|
on Health Economics |
| By: | Daysal, N. Meltem (University of Copenhagen); Ding, Hui (affiliation not available); Rossin-Slater, Maya (Stanford University); Schwandt, Hannes (Northwestern University) |
| Abstract: | Preschool-aged children get sick frequently and spread disease to other family members. Despite the universality of this experience, there is limited causal evidence on the magnitudes and consequences of these externalities, especially for infant siblings with developing immune systems and brains. We use Danish administrative data to document that, before age one, younger siblings have 2-3 times higher hospitalization rates for respiratory conditions than older siblings. We combine birth order and within-municipality variation in respiratory disease prevalence among young children, and find lasting differential impacts of early-life respiratory disease exposure on younger siblings’ earnings, educational attainment, chronic respiratory health and mental health-related outcomes. |
| JEL: | I12 I18 J12 J13 |
| Date: | 2025–08 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp18078 |
| By: | Costa-Font, Joan; Cowell, Frank |
| Abstract: | An individual’s inequality aversion (IA) is a central preference parameter that captures the welfare sacrifice from exposure to inequality. However, it is far from trivial how best to elicit IA estimates. Also, little is known about the behavioural determinants of IA and how they differ across domains such as income and health. Using representative surveys from England, this paper elicits comparable estimates of IA in the health and income domains using two alternative elicitation techniques: a direct trade-off and an indirect “imaginary-grandchild” approach that results from the choices between hypothetical lotteries. We make three distinct contributions to the literature. First, we show that IA systematically differs between income and health domains. Average estimates are around 0.8 for health IA and range from 0.8 to 1.5 for income IA. Second, we find that risk aversion and locus of control are central determinants of IA in both income and health domains. Finally, we present evidence suggesting that the distribution and comparison of IA vary depending on the elicitation method employed. |
| Keywords: | inequality aversion; income inequality aversion; health inequality aversion; imaginary grandchild; inequality and efficiency trade-offs; risk attitudes; locus of control |
| JEL: | H10 I18 |
| Date: | 2025–08–14 |
| URL: | https://d.repec.org/n?u=RePEc:ehl:lserod:128734 |
| By: | Nicole Black (Centre for Health Economics, Monash Business School, Monash University); Danusha Jayawardana (Centre for Health Economics, Monash Business School, Monash University); David W. Johnston (Centre for Health Economics, Monash Business School, Monash University); Trong-Anh Trinh (Centre for Health Economics, Monash Business School, Monash University) |
| Abstract: | Rising out-of-pocket costs for psychotherapy in Australia have heightened concerns about financial barriers to mental healthcare, particularly for lower-income households, who disproportionately experience psychological distress. Using nationwide linked administrative records of income and healthcare use, we estimate the magnitude of income-related inequity in psychotherapy use among 5.4 million individuals diagnosed with a mental health condition, and examine how such inequity has evolved over the decade from 2014 to 2023. Our findings show that income-related inequity is substantial, consistently higher among children than among adults, and has nearly doubled over the decade. By 2023, only 32% of low-income children and 40% of low-income adults accessed psychotherapy within three months of receiving a mental health treatment plan, compared with 55% among both high-income children and adults. We rule out changes in complexity of mental health disorders and the introduction of telehealth services as key drivers. We find no discernible difference by gender or age subgroups. Examination of antidepressant use reveals a growing gap in the opposite direction, with lower-income individuals increasingly reliant on medication without psychotherapy, relative to higher-income individuals. This suggests a shift towards lower-cost treatment pathways among disadvantaged groups. Our findings highlight the need for policies to address the increasing costs and other barriers to accessing psychotherapy, especially for lower-income households. |
| Keywords: | mental health, income inequity, unmet mental health need, horizontal inequity |
| JEL: | I12 I14 |
| Date: | 2025–08 |
| URL: | https://d.repec.org/n?u=RePEc:mhe:chemon:2025-13 |
| By: | Nguyen, Ha; Mitrou, Francis |
| Abstract: | The catastrophic effects of natural disasters on social and economic systems are well documented; however, their impacts on individual life satisfaction remain insufficiently understood. This study pioneers a causal analysis of the effects of cyclones on life satisfaction in Australia, leveraging local cyclone exposure as a natural experiment. Drawing on more than two decades of nationally representative panel data, individual fixed-effects models reveal that only the most severe Category 5 events—particularly those occurring in close proximity to residences—significantly reduce overall life satisfaction, as well as satisfaction with community and health. Notably, these severe cyclones exhibit either lasting or delayed adverse effects on satisfaction with employment opportunities, neighbourhood, community, and personal safety. The findings are robust across a range of sensitivity checks, including a falsification test confirming no effect of future cyclones on current life satisfaction, and three randomization tests. Furthermore, these negative impacts are more pronounced among males, younger individuals, and those without prior residential insurance coverage. |
| Keywords: | Natural Disasters; Life Satisfaction; Happiness; Wellbeing; Australia |
| JEL: | I12 I31 Q5 Q51 |
| Date: | 2024 |
| URL: | https://d.repec.org/n?u=RePEc:pra:mprapa:125390 |
| By: | Balleer, Almut; Hirsch, Michael; Nöller, Marvin |
| Abstract: | We present evidence that air pollution negatively affects current well-being. To do so, we create a new dataset, matching particulate matter concentration at the exact day and location with individual-level survey responses about current life satisfaction. The panel structure of our data allows us to overcome several identification challenges in the literature. Additionally, we show how aggregation of air pollution across time and space mis-measures the relevant exposure. Our results further suggest that air pollution affects current well-being mostly through negative emotions like sadness or worry. We estimate the willingness to pay for clean air that refers to the direct, immediate effects of air pollution and can be mapped well to economic models. |
| Abstract: | Luftverschmutzung beeinflusst das aktuelle Wohlbefinden negativ. Wir zeigen dies anhand eines neuen Datensatzes, in dem wir die Feinstaubkonzentration an einem bestimmten Tag und Ort mit individuellen Umfrageantworten zur aktuellen Lebenszufriedenheit abgleichen. Dank der Panelstruktur unserer Daten können wir hierbei mehrere Identifikationsprobleme aus der Literatur überwinden. Wir zeigen zudem, wie die Aggregation von Luftverschmutzung über Zeit und Raum zu einer falschen Messung der relevanten Belastung führt. Unsere Ergebnisse deuten darauf hin, dass Luftverschmutzung das aktuelle Wohlbefinden vor allem durch negative Emotionen wie Traurigkeit oder Sorgen beeinflusst. Darüber hinaus schätzen wir die kurzfristige Zahlungsbereitschaft für saubere Luft, die gut in ökonomische Modelle überführt werden kann. |
| Keywords: | Subjective well-being, air pollution, willingness to pay, compensating variation |
| JEL: | H41 I31 Q53 |
| Date: | 2025 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:rwirep:324660 |
| By: | Flynn, James (Miami University); Meyers-Richter, Noah (Miami University); Nencka, Peter (Miami University) |
| Abstract: | Sleep deprivation imposes significant public health and economic burdens. While researchers studying events like daylight saving time have quantified the impacts of population-wide sleep shifts, less is known about the consequences of acute, voluntary, and recreation-driven sleep loss. This paper investigates this gap by studying the 2002 FIFA World Cup, hosted in South Korea and Japan. The extreme time difference meant that US-based fans sacrificed significant sleep to watch live matches. We track fatal car accidents in areas with large German populations on days when the German national team played early morning games. Areas with greater than 30% German heritage experienced increases in fatal car accidents of 35% relative to control areas after German games. The effects are dose-dependent and rise as the share of the German population increases. Our results are larger for crucial tournament games and non-alcohol-related incidents, consistent with sleep-deprived driving. Effects are driven by male drivers, mirroring World Cup viewer demographics. Placebo tests using the 2006 World Cup, where no games were played during normal U.S. sleeping hours, confirm that sleep disruption, not the sporting event itself, drives our findings. |
| Keywords: | impaired driving, fatal car accidents, sleep loss |
| JEL: | I12 R41 D62 |
| Date: | 2025–07 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp18050 |
| By: | Schreiber, Andrew; Maniloff, Peter |
| Abstract: | This paper assesses the welfare implications of air pollution induced labor productivity improvements in a computable general equilibrium framework. We document that labor market productivity changes associated with a one μg/m3 reduction in PM2.5 can have a large welfare impact. Variation in the existing econometric evidence produces a range of possible welfare effects equal to approximately $950-3000 per household per year which is 50-160% of the estimated mortality impacts. Accounting for general equilibrium effects increases the welfare effect by roughly 45% relative to a back of the envelope estimate. Allowing for sector-specific shocks or impacts to leisure preferences have little effect on aggregate results. We also find that the aggregate welfare effect is approximately proportional to the shock size. |
| Keywords: | Environmental Economics and Policy |
| Date: | 2025 |
| URL: | https://d.repec.org/n?u=RePEc:ags:nceewp:368257 |
| By: | Mangiavacchi, Lucia (University of Perugia); Piccoli, Luca (University of Trento); Gambardella, Giulia (University of Perugia) |
| Abstract: | This paper estimates the long-term causal effects of music proficiency on emotional intelligence and mental health. Leveraging the staggered rollout of a school orchestra program as a quasi-experimental setting, we identify the causal impact of adolescent musical engagement. Our findings reveal that music training significantly improves both emotional intelligence and mental health into young adulthood. Specifically, musical proficiency fosters key non-cognitive traits, including self-motivation, optimism and adaptability, while also mitigating symptoms of poor mental health, including depression and anxiety. These positive effects are particularly pronounced for males and second-generation migrants. Our evidence demonstrates that learning music has a lasting positive impact on non-cognitive skills, suggesting that universal educational music programs can be a powerful, long-term tool for human capital development and inequality reduction. |
| Keywords: | transition to adulthood, mental health, emotional intelligence, music training, extracurricular activities |
| JEL: | D91 I24 J13 |
| Date: | 2025–08 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp18064 |
| By: | Conzo, Pierluigi (University of Turin); Della Giusta, Marina (University of Turin); Dubois, Florent (University of Torino); Rosso, Giacomo (University of Turin); Razzu, Giovanni (University of Reading) |
| Abstract: | Mental health is vital for well-being and productivity, yet investment remains chronically low. We study how different framings of mental health investment affect cooperation and donations using a pre-registered online experiment across five European countries (N = 8, 312). Participants were randomly assigned to receive information emphasizing either individual benefits (Private Perspective), collective benefits (Public Perspective), or prevalence data (Neutral Perspective). All treatments significantly increase cooperation in a Public Goods Game and donations in a Charity Dictator Game, suggesting intrinsic motivation drives behavior. Only the Private Perspective increases personal normative expectations, while empirical expectations remain unaffected—suggesting that interventions influence moral beliefs more than beliefs about others’ actions. All treatments reduce self-reported mental health stigma, consistent with evidence from a list experiment, suggesting stigma reduction as a key mechanism. Heterogeneity analyses show stronger treatment effects among individuals with lived experience or prior concern, and reduced contributions under collective framings when public provision is perceived as adequate—consistent with a substitution effect between public and private action. Donations also decline in post- communist countries, aligning with historically lower institutional trust and weaker norms of private giving. These findings highlight how individual perceptions and institutional legacies shape behavioural responses, and suggest that perceived adequacy of public provision can backfire by discouraging private engagement—potentially trapping societies in a bad equilibrium of persistent underinvestment in mental health. |
| Keywords: | online survey experiment, stigma, donations, cooperation, mental health, information treatment |
| JEL: | C90 I12 I18 I31 |
| Date: | 2025–08 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp18054 |
| By: | Lundberg, Dielle J. (Ableism & Healthcare Now) |
| Abstract: | This research brief presents a methodological critique of the disability-adjusted life year (DALY), questioning the validity of this metric and arguing that it functions to uphold structural ableism in public health and healthcare. I establish first that the disability weights underlying the DALY are subjective social valuations of health states and are not valid measures of “the magnitude of health loss associated with specific health outcomes” as the Global Burden of Disease Study claims. I then document ableism throughout the assessment protocols used in creating the disability weights for the DALY at the levels of (a) selection of participants to complete the valuation, (b) description of health states for valuation, and (c) consideration of context where the valuation occurs. I conclude the research brief by examining two questions. First, why have the creators of the DALY and its champions positioned a subjective and ableist social valuation as rigorous science? And second, what does the widespread acceptance of the DALY across health disciplines reveal about the pervasiveness of structural ableism in health policy? |
| Date: | 2025–07–31 |
| URL: | https://d.repec.org/n?u=RePEc:osf:socarx:nzk62_v1 |
| By: | Si, Yafei (University of Melbourne); Meng, Yurun (Xi’an Jiaotong University); Chen, Xi (Yale University); An, Ruopeng (Washington University, St. Louis); Mao, Limin (University of New South Wales); Li, Bingqin (University of New South Wales); Bateman, Hazel (University of New South Wales); Zhang, Han (Xi’an Jiaotong University); Fan, Hongbin (Xi’an Jiaotong University); Zu, Jiaqi (Duke Kunshan University); Gong, Shaoqing; Zhou, Zhongliang (Xi’an Jiaotong University); Miao, Yudong |
| Abstract: | The rapid development of AI solutions reveals opportunities to address the underdiagnosis and poor management of chronic conditions in developing settings. Using the method of simulated patients and experimental designs, we evaluate the quality, safety, and disparity of medical consultation with ERNIE Bot in China among 384 patient-AI trials. ERNIE Bot reached a diagnostic accuracy of 77.3%, correct drug prescriptions of 94.3%, but prescribed high rates of unnecessary medical tests (91.9%) and unnecessary medications (57.8%). Disparities were observed based on patient age and household economic status, with older and wealthier patients receiving more intensive care. Under standardized conditions, ERNIE Bot, ChatGPT, and DeepSeek demonstrated higher diagnostic accuracy but a greater tendency toward overprescription than human physicians. The results suggest the great potential of ERNIE Bot in empowering quality, accessibility, and affordability of healthcare provision in developing contexts but also highlight critical risks related to safety and amplification of sociodemographic disparities. |
| JEL: | C0 I10 I11 C90 C93 |
| Date: | 2025–08 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp18074 |
| By: | Raffaella Intinghero; Pietro Lazzaretto; Paolo Manasse |
| Abstract: | Obituaries are traditionally seen as expressions of grief and remembrance. We argue that they also have an underappreciated economic role: they are vehicles for strategic social and economic signaling. In this paper, we develop a simple theoretical framework in which paid obituaries serve as a form of self-promotion for the authors, especially when the deceased is a prominent public figure. We then test this hypothesis using data from Italy, exploiting the variation in mortality caused by the COVID-19 pandemic as a natural experiment. We show that higher mortality rates are associated with increases in per-capita obituaries, driven not by informational needs but by strategic advertising motives. Our results suggest that obituaries function as a marketplace for visibility and status, where social and economic incentives intersect. |
| JEL: | A10 A13 D71 D85 D91 |
| Date: | 2025–08 |
| URL: | https://d.repec.org/n?u=RePEc:bol:bodewp:wp1209 |
| By: | Gorjian, Mahshid |
| Abstract: | Background A significant approach to enhancing children's health and addressing environmental disparities in metropolitan regions of the United States has emerged: schoolyard greening. The advantages of physical activity and well-being are increasingly recognized; nevertheless, the wider ramifications for community dynamics, social equality, and the risks of green gentrification remain poorly comprehended. Purpose This review carefully assesses the evidence about the impact of schoolyard greening efforts on children's health, neighborhood transformation, and the equitable distribution of benefits and risks across diverse urban communities. Methods A comparative literature analysis was performed to synthesize findings from quantitative studies, qualitative research, and case analyses specifically addressing schoolyard greening projects in prominent U.S. cities. Results Evidence consistently indicates that schoolyard greening positively influences children's socioemotional well-being and physical activity levels, while also enhancing the use of outdoor spaces. Increased unstructured play and student engagement correlate with renovation techniques that incorporate varied play areas and natural features. Nonetheless, the allocation of gains is uneven; educational institutions situated in rapidly evolving or affluent communities are more prone to improvements in infrastructure and accessibility. Furthermore, greening projects can act as drivers for neighborhood development, potentially leading to green gentrification processes that threaten the tenure of disadvantaged people and elevate property values. These results underscore the importance of context-sensitive and inclusive planning. Conclusions Schoolyard greening can offer substantial health advantages for children and support the broader goals of urban sustainability. Nonetheless, these initiatives may exacerbate socioeconomic disparities and contribute to displacement patterns without intentional policies and community-driven strategies. To ensure the equitable distribution of schoolyard greening benefits, it is imperative that effective solutions emphasize equity, substantial community involvement, and the safeguarding of at-risk populations. |
| Date: | 2025–07–29 |
| URL: | https://d.repec.org/n?u=RePEc:osf:socarx:d85tg_v1 |
| By: | Diaz, Maria Dolores Montoya; Pereda, Paula; Rocha, Fabiana; Oliveira, Pedro A.C.; Árabe, Isadora Bousquat; Kreif, Noemi; Lordemus, Samuel; Moreno-Serra, Rodrigo |
| Abstract: | With the outbreak of the COVID-19 pandemic in early 2020, concerns arose that stay-at-home policies could exacerbate Violence Against Women (VAW). Evidence shows an increase in calls to domestic violence helplines in several countries. However, limited economic studies have investigated the pandemic’s effects on femicides, the most extreme form of VAW. This paper examines the effects of social isolation measures and emergency aid policies implemented during the COVID-19 outbreak on femicides in São Paulo, Brazil. Using daily femicide data from 2016 to 2020, a social isolation index, and monthly employment and emergency cash transfer data, we estimate fixed-effects models. Our findings reveal that the probability of femicide more than doubled (0.32 p.p.) during periods of pronounced isolation (March-April 2020). The impact was more significant in poorer municipalities, where male job losses drove this increase. However, the provision of emergency aid in poorer areas, which covered 29.8% of the population in these areas, mitigated this harmful effect, reducing it by more than twice the magnitude of the employment shock. These results underline the interplay between economic conditions, social policies, and gender-based violence during crises. |
| Keywords: | violence against women; femicide; Covid-19; pandemic; social isolation; coronavirus |
| JEL: | J12 I18 |
| Date: | 2025–09–30 |
| URL: | https://d.repec.org/n?u=RePEc:ehl:lserod:129090 |
| By: | Joshua Mitchell; Daniel Thompson |
| Abstract: | Allowance rates for disability insurance applications vary by race and ethnicity, but it is unclear to what extent these differences are artifacts of other differing socio-economic and health characteristics, or selection issues in SSA’s race and ethnicity data. This paper uses the 2015 American Community Survey linked to 2015-2019 SSA administrative data to investigate DI application allowance rates among non-Hispanic White, non-Hispanic Black, non-Hispanic Asian, non-Hispanic American Indian/Alaska Native, and Hispanic applicants aged 25-65. The analysis uses regression, propensity score matching, and inverse probability weighting to estimate differences in allowance rates among applicants who are similar on observable characteristics. Relative to raw comparisons, differences by race and ethnicity in multivariate analyses are substantially smaller in magnitude and are generally not statistically significant. |
| Date: | 2025–08 |
| URL: | https://d.repec.org/n?u=RePEc:cen:wpaper:25-54 |