delaying retirement by one year increases the hazard of dying between the ages of 60 and 69 by 38 percent. We show that the reform leads to higher mortality in all subgroups, and the effects are statistically stronger for those employed in sectors with the highest workplace accidents and for those with low self-value jobs. Moreover, we show that allowing flexible retirement mitigates the adverse effects of delaying retirement. |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:fda:fdaeee:eee2024-27 |
| By: | Joan Costa-Font; Frank Cowell; Joan Costa-i-Font |
| Abstract: | An individual’s inequality aversion (IA) is a central preference parameter that captures the welfare sacrifice from exposure to inequality. However, it is far from trivial how to best elicit IA estimates. Also, little is known about the behavioural determinants of IA and how they differ across domains such as income and health. Using representative surveys from England, this paper elicits comparable estimates of IA in the health and income domains using two alternative elicitation techniques: a direct trade-off and an indirect “imaginary-grandchild” approach that results from the choices between hypothetical lotteries. We make three distinct contributions to the literature. First, we show that IA systematically differs between income and health domains. Average estimates are around 0.8 for income IA and range from 0.8 to 1.5 for health IA. Second, we find that risk aversion and locus of control are central determinants of IA in both income and health domains. Finally, we present evidence suggesting that the distribution and comparison of IA vary depending on the elicitation method employed. |
| Keywords: | inequality aversion, income inequality aversion, health inequality aversion, imaginary grandchild, inequality and efficiency trade-offs, risk attitudes |
| JEL: | H10 I18 |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:ces:ceswps:_11261 |
| By: | Breen, Casey |
| Abstract: | The Black-White mortality crossover is well-studied demographic paradox. Black Americans experience higher age-specific mortality rates than White Americans throughout most of the life course, but this puzzlingly reverses at advanced ages. The leading explanation for the Black-White mortality crossover centers around selective mortality over the life course. Black Americans who survived higher age-specific mortality risk throughout their life course are highly selected on robustness, and have lower mortality than White Americans in late life. However, skeptics argue the Black-White mortality crossover is simply a data artifact from age misreporting or related data quality issues. We use large-scale linked administrative data (N = 2.3 million) to document the BlackWhite mortality crossover for cohorts born in the early 20 th century. We find evidence the crossover is not a data artifact and cannot be uncrossed using sociodemographic characteristics alone. |
| Date: | 2024–08–23 |
| URL: | https://d.repec.org/n?u=RePEc:osf:socarx:ax9u3 |
| By: | Victoria Y. Fan (Center for Global Development); Sun Kim (Harvard University); Diego Pineda (University of California at Berkeley); Stefano M. Bertozzi (University of California at Berkeley) |
| Abstract: | The COVID-19 pandemic exposed critical gaps in the global response to health crises, particularly in the financing of pandemic prevention, preparedness, response, recovery, and reconstruction. This paper presents a comprehensive framework for pandemic financing that spans the entire pandemic cycle, emphasizing the need for timely, adequate, and effective financial resources. The framework is designed to support policymakers in both low- and middle-income countries (LMICs) and high-income nations, providing a guide to appropriate financing tools for each stage of a pandemic, from prevention and preparedness to response and recovery. Key economic concepts such as global public goods, time preference, and incentives are explored to underscore the complexities of pandemic financing. The paper also highlights the importance of timely, accessible, and sustainable financial instruments. The paper lists the pandemic financing instruments used for health during the COVID-19 pandemic, identifying 23 different tools. We also used the IHME 2024 Financing Global Health database to estimate that US$91.6 billion was spent for COVID-19 health support, primarily for response financing, over 2020 to 2023. The COVID-19 pandemic wrought significant economic impacts on the order of trillions of dollars, even as investments in pandemic preparedness to mitigate future risks is relatively small, on the order of $10 billion annually. The paper concludes with policy recommendations, calling for the establishment of a rapid-response financing mechanism, tailored to the unique challenges of pandemics, and a redesign of global health governance to better address these threats. |
| Date: | 2024–08–21 |
| URL: | https://d.repec.org/n?u=RePEc:cgd:ppaper:334 |
| By: | Francetic, I.;; Meacock, R.;; Siciliani, L.;; Sutton, M.; |
| Abstract: | The sharp increase in emergency department (ED) use in England has created long queues at busy times. Care professionals may prioritize some patients in these queues, increasing delays for others and potentially impacting both equity and efficiency. We calculate a measure of queue prioritisation for all 11M attendances at an ED in England in 2017/18, and examine whether some patient groups (ethnic minorities, females, and residents of deprived neighbourhoods) are discriminated against in this prioritisation process. We reduce the risk of unobservable confounding by examining how patient re-ordering responds to unexpected demand surges. To do so, we leverage high-dimensional fixed effects to partial out hospital-specific month-day-of-the-week seasonality to obtain plausibly exogenous daily demand shocks. We further reduce the risk of observable confounding by including detailed severity adjusters. We find that females, ethnic minorities and residents of deprived neighbourhoods are all systematically deprioritised, especially when EDs are busy. Our findings highlight the importance of queue prioritization as a contributor to ED inequities in access to care. |
| Keywords: | prioritisation; waiting time; urgent care; equity; |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:yor:hectdg:24/14 |
| By: | Miao Guo (Hunan University); Yang Li (University of Nottingham Ningbo China); Minghao Wu (China Life Insurance Company Ltd.); Terence C. Cheng (Harvard T.H. Chan School of Public Health & Monash University) |
| Abstract: | This study analyzes the effects of China’s long-term care insurance (LTCI) benefit design on household consumption and intergenerational support. The program provides two benefit options: in-kind benefits (or services) and cash allowances. We introduce a conceptual framework to analyze economic decision making under the two types of LTCI benefits. Using an empirical framework that exploits variations in LTCI benefit designs across China’s pilot cities, we find that both types of LTCI benefits increase household consumption and reduce medical expenditure. Specifically, ‘mixed’ benefits households – those with a choice between in-kind and cash benefits – significantly increase spending on food and housing, while households receiving services spend more on housing, transport, and clothing. Additionally, in-kind benefit recipients report receiving lower informal care from their children, implying a substitution with formal care. Households with mixed benefits experience a decline in financial support from children, suggesting a crowding-out of intergenerational transfers. Finally, we estimate income and sub-stitution effects that are implicit in recipients’ behavior to analyze welfare implications under China’s LTCI. |
| Keywords: | Long-term Care Insurance, Benefit Design, In-kind Benefits, Cash Benefits, Household Consumption |
| JEL: | I11 I13 I18 D10 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:mhe:chemon:2024-13 |
| By: | Amanda Dahlstrand; Nestor Le Nestour; Guy Michaels |
| Abstract: | Online delivery of one-to-one services offers potential cost savings and increased convenience, yet relatively little is known about its impacts on providers and consumers. This paper studies the online delivery of healthcare, focusing on primary care doctor consultations. We use novel data from Sweden and an effectively random assignment of patients to nurses, who differ in their propensity to direct patients to online versus in-person consultations. Our findings reveal that online consultations are delivered sooner, are shorter, and yield similar in-consultation outcomes, including rates of diagnosis, prescriptions, and specialist referrals, as well as patient satisfaction. However, in the short term, online consultations lead to more emergency department (ED) visits and additional in-person primary care visits, though no significant medium-term health effects are observed. We discuss the extent to which follow-ups reduce online’s cost savings, as well as online’s advantages for different patients and how to improve hybrid organizations’ cost effectiveness. |
| Keywords: | telehealth, remote work, online services |
| JEL: | J44 I11 O33 |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:ces:ceswps:_11250 |
| By: | Pia Heckl; Elisabeth Wurm |
| Abstract: | This paper investigates the impact of workplace breastfeeding laws on the labor supply of mothers. We exploit a unique setting, when throughout 1998-2009 states in the US introduced laws requiring employers to provide break time and a private room for women to express milk or breastfeed. Our results show an increase in breastfeeding initiation and the probability that a child was breastfed at three and six months after birth. We find that workplace breastfeeding significantly increase maternal employment by 4% when children are in breastfeeding age. |
| Keywords: | female labor supply, breastfeeding, workplace policies |
| JEL: | J08 J13 J16 J18 J22 |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:ces:ceswps:_11248 |
| By: | Martina Börsch-Supan; Karen Andersen-Ranberg; Nis Borbye-Lorenzen; Jake Cofferen; Rebecca Groh; Hannah M. Horton; Elizabeth Kerschner; Thu Minh Kha; Alan Potter; Daniel Schmidutz; Kristin Skogstrand; Aijing Sun; Luzia Weiss; Mark H. Wener; Axel H. Börsch-Supan |
| Abstract: | SHARE, the “Survey of Health, Ageing and Retirement in Europe”, is a large population-based panel survey among people aged 50 and over with data from 28 European countries and Israel. It investigates individual, economic, health-related, and social life-course circumstances in order to shed light on the challenges of population aging for individuals and society as a whole. Understanding aging per se, and how we age differently over the life course given our individual backgrounds, current health, and socio-economic factors, are the aims of SHARE. In order to maintain intertemporal, international and intercultural comparability, SHARE has adopted collection of objective data in the health domain. SHARE measures physical performance, such as grip strength, peak expiratory flow, walking speed, chair stand, word recall, and Euro-D depression among others in the physical, cognitive and mental health modules. In 2015, SHARE collected dried blood spot (DBS) samples as an additional objective measure of health. Eleven European countries and Israel participated in the DBS collection. The collection was harmonized in terms of designing documents, gaining consent, procuring blood-collection material, and training interviewers how to collect DBS samples while observing the national ethic and administrative regulations in all countries. Altogether, approximately 27, 200 respondents consented, resulting in an overall participation rate of 67% with considerable differences between countries and interviewers. This report describes the carefully monitored processes of gaining consent for DBS collection and for the implementation, collection and evaluation of the to-date largest DBS-based study of a representative adult population in Europe. We also describe the choice of blood biomarkers, the assays employed to determine the blood biomarker concentrations in DBS collected in the home of survey respondents and the validation and adjustment of the laboratory results for the impact of sample collection in a non-medical environment. Finally, we present the data obtained for seven out of 17 blood biomarkers. The data for the remaining ten biomarkers analyzed at the Statens Serum Institut will follow in a separate release. |
| JEL: | I1 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32764 |
| By: | Adebisi, Luke O.; Omotesho, Abayomi O.; Adebisi, Oluwaremilekun A. |
| Abstract: | Prior use of the stochastic frontier model and subsequent measurement of performance of the agricultural produce sector, which relies on the presumption that the underlying technology is the same for all the different agricultural systems is not adequate as heterogeneity does exist in most agricultural production environments and failure to account for this, is likely to result in biased production frontier and efficiency. This study contributed to the existing knowledge, estimating technical efficiency and the technological gap in Nigerian Small Ruminant farms using the stochastic meta-frontier approach. For this study, we classified the farms based on the different production technologies adopted. The result of the analysis shows that farms differ in performance and technology use with the farms engaging both orthodox and traditional animal healthcare technologies having the highest efficiency. Furthermore, the results prove support for specific agricultural policies targeted at increasing the performance of indigenous technology in the livestock industry for better productivity and the prosperity of Nigeria. |
| Keywords: | Livestock Production/Industries |
| Date: | 2024–08–07 |
| URL: | https://d.repec.org/n?u=RePEc:ags:cfcp15:344262 |
| By: | Elisa Failache (Universidad de la República (Uruguay). Facultad de Ciencias Económicas y de Administración. Instituto de Economía); Noemí Katzkowicz (Universidad de la República (Uruguay). Facultad de Ciencias Económicas y de Administración. Instituto de Economía); Cecilia Parada (Universidad de la República (Uruguay). Facultad de Ciencias Económicas y de Administración. Instituto de Economía); Martina Querejeta (Universidad de la República (Uruguay). Facultad de Ciencias Económicas y de Administración. Instituto de Economía); Tatiana Rosá (Pontificia Universidad Católica de Chile. Facultad de Economía y Administración. Departamento de Economía) |
| Abstract: | The COVID-19 pandemic affected people’s lives in several domains. This study provides evidence of the pandemic’s gendered effects on university enrollment and major choices. Using novel administrative records of university students in Uruguay, we conduct a counterfactual exercise that demonstrates a negative correlation between the COVID-19 pandemic and university enrollment. Heterogeneities across fields reveal a positive effect on enrollment in Social Sciences, yet null or even negative effects in Health and Science. These results are driven by male students. For women, we observe an increase in enrollment, particularly in Science. Notably, women are more likely to opt for Science-related majors over Social Sciences. Our results suggest that the recent crisis helped reduce the gender gap in major choices. |
| Keywords: | COVID-19, University enrollment, Major choices, Educational gender gap |
| JEL: | I23 J16 |
| Date: | 2024–05 |
| URL: | https://d.repec.org/n?u=RePEc:ulr:wpaper:dt-05-24 |
| By: | Victoria Y. Fan (Center for Global Development); Brian S. Webster (Center for Global Development); Venkatesh Subramanian (The University of Texas at Dallas); Karen A. Grépin (Hong Kong University); David A. Watkins (University of Washington); Joseph L. Dieleman (University of Washington) |
| Abstract: | One approach to development assistance for health, or health aid, emphasizes the ex ante selection of cost-effective health interventions, an approach that began with the World Development Report (1993) on Investing in Health and has since been adopted by the Effective Altruism community. But just how much of health aid is cost-effective? In this paper, we examine projects in the Organisation for Economic Co-operation and Development (OECD) Creditor Reporting System, the standard dataset that measures and characterizes development assistance for health, for the years 2019 to 2021, and count the number of projects that refer to interventions from a list of highly cost-effective interventions as defined by the Disease Control Priorities Project, third edition. This exploratory quantitative analysis indicates that 61% of projects used a key word/phrase of a cost-effective intervention. There were 11.9 interventions mapped per project on average. There is little evidence that donors tailor the set of interventions to country income levels by cost-effectiveness. Policymakers may benefit from reviewing the full portfolio of interventions covered by domestic and external resources. |
| Date: | 2024–08–26 |
| URL: | https://d.repec.org/n?u=RePEc:cgd:wpaper:700 |