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on Health Economics |
| By: | Orazio Attanasio; Darwin Cortes; Dario Maldonado; Paul Rodriguez-Lesmes; Nathalie Charpak; Rejean Tessier; Juan G. Ruiz; Juan Gallego; Tiberio Hernandez; Felipe Uriza; Andres Gallegos |
| Abstract: | What happens to children during the early years is recognized to be very important for their long run development. It is also increasingly clear that the skills that are relevant for economic success and more generally well-being are multidimensional, including different types of socioemotional skills. In this paper, we look at the long run impacts of an intervention targeted to premature children, known as Kangaroo Mother Care. We do so using data from a randomised control trial performed several decades ago in Bogotá, Colombia, to assess the short run impacts of such an intervention. A large fractions of the participants to that trial were examined over 20 years after the original intervention. We first show that the original intervention had a significant impact on externalizing socio-emotional skills at age 22 and a variety of adult outcomes. We then perform a mediation analysis which involves the estimation of a production function of socioemotional skills and show that the long run impact seems to be explained entirely by an increase on one type of parental investment measured when the participants were 12 months old. Our results also show a remarkable degree of persistence of different types of skills. |
| JEL: | I19 J13 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32851 |
| By: | Albrecht, James (Georgetown University); Edin, Per-Anders (Uppsala University); Fernández, Raquel (New York University); Lee, Jiwon (New York University); Thoursie, Peter Skogman (Stockholm University); Vroman, Susan (Georgetown University) |
| Abstract: | The distribution of parental leave uptake and childcare activities continues to conform to traditional gender roles. In 2002, with the goal of increasing gender equality, Sweden added a second "daddy month, " i.e., an additional month of pay-related parental leave reserved exclusively for each parent. This policy increased men's parental leave uptake and decreased women's, thereby increasing men's share. To understand how various factors contributed to these outcomes, we develop and estimate a quantitative model of the household in which preferences towards parental leave respond to peer behavior. We distinguish households by the education of the parents and ask the model to match key features of the parental leave distribution before and after the reform by gender and household type (the parents' education). We find that changed incentives and, especially, changed social norms played an important role in generating these outcomes whereas changed wage parameters, including the future wage penalty associated with different lengths of parental leave uptake, were minor contributors. We then use our model to evaluate three counterfactual policies designed to increase men's share of parental leave and conclude that giving each parent a non-transferable endowment of parental leave or only paying for the length of time equally taken by each parent would both dramatically increase men's share whereas decreasing childcare costs has almost no effect. |
| Keywords: | parental leave, gender equality, childcare, culture |
| JEL: | D10 J16 Z10 Z18 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17210 |
| By: | Kate Ho; Robin S. Lee |
| Abstract: | We investigate how formularies used by pharmacy benefit managers (PBMs) can affect manufacturer rebates for branded drugs. We first present a theoretical model of multidimensional contracting in which a PBM negotiates with drug manufacturers over menus of formulary-contingent rebate payments and then selects a formulary. We then estimate how formulary placement affects drug demand for statins using data from Princeton University, a large employer that contracts with a single PBM to offer prescription drug coverage to its employees. Using our theoretical model and demand estimates, we predict how rebates are affected by the use of a preferred tier in the formulary or the ability to exclude a drug from coverage. Our predictions align with aggregate rebate data, and we find that allowing a PBM to place branded drugs on preferred and non-preferred tiers can substantially increase negotiated rebate payments. |
| JEL: | I11 L14 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32790 |
| By: | Jeremy Greenwood; Nezih Guner; Karen A. Kopecky |
| Abstract: | There have been more than 700, 000 opioid overdose deaths since 2000. To analyze the opioid epidemic, a model is constructed where individuals choose whether to use opioids recreationally, knowing the probabilities of addiction and dying. These odds are functions of recreational opioid usage. The model is fit to estimated Markov chains from the US data that summarize the transitions into and out of opioid addiction as well as to a deadly overdose. The epidemic is broken down into two subperiods: 2000-2010 and 2010-2019. The opioid epidemic's drivers, their impact on employment, and the impact of medical interventions are examined. Lax prescribing practices and misinformation about the risk of addiction are important drivers of the first half of the epidemic. Falling prices for black-market opioids combined with an increase in their lethality are found to be important for the second half. |
| Keywords: | addiction; college/non-college educated; deaths; employment; fentanyl; Markov chain; medical interventions; opioids; OxyContin; pain; prices; prescribing practices; state-contingent preferences; structural model; subjective and objective beliefs |
| JEL: | D11 D12 E13 I12 I14 I31 J11 J17 |
| Date: | 2024–08–27 |
| URL: | https://d.repec.org/n?u=RePEc:fip:fedcwq:98713 |
| By: | Janet Currie; W. Bentley MacLeod; Kate Musen |
| Abstract: | Doctors facing similar patients often make different treatment choices. These decisions can have important effects on patient health and health care spending. This paper seeks to organize the recent economics literature on physician decision making using a simple model that incorporates doctor diagnostic and procedural skills, differences in beliefs and patient populations, and incentives. Economic considerations that affect the quality of decision making include training, experience, peer effects, financial incentives and time constraints. We also consider interventions aimed at improving decision making including provision of informational, heuristics and guidelines, and the use of technologies including electronic medical records and algorithmic decision tools. Our review suggests that we have learned a great deal about specific factors that influence doctor decision making but that our knowledge of how to apply that knowledge to improve health care is still quite limited. |
| JEL: | I11 I12 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32788 |
| By: | Ahammer, Alexander (University of Linz); Packham, Analisa (Vanderbilt University) |
| 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. |
| Keywords: | opioids, substance use disorder treatment, benzodiazepines |
| JEL: | I38 I12 J18 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17192 |
| By: | Malani, Anup (University of Chicago); Kinnan, Cynthia (NBER); Conti, Gabriella (University College London); Imai, Kosuke (Harvard University); Miller, Morgen (University of Chicago); Swaminathan, Shailender (Brown University); Voena, Alessandra (Stanford University); Woda, Bartek (Amazon) |
| Abstract: | Universal health coverage is a widely shared goal across lower-income countries. We conducted a large-scale, 4-year trial that randomized premiums and subsidies for India's first national, public hospital insurance program, called RSBY. We find substantial demand (~ 60% uptake) even when consumers were charged a price equal to the premium the government paid for insurance. We also find substantial adverse selection into insurance at positive prices. Insurance enrollment increases insurance utilization, partly due to spillovers from use of insurance by neighbors. However, healthcare utilization does not rise substantially, suggesting the primary benefit of insurance is financial. Many enrollees attempted to use insurance but failed, suggesting that learning is critical to the success of public insurance. We find very few statistically significant impacts of insurance access or enrollment on health. Because there is substantial willingness-to-pay for insurance, and given how distortionary it is to raise revenue in the Indian context, we calculate that our sample population should be charged a premium for RSBY between 67-95% of average costs (INR 528-1052, $30-60) rather than a zero premium to maximize the marginal value of public funds. |
| Keywords: | health insurance, adverse selection, spillovers, marginal value of public funds |
| JEL: | D1 I13 |
| Date: | 2024–07 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17185 |
| By: | Ramirez Lizardi, Eduardo (University of Oslo); Fevang, Elisabeth (Ragnar Frisch Centre for Economic Research); Røed, Knut (Ragnar Frisch Centre for Economic Research); Øien, Henning (Norwegian Institute of Public Health) |
| Abstract: | Using Norwegian administrative register data, we assess the impact of health shocks hitting lone parents, specifically stroke and hip fractures, on labor market outcomes and the well-being of adult offspring. We identify small, but statistically significant immediate responses in terms of an increase in physician-certified sickness absences and a higher risk of diagnosed mental disorders. However, these effects tend to fade out quickly, and the negative impacts on subsequent employment and earnings are small and only borderline statistically significant. In general, our results suggest that the responses to the deteriorating health of a parent tend to be short-lived and mostly manifest as temporary absences from work rather than complete detachment from the labor market. |
| Keywords: | health shocks, labor supply, mental health, informal care, parental health, event-studies |
| JEL: | I12 I31 J14 J22 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17232 |
| By: | Mir M. Ali; Thanh Lu; Johanna Catherine Maclean; Angélica Meinhofer |
| Abstract: | Child maltreatment is a pressing concern in the United States, with more than four million children referred to child protective services in 2022. Reducing child maltreatment is a national health objective given the substantial, negative consequences for children who experience maltreatment, both in the short- and long-term. Parental mental health and substance use disorders are strongly associated with child maltreatment. In this study, we use administrative data over the period 2004 to 2021 to study the relationship between the number of mental health and substance use treatment centers per county and child maltreatment reports. Our findings provide evidence that better access to mental health and substance use treatment reduces child maltreatment reports. In particular, an 8% increase in the supply of treatment would reduce maltreatment reports by 1%. These findings suggest that recent and ongoing efforts by the federal government to expand mental health and substance use treatment availability may lead to reduced child maltreatment. |
| JEL: | H0 I0 K0 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32895 |
| By: | Marianne Simonsen; Lars Skipper |
| Abstract: | We employ a large social experiment combined with register-based data allowing for up to 12-year follow-up to evaluate a long-lasting employer-sponsored health and well-being program. We show that employees at treated worksites receive fewer consultations from their primary care physician and purchase fewer prescription drugs. These effects persist up to seven years after randomization, though with some fade-out. We find no effects on overall hospitalizations, neither in the short or longer run, and the program was not successful in improving labor-related outcomes such as absence and turnover. Finally, we show some evidence of spillovers within the family. |
| Keywords: | worksite health program, health outcomes, labor outcomes, social experiment |
| JEL: | I12 I18 |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:ces:ceswps:_11209 |
| By: | Michael R. Richards; Maggie Shi; Christopher M. Whaley |
| Abstract: | Private equity (PE) plays an increasingly important role in the modern US economy. However, its impacts on owned-firms are incompletely understood. We exploit a historically large leveraged buyout of a national hospital chain to examine how the full life cycle of PE influences hospital-level revenues, technology sourcing, labor use, and financial performance. We find permanent improvements in hospital volumes and revenues. PE also reduces growth in full-time employees, with a suggestive partial substitution toward part-time workers. Technology adoption is restrained, but the number of vendors expands. Overall, PE has nuanced effects on hospital management, which translate to improved operating margins. |
| JEL: | I11 I18 L20 L24 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32840 |
| By: | Aranco, Natalia; Bauhoff, Sebastian; Schwarz, Natalie Vanessa; Stampini, Marco |
| Abstract: | Prolonged hospital stays, or hospital stays that are longer than medically necessary, are a major concern for patients, payers, and providers. We conceptualize and empirically estimate the prevalence and cost of prolonged stays among elderly hospital patients (65 years and older) in Brazil and Mexico. We develop a continuum-of-care conceptual framework based on prior literature and insights obtained through interviews and focus group discussions with experts from Mexico, Argentina, and Colombia. In this framework, hospitals are part of a wider system. This system involves both pre-admission and post-discharge medical and social care services. There are three main sources of prolonged stays: (i) lack of appropriate primary healthcare that leads to more complex admissions; (ii) hospital inefficiency; and (iii) lack of rehabilitation, social, and long-term care at discharge. We estimate the count and share of inappropriate hospital days due to prolonged stays overall and for each source. This estimation is based on administrative records on discharges from public sector hospitals in 2019. Our results show that hospital days due to prolonged stays account for approximately half of all hospital days. Although most of the inappropriate days can be attributed to hospital inefficiency (36% in Brazil and 49% in Mexico), an important share is linked to the lack of rehabilitation, social, and long-term care. Lack of these services accounts for 12% of total hospital days in Brazil and 7% in Mexico. In a back-of-the-envelope calculation, we estimate that providing six weeks of long-term care services to address the care needs brought about by only thirteen causes of admission would generate annual net savings of approximately US$174 million per year in Brazil and US$45 million in Mexico. |
| Keywords: | Healthcare costs;prolonged hospitalizations;primary health care;long-term care;medical care;population aging;older persons;public policy;social care;rehabilitation care |
| JEL: | I10 J14 H55 J18 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:idb:brikps:13701 |
| By: | José Ignacio Cuesta; Carlos E. Noton; Benjamin Vatter |
| Abstract: | We measure the impacts of vertical integration between insurers and hospitals. In the Chilean market, where half of private hospital capacity is vertically integrated, integration increases inpatient care spending by 6 percent and decreases consumer surplus and total welfare. Integrated insurers offer generous coverage at integrated hospitals, limited access to rival hospitals, and lower premiums. Competition for enrollees forces non-integrated insurers to provide additional coverage to high-quality non-integrated hospitals, resulting in plan networks that limit hospital competition. Whereas vertical integration reduces double marginalization, skewed cost-sharing structures—and their effect on hospital competition—more than compensate, leading to an overall negative welfare impact. |
| JEL: | I11 L13 L40 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32833 |
| By: | Nicole Black (Centre for Health Economics, Monash Business School, Monash University); David W. Johnston (Centre for Health Economics, Monash Business School, Monash University); Martin Knapp (Health Policy Department, London School of Economics and Political Science); Michael A. Shields (Centre for Health Economics, Monash Business School, Monash University); Gloria H.Y. Wong (School of Psychology and Clinical Language Sciences, University of Reading) |
| Abstract: | For people experiencing mental health problems, timely access to high-quality healthcare is imperative for improving outcomes. However, limited availability of services, high out-of-pocket costs, insufficient health literacy and stigmatising attitudes may mean people do not receive the necessary treatment. We analyse Australian longitudinal data to document the extent and predictors of horizontal inequity in mental healthcare use among people with a newly developed mild or moderate mental disorder. Importantly, we compare people with similar health, residing in the same area, thus controlling for differences in healthcare needs and availability of services. Results suggest that mental healthcare use is not significantly associated with household income or financial hardship. In contrast, we find significant inequities by educational attainment, with university graduates around 50% more likely to receive mental healthcare than high-school dropouts. These findings are robust across subsamples and alternative modelling approaches, including panel data models with individual fixed- effects. Additional explorations of the education gradient suggest a potential pathway through mental health-specific knowledge and attitudes. |
| Keywords: | Mental Health, Healthcare, Inequity, Income, Education |
| JEL: | I12 I14 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:mhe:chemon:2024-14 |
| By: | Eunsik Chang; Sandra Orozco-Aleman; María Padilla-Romo |
| Abstract: | This paper studies the effects of mothers' long-term pre-conception exposure to local violence on birth outcomes. Using administrative data from Mexico and two different empirical strategies, our results indicate that mothers' long-term exposure to local violence prior to conception has detrimental effects on infant health at birth. The results suggest that loss of women's human capital and deterioration of mental health are potential underlying mechanisms behind the adverse effects, highlighting intergenerational consequences of exposure to local violence. Our findings shed light on the welfare implications of local violence that are not captured in in-utero exposure to violence. |
| JEL: | I12 J13 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32806 |
| By: | Kuan-Ming Chen; Janet Currie; Hui Ding; Wei-Lun Lo |
| Abstract: | This study uses administrative health insurance records in Taiwan to examine changes in child mental health treatment around four school milestones including: Primary and middle school entry, high stakes testing for high school, and high stakes testing for college entry. Leveraging age cutoffs for school entry in Taiwan, we compare August-born children to children born in September of the same year. The former hit all the milestones one year earlier than the latter, enabling us to identify each milestone’s effect. We find that entry into both primary school and middle schools is associated with increases in mental health prescribing, not only for ADHD but also for depression. Middle school entry is also associated with increases in the prescribing of anti-anxiety and antipsychotic medications. Perhaps surprisingly, there is no run-up in the use of psychiatric medications prior to high-stakes tests. But the use of psychiatric medications falls sharply following the tests. These effects are stronger in counties where both parents and children have higher educational aspirations. Hence, the use of psychiatric drugs increases at junctures when educational stresses increase and falls when these stresses are relieved. |
| JEL: | I1 I12 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32842 |
| By: | David G. Blanchflower; Alex Bryson; David N.F. Bell |
| Abstract: | We show the incidence of mental ill-health has been rising especially among the young in the years and especially so in Scotland. The incidence of mental ill-health among young men in particular, started rising in 2008 with the onset of the Great Recession and for young women around 2012. The age profile of mental ill-health shifts to the left, over time, such that the peak of depression shifts from mid-life, when people are in their late 40s and early 50s, around the time of the Great Recession, to one’s early to mid-20s in 2023. These trends are much more pronounced if one drops the large number of proxy respondents in the UK Labour Force Surveys, indicating fellow family members understate the poor mental health of respondents, especially if those respondents are young. We report consistent evidence from the Scottish Health Surveys and UK samples from Eurobarometer surveys. Our findings are consistent with those for the United States and suggest that, although smartphone technologies may be closely correlated with a decline in young people’s mental health, increases in mental ill-health in the UK from the late 1990s suggest other factors must also be at play. |
| JEL: | I31 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32879 |
| By: | Geyer, Johannes (DIW Berlin); Haan, Peter (DIW Berlin); Teschner, Mia (IZA) |
| 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: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17197 |
| By: | Maynou, Laia; Saez, Marc; López-Casasnovas, Guillem |
| Abstract: | In this paper, we evaluate the association of changes in income and wealth with self-perceived health for the European Union (EU) countries, using a longitudinal sample of individuals. We estimated generalized linear mixed models for three waves of the Eurosystem Household Finance and Consumption Survey (2011, 2015, 2017), adjusting for family and individual heterogeneity and for temporal trends. Results show that variations in income have a positive and significant impact on changes in self-perceived health during the financial crisis, but not after 2015. In conclusion, we find that income, rather than wealth, played an important role in protecting health. |
| Keywords: | asset composition; European Union; self-perceived health; wealth |
| JEL: | I10 C23 G00 |
| Date: | 2024–06–30 |
| URL: | https://d.repec.org/n?u=RePEc:ehl:lserod:124212 |
| By: | Caroline Krafft; Ragui Assaad; Jackline Wahba |
| Abstract: | As of 2022, Sudan was home to 1.1 million refugees and 3.7 million internally displaced persons(IDPs), along with a substantial population that had previously experienced displacement. TheSudan Labor Market Panel Survey (SLMPS) 2022 over-sampled locations hosting the displacedin order to facilitate research on refugees and IDPs. This paper investigates the geographicdistribution of the displaced, their demographics, their labor market and socioeconomic statusand outcomes, and their education, health, food security outcomes. It also reviews theirexperiences of shocks, their coping strategies, and the types of social assistance they receive.Important distinctions are made between current and returned IDPs and refugees and theiroutcomes are compared to those of Sudanese who were never displaced. Analyses also exploredifferences by location of residence (in host communities and camps), by sex, and acrossdifferent age groups. |
| Keywords: | demographics, displacement, education, health, internally displaced persons, labor, refugees, sudan |
| JEL: | F22 I14 I24 J11 J21 O15 R23 |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:hic:wpaper:413 |
| By: | Dimico, Arcangelo |
| Abstract: | I evaluate the impact of abortion policies in sub-Saharan Africa to understand possible consequences from a reduced international support for women's rights following the overturn of Roe v. Wade. I find that decriminalizing abortion reduces fertility through two complementary channels. For households at the top of the wealth distribution, the effect manifests as a reduction in excess fertility, which is more pronounced among lower-educated women due to their lower likelihood of using contraception. For households at the bottom of the wealth distribution, the impact runs through a decline in the number of children with a low survival probability. This latter effect is more pronounced among highly educated women, who are more likely to control their own health-related decisions and view abortion as a viable option. I also find that while women's education levels rise after decriminalization, this does not lead to better labor market opportunities. However, children born afterward tend to achieve higher levels of education. |
| Keywords: | Abortion, fertility, child mortality, human capital |
| JEL: | O15 J13 J16 K38 |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:qmsrps:202406 |
| By: | Si, Yafei (University of New South Wales); Yang, Yuyi (Washington University, St. Louis); Wang, Xi (Washington University, St. Louis); An, Ruopeng (Washington University, St. Louis); Zu, Jiaqi (Duke Kunshan University); Chen, Xi (Yale University); Fan, Xiaojing (Xi’an Jiaotong University); Gong, Sen (Zhejiang University) |
| Abstract: | Using simulated patients to mimic nine established non-communicable and infectious diseases over 27 trials, we assess ChatGPT's effectiveness and reliability in diagnosing and treating common diseases in low- and middle-income countries. We find ChatGPT's performance varied within a single disease, despite a high level of accuracy in both correct diagnosis (74.1%) and medication prescription (84.5%). Additionally, ChatGPT recommended a concerning level of unnecessary or harmful medications (85.2%) even with correct diagnoses. Finally, ChatGPT performed better in managing non-communicable diseases compared to infectious ones. These results highlight the need for cautious AI integration in healthcare systems to ensure quality and safety. |
| Keywords: | ChatGPT, Large Language Models, generative AI, simulated patient, healthcare, quality, safety, low- and middle-income countries |
| JEL: | C0 I10 I11 C90 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17204 |
| By: | Luca Salerno; Axel H. Börsch-Supan; Diana López-Falcón; Johannes Rausch |
| Abstract: | The COVID-19 pandemic led to significant economic disruptions, prompting many governments to implement short-time employment aid (STEA) to mitigate job losses and income reductions. This study examines the effectiveness of STEA in the short and long term in Europe among workers aged 50 and older, a part of the population that was especially threatened by the disease. Using data from the Survey of Health, Ageing and Retirement in Europe (SHARE), we analyze the impact of STEA on employment status, working hours, and income during and after the pandemic. STEA was widespread in Europe. Our findings indicate that the use of STEA was in general reasonably targeted and may have helped its recipients to avoid even worse economic losses during the pandemic, especially after a learning process from 2020 to 2021. However, STEA may have led to increased employment instability in the longer run. Specifically, recipients of STEA were more likely to experience unemployment or furloughs post-pandemic. These results highlight the importance of designing STEA policies that not only provide immediate economic relief but also support sustainable employment and economic resilience. |
| JEL: | H52 J20 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32760 |
| By: | Lepinteur, Anthony (University of Luxembourg); Rebechi, Alessio (University of Luxembourg); Clark, Andrew E. (Paris School of Economics); D'Ambrosio, Conchita (University of Luxembourg); Rohde, Nicholas (Griffith University); Vögele, Claus (University of Luxembourg) |
| Abstract: | We use quarterly panel data from the COME-HERE survey covering five European countries to analyse three facets of the experience of loneliness during the COVID-19 pandemic. First, in terms of prevalence, loneliness peaked in April 2020, followed by a U-shape pattern in the rest of 2020, and then remained relatively stable throughout 2021 and 2022. We then establish the individual determinants of loneliness and compare them to those found in the literature predating the COVID-19 pandemic. As in previous work, women are lonelier, and partnership, education, income, and employment protect against loneliness. However, the pandemic substantially shifted the age profile: it is now the youngest who are the loneliest. We last show that pandemic policies affected loneliness, which rose with containment policies but fell with government economic support. Conversely, the intensity of the pandemic itself, via the number of recent COVID-19 deaths, had only a minor impact. The experience of the pandemic has thus shown that public policy can influence societal loneliness trends. |
| Keywords: | loneliness, COVID-19, COME-HERE, age, pandemic policies |
| JEL: | H51 I18 I31 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17223 |