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on Health Economics |
| By: | Dodini, Samuel (Federal Reserve Bank of Dallas); Lundborg, Petter (Dept. of Economics, Lund University); Løken, Katrine (Dept. of Economics, Norwegian School of Economics and Business Administration); Willén, Alexander (Dept. of Economics, Norwegian School of Economics and Business Administration) |
| Abstract: | This paper examines the welfare consequences of reallocating high-skilled labor across borders. A labor demand shock in Norway—driven by a surge in oil prices—substantially increased physician wages and sharply raised the incentive for Swedish doctors to commute across the border. Leveraging linked administrative data and a dose-response difference-in-differences design, we show that this shift doubled commuting rates and significantly reduced Sweden’s domestic physician supply. The result was a persistent rise in mortality, with no corresponding health gains in Norway. These effects were unevenly distributed, disproportionately harming certain places and populations. The underlying mechanism was a severe strain on Sweden’s healthcare system: shortages of young, high-skilled generalists led to more hospitalizations, premature discharges, higher readmission rates, and delayed care. Mortality effects were larger in low-density physician regions and concentrated in older individuals and acute conditions—circulatory, respiratory, and infectious diseases. Our findings show that even temporary, intensive-margin shifts in skilled labor can generate large and unequal welfare losses when public services are already capacity-constrained. |
| Keywords: | Brain Drain; Worker Mobility; Mortality |
| JEL: | H11 J12 J16 |
| Date: | 2025–04–02 |
| URL: | https://d.repec.org/n?u=RePEc:hhs:nhheco:2025_009 |
| By: | Bertoli, P.;; Grembi, V.; |
| Abstract: | In many countries, public healthcare systems are facing the unprecedented challenge of attracting new physicians and retaining existing physicians. Given that the role of non economic factors in responding to such a challenge is as important as the role played by economic factors, we use outbreaks of healthcare scandals from 2000 to 2020 in approximately 100 Italian provinces to address the impact of perceived corruption on the density of public hospital physicians. The outbreak of a scandal is associated with a 3.6% decrease in the presence of public hospital physicians. The effect is explained mainly by so-called supply-side drivers, such as ethical concerns(i.e., a scandal related to a malpractice case), a lack of motivation in the workplace, concerns about the high salience of the scandal(e.g. more media coverage), and more outside options. Demand-side drivers, such as a lower level of trust on the patient side, which affects the patient distribution and, indirectly, the physician distribution, do not seem to play a crucial role within the institutional setting analyzed. Our results are robust to different staggered DID estimators, the inclusion of trends to capture potential time-varying attitudes toward corrupt behaviours, and the inclusion of variables that are expected to affect both the density of public hospital physicians and the occurrence of scandals. Healthcare scandals do not seem to affect the density of other types of civil servants, such as teachers or firefighters. |
| Keywords: | healthcare; corruption; staggered Di-in-Di; physicians' supply; |
| JEL: | D7 I19 J24 |
| Date: | 2025–04 |
| URL: | https://d.repec.org/n?u=RePEc:yor:hectdg:25/03 |
| By: | Hagmann, David (The Hong Kong University of Science and Technology); Liao, Yi-tsen; Chater, Nick; Loewenstein, George |
| Abstract: | Policy challenges can typically be addressed both through systemic changes (e.g., taxes and mandates) and by encouraging individual behavior change. In this paper, we propose that, while in principle complementary, systemic and individual perspectives can compete for the limited attention of people and policymakers. Thus, directing policies in one of these two ways can distract the public’s attention from the other—an “attentional opportunity cost.” In two pre-registered experiments (n = 1, 800) covering three high-stakes domains (climate change, retirement savings, and public health), we show that when people learn about policies targeting individual behavior (such as awareness campaigns), they are more likely to themselves propose policies that target individual behavior, and to hold individuals rather than organizational actors responsible for solving the problem, than are people who learned about systemic policies (such as taxes and mandates, Study 1). This shift in attribution of responsibility has behavioral consequences: people exposed to individual interventions are more likely to donate to an organization that educates individuals rather than one seeking to effect systemic reforms (Study 2). Policies targeting individual behavior may, therefore, have the unintended consequence of redirecting attention and attributions of responsibility away from systemic change to individual behavior. |
| Date: | 2023–04–22 |
| URL: | https://d.repec.org/n?u=RePEc:osf:osfxxx:z2vwb_v1 |
| By: | Vizcaíno-Cuenca, Rocío; SANCHEZ, MONICA ROMERO; Carretero-Dios, Hugo |
| Abstract: | Cyber-sexual violence is a social and public health concern perpetuated by (cyber)rape culture. However, there are no measures to assess attitudes toward cyber-sexual violence. In this research, we developed and validated the Acceptance of Myths About Cyber-Sexual Violence (AMCYS) Scale in Spanish and English. After a literature review, we developed the items through qualitative analyses of social reactions to victims on Twitter, focus groups, and an expert-based content validity study. Next, a pool of items was administered to 548 Spanish social network users. Based on preliminary analyses, differential functioning item, and exploratory analyses, 10 items were retained. We validated the measure using independent samples from Spain (Sample 2 = 489; Sample 3 = 467) and the United States (Sample 4 = 470; Sample 5 = 512). Results showed high reliability and a one-dimensional structure for the AMCYS, with measurement invariance across genders and countries. Scores on the scale correlated positively with sexism, offline myths on gender violence, and social dominance, and correlated negatively with feminism. Additionally, the AMCYS predicted victim blaming and minimization of cyber-sexual violence and accounted for more variance in scenario responses than other measures. This study can be useful for the prevention and intervention of cyber-sexual violence. |
| Date: | 2025–03–24 |
| URL: | https://d.repec.org/n?u=RePEc:osf:osfxxx:apyqu_v1 |
| By: | Anna Sanz-de-Galdeano (University of Alicante); Daniela Vuri (DEF & CEIS, University of Rome "Tor Vergata") |
| Abstract: | We analyze the impact of unexpected health shocks—defined as the sudden diagnosis of cancer, stroke, or heart attack—on the probability of couple dissolution using longitudinal representative data on older individuals (50+). We leverage the longitudinal nature of the HRS and utilize a quasi-experimental research approach that creates counterfactual scenarios for affected households by comparing them to households set to experience the same event in subsequent years. We find that experiencing a health shock significantly increases the probability of couple dissolution by approximately 19% of the mean divorce prevalence. This effect intensifies gradually over time rather than appearing immediately after the adverse health event. Additionally, we examine several mechanisms through which health shocks may influence divorce, focusing on three potential channels: mental health, cognitive decline, and financial strain. Our findings suggest that all three mechanisms likely play a role in mediating the relationship between health shocks and the increased probability of divorce. |
| Keywords: | Health shocks, divorce, aging |
| JEL: | I14 I24 J15 Z13 J13 |
| Date: | 2025–04–15 |
| URL: | https://d.repec.org/n?u=RePEc:rtv:ceisrp:597 |
| By: | Reichert, Arndt; Simon, Anne |
| Abstract: | This study empirically examines the effects of exposure to paternal smoking on child growth, utilizing comprehensive data from the Indonesian Family Life Survey. We use doubly robust estimations to compare the health outcomes of children whose fathers began smoking before pregnancy with children whose fathers abstained from smoking during the same time. We present separate point estimates for children from ethnic minorities and the ethnic majority group to analyze whether smoking is a channel through which the majority-minority gradient in health outcomes is transmitted from one generation to the next. Our findings reveal a significant reduction in the anthropometric height-for-age z-score among children from ethnic minority groups but not from the ethnic majority group, suggesting that smoking is an important conduit for these disparities. We present suggestive evidence that ethnic segregation contributes to the effect heterogeneity of secondhand smoke exposure between the ethnic majority and ethnic minorities. These findings underscore the importance of strengthening tobacco control regulations, such as increasing tobacco taxes and enforcing smoking bans, and point to the need to address ethnic segregation to mitigate the disproportionate impact of second-hand smoke exposure on ethnic minority children. |
| Keywords: | secondhand smoke, birth weight, height-for-age, z-scores, ethnic disparities, development |
| JEL: | I14 J13 J15 |
| Date: | 2025–04 |
| URL: | https://d.repec.org/n?u=RePEc:han:dpaper:dp-736 |
| By: | Zheng, Yeqiu; Gu, Yan; van Soest, Arthur |
| Abstract: | We investigated (1) what psychological (e.g., five big personality traits, self-esteem) and social-demographic factors contribute to the prevalence and intensity of drug use in the Netherlands and (2) the impact of taking illicit drugs on individuals’ (N=1170) health, labour market performance and financial wealth. First, analyses of various factors showed that emotional stability, employment status, urban character of the place of residence, number of children, gender, and compliance with parents can predict individuals’ drug use concurrently. Particularly, emotional stability, employment and gender can still predict drug use four years later, even when the concurrent baseline of drug use has been additionally controlled for. Instrumental variable analysis suggested that emotional stability may have a causal effect. Furthermore, we showed that, controlling for standard demographic factors, self-control, patience, risk aversion, IQ, etc., taking drugs negatively relate to participants’ physical health (e.g., general health, BMI, disease days, diabetes, and recurrent complaints) and mental health (e.g., feeling more depressed and anxious; less happy or calm), as well as predicts a significantly lower employment possibilities, income, and financial wealth than non-drug users. Our results not only show the consequences of taking drugs for different aspects of well-being, but also suggest that an intervention for drug users may also give more importance to their emotional stability and employment opportunities. |
| Date: | 2023–04–13 |
| URL: | https://d.repec.org/n?u=RePEc:osf:osfxxx:phnyg_v1 |
| By: | Jacopo Lunghi; Maurizio Malpede; Marco Percoco |
| Abstract: | This study shows how soil aridity (proxied with a measure of soil potential evapotranspiration) impacts child wellbeing in Sub-Saharan Africa. Using climate and infant health data from a grid of approximately 4, 000 cells in 34 African countries, we find that infants born in arid areas are comparatively more likely to die under the age of 5 and be systematically underweight at birth. In addition, we show how the aridity measure in this study reduces the effect of rainfall on child wellbeing and how aridification drives substantial heterogeneity in the estimated response to increasing precipitation. The findings are combined with model projections of future climate conditions to emphasize the importance of accounting for aridity alongside precipitations when assessing the economic impact of climate. |
| Keywords: | Rainfall, climate change, potential evapotranspiration, child mortality, infant health |
| JEL: | J1 J13 I15 Q54 Q56 O15 |
| Date: | 2023–05 |
| URL: | https://d.repec.org/n?u=RePEc:bcu:greewp:greenwp23 |
| By: | Hurerah, Abu; Shehzad, Hafiz Tamoor; Anwar, Muhammad Adnan; Razzaq, Mudassar; Becker, Marcus |
| Abstract: | Managing electronic health records (EHRs) within hospitals presents significant challenges, particularly in ensuring the security, privacy, and accessibility of sensitive patient data. Traditional systems are often vulnerable to breaches and inefficiencies, demanding the need for exploration of innovative technologies. This paper proposes a blockchain-based electronic health records (BbEHR) system utilizing the Ethereum blockchain and Flutter framework to create a decentralized, immutable, and tamperproof platform for hospital management. The Ethereum blockchain's smart contract functionality provides secure storage and guarantees data integrity, while the Flutter framework enables the development of responsive and visually appealing user interfaces across multiple devices. This decentralized approach enhances data privacy, accessibility, and system resilience against failures, offering a transformative solution for EHR management. The proposed system has the potential to secure healthcare data management by providing a secure, efficient, and user-friendly platform that meets the stringent requirements of modern healthcare institutions, adding the fact that introducing a BbEHR would minimize the danger of manipulating patient data due to its decentralized structure including unique cryptography methods for reaching consensus in each block of the chain. |
| Date: | 2025 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:ismwps:313091 |
| By: | Skretkowicz, Yvette; Perret, Jens K. |
| Abstract: | The Nutri-Score is currently used in 7 countries in the EU and is part of the German reduction and innovation strategy to combat non-communicable diseases related to unhealthy eating. The Nutri-Score is intended to inform consumers and serves as a guide when buying packaged food. The aim of this study is to investigate the significance, benefits, function and credibility of the Nutri-Score in Germany from the perspective of nutrition experts, business representatives from food companies, packaging experts and general consumers. A qualitative method was selected for the evaluation and a survey was conducted with the help of expert interviews with 23 industry experts on their personal opinion of the Nutri-Score. The qualitative method allowed the research questions to be considered from the perspective of different experts and two-sided responses showed that the answers varied depending on the professional background of the experts. In summary, it can be said that the Nutri-Score can be used as a guide for the average consumer, but there are still some suggestions for improvement, such as the consideration of additional ingredients, the controlling of the label and a fundamental holistic nutritional education. |
| Keywords: | Nutri-Score, visual nudging, FMCG, nutrition policy, qualitative, expert interviews |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:ismwps:313088 |
| By: | Eduardo Levy Yetati; Rodrigo Valdés |
| Abstract: | Most analyses of the socioeconomic impact of COVID-19 rely on data from advanced and East Asian economies, for good reasons: those countries were hit first by the pandemic. This debate contrasts with the realities in Latin American countries, not only because of economic restrictions but also because the pandemic dynamics have been surprisingly difficult to control in several countries. Countries that shied away from severe lockdowns are topping daily case rankings, but others that adopted lengthy and stringent measures early on still have a growing number of cases. In this chapter, we discuss how the combination of a limited fiscal and financial space and a precarious labour market, against the backdrop of a delicate political landscape, poses severe challenges to the intensity and the socioeconomic management of the policy response to the pandemic in the region. |
| Date: | 2025–03 |
| URL: | https://d.repec.org/n?u=RePEc:udt:wpgobi:20250323 |
| By: | Ménard, Timothé |
| Abstract: | Randomized Controlled Trials are the gold standard for evaluating medical interventions but can pose ethical challenges. This article explores these issues using the principles of beneficence, justice, non-maleficence, and autonomy as defined by Beauchamp and Childress. Major ethical challenges could emerge from informed consent, the use of placebo, suboptimal control arms, participant selection, endpoints, and post-trial access to treatments. The analysis highlights the need for rigorous ethical oversight to balance participant protection with scientific advancement. |
| Date: | 2025–03–26 |
| URL: | https://d.repec.org/n?u=RePEc:osf:socarx:uxst9_v1 |