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on Health Economics |
| By: | Attila Gyetvai; Anikó Bíró; István Boza; Dániel Prinz |
| Abstract: | We study the role that firms play in social insurance benefit uptake after their workers experience health shocks. Social insurance in our setting, Hungary, is universal and comprehensive, thus allowing us to quantify the impact of firms on benefit uptake and labor market outcomes on top of the social safety net. Using matched employer-employee administrative data linked to individual-level health records, we find that firm responses to worker health shocks are heterogeneous: workers hit by a health shock at high-quality firms are less likely to take up disability insurance or exit the labor force than those at low-quality firms. |
| JEL: | H55 I10 J23 |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:ptu:wpaper:w202411 |
| By: | Brüll, Eduard; Rostam-Afschar, Davud; Schlenker, Oliver |
| Abstract: | We study how the threat of entry affects service quantity and quality of general practitioners (GPs). We leverage Germany's needs-based primary care planning system, in which the likelihood of new GPs reduces by 20 percentage points when primary care coverage exceeds a cut-off. We compile novel data covering all German primary care regions and up to 30, 000 GP-level observations from 2014 to 2019. Reduced threat of entry lowers patient satisfaction for incumbent GPs without nearby competitors but not in areas with competitors. We find no effects on working hours or quality measures at the regional level including hospitalizations and mortality. |
| Keywords: | Entry regulation, general practitioners, healthcare provision, threat of entry, regression discontinuity design |
| JEL: | I11 I18 J44 J22 L10 L22 R23 |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:glodps:1537 |
| By: | Muñoz-Blanco, Laura; Frattini, Federico Fabio |
| Abstract: | The rising number of refugees and internally displaced people (IDPs) presents new challenges for vaccine distribution and the spread of diseases. How do forcibly displaced population inflows affect infectious diseases incidence in host communities? Can a policy intervention that vaccinates children during their migration mitigate the impacts? To answer these questions, we examine the Pakistani mass internal displacement from the conflict-affected Federally Administered Tribal Areas in 2008. Using a difference-in-differences approach, we compare new polio cases in districts near and far from the conflict zone before and after 2008. The spatial distribution of districts relative to the historical region of Pashtunistan allows us to design a sample of comparable units. We show that a standard deviation increase in predicted IDP inflow leads to a rise in the new polio cases per 100, 000 inhabitants. Poorer vaccination levels among IDP compared to native children in host communities are one of the main mechanisms. Implementing a vaccination policy targeting IDP children during their migration journey helps bridge the vaccination gap, with important welfare implications. |
| Keywords: | Health Economics and Policy |
| Date: | 2024–12–13 |
| URL: | https://d.repec.org/n?u=RePEc:ags:feemwp:348733 |
| By: | Martín-Román, Ángel L.; Moral, Alfonso; Pinillos-Franco, Sara |
| Abstract: | This study addresses the gender gap in workplace sick leave duration, focusing on the underlying economic and biological factors that contribute to this disparity. Using a novel methodological approach, we combine the stochastic frontier technique with an Oaxaca-Blinder-type decomposition to separate sick leave into medically justified and "opportunistic" days. Our analysis, based on detailed administrative data of workplace accidents in Spain, reveals that men and women recover at different rates for the same injuries, with biological differences explaining the majority of the observed gender gap. Additionally, we identify that men tend to use more sick leave days for reasons unrelated to health recovery. The findings offer valuable insights for policymakers and employers, providing an empirical foundation for targeted policies that reduce gender-based discrimination in the workplace and ensure fairer resource allocation. This research contributes to a deeper understanding of the gender gap in occupational health and offers implications for improving workplace equality. |
| Keywords: | Gender Gap, Sick Leave Duration, Workplace Accidents, Stochastic Frontier Analysis, Occupational Health |
| JEL: | I12 I13 J16 J28 C21 |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:glodps:1542 |
| By: | Halla, Martin (Vienna University of Economics and Business); Schmidpeter, Bernhard (Vienna University of Economics and Business) |
| Abstract: | Suicide is a leading cause of death worldwide and a critical public health concern. We examine the hypothesis of suicide contagion within in the workplace, investigating whether exposure to a coworker's suicide increases an individual's suicide risk. Using high-quality administrative data from Austria and an event study approach, we compare approximately 150, 000 workers exposed to a coworker's suicide with a matched group exposed to a "placebo suicide". We find a significant increase in suicide risk for exposed individuals, with a cumulative treatment effect of 0.04 percentage points (33.3 percent) over a 20-year post-event period. Exposed individuals who also die by suicide are more likely to use the same method as their deceased coworker, strongly suggesting a causal link. Two placebo tests bolster this interpretation: workers who left the firm before the suicide and those exposed to a coworker's fatal car accident do not show an elevated suicide risk. |
| Keywords: | suicide, workplace, contagion hypothesis, Werther-effect, mental health |
| JEL: | I10 I12 I18 D81 J10 |
| Date: | 2024–12 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17580 |
| By: | Bagues, Manuel (University of Warwick); Villa, Carmen (University of Warwick and Institute for Fiscal Studies) |
| Abstract: | Over the past decades, many European countries have raised the minimum legal drinking age (MLDA) from 16 to 18 years. This study provides novel evidence of the impact of this policy on educational outcomes by exploiting the staggered timing of MLDA changes across Spanish regions. Raising the MLDA decreased alcohol consumption among adolescents aged 14–17 by 8 to 18% and improved their exam performance by 4% of a standard deviation. This effect appears driven by alcohol’s direct impact on cognitive ability, as we find no significant changes in potential mediators like use of other substances or time spent on leisure activities, including socialising, sports, gaming, or internet use. We also observe a decrease in tranquilliser and sleeping pill use, suggesting improved mental health. Our findings indicate that reducing teenage alcohol consumption represents a significant opportunity to improve educational outcomes in Europe, where youth drinking rates remain notably high. |
| Keywords: | alcohol ; adolescence ; minimum legal drinking age ; PISA JEL Codes: I18 ; I12 ; I21 |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:wrk:warwec:1529 |
| By: | Lopez-Mayan, Cristina (University of Barcelona); Montresor, Giulia (University of Verona); Nicodemo, Catia (University of Oxford) |
| Abstract: | This paper investigates the impact of the school entry age policy on adolescent risk–taking behaviors. The policy mandates that children begin primary education in the year they turn six, creating relative age differences within cohorts due to a January 1st cutoff date. Using data from the Spanish School Survey on Drug Use, we analyze a comprehensive set of risky behaviors, including substance use, gambling, gaming, internet use, and sexual activity among students in the early adolescence in compulsory education. Employing an empirical strategy that compares students born in December (young–for–grade) and January (old–for–grade) while controlling for potential confounders, we find that young–for–grade students are less likely to engage in risky behaviors. Findings are consistent across various robustness checks. Further analysis shows that age differences and educational cycle effects contribute to the findings, with gender-specific patterns for boys and girls, while school type shows limited variation. Most behavioral differences diminish by late adolescence in high school. This research expands our understanding of the non-academic impacts of school entry age policies on education and adolescent development. |
| Keywords: | young–for–grade and old–for–grade students, school entry age, risky health behaviors, education policy |
| JEL: | I12 I21 J13 |
| Date: | 2024–12 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17589 |
| By: | Lin, Zhuoer; Wang, Yi; Gill, Thomas M.; Chen, Xi |
| Abstract: | Disparities in cognition persist between non-Hispanic Black (hereafter, Black) and non-Hispanic White (hereafter, White) older adults, and are possibly influenced by early educational differences stemming from structural racism. However, the relationship between school racial segregation and later-life cognition remains underexplored. We examined a nationally sample of older Americans from the Health and Retirement Study. Utilizing childhood residence data and cognitive assessment data (1995-2018) for Black and White participants aged 65 and older, Black-White dissimilarity index for public elementary schools measuring school segregation, multilevel analyses revealed a significant negative association between school segregation and later-life cognitive outcomes among Black participants, but not among White participants. Potential mediators across the life course, including educational attainment, explained 58-73% of the association, yet the associations remained large and significant among Black participants for all outcomes. Given the rising trend of school segregation in the US, educational policies aimed at reducing segregation are crucial to address health inequities. Clinicians can leverage patients' early-life educational circumstances to promote screening, prevention, and management of cognitive disorders. |
| Keywords: | early-life circumstances, school segregation, quality of education, racial disparity, cognition, dementia, health equity |
| JEL: | I14 I24 I10 J14 J15 H75 |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:glodps:1527 |
| By: | Pickard, Harry (Newcastle University Business School); Bove, Vincenzo (IMT School for Advanced Studies Lucca and CAGE, University of Warwick); Efthyvoulou, Georgios (University of Sheffield) |
| Abstract: | Do terrorist attacks affect life satisfaction and mental health? To explore this question, we analyse data on all casualty-causing terrorist incidents in Great Britain from 1992 to 2020, and combine this information with individual-level data from the British Household Panel Survey and the UK Household Longitudinal Survey over the same period. To get as close as possible to a causal interpretation, we exploit variation within individuals, net of potential temporal and attack-specific unobserved factors, and report an array of different specifications and robustness tests. Our analysis reveals that geographic proximity to terrorist attacks decreases life satisfaction, particularly when the incidents occurred within the month before the interview. We also find that individuals with pre-existing mental vulnerabilities exhibit higher distress levels following a recent terrorism shock. |
| Keywords: | wellbeing, life satisfaction, mental health, terrorism, security JEL Classification: I10, I31, H56, D74 |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:cge:wacage:734 |
| By: | Hugo Reis; Pedro Carneiro; Alessandro Toppeta |
| Abstract: | Generous maternity leave, affordable daycare, extensive social safety nets, excellent universal health care, and high-quality public schools, are all notable features of Nordic countries. There is a widespread belief that such strong public investments in children contribute to a levelled playing field and promote social mobility. However, gaps in learning outcomes between children of rich and poor parents remain as high in Nordic countries as elsewhere in Europe. One explanation for this paradox is that the equalizing impacts of public investments are undone by parental investments in children of rich and poor families, which are as unequal in Nordic countries as in the rest of the European continent. |
| JEL: | J62 D63 I21 J24 |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:ptu:wpaper:w202407 |
| By: | van de Kraats, Coen (Erasmus University Rotterdam); Galama, Titus (University of Southern California); Lindeboom, Maarten (Vrije Universiteit Amsterdam); Deng, Zichen (University of Amsterdam) |
| Abstract: | We provide evidence that the social norm (expectation) that adults work has a substantial detrimental causal effect on the mental well-being of unemployed men in mid-life, as substantial as, e.g., the detriment of being widowed. As their peers in age retire and the social norm weakens, the mental well-being of the unemployed improves. Using data on individuals aged 50+ from 10 European countries, we identify the social norm of work effect using exogenous variation in the earliest eligibility age for old-age public pensions across countries and birth cohorts. |
| Keywords: | mental well-being, social norm of work, retirement institution |
| JEL: | I10 I31 J60 D63 |
| Date: | 2024–12 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17586 |
| By: | Ponthiere, Gregory |
| Abstract: | This paper examines the potential role of higher education subsidies as an insurance device against the risk of having a short life, that is, as a device reducing the variance in lifetime well-being due to unequal longevities. We use a two-period dynamic OLG economy with human capital and risky lifetime to study the impact of a subsidy on higher education (financed by taxing labor earnings at older ages) on the distribution of lifetime well-being between long-lived and short-lived individuals. It is shown that, whereas the subsidy on higher education improves necessarily the lot of short-lived individuals in comparison to the laissez-faire, it is only when the subsidy is higher than a critical threshold that this reduces inequalities in lifetime well-being between long-lived and short-lived individuals. Whether one adopts the utilitarian or the ex post egalitarian social welfare function, the optimal subsidy on higher education lies above the critical threshold, but is larger under the latter social objective. |
| Keywords: | higher education, mortality risk, insurance, longevity, human capital |
| JEL: | I25 I28 I31 J17 |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:glodps:1528 |
| By: | Tiffanie Perrault; Erin C. Strumpf |
| Abstract: | One in eight women will be diagnosed with breast cancer in her lifetime. In Canada, breast cancer is the second leading cause of cancer death in women of all ages, but the leading cause in women aged 30 to 49. Late diagnosis can worsen the disease and reinforce inequalities. In Quebec, delays in diagnosis are much longer than in Ontario or Alberta, where delays are the shortest in the country. An outdated cancer registry and a lack of standardization of care contribute to Quebec's delays. In this article, the authors explore the capabilities, performance and innovations of breast cancer diagnosis in Quebec, and compare them to those in other provinces. In their view, Quebec can and must do better by strengthening its commitment to innovative policies and developing effective methods for collecting comprehensive, standardized, up-to-date and accessible data. These efforts are essential, both for health care planning and for the advancement of research. |
| Keywords: | Cancer, Health, Public health, Breast cancer, Screening, Healthcare performance, Diagnosis, |
| Date: | 2024–11–26 |
| URL: | https://d.repec.org/n?u=RePEc:cir:circah:2024pj-09 |
| By: | Eskander, Shaikh (University of Alabama Birmingham); Mahmud, Minhaj (Asian Development Bank) |
| Abstract: | This paper explores the mitigating effects of climate policies in addressing climate-induced health adversities. We first investigate the effect of in utero exposure to rainfall variations on child health outcomes in Bangladesh and find that in utero exposure to rainfall variations negatively affects children’s anthropometric outcomes. We then exploit the heterogeneity in location and timing of district-level allocations for climate projects under the Bangladesh Climate Change Trust Fund to identify that some of these rainfall-induced health adversities can be mitigated through climate policies. Our findings are robust to alternative empirical specifications and have important policy implications. |
| Keywords: | climate change; climate finance; health; rainfall |
| JEL: | I38 Q54 Q58 |
| Date: | 2024–12–04 |
| URL: | https://d.repec.org/n?u=RePEc:ris:adbewp:0756 |
| By: | Nguyen, Manh-Hung; Hoang, Viet-Ngu; Nghiem, Son; Nguyen, Lan Anh |
| Abstract: | Mandatory vaccination for COVID-19 has received intense political and ethical debates, while the literature on the causal effects of vaccination mandates on vaccination outcomes is very limited. In this study, we examine the effects of the announcement of vaccine mandates (VMs) for workers working in three sectors, including health, education, and state governments, on the uptake of first-dose and second-dose vaccination across 50 states in the United States of America. We show that VM announcements have heterogeneous effects; hence, standard two-way fixed effects and difference-in-differences estimators are biased. We present evidence for the heterogeneous treatment effects using recently developed estimators of de Chaisemartin and D’Haultfœuille (2020b) in single and two-treatment settings. In the setting of a single treatment, when treating all VM announcements equally, our results show that VM announcement was associated with an increase of 20.6% first-dose uptake from 1 July to 31 August 2021. In two-treatment settings, our results suggest that VM announcements for workers in health or state government sectors have significant causal effects on first-dose vaccination. Additionally, VM announcements do not have significant causal effects on second-dose uptake. Our results are robust to the choice of differing outcome variables and periods after controlling for state-level covariates, including COVID-19 death, unemployment, and cumulative two-dose vaccination. |
| Keywords: | COVID-19; heterogeneous treatment effects; multiple treatment effects; Difference-in-Differences estimator |
| JEL: | I12 I15 I18 J18 J21 J23 |
| Date: | 2024–11 |
| URL: | https://d.repec.org/n?u=RePEc:tse:wpaper:129950 |
| By: | Karimi, Hanie; Mahdavi, Sara; Moghaddam, Sahar Saeedi; Abbasi-Kangevari, Mohsen; Soleimani, Zahra; Esfahani, Zahra; Masinaei, Masoud; Fateh, Sahar Mohammadi; Golestani, Ali; Dilmaghani-Marand, Arezou; Kompani, Farzad; Rezaei, Negar; Ghasemi, Erfan; Larijani, Bagher; Farzadfar, Farshad |
| Abstract: | This study aimed to investigate the estimated burden attributed to lead exposure (LE), at the national and subnational levels from 1990 to 2019 in Iran. The burden attributed to LE was determined through the estimation of deaths, disability-adjusted life years (DALYs), years of life lost (YLLs) and years lived with disability (YLDs) using the comparative risk assessment method of Global Burden of Disease (GBD) study presenting as age-standardized per 100, 000 person year (PY) with 95% uncertainty intervals (95% UI). Furthermore, the burden of each disease were recorded independently. Eventually, the age-standardized YLLs, DALYs, deaths and YLDs rates attributed to LE demonstrated a decrease of 50.7%, 48.9%, 38.0%, and 36.4%, respectively, from 1990 to 2019. The most important causes of LE burden are divided into two acute and chronic categories: acute, mainly causes mental disorders (DALYs rate of 36.0 in 2019), and chronic, results in cardiovascular diseases (CVDs) (DALYs rate of 391.8) and chronic kidney diseases (CKDs) (DALYs rate of 26.6), with CVDs bearing the most significant burden. At the sub-national level, a decrease in burden was evident in most provinces; moreover, low and low-middle SDI provinces born the highest burden. The burden increased mainly by ageing and was higher in males than females. It was concluded that although the overall decrease in the burden; still it is high, especially in low and low-middle SDI provinces, in advanced ages and in males. Among IDID, CKDs and CVDs that are the most important causes of LE-attributed burden in Iran; CVDs bear the highest burden. |
| Keywords: | Environmental pollutants, Cardiovascular diseases, Death, Disability-adjusted life years, Global burden of disease, Lead |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:ifwkie:307098 |