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on Health Economics |
| By: | Cotti, Chad D. (Department of Ag, Food, and Resource Economics Michigan State University and Center for Demography of Health and Aging University of Wisconsin-Madison); Courtemanche, Charles J. (Department of Economics Gatton College of Business and Economics University of Kentucky Lexington, KY 40506-0034 and NBER); Liang, Yang (Department of Economics Center for Health Economics & Policy Studies San Diego State University San Diego, CA 92182); Maclean, Johanna Catherine (Schar School of Policy and Government George Mason University Arlington, VA 22201 and NBER); Nesson, Erik T. (Wake Forest University, Economics Department); Sabia, Joseph J. (Center for Health Economics & Policy Studies San Diego State University San Diego, CA 92182 and IZA & ESSPRI) |
| Abstract: | Advocates for sales restrictions on flavored e-cigarettes argue that flavors appeal to young people and lead them down a path to nicotine addiction. This study is among the first to examine the effect of state and local restrictions on the sale of flavored electronic nicotine delivery system (ENDS) products on youth and young adult tobacco use. Using data from the State and National Youth Risk Behavior Surveys, we find that the adoption of an ENDS flavor restriction reduces frequent and everyday youth ENDS use by 1.2 to 2.5 percentage points. Auxiliary analyses of the Behavioral Risk Factor Surveillance System show similar effects on ENDS use for young adults ages 18-20. However, we also detect evidence of an unintended effect of ENDS flavor restrictions that is especially clear among 18-20-year-olds: inducing substitution to combustible cigarette smoking. Finally, there is no evidence that ENDS flavor restrictions affect ENDS use among adults aged 21 and older or non-tobacco-related health behaviors such as binge drinking and illicit drug use |
| Keywords: | ENDS flavor restrictions; flavored e-cigarettes; youth tobacco use |
| JEL: | I12 I18 |
| Date: | 2024–08–30 |
| URL: | https://d.repec.org/n?u=RePEc:ris:wfuewp:0114 |
| By: | Cotti, Chad D. (Department of Ag, Food, and Resource Economics Michigan State University and Center for Demography of Health and Aging University of Wisconsin-Madison); DeCicca, Philip (Department of Economics Ball State University Muncie, IN 47303 and NBER); Nesson, Erik T. (Wake Forest University, Economics Department) |
| Abstract: | We use data from the Population Assessment of Tobacco Use and Health (PATH), a longitudinal data set including self-reported and biomarker measures of tobacco use, to examine the effects of state-level tobacco 21 (T21) laws on smoking and vaping. T21 laws reduce self-reported cigarette smoking among 18-to-20 year olds, concentrated in males. Initial non-users who “age-out” of treatment are less likely to subsequently initiate self-reported smoking or vaping. Treated smokers are less likely to buy their own cigarettes and more likely to buy cigarettes in a different state. Biomarker results are mixed, and we find some evidence of a reduction in nicotine exposure but less evidence for a reduction in exposure to tobacco. Finally, we test for non-classical measurement error. T21 laws reduce the probability that clinically identified likely cigarette smokers self-report as smokers, which may increase the apparent effect of T21 laws on cigarette smoking as measured by self-reports. |
| Keywords: | Tobacco T21; Smoking; Vaping; Biomarkers |
| JEL: | I12 I18 K42 |
| Date: | 2024–08–30 |
| URL: | https://d.repec.org/n?u=RePEc:ris:wfuewp:0113 |
| By: | Hull, Marie C. (University of North Carolina, Greensboro); Yan, Ji (Appalachian State University) |
| Abstract: | While a large literature examines the immediate and long-run effects of public health insurance, much less is known about the impacts of total program exposure on child developmental outcomes. This paper uses an instrumental variable strategy to estimate the effect of cumulative eligibility gain on cognitive and behavioral outcomes measured at three points during childhood. Our analysis leverages substantial variation in cumulative eligibility due to the dramatic public insurance expansions between the 1980s and 2000s. We find that increased eligibility improves child cognitive skills and present suggestive evidence on better behavioral outcomes. There are notable heterogeneous effects across the subgroups of interest. Both prenatal eligibility and childhood eligibility are important for driving gains in the test scores at older ages. Improved child health is found to be a mediator of the impact of increased eligibility. |
| Keywords: | Medicaid, state children's health insurance program, health insurance, human capital, cognitive development, non-cognitive skills |
| JEL: | H51 I13 I38 J13 J24 |
| Date: | 2024–07 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17190 |
| By: | Adriana Lleras-Muney; Hannes Schwandt; Laura Wherry |
| Abstract: | Poverty is strongly associated with worse health across countries and within countries across individuals. However, not all poor individuals suffer from poor health: the effects of poverty on health vary across place and time. In this review, we discuss the evidence documenting these patterns, and the reasons for the associations. We then provide an overview of what is known about policies that may improve the health of the poor. We focus primarily on the modern-day United States, but also discuss evidence from historical experiences and low- and middle-income countries. Throughout we discuss areas in need of future research. |
| JEL: | H50 I1 I14 I18 I30 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32866 |
| By: | Dahlstrand, Amanda (University of Zurich); Le Nestour, Nestor (Stockholm University); Michaels, Guy (London School of Economics) |
| 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 inperson 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: | 2024–07 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17177 |
| By: | Adriana Corredor-Waldron; Janet Currie; Molly Schnell |
| Abstract: | Black mothers with unscheduled deliveries are 25 percent more likely to deliver by C-section than non-Hispanic white mothers. The gap is highest for mothers with the lowest risk and is reduced by only four percentage points when controlling for observed medical risk factors, sociodemographic characteristics, hospital, and doctor or medical practice group. Remarkably, the gap disappears when the costs of ordering an unscheduled C-section are higher due to the unscheduled delivery occurring at the same time as a scheduled C-section. This finding is consistent with provider discretion—rather than differences in unobserved medical risk—accounting for persistent racial disparities in delivery method. The additional C-sections that take place for low-risk women when hospitals are unconstrained negatively impact maternal and infant health. |
| JEL: | I1 I14 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32891 |
| By: | Kuss, Pauline; Meske, Christian; Gersch, Martin; Balzer, Felix; Fürstenau, Daniel; Thissen, Alica; Dewey, Marc; Michallek, Florian; Füllhase, Josch |
| Abstract: | This whitepaper based on the "Algorithms and Agency in Hospitals" project delves into the effects of digital transformation on the work of healthcare professionals and seeks methods to represent their interests throughout this process. Two case studies were carried out in collaboration with Charité Berlin, focusing on the impact of documentation software and algorithm-based decision support tools on clinical workflows, diagnostics, patient care, and the individual's sense of agency. The results underscore the importance of sufficient resources and a user-centered approach to technology design in supporting clinicians' work. The whitepaper concludes with recommendations for clinical managers, employee groups and their representatives, as well as policymakers. |
| Keywords: | artificial intelligence, digitalization, healthcare, decision support, radiology |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:hbsfof:302189 |
| By: | Rose, Julian; Neubauer, Florian; Ankel-Peters, Jörg |
| Abstract: | Banerjee, Duflo, and Sharma (BDS, 2021a) conduct a ten-year follow-up of a randomized transfer program in West Bengal. BDS find large effects on consumption, food security, income, and health. We conduct a replicability assessment. First, we successfully reproduce the results, thanks to a perfectly documented reproduction package. Results are robust across alternative specifications. We furthermore assess the paper's pre-specification diligence and the reporting in terms of external and construct validity. While the paper refers to a pre-registration, it lacks a pre-analysis plan. Assessing the validity of findings for other contexts is difficult absent necessary details about the exact treatment delivery. |
| Keywords: | replicability, randomized controlled trial, transfer programs, research transparency |
| JEL: | A1 O12 |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:i4rdps:142 |
| By: | Fukushima, Nanna (The Swedish National Road and Transport Research Institute); von Hinke, Stephanie (University of Bristol); Sørensen, Emil N. (University of Bristol) |
| Abstract: | This paper investigates the effects of the staggered roll-out of a pollution reduction programme introduced in the UK in the 1950s. The policy allowed local authorities to introduce so-called "Smoke Control Areas" (SCAs) which banned smoke emissions. We start by digitizing historical pollution data to show that the policy led to an immediate reduction in black smoke concentrations. We then merge data on the exact location, boundary and month of introduction of SCAs to individual-level outcomes in older age using individuals' year-month and location of birth. We show that exposure to the programme increased individuals' birth weights as well as height in adulthood. We find no impact on their years of education or fluid intelligence. |
| Keywords: | control areas, developmental origins, staggered treatment effects |
| JEL: | I18 I15 C21 C22 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17205 |
| By: | Federico Zilio (Melbourne Institute: Applied Economic & Social Research, The University of Melbourne); Yuting Zhang (Melbourne Institute: Applied Economic & Social Research, The University of Melbourne); Ross Hickey (University of British Columbia); Ted McDonald (University of New Brunswick); Eric Sun (Stanford University School of Medicine) |
| Abstract: | Using the Household Income and Labour Dynamics in Australia data, we study changes in household allocation of time and spending when a family member experiences a health shock. Applying an event study design, we document that health shocks increase household expenditures and time spent in home production activities that are complements for healing and reduce those that are substitutes. Medical expenditures and spousal caregiving time rise; while spending on alcohol, a good that detracts from healing, declines. Labour supply of the ill person decreases at both the intensive and extensive margin. As the ill person’s labour supply declines, we find an increase in consumption of complements for staying at home, such as spending on household utilities and time for housework by the unaffected spouse. Although the fall in earnings is partially offset by worker compensation and social security payments, the inability to cut total spending results in a higher proportion of individuals reporting financial stress. |
| Keywords: | health shocks, household behaviour, time use, spending, consumption |
| JEL: | J22 I10 D12 D13 |
| Date: | 2024–05 |
| URL: | https://d.repec.org/n?u=RePEc:iae:iaewps:wp2024n04 |
| By: | Susan J. Méndez (Melbourne Institute: Applied Economic & Social Research, The University of Melbourne); Jongsay Yong (Melbourne Institute: Applied Economic & Social Research, The University of Melbourne); Hugh Gravelle (Centre for Health Economics, University of York, England); Anthony Scott (Centre for Health Economics, Monash University) |
| Abstract: | We examine the pricing behaviour of medical specialists in a setting where fees are unregulated and patients receive a fixed subsidy from the government. We use eight years of specialist-level panel data from the Medicine in Australia Balancing Employment and Life (MABEL) survey. We find that local competition is not associated with a specialist’s willingness to accept the fixed subsidy as full payment nor with the level of fee charged above the subsidy. Instead, we show that fees are associated with specialists’ personality traits. Specialists who score more highly on agreeableness are more likely to accept the government subsidy as full payment, while those who score more highly on conscientiousness and neuroticism are less likely to do so. Furthermore, higher neuroticism scores are associated with higher fees. |
| Keywords: | medical specialists, prices, fees, behaviour, competition |
| JEL: | I11 I13 L1 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:iae:iaewps:wp2024n11 |
| By: | Chung, Andy (University of Reading); Hamermesh, Daniel S. (University of Texas at Austin); Singleton, Carl (University of Stirling); Wang, Zhengxin (Zhejiang University of Finance and Economics); Zhang, Junsen (Zhejiang University) |
| 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: | 2024–07 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17191 |
| By: | Elizabeth Ananat; Irwin Garfinkel |
| Abstract: | For many of those who worked to include an expanded Child Tax Credit in the 2021 American Rescue Plan, an important motivation was to test the feasibility and effectiveness of a permanent U.S. child allowance similar to those provided in other rich countries. Because this expansion was short-lived, however, evaluations of its effects cannot provide complete evidence on the long-run effects of a permanently expanded CTC. We leverage theoretical predictions from standard economic models, behavioral science, and child development frameworks, along with empirical evidence from literature evaluating previous long-term cash and quasi-cash transfers to families with children, to predict the likely long-run impacts of a permanent child allowance. We find that it would lead to increased future earnings and tax payments, improved health and longevity, and reduced health care, crime, and child protection costs; using conventional valuations, benefits to society outweigh costs nearly 10 to 1, with most benefits due to credit refundability. |
| JEL: | H31 I38 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32870 |
| By: | Harris, Jorgen M. (Occidental College); Patacchini, Eleonora (Cornell University) |
| Abstract: | In many countries, a significant share of the gender earnings gap stems not only from firm's practices, or self-selection into lower productivity jobs, but also from a lower participation among women. Inactivity around the age of motherhood is frequent including in the most advanced countries, and can have lasting consequences on the chances to return to the labor market, as well as future earnings and promotions. In this paper, we discuss the major barriers reducing women's labor force participation and examine the effects of several policies aimed at overcoming those barriers: parental leave, reserved paternal leave, state-funded childcare for young children, extended school hours, and individual taxation. For each, we provide a brief discussion of policy design and effectiveness. |
| Keywords: | economics of gender, child care, time allocation and labor supply, labor market policy, maternal and paternal labor force participation, gender norms |
| JEL: | J16 J13 J22 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17219 |
| By: | Matteo Picchio (Department of Economics and Social Sciences, Universita' Politecnica delle Marche); Jan C. Van Ours (Erasmus School of Economics and Tinbergen Institute, The Netherlands) |
| Abstract: | High temperatures can have a negative effect on workplace safety for a variety of reasons. Discomfort and reduced concentration caused by heat can lead to workers making mistakes and injuring themselves. Discomfort can also be an incentive for workers to report an injury that they would not have reported in the absence of heat. We investigate how temperature affects injuries of professional tennis players in outdoor singles matches. We find that for men injury rates increase with ambient temperatures. For women, there is no effect of high temperatures on injuries. Among male tennis players, there is some heterogeneity in the temperature effects, which seem to be influenced by incentives. Specifically, when a male player is losing at the beginning of a crucial (second) fourth set in (best-of-three) best-of-five matches, the temperature effect is much larger than when he is winning. In best-of-five matches, which are more exhausting, this effect is age-dependent and stronger for older players. |
| Keywords: | Climate change, temperatures, tennis, injuries, health. |
| JEL: | J24 J81 Q51 Q54 |
| Date: | 2024–09 |
| URL: | https://d.repec.org/n?u=RePEc:anc:wpaper:489 |
| By: | Mounira Boulmelh (UMSBJ - Université Mohammed Seddik Benyahia [Jijel] | University of Jijel) |
| Abstract: | This study aims to highlight the importance of artificial intelligence systems in achieving traffic safety in Algeria by analyzing the situation of traffic accidents over the period from 2010 to 2023. It also aims to showcase the efforts and measures taken to implement artificial intelligence systems to reduce these accidents and propose suitable solutions to achieve economic performance. The study found that, in the field of traffic safety in Algeria, many regulatory measures and efforts have been taken; however, these laws have not succeeded in reducing traffic accidents. Regarding the application of artificial intelligence systems, their use is limited to security services only, such as radars and cameras. |
| Keywords: | Artificial Intelligence Traffic Safety health economics Economic Performance JEL Classification Codes: H51 I11 J28 K32 R41, Artificial Intelligence, Traffic Safety, health economics, Economic Performance JEL Classification Codes: H51, I11, J28, K32, R41 |
| Date: | 2024–06–30 |
| URL: | https://d.repec.org/n?u=RePEc:hal:journl:hal-04678760 |
| By: | Cylus, Jonathan; Thomson, Sarah; Tayara, Lynn Al; Cerezo, José Cerezo; Martínez, Marcos Gallardo; García-Ramírez, Jorge Alejandro; Karanikolos, Marina; Gregori, María Serrano; Evetovits, Tamás |
| Abstract: | Progress towards universal health coverage is monitored by the incidence of catastrophic spending. Two catastrophic spending indicators are commonly used in Europe: Sustainable Development Goal (SDG) indicator 3.8.2 and the WHO Regional Office for Europe (WHO/Europe) indicator. The use of different indicators can cause confusion, especially if they produce contradictory results and policy implications. We use harmonised household budget survey data from 27 European Union countries covering 505, 217 households and estimate the risk of catastrophic spending, conditional on household characteristics and the design of medicines co-payments. We calculate the predicted probability of catastrophic spending for particular households, which we call LISAs, under combinations of medicines co-payment policies and compare predictions across the two indicators. Using the WHO/Europe indicator, any combination of two or more protective policies (i.e. low fixed co-payments instead of percentage co-payments, exemptions for low-income households and income-related caps on co-payments) is associated with a statistically significant lower risk of catastrophic spending. Using the SDG indicator, confidence intervals for every combination of protective policies overlap with those for no protective policies. Although out-of-pocket medicines spending is a strong predictor of catastrophic spending using both indicators, the WHO/Europe indicator is more sensitive to medicines co-payment policies than the SDG indicator, making it a better indicator to monitor health system equity and progress towards UHC in Europe. |
| Keywords: | universal health coverage; financial protection; health financing; catastrophic spending; co-payments; SDGs; coverage policy; Elsevier deal |
| JEL: | F3 G3 |
| Date: | 2024–09–01 |
| URL: | https://d.repec.org/n?u=RePEc:ehl:lserod:124416 |
| By: | Beniamin Liviu Ros (Aurel Vlaicu University, Arad, Romania) |
| Abstract: | In this study, the author aimed to clarify some issues concerning the relationship between religion and the COVID-19 pandemic from a (mental) health perspective. The conclusion reached is that only three of the factors related to religion, COVID-19 and mental health have been investigated in the literature: Religious doctrinal responses to the pandemic - the effect of religiosity/spirituality on promoting health in the COVID-19 pandemic type; changes in religious behavior - the effect of spiritual connections, religious practices, 'social distancing', religion as a risk of virus spread, restrictions, and technology; and religious confrontations - the effects of religiosity/spirituality on (promoting) health. Prejudice, i.e., attitudes and behavior towards religious groups that increase suffering and precipitate mental illness, was ignored. |
| Keywords: | religion, religiosity, spirituality, COVID-19 pandemic |
| Date: | 2024–02 |
| URL: | https://d.repec.org/n?u=RePEc:smo:scmowp:01301 |
| By: | Malcolm Campbell (Department of Computer Science and Information System, Shanghai Jiao Tong University) |
| Abstract: | Cytokines play a crucial role in the immune response, mediating and regulating inflammation, immunity, and hematopoiesis. Understanding the complex dynamics of cytokines is essential for developing effective treatments for various inflammatory and autoimmune diseases. This article employs Total Variation Diminishing (TVD) methods to model the intricate dynamics of cytokines. Additionally, it examines the impact of corruption on healthcare delivery and access, considering how corruption can exacerbate health disparities and impede effective treatment. A comprehensive literature review is presented, followed by detailed research methodology, results from the model application, and concluding insights on the potential of these approaches to inform better health policies. |
| Keywords: | TVD method, cytokines, corruption |
| Date: | 2024–05–01 |
| URL: | https://d.repec.org/n?u=RePEc:hal:journl:hal-04663207 |
| By: | Sarena Goodman; Alice Henriques Volz; Gina Li; Kevin B. Moore |
| Abstract: | The COVID-19 pandemic caused severe disruptions to the U.S. labor market and economic activity. We establish connections between family experiences of the pandemic, their income under normal conditions, and their later economic well-being using the 2022 Survey of Consumer Finances. By their interview, one-third of families experienced net employment declines, one-third had teleworked, and one-fifth had significant COVID-19-related health events. These experiences strongly reflected families’ positions in the income distribution, with lower-income families bearing the brunt. They also tightly predict income and wealth after the initial disruptions, signifying that the pandemic economy likely amplified pre-pandemic differences and fostered new divides. |
| Keywords: | COVID-19; Survey of Consumer Finances; Family economic well-being |
| JEL: | G50 I18 J21 D31 |
| Date: | 2024–08–23 |
| URL: | https://d.repec.org/n?u=RePEc:fip:fedgfe:2024-68 |
| By: | Chatzilena, Anastasia; Demiris, Nikolas; Kalogeropoulos, Konstantinos |
| Abstract: | Despite the progress in medical data collection the actual burden of SARS-CoV-2 remains unknown due to under-ascertainment of cases. This was apparent in the acute phase of the pandemic and the use of reported deaths has been pointed out as a more reliable source of information, likely less prone to under-reporting. Since daily deaths occur from past infections weighted by their probability of death, one may infer the total number of infections accounting for their age distribution, using the data on reported deaths. We adopt this framework and assume that the dynamics generating the total number of infections can be described by a continuous time transmission model expressed through a system of nonlinear ordinary differential equations where the transmission rate is modeled as a diffusion process allowing to reveal both the effect of control strategies and the changes in individuals behavior. We develop this flexible Bayesian tool in Stan and study 3 pairs of European countries, estimating the time-varying reproduction number ( ) as well as the true cumulative number of infected individuals. As we estimate the true number of infections we offer a more accurate estimate of . We also provide an estimate of the daily reporting ratio and discuss the effects of changes in mobility and testing on the inferred quantities. |
| Keywords: | Bayesian inference; SARS-COV2; Stan; compartmental models; reporting ratio; time-varying reproduction number; Covid-19; coronavirus |
| JEL: | C1 |
| Date: | 2024–08–09 |
| URL: | https://d.repec.org/n?u=RePEc:ehl:lserod:124573 |