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on Health Economics |
| By: | Margherita Borella; Francisco 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. |
| Keywords: | Mortality dynamics; Health inequality; Health dynamics; Inequality; Health types |
| JEL: | I10 |
| Date: | 2024–08–23 |
| URL: | https://d.repec.org/n?u=RePEc:fip:fedmoi:98796 |
| By: | Davillas, Apostolos (University of Macedonia); de Oliveira, Victor Hugo (Instituto de Pesquisa e Estratégia Econômica do Ceará (IPECE)); Raftopoulou, Athina (University of Patras) |
| Abstract: | Drawing on nationally representative UK data, we explore the association of parental health and disability with mental distress and non-cognitive skills development of adolescents; both self-reported and more objectively measured bio-measures are used to capture parental health. Overall, we demonstrate a systematic association of parental health/disability with the non-cognitive skills development of adolescents living in the same household. However, considerable heterogeneity in these associations is observed between (and within) the mother's and father's health and disability measures. Much less evident is the link between parental health/disability and adolescents' mental distress. Our findings suggest that each parent's health and disability status may be differentially associated with adolescents' non-cognitive skills development. |
| Keywords: | adolescents, biomarkers, mental distress, non-cognitive skills, parental health |
| JEL: | I10 J24 C21 J12 |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17239 |
| By: | Rosanne Freak-Poli (School of Clinical Sciences at Monash Health, Monash University, Australia); Stephen P. Jenkins (Department of Social Policy, London School of Economics, UK); Michael A. Shields (Centre for Health Economics, Monash Business School, Monash University, Australia); Trong-Anh Trinh (Centre for Health Economics, Monash Business School, Monash University, Australia) |
| Abstract: | Despite a substantial literature on the links between social relationships and mortality, the size of the relative risks from loneliness, social isolation, and living alone, remain controversial. Further research is therefore important given demographic changes meaning that more people are living alone, for longer, and with chronic health conditions. Using 19 waves of high-quality Australian longitudinal data we provide new evidence using multiple measures of social relationships, model specifications, and adjustments for confounding. We focus on chronic measures of (poor) social relationships and provide separate estimates by gender. We find that both functional and structural aspects of social relationships are independently strongly associated with all-cause mortality. We estimate a hazard ratio for loneliness of 1.41, which is greater for males (1.55) than females (1.24). These hazard ratios are larger than found for social isolation (1.19). We also find a strong relationship between being an active member of a club and reduced mortality risk, but no evidence that living alone is an independent risk factor. We provide useful comparisons with the mortality risks associated with smoking and household income. Overall, our findings suggest that interventions should focus on reducing both loneliness and social isolation, as well as encouraging active social participation. |
| Keywords: | Mortality, Social Relationships, Loneliness, Social Support, Social Isolation |
| JEL: | I12 I10 |
| Date: | 2024–09 |
| URL: | https://d.repec.org/n?u=RePEc:mhe:chemon:2024-15 |
| By: | Matteo Picchio (Marche Polytechnic University); Jan C. van Ours (Erasmus University Rotterdam) |
| 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: | 2024–09–13 |
| URL: | https://d.repec.org/n?u=RePEc:tin:wpaper:20240057 |
| By: | Muhammad Fikru Rizal (Health Economics Group, School of Public Health and Preventive Medicine, Monash University); David W. Johnston (Centre for Health Economics, Monash Business School, Monash University); Nicole Black (Centre for Health Economics, Monash Business School, Monash University); Rohan Sweeney (Centre for Health Economics, Monash Business School, Monash University) |
| Abstract: | In many low- and middle-income countries (LMICs), a high proportion of people with mental health needs do not receive treatment, contributing to a significant “treatment gap”. Despite this, there is limited robust evidence on the socioeconomic factors that shape mental healthcare use in these settings. Using data from over 400, 000 adults in Indonesia, this study examines how wealth, education, and health insurance coverage influence the likelihood of accessing mental healthcare among those with probable depression. Indonesia is an important context for this analysis because undertreatment and stigma are particularly severe. We find that only 9.3% of those identified as having probable depression receive treatment. Wealth and health insurance are positively associated with the probability of mental healthcare utilisation, while education is not. The wealth gradient diminishes at the highest income levels, and we show this is possibly due to increased stigma. These findings underscore the importance of reducing financial barriers, such as through public health insurance expansion, and reducing stigma to address the mental health treatment gap in LMICs. |
| Keywords: | mental health, treatment gap, depression, mental healthcare |
| JEL: | I10 I14 I15 I18 D31 |
| Date: | 2024–09 |
| URL: | https://d.repec.org/n?u=RePEc:mhe:chemon:2024-16 |
| By: | Sebastian Becker; Annica Gehlen; Johannes Geyer; Peter Haan |
| Abstract: | We provide novel evidence about the incentive and welfare effects of an increase in the generosity of disability benefits. Importantly, a unique policy variation in Germany allows us to isolate the income effect of a change in benefit generosity. We leverage this quasi-experimental policy variation using an RD design to estimate the effect of increasing disability benefits on employment, earnings, labor market transitions, and mortality outcomes using administrative data on the universe of new disability benefit recipients. Contrary to previous literature, our analysis reveals no significant impact on the employment and earnings of DI recipients due to the increased benefits. However, we find a sizable effect of the probability of returning to the labor market. We find no effects on recipient mortality six years after benefit award, but estimates imply a notable reduction in poverty risk, highlighting meaningful welfare implications of increased generosity. |
| Keywords: | disability insurance, pension reform, wealth effect, labor supply, mortality, RDD |
| JEL: | H55 I12 J22 J26 |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:diw:diwwpp:dp2098 |
| By: | Hirao, Tomotaka (Setsunan University); Igawa, Shizue |
| Abstract: | Understanding the parental leave system at childbearing age is crucial for life after childbirth, regardless of gender. According to a 2021 UNICEF report, Japan has the best paid paternity leave policy in the world. However, the uptake rate of parental leave for Japanese male employees remains low compared to international averages. Many Japanese fathers may be underutilizing this benefit of this highly ranked parental leave system. Although there are several reasons for this, this study focuses on a lack of understanding of the particulars parental leave system. The empirical results of this study show that female employees possess more knowledge than their male counterparts and that the determinants of this knowledge differ between men and women. A worrying aspect of these results is the lack of opportunities for young male employees to improve their parental leave knowledge in the “lowest-low fertility” society of Japan. Future research is needed to try to identify new determinants of this knowledge to better understand and overcome the relationship of this problem to Japan’s low fertility rate. |
| Date: | 2024–09–06 |
| URL: | https://d.repec.org/n?u=RePEc:osf:socarx:r9q8n |
| By: | Haoran He; David Neumark; Qian Weng |
| Abstract: | A recent approach to testing for customer statistical discrimination involves studying price gaps between sellers from different gender, race, or ethnic groups and how they evolve as buyers obtain more information about seller quality. We consider a similar setting, testing for statistical discrimination against female doctors in an online health care market. But we show that this kind of analysis does not provide evidence on statistical discrimination in this setting because doctors have a choice about how strongly to signal gender. We develop a new approach to identifying statistical discrimination using doctors’ choices about signaling their gender. We find evidence of statistical discrimination against female doctors in male-dominated fields, and against male doctors in female-dominated fields. In particular, female doctors mask gender more strongly initially in male-dominated fields, and male doctors do the same in female-dominated fields. But in both female- and male-dominated fields the gender gap in signaling decreases with number of customer reviews of doctors. More generally, our evidence indicates how, in some markets, sellers may be able to reduce statistical discrimination by masking their group membership. |
| JEL: | I11 J16 J40 J70 |
| Date: | 2024–09 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32929 |
| By: | Sollis, Kate; Rajeevan, Usitha; van Eeden, Lily; Lee, Kate; Keniger, Lucy; Lin, Brenda; Marsh, Pauline; Flies, Emily |
| Abstract: | Nature connection is an important leverage point for both human wellbeing and planetary health. While previous research has identified associations between nature connection and wellbeing, there has been little examination of how different wellbeing measures are associated with nature connection, and how this correlation varies by population groups. We seek to fill this gap through a survey of 4006 individuals in Australia. We find a strong association between nature connection and two measures of wellbeing: life satisfaction, and health-related quality-of-life. The association between nature connection and life satisfaction was similar to that of income and life satisfaction. The association between nature connection and wellbeing was found to be particularly strong for younger people, and those who speak a language other than English at home. Through developing a measure examining one’s life satisfaction relative to their health-related quality-of-life, we find that those with higher levels of nature connection tend to have greater life satisfaction than health-related quality-of-life. These findings highlight the important role policy can play in enhancing nature connection to improve wellbeing, such as expanding green space development and providing individuals with more opportunities to meaningfully connect with nature. Keywords: Nature connection, wellbeing, life satisfaction, health-related quality-of-life |
| Date: | 2024–09–05 |
| URL: | https://d.repec.org/n?u=RePEc:osf:socarx:s74k9 |
| By: | Carine Milcent (PSE - Paris School of Economics - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris Sciences et Lettres - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement, PJSE - Paris Jourdan Sciences Economiques - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris Sciences et Lettres - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement); Hanta Ramaroson; Fleur Maury; Florence Binder-Foucard; Marie Moitry; Anne-Marie Moulin |
| Abstract: | To counter the spread of COVID-19, the French government imposed several stringent social and political measures across its entire population. We hereto assess the impact of these political decisions on healthcare access in 2020, focusing on patients who suffered from an ischemic stroke. We divide our analysis into four distinct periods: the pre-COVID-19 pandemic period, the lockdown period, the "in-between" or transitional period, and the shutdown period. Our methodology involves utilizing a retrospective dataset spanning 2019–2020, an exhaustive French national hospital discharge diagnosis database for stroke inpatients, integrated with income information from the reference year of 2019. The results reveal that the most affluent were more likely to forgo medical care, particularly in heavily affected areas. Moreover, the most disadvantaged exhibited even greater reluctance to seek care, especially in the most severely impacted regions. The data suggest a loss of opportunity for less severely affected patients to benefit from healthcares during this lockdown period, regardless of demographic, location, and socioeconomic determinants. Furthermore, our analysis reveals a notable discrepancy in healthcare-seeking behavior, with less affluent patients and seniors (over 75 years old) experiencing slower rates of return to healthcare access compared to pre-pandemic levels. This highlights a persistent gap in healthcare accessibility, particularly among socioeconomically disadvantaged groups, despite the easing of COVID-19 restrictions. |
| Keywords: | deprivation, geographical residence, inequity, COVID-19 pandemic, healthcare access, public health, Stroke |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:hal:journl:hal-04690280 |
| By: | Pinchbeck, Edward W.; Roth, Sefi; Szumilo, Nikodem; Vanino, Enrico |
| Abstract: | This study uses the housing market to examine the costs of indoor air pollution. We focus on radon, a common indoor air pollutant which is the leading cause of lung cancer after smoking. For identification, we exploit a natural experiment whereby a risk map update in England induces exogenous variation in published pollution risk levels. We find a significant negative relationship between changes in published pollution risk levels and residential property prices. Interestingly, we do not find a symmetric effect for decreasing risk. We also show that the update of the risk map led higher socioeconomic groups (SEGs) to move away from affected areas, attracting lower SEG residents via lower prices. Overall, our results demonstrate that indoor air quality has material economic effects on the housing market and provide novel policy-relevant insights into how the market responds to information on environmental risks. |
| Keywords: | indoor air pollution; neighbourhood sorting; house prices; risk information; radon |
| JEL: | Q53 H23 R21 |
| Date: | 2023–11–01 |
| URL: | https://d.repec.org/n?u=RePEc:ehl:lserod:118450 |
| By: | David Frayman; Christian Krekel; Richard Layard; Sara MacLennan; Isaac Parkes |
| Abstract: | The government spends billions on our behalf. How do we want this money to be spent? This report reviews a range of policies and asks the fundamental question which should be asked of every policy: Does it deliver value for money? In other words, what benefit does it deliver to people relative to its net cost to the government. This benefit/cost ratio is the key single number the government should be looking at when it makes its spending decisions. In each case the benefits are measured in terms of the monetary equivalent of the impact of the policy in improving wellbeing. And the costs include an allowance for savings in subsequent years. |
| Keywords: | wellbeing, public spending, community wellbeing, mental health, schools, apprenticeships, police, crime, research and development, roads, rail, pension, house building, planning |
| Date: | 2024–09–03 |
| URL: | https://d.repec.org/n?u=RePEc:cep:cepsps:44 |
| By: | Jiayi Wen; Xiaoqing Yu |
| Abstract: | Does public insurance reduce uninsured long-term care (LTC) risks in developing countries, where informal insurance predominates? This paper exploits the rollout of LTC insurance in China around 2016 to examine the impact of public LTC insurance on healthy workers' labor supply, a critical self-insurance channel. We find that workers eligible for public LTC insurance were less likely to engage in labor work and worked fewer weeks annually following the policy change, suggesting a mitigation of uninsured risks. However, these impacts were insignificant among those with strong informal insurance coverage. Parallel changes in anticipated formal care use corroborate these findings. While our results reveal that public LTC insurance provides limited additional risk-sharing when informal insurance predominates, they also underscore its growing importance. |
| Date: | 2024–08 |
| URL: | https://d.repec.org/n?u=RePEc:arx:papers:2408.14243 |
| By: | Stephen Gibbons; Sandra McNally; Piero Montebruno |
| Abstract: | School absences increased massively during the Covid-19 pandemic and remain high internationally. We investigate whether policy variation in restrictions influenced pupil absence during the pandemic and how this affected post-pandemic attendance and academic achievement. Variation in restrictions during autumn 2020 that restricted social contact (but that were not aimed at schools) caused higher rates of school absence at the time and in subsequent years. The school attendance of pupils from lower socio-economic groups was much more strongly impacted by variation in restrictions |
| Keywords: | schools, COVID-19, pupil absence |
| Date: | 2024–09–06 |
| URL: | https://d.repec.org/n?u=RePEc:cep:cepsps:45 |
| By: | Kimberly Dadisman; Andre Nickow; Philip Oreopoulos |
| Abstract: | Parenting is widely considered to be among the most important influences on early childhood (EC) development. But to what extent and under what circumstances can EC parenting programs improve child learning outcomes? While substantial progress has been made toward addressing these questions in recent years, there have been few attempts to systematically synthesize the evidence thus far with a view toward scaling and policy implications. This paper works toward filling this gap through a systematic review including both a quantitative meta-analysis and a detailed narrative analysis of randomized evaluations that test the impacts of EC parenting programs on learning outcomes. We find that these programs generate substantial effects across a wide range of contexts, and that the largest impacts are associated with programs that are conducted in low- or middle-income countries and that use curricula focusing on cognitive stimulation. Group parenting programs tend to yield effect sizes that are, on average, comparable to home visiting programs, typically at substantially lower costs. Qualitative analysis of evaluations of scaled interventions reveals that administrative implementation barriers rather than program ineffectiveness likely represent the primary impediment to stronger impact. We conclude by reflecting on implications for theory, policy, and priorities for future research. |
| JEL: | I2 J13 |
| Date: | 2024–09 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32959 |
| By: | Pol Campos-Mercade; Armando N. Meier; Stephan Meier; Devin G. Pope; Florian H. Schneider; Erik Wengström |
| Abstract: | Whether monetary incentives to change behavior work and how they should be structured are fundamental economic questions. We overcome typical data limitations in a large-scale field experiment on vaccination (N = 5, 324) with a unique combination of administrative and survey data. We find that guaranteed incentives of $20 increase uptake by 13 percentage points in the short run and 9 in the long run. Guaranteed incentives are more effective than lottery-based, prosocial, or individually-targeted incentives, though all boost vaccinations. There are no unintended consequences on future vaccination or heterogeneities based on vaccination attitudes and incentivized economic preferences. Further, administrative data on relatives shows substantial positive spillovers. Our findings demonstrate the great potential of incentives for improving public health and provide guidance on their design. |
| JEL: | C93 D01 D62 I12 I18 |
| Date: | 2024–09 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:32899 |