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on Health Economics |
| By: | Charles F. Manski; John Mullahy |
| Abstract: | This paper considers quantile-welfare evaluation of health policy as an alternative to utilitarian evaluation. Manski (1988) originally proposed and studied maximization of quantile utility as a model of individual decision making under uncertainty, juxtaposing it with maximization of expected utility. That paper's primary motivation was to exploit the fact that maximization of quantile utility requires only an ordinal formalization of utility, not a cardinal one. This paper transfers these ideas from analysis of individual decision making to analysis of social planning. We begin by summarizing basic theoretical properties of quantile welfare in general terms rather than related specifically to health policy. We then propose a procedure to nonparametrically bound the quantile welfare of health states using data from binary-choice time-tradeoff (TTO) experiments of the type regularly performed by health economists. After this we assess related econometric considerations concerning measurement, using the EQ-5D framework to structure our discussion. |
| JEL: | I1 |
| Date: | 2025–09 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:34247 |
| By: | Cavit Baran; Janet Currie; Bahadir Dursun; Erdal Tekin |
| Abstract: | This paper provides the first nationwide evidence on how electric vehicle (EV) adoption has improved both air quality and child health. We assemble a rich dataset from 2010–2021 that links county-level EV registrations to measures of air pollution, birth outcomes, and emergency department visits. The endogeneity of EV adoption is addressed using two complementary strategies: Two-way fixed effects and instrumental variables (IV). The IV exploits the staggered rollout of Alternative Fuel Corridors as a source of exogenous variation in charging infrastructure that affected EV adoption. The estimates show that greater EV penetration significantly reduces nitrogen dioxide (NO2), a key pollutant linked to vehicular emissions. These improvements in air quality yield significant health benefits, including reductions in very low birth weight and very premature births, as well as fewer asthma-related emergency department visits among children ages 0 to 5. This is true even when potentially offsetting increases in pollution from the electricity generation needed to power EVs are accounted for. The benefits are higher in the high-pollution counties with Alternative Fuel Corridors, where baseline exposures are greatest. The resulting reductions in very low birth weight births alone could generate annual benefits of $1.2 to $4.0 billion. These findings underscore the dual environmental and public health benefits of EV adoption. |
| JEL: | I14 I18 Q53 R38 |
| Date: | 2025–09 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:34278 |
| By: | Anne M. Burton; Brandyn F. Churchill |
| Abstract: | While policymakers routinely limit the sale of goods thought to be of risk to public health, relatively less is known about whether and how these policies affect firm performance. Using 2000-2018 National Establishment Time-Series data and a difference-in-differences strategy, we show that state “pill mill” laws intended to reduce the overprescribing of opioids reduced retail pharmacy sales and employment. These reductions were most pronounced in highly competitive areas and for standalone pharmacies – two characteristics associated with pharmacy drug diversion. Meanwhile, pharmacies located across the border in states without a pill mill law experienced increases in sales and employment. Next, we show that state pill mill laws were associated with an increase in standalone pharmacy closures, though the total number of pharmacies was unchanged. Our results are consistent with these laws adversely affecting pharmacies filling inappropriate opioid prescriptions without meaningfully altering patient access to retail pharmacies. |
| JEL: | I18 K23 M20 |
| Date: | 2025–09 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:34281 |
| By: | Da, Linlin; Jin, Zhezheng; Xu, Qianhui; Renzi-Hammond, Lisa M.; Chen, Zhuo; Khan, M. Mahmud; Rajbhandari-Thapa, Janani; Chen, Xi; Wu, Bei; Song, Suhang |
| Abstract: | This study examines how SNAP participation may affect age-related cognitive decline among cognitively intact older adults over 10 years. Leveraging a longitudinal survey of SNAP-eligible participants in the Health and Retirement Study (HRS) collected biennially from 2010 to 2020, we estimate the relationship between SNAP participation and cognitive decline across different population groups. We show that SNAP participation is associated with a slower cognitive decline in global cognition, memory, and executive function. A significant three-way interaction among SNAP participation, race/ethnicity, and time indicates faster decline in global cognition among Non- Hispanic Black and Hispanic SNAP users. Our findings suggest that SNAP participation may help slow age-related cognitive decline. However, the benefits of SNAP vary across different population groups. Policies promoting equitable access to SNAP benefits have significant potential to improve cognitive health across diverse populations. |
| Keywords: | Supplemental Nutrition Assistance Program (SNAP), cognitive decline, longitudinal study, disparity |
| JEL: | H53 I38 J14 I18 H75 |
| Date: | 2025 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:glodps:1671 |
| By: | Bensnes, Simon (Statistics Norway); Hernaes, Øystein (Ragnar Frisch Centre for Economic Research); King, Max-Emil M. (Ragnar Frisch Centre for Economic Research) |
| Abstract: | This study examines the impact of receiving one additional week of paid vacation on labor market attachment among Norwegian workers aged 60+. Employing a triple-differences estimation strategy, we exploit age-based eligibility thresholds before and after a 2009 reform to identify causal effects. Our findings indicate that the extra leave has negligible effects on both employment, sickness absence and disability benefit receipt in the year workers first receive it. If anything, some workers use the additional vacation time to increase earnings from secondary employers. The results imply that policymakers should consider alternative measures to mandated leave to support an aging workforce. |
| Keywords: | triple-differences, labor supply, older workers, paid vacation, public policy |
| JEL: | H8 I12 J22 J26 |
| Date: | 2025–09 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp18121 |
| By: | Matthew Eisenberg; Yimin Ge; Ezra Golberstein; Johanna Catherine Maclean |
| Abstract: | We study the effects of state paid sick leave (PSL) mandates on mental healthcare use. To do so, we use all-payer health insurance claims data from IQVIA 2015-2022 combined with difference-in-differences methods. Findings suggest that overall mental healthcare use does not change post-PSL mandate. The null finding overall masks clinically relevant changes along the intensive margin: patients substitute away from lower levels of care to higher levels of care as time constraints are relaxed. Further, analysis of survey data hints that this change in treatment use improves mental health. Keywords: Paid sick leave; social insurance; social insurance. |
| JEL: | H0 I1 I11 |
| Date: | 2025–09 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:34254 |
| By: | Erkmen G. Aslim; Wei Fu; Caitlin K. Myers; Erdal Tekin; Bingjin Xue |
| Abstract: | We study how abortion access affects economic hardship and crime. Using a database of abortion provider locations and operations in Texas from 2009–2019, we exploit variation in travel distance to the nearest facility created by clinic closures following the enforcement of Texas HB-2 in 2013. We confirm previous evidence that increased distance to the nearest abortion facility reduces abortions and increases births. We provide novel evidence that reduced access to abortion also leads to significant economic hardship, reflected in lower labor force participation, rising debt, widening income inequality, and heightened housing insecurity. This financial strain translates into higher rates of financially motivated crime, such as theft and burglary, with no significant effect on violent crime. These effects extend beyond directly affected individuals, reflecting intrahousehold spillovers. These findings suggest far-reaching consequences of restricted access to reproductive healthcare. |
| JEL: | I12 I18 J13 K42 |
| Date: | 2025–09 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:34245 |
| By: | Isil Erel; Shan Ge; Pengfei Ma |
| Abstract: | We examine how healthcare providers’ opioid prescriptions are affected by changes in their home values, which proxy for shocks to their wealth. We find that providers increase opioid prescriptions when experiencing adverse financial conditions. Results are robust to including provider office–year fixed effects and using the subsample of providers who live far away from their offices, thereby largely ruling out a patient–demand explanation. Providers living in ZIP codes with price changes in the bottom half in 2007–2009 increased their opioid prescriptions in 2010–2012 by approximately 16% more than others. The effect is stronger among providers facing more provider competition and those serving vulnerable populations. Providers experiencing adverse financial conditions also receive more opioid-related payments from pharmaceutical companies. We also extend our analysis to ADHD medications, demonstrating a similar pattern of increased prescriptions under negative financial shocks, suggesting broader implications for other medical decisions. Our findings offer novel insights into professional conduct under personal financial pressure, with implications extending beyond healthcare. |
| JEL: | G51 I11 I13 I14 I18 R30 |
| Date: | 2025–09 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:34273 |
| By: | Daniel W. Sacks; Justin R. Sydnor |
| Abstract: | Can economic tools help inform the puzzlingly low rate of flu vaccination? Existing interventions focus on misinformation or nudges, not preferences over or beliefs about vaccine characteristics. Using an online experiment, we find a key role for effectiveness and short-run side-effects: equalizing only beliefs and preferences about these characteristics nearly eliminates the vaccination-intention gap between the vaccine hesitant and confident. Fear of needles, inconvenience, and perceived long run health risks play smaller roles. The vaccine hesitant hold pessimistic but plausible beliefs about effectiveness but greatly overestimate side-effect risks. We estimate the impact of correcting inaccurate beliefs and potential subsidies on vaccination rates. |
| JEL: | D9 I1 I12 |
| Date: | 2025–09 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:34230 |
| By: | Momotazur Rahman; Brian McGarry; Elizabeth M. White; David C. Grabowski; Cyrus M. Kosar |
| Abstract: | Nursing homes face unique financial incentives that encourage under-investment in onsite clinical capabilities and overreliance on hospitals to triage and care for residents with dementia, contributing to high levels of health care spending for this population. A proposed solution to align incentives are Institutional Special Needs Plans (I-SNPs), which combine capitated financing with plan-provided onsite clinician presence. Using 12 million resident-quarters of data from 2016-2022, we exploit the timing of nursing homes’ I-SNP contracting to instrument for plan enrollment and estimate causal effects on hospitalization and other health outcomes. We found that I-SNP enrollment reduced quarterly hospitalization rates by 3 to 4 percentage points, which equates to one third of hospitalizations relative to the sample mean. We do not find consistent evidence of an impact on other health outcomes and quality of care indicators. |
| JEL: | I10 I13 I18 |
| Date: | 2025–09 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:34235 |
| By: | Albanese, Andrea (Luxembourg Institute of Socio-Economic Research (LISER)); Deschenes, Olivier (Department of Economics, University of California, Santa Barbara); Gathmann, Christina (Luxembourg Institute of Socio-Economic Research (LISER)); Nieto, Adrian (Department of Economics, Lund University) |
| Abstract: | This paper provides novel evidence of the impact of temperature fluctuations on retirement behavior and underlying mechanisms, combining 30 years of rich longitudinal survey data with granular daily weather information. Exposure to cold and hot temperatures accelerates transitions into retirement, particularly among individuals unaccustomed to such conditions, and the effects are strongest among vulnerable populations facing greater health challenges and limited access to healthcare. Extreme temperatures deteriorate health through a higher incidence of cardiovascular diseases and strokes, reducing individuals' ability to work, while better access to healthcare mitigates the adverse effects of extreme temperatures on retirement behavior. |
| Keywords: | Temperature; Health; Retirement; Healthcare; |
| JEL: | I14 I18 J26 Q54 |
| Date: | 2025–09–25 |
| URL: | https://d.repec.org/n?u=RePEc:hhs:lunewp:2025_008 |
| By: | William N. Evans; Ethan M.J. Lieber |
| Abstract: | A county’s fraction of adults in 1990 on Social Security Disability Insurance (SSDI) is a strong predictor of growth in local drug death rates after 2000. The part of the SSDI rate related to drug deaths is not proxying for well-known contributors to the drug crisis, e.g. OxyContin. Instead, it appears to capture the fraction of people in chronic pain. We show that in the late 1990s, physicians began prescribing opioids more aggressively to treat pain. Taken together, our estimates suggest that drug deaths rates would be 43% lower in 2015 had prescribing practices stayed at 1995 levels. |
| JEL: | I12 I14 I18 |
| Date: | 2025–09 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:34265 |
| By: | Hoehn-Velasco, Lauren (Georgia State University); Huang, Yu-Ting (Georgia State University); Yusuff, Olanrewaju (Georgia State University) |
| Abstract: | Public insurance reimbursement policies shape the structure and reach of healthcare markets. In this study, we examine the 1980 federal Medicaid mandate requiring states to reimburse Certified Nurse-Midwives, one of the first reforms targeting non-physician providers. We find the mandate increased midwife-attended deliveries by 1.1 percentage points, an 80% rise, adding about 1, 100 midwife births annually per state by 1985. We also document a geographic expansion of midwife services into unserved areas and increased hospital employment, consistent with supply-side labor market responses. Our findings demonstrate that reimbursement mandates directly alter healthcare delivery by expanding provider use and reshaping the workforce. |
| Keywords: | non-physician provider, public insurance, certified nurse-midwife, maternal health, Medicaid reimbursements, health insurance. |
| JEL: | H51 H75 I18 I11 I13 |
| Date: | 2025–09 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp18149 |
| By: | Fernández Guerrico, Sofía (University of Konstanz); Tojerow, Ilan (Université Libre de Bruxelles) |
| Abstract: | We examine the causal impact of high-speed internet on adult mental health using administrative data from Belgium. We exploit predetermined telecommunications infrastructure and broadband technology's distance-sensitive nature for identification. Our difference-in-differences estimates show internet increased mental health-related disability insurance claims by 0.054 percentage points—a 31% increase relative to the control group. These findings are supported by increased antidepressant use at the municipality level. Results point to a work-related mechanism: effects are concentrated among knowledge workers and those in high work-from-home potential jobs. Time-use data show a substitution from leisure to work and less social interaction on weekends. |
| Keywords: | disability insurance, internet, mental health, employment |
| JEL: | H55 I1 J2 L86 |
| Date: | 2025–09 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp18130 |
| By: | Grant Miller; Nieves Valdés; Marcos Vera-Hernández |
| Abstract: | An important but poorly understood way that economic development may influence health is through the private incentives that it creates for individuals to invest in their own health. In this paper, we study how individuals' forward-looking health investments respond to changes in expected future (but not current) wealth. Focusing on institutional features of Chile's public pension overhaul in 1981, we link administrative microdata to a detailed household panel survey, and we then exploit discrete breaks in the resulting cohort pension wealth profile using a fuzzy regression kink design (RKD). Although theoretically ambiguous, empirically we find that greater expected pension wealth increases the use of important preventive medical care (and to a lesser extent, promotes more costly healthy lifestyle behaviors) – leading to measurable increases in chronic disease diagnosis (a requisite for appropriate disease management), reductions in disease prevalence, and measurably lower mortality in old age (particularly due to chronic diseases). In general, these results provide new evidence that economic development can have a meaningful incentive effect on health. |
| JEL: | H55 I12 I15 I18 J18 |
| Date: | 2025–09 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:34249 |
| By: | Sophie Massin; Phu Nguyen-Van; Dimitri Dubois; Marc Willinger; Bruno Ventelou |
| Abstract: | How can individuals who have experienced a shock in their addictive consumption trajectories return to their habitual use? As part of a behavioral economics online survey conducted on a representative sample of the French population, we asked respondents to retrospectively quantify their consumption of tobacco, alcohol, and recreational screen use at three moments: before, during, and after the first Covid-19 lockdown. Using a methodology that controls for inter-individual heterogeneity, we test for the presence of a hysteresis effect, i.e. whether the shocks in use that occurred during the lockdown last beyond the end of it and the return to a more normal life. We find persistent hysteresis for the three addictive goods. Studying this hysteresis effect in relation to time preferences, we find that, for tobacco, present-biased individuals exhibit more hysteresis. This hysteresis insight, related to time preferences, offers valuable perspectives for addiction research and policy design addressing population resilience to shocks. |
| Keywords: | Addictive goods; hysteresis; panel data; time preferences; behavioral economics |
| JEL: | C33 D90 I10 I18 |
| Date: | 2025 |
| URL: | https://d.repec.org/n?u=RePEc:drm:wpaper:2025-38 |
| By: | Benjamin W. Cowan; Todd R. Jones |
| Abstract: | This paper examines how people adjust their time use when they experience an increase in time spent alone, which is a growing share of adults’ lives. We utilize the dramatic rise in remote work following the onset of the pandemic, which is associated with a large decline in time spent in the physical presence of non-household members during the workday, to observe the extent to which individuals substitute toward more in-person interactions in non-work settings. We first document that on days that individuals work from home, they spend 3.5 additional hours in activities spent entirely alone and over 5 fewer hours in activities that include any non-household members. We then use a difference-in-difference strategy to ask what happens to time allocations when workers are induced toward remote work by analyzing changes over time in how workers in teleworkable occupations—who experienced the lion’s share of the post-COVID increase in remote work—spend their time relative to workers in non-teleworkable occupations. Averaging over all days of the week, we see a relative increase in time spent in activities spent entirely alone by 32 minutes and a decrease in activities that include any non-household members by 38 minutes for workers in teleworkable jobs. Normalizing by the increase in average daily remote work time (46 minutes), these estimates are of a similar magnitude to what we observe in our descriptive analysis. When individuals are induced to work from home, they exhibit almost no substitution toward spending more time with others who are not in their household to make up for the loss of time with others at work. |
| JEL: | I12 J22 |
| Date: | 2025–09 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:34239 |
| By: | Monica Deza; Maria Zhu |
| Abstract: | Using individual-level data from the Add Health surveys, we leverage idiosyncratic variation in gender composition across cohorts within the same school to examine whether being exposed to a higher share of female peers affects mental health and school satisfaction. We find that being exposed to a higher proportion of female peers, despite only improving school satisfaction for boys, improves mental health for both boys and girls. The benefits are greater among boys of low socioeconomic backgrounds, who would otherwise be more likely to be exposed to violent and disruptive peers. We find suggestive evidence that the mechanisms driving our findings are consistent with stronger school friendships for boys and better self-image and grades for girls. |
| JEL: | I1 I12 I20 |
| Date: | 2025–09 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:34269 |
| By: | Ai, Jingyi (Fundan University); Chen, Xi (Yale University); Feng, Jin (Fudan University, China); Xie, Yufei (San Diego State University) |
| Abstract: | The study examines the early effects of cognitive-impairment (CI) friendly communities on health care utilization among older adults in Shanghai, China. By exploiting the rollout of CI-friendly communities and employing a difference-in-differences approach, we evaluate the impact of CI-friendly communities. We find that CI-friendly communities significantly increase the probability and frequency of visiting cognition-disease-related departments (CRD) by 0.7 (13.73%) percentage points and 0.02 (17.24%) times, respectively. In particular, the effect is more pronounced for individuals not previously received CRD care. The dominant mechanisms may include information and early screening effects. Additionally, CI-friendly communities affect health care utilization in other positive ways, such as reducing emergency room (ER) visits and promoting primary care use. |
| Keywords: | awareness of cognitive impairment, health care utilization, CI-friendly community |
| JEL: | I18 J14 I11 |
| Date: | 2025–09 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp18118 |
| By: | Johnston, David W. (Monash University); Knott, Rachel (Monash University); Menon, Nidhiya (Brandeis University) |
| Abstract: | Although studies have evaluated the costs of violating the male breadwinner norm, little is known about the mental health consequences, particularly for common conditions such as depression and anxiety. We explore this issue using Australian national administrative tax and healthcare records. We estimate individual- and employer-level fixed models of mental health service use and prescription medication. We find that men are significantly more likely to use mental health care following periods when their wife earns more, with the strongest effects emerging two years after the earnings shift. By contrast, we find no consistent effects for women. Our results are robust to alternative specifications, including the inclusion of controls for labour market shocks, and an alternative estimation strategy based on a local linear regression discontinuity design. We find that couples are also more likely to separate following norm violations, suggesting relationship strain as a key mechanism. Complementary evidence on relationship satisfaction from Australian household survey data provide further support of this pathway. Our findings demonstrate that traditional gender identity norms impose psychosocial costs within modern households. |
| Keywords: | medication, mental health, relative income, relationship strain, separation |
| JEL: | D10 J12 J16 J31 J22 I10 I12 |
| Date: | 2025–09 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp18141 |
| By: | Albin Salmon; Vincent Fleuriet; Paul Vertier |
| Abstract: | This paper investigates the effects on children and adult height of currency crises experienced during childhood. It uses survey data from Demographic and Health Surveys (DHS) collected in 57 countries between 1986 and 2023 for hundreds of thousands of children and adults, combined with a monthly dataset indicating the start of currency crises between 1970 and 2017. It finds that children facing a currency crisis between their birth and the date of the survey tend to be shorter, by about - 0.1 standard deviation (SD). Reduced food affordability explains part of the results: estimated effects are larger in net food importing developing countries and smaller when controlling for inflation. Children growing up during a currency crisis are less likely to eat any solid food and to have a diversified diet on the day preceding the survey, mostly because of a reduced consumption of nutrient-rich non-starchy food. Early exposure to currency crises have persistent effects on adult height. Adults having faced a currency crisis between their birth and 10 years old are on average shorter than their peers, with a maximum effect of about -0.04 SD for crises experienced between 5-6 years old. They are also less likely to have completed secondary or higher education. Our results are unlikely to be influenced by differential selection in parenting across households’ wealth levels, and are robust to a large number of alternative specifications and sample restrictions. |
| Keywords: | Currency Crises, Malnutrition, Human Development |
| JEL: | F31 I14 J13 O15 |
| Date: | 2025 |
| URL: | https://d.repec.org/n?u=RePEc:bfr:banfra:1003 |
| By: | Petach, Luke |
| Abstract: | Prior to the widespread adoption of barbed wire in the late 19th century, the absence of cheap fencing materials in the western United States led to violent conflict in the presence of competing claims over land-use. Using data from the full count U.S. Censuses of Mortality for the years 1850 to 1880, I demonstrate that an increase in the cost of property rights enforcement- captured by an increase in fencing costs per-acre-results in an increase in violent mortality. The effect of fence prices on violent mortality is exacerbated in counties with a greater degree of agricultural land-use polarization. The main findings are supported by an instrumental variables specification using the county woodland area share-a measure of the local scarcity of natural fencing materials, and a placebo specification demonstrating that fence prices have no effect on infectious disease mortality. |
| Keywords: | Property Rights, the West, Barbed Wire, Violent Conflict |
| JEL: | N41 D23 K42 |
| Date: | 2025 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:glodps:1672 |
| By: | Growiec, Jakub; Prettner, Klaus |
| Abstract: | We investigate the salience of extinction risk as a source of impatience. Our Framework distinguishes between human extinction risk and individual mortality risk while allowing for various degrees of intergenerational altruism. Additionally, we consider the evolutionarily motivated "selfish gene" perspective. We find that the risk of human extinction is an indispensable component of the discount rate, whereas individual mortality risk can be hedged against partially or fully, depending on the setup-through human reproduction. Overall, we show that in the face of extinction risk, people become more impatient rather than more farsighted. Thus, the greater the threat of extinction, the less incentive there is to invest in avoiding it. Our framework can help explain why humanity consistently underinvests in mitigation of catastrophic risks, ranging from climate change mitigation, via pandemic prevention, to addressing the emerging risks of transformative artificial intelligence. |
| Keywords: | Discounting; Human Extinction; Mortality; Idiosyncratic Risk; Aggregate Risk; Risk Mitigation |
| Date: | 2025–09 |
| URL: | https://d.repec.org/n?u=RePEc:wiw:wus005:77527408 |
| By: | Salla Kalin (Labour Institute for Economic Research Labore); Tomi Kyyrä (VATT Institute for Economic Research); Tuomas Matikka (VATT Institute for Economic Research) |
| Abstract: | We use detailed, population-wide data from Finland to provide evidence of the impact of earnings disregard policies on part-time work during unemployment spells.The share of part-time workers among benefit recipients increased sharply from 10% to 18% over a few years after the implementation of earnings disregards in unemployment beneifts and housing allowances, which allowed individuals to earn up to 300 euros per month without reductions in their benefits. Using variation in the impact of the reforms on incentives between individuals eligible for different types of benefits, we estimate a 21–30% increase in participation in part-time work due to the implementation of earnings disregards. On average, we find no economically sizable effects of the earnings disregards on future full-time employment or the likelihood of leaving unemployment benefits, but find moderate positive employment effects among those unemployed individuals who are more attached to the labor market. |
| Keywords: | labor supply; social benefits; part-time work; earnings disregards |
| JEL: | H24 J21 J22 |
| Date: | 2025–09 |
| URL: | https://d.repec.org/n?u=RePEc:fit:wpaper:36 |
| By: | Gabriel Agostini; Rachel Young; Maria D. Fitzpatrick; Nikhil Garg; Emma J. Pierson |
| Abstract: | Fine-grained migration data illuminate important demographic, environmental, and health phenomena. However, migration datasets within the United States remain lacking: publicly available Census data are neither spatially nor temporally granular, and proprietary data have higher resolution but demographic and other biases. To address these limitations, we develop a scalable iterative-proportional-fitting based method that reconciles high-resolution but biased proprietary data with low-resolution but more reliable Census data. We apply this method to produce MIGRATE, a dataset of annual migration matrices from 2010-2019 that captures flows between 47.4 billion pairs of Census Block Groups — about four thousand times more granular than publicly available data. These estimates are highly correlated with external ground-truth datasets, and improve accuracy and reduce bias relative to raw proprietary data. We use MIGRATE to analyze both national and local migration patterns. Nationally, we document temporal and demographic variation in homophily, upward mobility, and moving distance: for example, we find that people are increasingly likely to move to top-income-quartile CBGs and identify racial disparities in upward mobility. We also show that MIGRATE can illuminate important local migration patterns, including out-migration in response to California wildfires, that are invisible in coarser previous datasets. We publicly release MIGRATE to provide a resource for migration research in the social, environmental, and health sciences. |
| JEL: | J19 R2 R23 |
| Date: | 2025–09 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:34263 |
| By: | Low, Tina |
| Abstract: | Low maternal mortality and under-5 mortality rates form part of Sustainable Development Goal 3. Its extensive prevalence in low-income countries calls for a reliable method to measure the effectiveness of government expenditure in the area, especially because many countries underperform or overperform on maternal and child health relative to health spending. This review establishes the Basic Health Infrastructure Index (BHII), constructed from normalized indicators of hospital beds, physician and midwifery personnel distribution, as a better matrix towards the predictability of maternal and child health statistics compared to the mere traditional health expenditure as % of Gross Domestic Product (GDP) proxy in determining associations. Results and case studies from 7 countries support the thesis that basic health infrastructure is a vital determinant of constraints, targeting optimizes outcomes, and GDP serves as a context rather than an indicator of reduced maternal mortality and under-5 mortality. This study recommends a three-step investment strategy for low-income countries: ensuring countries meet their determined minimum infrastructure threshold, then layering targeting programs for high-risk populations, followed by monitoring return-on-investment metrics. These are justified by philosophical approaches for the least advantaged. |
| Date: | 2025–09–15 |
| URL: | https://d.repec.org/n?u=RePEc:osf:socarx:rjbfy_v1 |
| By: | Aadya Bahl; Isaac Parkes |
| Abstract: | A central question for policy evaluation in the UK is how to measure wellbeing. To address this, wellbeing years (WELLBYs) were developed at the London School of Economics to assign social and economic value to changes in personal wellbeing. Now adopted in the Treasury's Green Book, a WELLBY represents a one-point change (on a 0-10 scale) in overall life satisfaction for one year, currently valued at GBP15, 920 in 2024 prices. While this approach works effectively for adults, a parallel measure for children has been absent, due to the lack of a consistent way of assigning value. Isaac Parkes, research associate in CEP's Wellbeing programme, proposes expanding the WELLBY framework by introducing child wellbeing years (C-WELLBYs). |
| Keywords: | Wellbeing, Schools, |
| Date: | 2025–09–23 |
| URL: | https://d.repec.org/n?u=RePEc:cep:ceppap:018 |
| By: | Jean Reignier; Bénédicte Gaillard-Le Roux; Pierre François Dequin; Valeria V.A. Bertoni Maluf; Julien Bohe; Michaël Paul Casaer; Agathe Delbove; Claire Dupuis; Eric Fontaine; Prescillia Gamon; Coralie Grange; Nicholas Heming; Melissa Jezequel; Adam Jirka; Corinne Jotterand-Chaparro; Mickael Landais; Nolwenn Letouze; Claire Morice; Olivier Pantet; Julie Pellecer; Gaël Piton; Shancy Rooze; Julie Starck; Jean Marc Tadie; Fabienne Tamion; Ronan Thibault; F.V. Valla; Thierry Vanderlinden; Arnaud A.W. Thille; Nadia Aissaoui |
| Abstract: | The objective of this work was to develop guidelines for nutritional support in critically ill adults and children (excluding neonates and burn patients) unable to maintain an adequate oral intake. We aimed to provide up-to-date recommendations based on high-level evidence including the results of recent landmark randomized controlled trials. Experts from the French Intensive Care Society (SRLF), the French Society of Clinical Nutrition and Metabolism (SFNCM), and the French-Speaking Group of Pediatric Emergency Physicians and Intensivists (GFRUP) used the GRADE methodology to develop the guidelines. Twenty-four Patient Intervention Comparator Outcome (PICO) questions were identified, resulting in 34 adult and 29 pediatric recommendations. Of the 34 recommendations for adults, three were based on high-level evidence, 12 on moderate-level evidence, and 19 on expert opinion. The corresponding numbers for the 29 pediatric recommendations were one, five, and 23. All recommendations achieved strong agreement among the experts. These guidelines emphasize the importance of individualized nutritional support strategies that incorporate recent high-quality evidence to optimize the outcomes of critically ill patients. |
| Keywords: | Adults; Calories; Children; Critical illness; Enteral nutrition; Nutritional support; Parenteral nutrition; Proteins; Recommendations |
| Date: | 2025–12 |
| URL: | https://d.repec.org/n?u=RePEc:ulb:ulbeco:2013/394120 |