|
on Health Economics |
| By: | Metcalfe, Robert; Roth, Sefi |
| Abstract: | Exposure to ambient air pollution has been shown to be detrimental to human health and productivity, and has motivated many policies to reduce such pollution. However, given that humans spend 90% of their time indoors, it is important to understand the degree of exposure to Indoor Air Pollution (IAP), and, if high, ways to reduce it. We design and implement a field experiment in London that monitors households’ IAP and then randomly reveals their IAP in real-time. At baseline, we find that IAP is worse than ambient air pollution when residents are at home and that for 38% of the time, IAP is above World Health Organization standards. Additionally, we observe a large household income-IAP gradient, larger than the income-ambient pollution gradient, highlighting large income disparities in IAP exposure. During our field experiment, we find that the randomized revelation reduces IAP by 17% (1.9 µg/m3 ) overall and 34% (5 µg/m3 ) during occupancy time. We show that the mechanism is households using more natural ventilation as a result of the feedback (i.e., opening up doors and windows). Finally, in terms of welfare, we find that: (i) households have a willingness to pay of £4.8 ($6) for every 1 µg/m3 reduction in indoor PM2.5; (ii) households have a higher willingness to pay for mitigation than for full information; (iii) households have a price elasticity of IAP monitor demand around -0.75; and (iv) a £1 subsidy for an IAP monitor or an air purifier infinite marginal value of public funds, i.e., a Pareto improvement. |
| JEL: | N0 |
| Date: | 2025–02–20 |
| URL: | https://d.repec.org/n?u=RePEc:ehl:lserod:128514 |
| By: | Janet Currie; Soodeh Saberian |
| Abstract: | This study examines the relationship between wildfires and mental health-related hospitalizations in Canada from 2006 to 2018. Most previous estimates of the mental health costs of wildfire have focused on the impacts of exposure to PM₂.₅. We break new ground by highlighting other pathways for wildfires to affect mental health, including evacuation orders, direct local costs of fires, and climate anxiety, which is proxied using wildfire-related Twitter activity. We find that all these mechanisms affect mental health-related hospitalizations, with especially large impacts on hospitalizations for anxiety and substance abuse. Conditional on air quality, wildfire events that draw national attention worsen the mental health of susceptible people, even when they live far away. Elderly people and those with pre-existing health conditions that make them more vulnerable, are more strongly affected. The results indicate that climate anxiety stoked by wildfire events may account for much of the overall mental health cost. Accounting for these additional mechanisms does little to diminish the estimated effect of PM ₂.₅ from wildfire smoke, however, suggesting that the additional factors have effects on mental health that are in addition to those of PM₂.₅. |
| JEL: | I1 Q54 |
| Date: | 2025–06 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:33912 |
| By: | Dhaval M. Dave; Christine Durrance; Bilge Erten; Yang Wang; Barbara L. Wolfe |
| Abstract: | In overturning Roe v. Wade and triggering laws in many states that ban or severely restrict abortions, the Supreme Court’s landmark 2022 Dobbs decision dramatically altered the landscape for reproductive health in the U.S. Prior research has highlighted the far-reaching impact of abortion restrictions for women and families, which extend beyond their proximate effects on abortions, births, and fertility. We provide some of the first causal evidence on how abortion restrictions in the post-Dobbs era have impacted women’s risk of exposure to intimate partner violence (IPV). IPV is the most common form of violence experienced by women, and changes in access to abortion may generate unintended effects on various inputs (economic resources, stress, intra-household bargaining) that could affect relationship dynamics and raise the risk of IPV. Leveraging information on IPV incidents reported to law enforcement from 2017-2023 combined with post-Dobbs changes in county-level travel distance to abortion facilities, analyses are based on a generalized difference-in-differences approach. We find that abortion restrictions – alternately measured by the increase in travel distance and by the presence of a near-total ban – significantly increased the rate of IPV for reproductive-aged women in treated counties on the order of about seven to 10 percent. These estimates imply at least 9, 000 additional incidents of IPV among women in the treated “trigger ban” states, which would be predicted to add over $1.24 billion in social costs. |
| JEL: | I11 I12 I18 J13 K23 |
| Date: | 2025–06 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:33916 |
| By: | Martinenghi, Fabio I. (University of Newcastle, Australia); Naghsh Nejad, Maryam (University of Technology, Sydney) |
| Abstract: | We use whole-population linked administrative data from Australia to ex- amine the economic and mental health impacts of IVF treatment and invol- untary childlessness. Leveraging detailed information on fertility treatment, income, and prescription drug use, we implement a dynamic triple-difference framework comparing women who remain childless five years after initiating IVF to those who successfully conceive. Results reveal large and persistent effects on both mental health and income. We further show that the IVF process itself leads to income declines among childless women, underscoring substantial unmeasured costs and suggesting downward bias in child penalty estimates that use unsuccessful IVF patients as controls. |
| Keywords: | involuntary childlessness, IVF, mental health, labor market outcomes, fertility and career trade-offs |
| JEL: | J13 J22 I14 I31 J16 |
| Date: | 2025–06 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17965 |
| By: | Zhang, Xin (Beijing Normal University); Chen, Xi (Yale University); Sun, Hong (Jiangsu Provincial CDC); Yang, Yuanjian (Nanjing University of Information Science and Technology) |
| Abstract: | This paper attempts to provide one of the first population-based causal estimates of the effect of air pollution on suicidal ideation—a key precursor to suicide attempt and completion—among school-age children. We use daily variations in the local wind direction as instruments to address endogeneity in pollution exposure. Matching a unique risk behavior survey of 55, 000 students from 273 schools with comprehensive data on air pollutants and weather conditions according to the exact date and location of schooling, our findings indicate that a 1% decline in daily PM2.5 is associated with a 0.36% reduction in the probability of suicidal ideation. Moreover, the dose-response relationship reveals that the marginal effects increase significantly and non-linearly with elevated concentration of PM2.5. The effect is particularly pronounced among younger, male, students from low-educated families, and students with lower grades. |
| Keywords: | suicidal ideation, air pollution, school-age children, risky behaviors, China |
| JEL: | I31 Q51 Q53 |
| Date: | 2025–06 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17961 |
| By: | Chad D. Cotti; Tessie Krishna; Johanna Catherine Maclean; Erik T. Nesson; Joseph J. Sabia |
| Abstract: | The confluence of a youth mental health crisis and high rates of teenage nicotine vaping has led some U.S. tobacco control advocates to argue that reducing access to electronic nicotine delivery systems (ENDS) — through policies such as ENDS taxation — may improve youth and young adult mental health. Using data from several nationally representative surveys (Youth Risk Behavior Survey, Behavioral Risk Factor Surveillance System, and Population Assessment of Tobacco and Health) and a generalized difference-in-differences approach, we find no evidence that ENDS taxation improves youth and young adult mental health. With 95 percent confidence, we can rule out that the mean state ENDS tax increase adopted during our analysis sample ($0.34 per mL of e-liquid in 2023$) reduces persistent depressive symptoms among youths by more than 0.3 percent and suicide ideation by more than 1.0 percent. Moreover, discrete-time hazard models provide little evidence that ENDS taxes affect dynamics in youth mental health. A similar pattern of results emerges when we examine a wider set of ENDS regulations, including minimum legal purchasing ages, e-cigarette licensure laws, online sales restrictions, and restrictions on indoor nicotine vaping. |
| JEL: | I10 I18 |
| Date: | 2025–06 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:33917 |
| By: | Eric Schneider (London School of Economics); Romola Davenport (University of Cambridge) |
| Abstract: | This paper uses population smallpox mortality rates in eighteenth-century Sweden and the death toll from the 1707-9 smallpox epidemic in Iceland to estimate plausible ranges for the case fatality rate (CFR) of the deadly form of smallpox, Variola major, in both its endemic (Sweden) and epidemic (Iceland) form. We find that smallpox CFRs could be extremely high (40-53%) when smallpox was epidemic and attacked a population where both children and adults were susceptible as in Iceland. However, where smallpox was endemic and therefore a disease of childhood, as in Sweden, a better estimate of the CFR is 8-10%. This is far lower than the consensus CFR of 20% to 30%. Part of the differences between the CFRs studied here could be due to differences in the inherent virulence of smallpox in the two contexts. However, we argue that social factors are more likely to explain the differences. Where both adults and children were susceptible to smallpox, smallpox epidemics fundamentally disrupted household tasks such as fetching water and food preparation and prevented parents from nursing their sick children, dramatically increasing the CFR. Thus, when historians and epidemiologists give CFRs of smallpox, they should consider the population and context rather than relying on an implausible intrinsic CFR of 20% to 30%. |
| JEL: | J10 N30 |
| Date: | 2025–05–26 |
| URL: | https://d.repec.org/n?u=RePEc:cmh:wpaper:47 |
| By: | Longden, Thomas (University of Western Sydney); Naghsh Nejad, Maryam (University of Technology, Sydney) |
| Abstract: | This paper examines how individuals respond financially to severe health shocks by analyzing early withdrawals from retirement savings following the initiation of cancer treatment (chemotherapy). Using comprehensive administrative data from Australia that link health, tax, and demographic records, we study behavior in a setting with universal health coverage and a mandatory retirement savings scheme that permits early access under hardship provisions. We find that early withdrawals increase significantly in the year of and the year after treatment, particularly among individuals who lose income or receive a terminal diagnosis. To interpret these patterns, we extend a dynamic Grossman-style model of health capital to account for survival probabilities and institutional features of the retirement system. Our findings show that health shocks prompt individuals to draw down retirement savings as a form of self-insurance, revealing how health risks interact with retirement policy. These results inform ongoing debates about the flexibility and adequacy of retirement savings systems. |
| Keywords: | early retirement withdrawals, health shocks, income loss, administrative data, life-cycle savings |
| JEL: | H55 I10 D14 D15 J32 |
| Date: | 2025–06 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17964 |
| By: | Luis Vieira |
| Abstract: | This study investigates the impact of acute health shocks on early labour market exits among individuals aged 50 and over in Europe. Utilising data from Waves 1-8 of the Survey of Health, Ageing, and Retirement in Europe (SHARE), encompassing over 140, 000 individuals, I employ survival analysis techniques, including Kaplan-Meier estimators and Cox proportional hazards models. The analysis explores how sudden, severe health events, alongside self-perceived health, chronic conditions, and socio-demographic factors, influence the probability of exiting the workforce before official retirement age. Results indicate that acute health shocks significantly increase the hazard of early labour market exit, with more pronounced effects observed for males. Poorer self-perceived health and lower educational attainment are also strong predictors of early exit. Gender differences are notable: while poorer health consistently raises exit risk for both genders, income acts as a protective factor for females, and living with a partner reduces exit risk for males but increases it for females. These findings highlight the critical role of health in labour market participation and suggest the need for targeted policies to support older workers, particularly those experiencing adverse health events. |
| Date: | 2025–05 |
| URL: | https://d.repec.org/n?u=RePEc:arx:papers:2505.06545 |
| By: | Iris Kesternich; André Romahn; Johannes Van Biesebroeck; Marjolein Van Damme |
| Abstract: | The German universal long-term care (LTC) insurance program offers beneficiaries the choice between in-kind services and a cash benefit, which can be used for anything, including informal care. The optimal level of the cash benefit depends on substitution between formal and informal care options, the cost of public funds, and distributional considerations. To evaluate various policy options, we estimate a random-coefficients demand model for the period 1999-2015 using data on the universe of LTC patients supplemented with micro moments from the German Mikrozensus. Results show strong heterogeneity in patient preferences for the three different LTC options: informal, ambulatory and stationary care. A counterfactual analysis predicts that abolishing the cash subsidy leads to a decline in patient surplus that far outweighs the savings in public expenditure. It suggests that manycountries could benefit from the introduction of a cash subsidy option for LTC. |
| Keywords: | aging, long-term care, insurance, informal care |
| JEL: | I11 G14 L1 |
| Date: | 2025 |
| URL: | https://d.repec.org/n?u=RePEc:ces:ceswps:_11875 |
| By: | Yuting Qian; Xi Chen |
| Abstract: | This paper analyzes the impact of paid family leave (PFL) policies on informal and formal care for middle-aged and older adults with disabilities in the U.S., and how the heterogeneous benefits accrue to different families. We use data from the 1998-2018 Health and Retirement Study (HRS) and leverage the PFL programs implemented in California (2004), New Jersey (2009), and New York (2018) in a difference-in-differences (DiD) design. We deploy both the conventional two-way fixed effects (TWFE) model and an adapted DiD estimator developed by Sun and Abraham for staggered rollout designs. We find that PFL access is associated with a 5.7 percentage point increase in the likelihood that individuals with disabilities receive informal care from their children. We also show that PFL access significantly increases the use of home care services and nursing home care. These effects are primarily concentrated among individuals with disabilities who have both a spouse and children, and are almost non-existent among those who have only children and no spouse. Our findings demonstrate that PFL policies improve care access and help address unmet care needs for middle-aged and older adults with disabilities, but their impact remains limited for certain vulnerable subgroups, particularly those with only children. |
| JEL: | I10 I38 J14 J18 |
| Date: | 2025–06 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:33918 |
| By: | Krekel, Christian; Kavetsos, Georgios; Ziebarth, Nicolas R. |
| Abstract: | To justify billion-dollar public expenditures on mega sports events, proponents often suggest lasting improvements in health behaviours among the general public. To estimate the returns to health behaviours from hosting the 2012 London Olympics, we collected panel data on more than 19, 000 respondents across two European capitals, London and Paris, between 2011 and 2013. Using a difference-in-differences design with Paris as counterfactual, we find an increase in physical activity by six percentage points among the inactive, from a baseline of 34%. Activation, however, lasts only for about 100 days. Although we also find suggestive evidence for reduced alcohol and tobacco consumption during the event, a cost-benefit analysis suggests that staging mega sports events is not a cost-effective policy to promote lasting health behaviour change. |
| Keywords: | mega sports events; olympics; health behaviours; physical activity; quasi-experiment; cost-benefit analysis |
| JEL: | I18 D90 I12 |
| Date: | 2025–07–31 |
| URL: | https://d.repec.org/n?u=RePEc:ehl:lserod:127473 |
| By: | Costa-Font, Joan; Nicińska, Anna; Rosello-Roig, Melcior |
| Abstract: | Past trauma resulting from personal life shocks, especially during periods of particular volatility such as regime transition (or regime change), can give rise to significant long-lasting effects on people’s health and well-being. We study this question by drawing on longitudinal and retrospective data to examine the effect of past exposure to major individual-level shocks (specifically hunger, persecution, dispossession, and exceptional stress) on current measures of an individual’s health and mental well-being. We examine the effect of the timing of the personal shocks, alongside the additional effect of ‘institutional uncertainty’ resulting from regime change in post-communist European countries. Our findings are as follows. First, we document evidence of the detrimental effects of shocks on a series of relevant health and well-being outcomes. Second, we show evidence of more pronounced detrimental consequences of such personal shocks experienced by individuals living in formerly communist countries (which accrue to about 8% and 10% in the case of persecution and hunger, respectively) than in non-communist countries. The effects are robust and take place in addition to the direct effects of regime change and exposure to personal shocks. |
| Keywords: | later life health; health care system; transition shocks; Soviet communism |
| JEL: | I18 H75 H79 |
| Date: | 2025–07–31 |
| URL: | https://d.repec.org/n?u=RePEc:ehl:lserod:127573 |
| By: | Kulshreshtha, Shobhit |
| Abstract: | Characteristics of a place, such as healthcare access and the local environment, influence healthcare utilization. Refugees resettled in developed countries are often assigned locations based on the host country's assignment policies, yet the impact of initial placement on their healthcare usage remains understudied. I use Dutch administrative data to examine the effect of conditions in the initial municipality on healthcare utilization of refugees, leveraging the random assignment of refugees. Being assigned to a municipality with a higher healthcare utilization as measured by depression medication usage, hospital visits, and general practitioner costs among non-refugees increases healthcare utilization of refugees. I provide suggestive evidence on possible mechanisms and find that local healthcare access and socio-economic status of the municipality play an important role in healthcare utilization of refugees. This study contributes to the ongoing policy debates on providing separate and more targeted healthcare services for the refugee population. |
| Keywords: | refugees, healthcare utilization, place effects, quasi-experiment |
| JEL: | J15 I15 I18 R23 |
| Date: | 2025 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:glodps:1622 |
| By: | Sandercock, Gavin; Scott-Bayfield, Alex; Snowdon, Christopher |
| Abstract: | Since 2015, the UK government has worked with the food industry to reformulate a wide range of food products to reduce sugar, fat and calorie content. The industry has been given the target of lowering the number of calories in certain products by 20% by 2025. The reformulation scheme was overseen by Public Health England (PHE) until 2021, and is now overseen by the Office for Health Improvement and Disparities. The scheme is voluntary, but some organisations have called for it to be mandatory. In modelling published in 2018, PHE acknowledged that lower calorie intake could have a 'potentially negative impact' on people who are a healthy weight or underweight, but it excluded these people from its model. Since being underweight is associated with a number of serious health problems, this was a major omission which we address in this paper by modelling the impact of the calorie reduction scheme on the prevalence of underweight among children. Using two different estimates of baseline energy flux, our model shows that among 4-5-year-olds, the calorie reduction scheme would lead to a ~4% reduction in energy intake, and a reduction in obesity rates between 0.8 and 1.3 percentage points. However, the prevalence of underweight would increase by between 3.0 and 4.8 percentage points. Among 10-11-year-olds, the model shows that energy intake would decline by between 2.6% and 5.4%, leading to a reduction in obesity prevalence of between 0.2 and 1.1 percentage points, but the prevalence of underweight would rise by between 2.1 and 4.1 percentage points. Under every scenario, for each child who moves from the obese category to the healthy weight category, at least two children become underweight. If the reformulation scheme works as intended by reducing calorie intake across the whole population, it will increase the number of underweight 10-11-year-olds by at least 30% and possibly by as much as 60%. This will lead to a net increase in the number of children who are an unhealthy weight. However, neither our model nor PHE's model should be taken seriously as a prediction of what would happen if the targets were met. It is much more likely that consumers would compensate by buying more food (or buying different types of food) to obtain the same number of calories. If so, it will increase the cost of feeding a typical household by around 10%. This compensatory behaviour makes it less likely that significant numbers of children would become underweight as a result of reformulation, but it also makes it less likely that the scheme would have its intended effect of reducing rates of obesity. The surprising results reported in this paper should be taken as an illustration of the flaws in the reformulation theory. |
| Keywords: | Nutritional behavior, health policy, sugar, dietary fat, impact analysis, children, body weight, Great Britain |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:ieadps:314026 |
| By: | Wang, Jingxuan; Wei, Yuchen; Galizzi, Matteo M.; Kwan, Hoi Shan; Zee, Benny Chung Ying; Fung, Hong; Yung, Tony Ka Chun; Wong, Eliza Lai Yi; Yue, Qianying; Lee, Michelle Kit Ling; Wu, Yushan; Wang, Kailu; Wu, Hongjiang; Yeoh, Eng Kiong; Chong, Ka Chun |
| Abstract: | Taxation on sugar-sweetened beverages (SSBs) is proposed as a measure to address the health consequences of excessive sugar intake, yet research on its implementation in Asian contexts is limited. This study examined the perceptions, willingness-to-pay, and associated socio-demographics of SSB taxation in Hong Kong, an affluent Asian setting. A random-sampled telephone survey was conducted with 1, 250 Hong Kong adults. We used the maximum willingness to pay (WTPM), defined as the highest accepted price that a subject willing to consume SSB products, as a measure of willingness to pay. The contingent valuation method was employed to assess the WTPM for different types of SSBs. A multiple linear regression analysis showed that, about 50% of participants were aware of negative health impacts, and over 60% being confident in reducing their intake. Even with a 30% tax, approximately 70% of individuals remained willing to continue consuming SSBs. Non-diet soft drinks had the highest WTPMs (83% of current price), while parents reported higher WTPM for their children (74%) than for themselves (66%). Full/part-time workers had higher WTPM, whereas higher income and better self-rated health correlated with lower WTPM. Full/part-time workers had higher WTPMs, while higher income and better self-rated health were associated with lower WTPMs. In summary, despite awareness of the potential health risks associated with consuming SSBs, a high tax rate was necessary to reduce SSB consumption, particularly among children and non-diet soft drinkers. Our study highlights how economic measures can influence consumer behavior and informs the implementation of such measures. |
| Keywords: | sugar-sweetened beverage; taxation; perception; health policy |
| JEL: | R14 J01 |
| Date: | 2025–06–17 |
| URL: | https://d.repec.org/n?u=RePEc:ehl:lserod:128414 |
| By: | Niemietz, Kristian |
| Abstract: | Until very recently, Britain's National Health Service used to be beyond argument. The reverence for the health service often precluded anything resembling a rational discussion around it: the social taboos were simply too strong. Yet over the past two years or so, this has begun to change. We can now quite regularly find articles in the mainstream media which openly criticise the NHS, and point to better alternatives. In particular, advocacy of Social Health Insurance (SHI) systems has become part of the mainstream debate. SHI systems are market-based, competitive and largely non-state systems, in which the role of the state is not to run healthcare facilities, but to insure universal access. In terms of clinical outcomes, these systems tend to outperform the NHS, and they have done so for as long as we have data. This is not simply the result of better funding. While examples of a wholesale switch from an NHS-type system to an SHI-type system are rare, they do exist. The Czech Republic and Slovakia did precisely that over the course of the 1990s, and eastern Germany did so in the early 1990s as part of the Reunification process. The example of the Netherlands is also instructive. They never had a national health service, but until the mid-2000s, they had a system which, while notionally private, was very NHS-like in practice. Since then, they have replaced that system with a competitive, market-based, private SHI system. None of these examples are easily transferable to the UK, but what they do show is that a transition from one healthcare system to another need not be especially disruptive. It can be done in an orderly fashion, and it has been successfully done. |
| Keywords: | Statutory health insurance, health care, health financing, Great Britain |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:ieadps:314028 |
| By: | Kirui, Oliver K.; Ahmed, Mosab; Raouf, Mariam; Abushama, Hala; Siddig, Khalid |
| Abstract: | This study investigates the determinants of access to safe water and reliable energy for households in Sudan using nationally representative data from a recent labor market survey. The results show that urbanization, education, and wealth significantly enhance the access households have to these essential services, while rural areas and less developed regions, particularly in the Darfur and Kordofan regions, face substantial challenges. Access to reliable energy correlates with better food security and health outcomes within households, and improved access to safe water significantly enhances the health of household members. Policy recommendations supported by these research results include targeted rural infrastructure investments, educational improvements, and regional interventions to address disparities in household access to safe water and reliable energy across Sudan. |
| Keywords: | energy policies; food security; health; households; socioeconomics; water; water policies; Sudan; Africa; Northern Africa |
| Date: | 2025–05–20 |
| URL: | https://d.repec.org/n?u=RePEc:fpr:gsspwp:174711 |
| By: | Nicole Hodrosky; Gabriel Cacho; Faiza Ahmed; Rohana Mudireddy; Yapin Wen; Kymora Nembhard; Michael Yan |
| Abstract: | Depression affects more than 280 million people worldwide, with poorer communities having disproportionate burden as well as barriers to treatment. This study examines the role of pharmacy pricing caps in access to antidepressants among poorer Americans through bibliometric analysis of the 100 most cited articles on antidepressant pricing and access in the Web of Science Core Collection. We used tools like Bibliometrix and VOSviewer to visualize publication trends, dominant contributors, thematic clusters, and citation networks in the literature. Findings highlight intransigent inequalities in access to antidepressants based on astronomically high drug pricing as well as systemic inequalities against racial and ethnic minorities in particular. Branded antidepressant high prices are associated with low initiation of therapy as well as regimen compliance, heightened mental illness outcomes, as well as increased health utilization. This work uncovers critical gaps in the literature and demands immediate policy action to make antidepressants affordable as well as appropriately accessible to marginalized communities. |
| Date: | 2025–06 |
| URL: | https://d.repec.org/n?u=RePEc:arx:papers:2506.14849 |
| By: | Snowdon, Christopher |
| Abstract: | What would government regulation of food, alcohol, vaping, tobacco and soft drinks look like in a more liberal Britain? There would be a lot less of it, naturally, but there would not be none. An ultra-libertarian approach would be to remove all sin taxes, abolish all health warnings, legalise all drugs, abolish age limits and sack every public health worker. But let us be realistic. Britain has been awash with nanny state policies for the last twenty years. Some of them are popular, and several of them can be justified on economic grounds. Rather than endorse a free-for-all, this paper sets itself the more modest task of making the UK the freest place in Europe for people who want to eat, drink, smoke and vape without being punished by the state. Every two years I edit the Nanny State Index, a league table of 30 European countries showing how they compare with regard to the over-regulation of food, soft drinks, alcohol and nicotine products. None of these countries is a libertarian utopia by any stretch of the imagination. Public health paternalism exists in them all, not least because of EU regulation. But there is a wide variation between the freest and most paternalistic nations. Germany and the Czech Republic have been the best performers in recent years and sit at the bottom of the table, while the top of the table is dominated by countries in Scandinavia and Eastern Europe. The UK has always been in the top half, with high scores for everything except e-cigarette regulation. At the end of this paper, we will look at what needs to be done to get the UK to the bottom of the league table and make it the best country in Europe for lifestyle freedom, but first we need to define our terms and ask what problem we are seeking to solve. |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:ieadps:314031 |
| By: | Dimico, Arcangelo (Queen's University Belfast) |
| Abstract: | I evaluate the impact of abortion policies in sub-Saharan Africa to understand the potential consequences of 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. Children born afterwards tend to achieve higher levels of education. |
| Keywords: | abortion, gender, fertility, child mortality, human capital |
| JEL: | O15 J13 J16 K38 |
| Date: | 2025–05 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17910 |
| By: | Wolfgang Stojetz; Tilman Brück; Mekdim D. Regassa; Anke Hoeffler |
| Abstract: | This study examines the impact of countermeasures, such as stay-at-home orders and school closures, on stress within households during the COVID-19 pandemic. In a phone survey carried out in Uganda, Tanzania, Sierra Leone, and Mozambique throughout 2021 (N = 22, 497), 70% of respondents reported the presence of intra-household tension. On average, we document that the stringency of the countermeasures increases intra-household tensions. The duration of the countermeasures significantly increases tension but at a diminishing rate. The type of countermeasure (e.g. workplace closure, public transport restrictions) is less important, with all measures, apart from international travel restrictions, significantly increasing tension. Income shocks, frequently experienced during the pandemic, were compounded by the countermeasures. Thus, countermeasures have a strong impact on the psychological and economic wellbeing of households. Policymakers need to carefully consider the intersection of economic vulnerability and public health interventions during future crises, balancing the expected benefits of countermeasures with their costs. |
| Keywords: | africa, corona, countermeasures, covid-19, crisis, intra-household tension, lockdown, pandemic |
| JEL: | D13 H12 I38 J12 R28 |
| Date: | 2025 |
| URL: | https://d.repec.org/n?u=RePEc:hic:wpaper:432 |
| By: | Song, Younghwan (Union College) |
| Abstract: | Although the COVID-19 pandemic has affected everyone’s life, the risk of hospitalization and death from COVID-19 increases exponentially with age. Using data from the 2013 and 2021 American Time Use Survey Well-Being Modules, this paper examines how various measures of subjective well-being have changed during the pandemic among two age groups in the United States: individuals aged 15 to 44 and those aged 45 to 85. The measures of subjective well-being include life evaluation and activity-level subjective well-being measures: happiness, pain, sadness, stress, tiredness, and meaningfulness. The results indicate younger people felt less happy, more stressed, and less tired during the pandemic because their time use patterns, such as activity types, timing, and with whom, changed. However, there was no change in the life evaluation of the younger group. The older group felt more pain, sadder, and less meaningful during the pandemic, even after controlling for their health status and time use patterns, perhaps because they had lost many family members and friends to COVID-19. Their life evaluation increased during the pandemic, maybe because they began to better appreciate their life after the deaths of many people around them. |
| Keywords: | subjective well-being, COVID-19, death, Cantril ladder |
| JEL: | I10 I31 J14 |
| Date: | 2025–05 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp17915 |