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on Health Economics |
| By: | Ellegård, Lina Maria; Kjellsson, Gustav; Monsees, Daniel |
| Abstract: | Disruptions of the patient-general practitioner (GP) relationship due to GP exits affect patient outcomes in various ways. The literature suggests that the loss of a trusted professional can have negative effects, but also points at the benefits of being examined by a new GP. We study the impact of GP exits in the Swedish primary care setting, in which care is provided in group practices and even those patients who have a main GP usually see different GPs. Since the practice is responsible for organizing a replacement GP after an exit, we expect the transition between GPs to be relatively smooth for patients. Using two different control groups we are able to separate the effects of being affected by the loss of ones main GP from the reduction of a practices' workforce. Our results show that GP exits have a negligible effect on patients health care utilization in the Swedish setting. We do observe some shifts in health care utilization patterns, however, this is not driven by the loss of the main GP but rather practice level disruptions. These findings suggest that in organizational settings such as in Sweden - where continuity of care is maintained at practice rather than GP level - patient outcomes are less dependent on individual GPs. Importantly, this conclusion holds even for patients with high baseline continuity of care. |
| Abstract: | Unterbrechungen der Beziehung zwischen Patient und Hausarzt aufgrund des Ausscheidens des Arztes wirken sich in unterschiedlicher Weise auf die Behandlungsergebnisse der Patienten aus. Die Literatur deutet darauf hin, dass der Verlust eines vertrauten Arztes negative Auswirkungen haben kann, weist aber auch auf die Vorteile einer Untersuchung durch einen neuen Arzt hin. Wir untersuchen die Auswirkungen des Ausscheidens von Hausärzten im schwedischen Gesundheitswesen, in dem die Primärversorgung in Gemeinschaftspraxen erfolgt und selbst Patienten, die einen Hausarzt haben, in der Regel von verschiedenen Ärzten behandelt werden. Da die Praxis dafür verantwortlich ist, nach einem Ausscheiden einen neuen Arzt zuzuweisen, gehen wir davon aus, dass der Übergang zwischen Ärzten für die Patienten relativ reibungslos verläuft. Anhand von zwei verschiedenen Kontrollgruppen können wir die Auswirkungen des Verlusts des Hausarztes von denen der Änderung der Personalstruktur in einer Praxis trennen. Unsere Ergebnisse zeigen, dass das Ausscheiden von Ärzten in Schweden nur einen vernachlässigbaren Einfluss auf die Inanspruchnahme von Gesundheitsleistungen durch Patienten hat. Wir beobachten zwar Änderungen der Inanspruchnahme von Gesundheitsleistungen, diese sind jedoch nicht auf den Verlust des Hausarztes zurückzuführen, sondern eher auf Störungen auf Praxisebene. Diese Ergebnisse deuten darauf hin, dass in Gesundheitssystemen wie in Schweden - wo die Kontinuität der Versorgung eher auf Praxis- als auf Arzt-Ebene gewährleistet ist - die Behandlungsergebnisse der Patienten weniger von einzelnen Ärzten abhängig sind. Wichtig ist, dass diese Schlussfolgerung auch für Patienten gilt, die ein hohes Maß an Kontinuität der Versorgung aufweisen. |
| JEL: | I11 I12 I18 |
| Date: | 2025 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:rwirep:337452 |
| By: | Aina, Carmen (Università degli Studi del Piemonte Orientale); Parisi, Lavinia (Università degli Studi di Salerno); Picchio, Matteo (Università Politecnica delle Marche) |
| Abstract: | Gender-based violence (GBV) remains a critical threat to women's safety and equality worldwide, yet the role of climate and environmental stressors in shaping violence against women remains underexplored, particularly in developed countries. This study identifies the causal impact of short-run temperature fluctuations on GBV in Italy using ten years of province-level data (2013-2022) on helpline calls and femicides and a two-way fixed effects estimation strategy. We find that higher temperatures increase both help-seeking behavior and lethal GBV. Accounting for nighttime temperatures shows that elevated minimum temperatures are particularly consequential relative to daytime heat. Heterogeneity analyses indicate that temperature effects are not uniform across provinces, with evidence of differential responses along selected dimensions related to adaptation and socio-economic context. Overall, the results highlight the relevance of considering climate-related stressors within violence prevention and social protection frameworks, even in high-income countries. |
| Keywords: | climate change, gender-based violence, temperatures, femicide, violence prevention |
| JEL: | J12 J16 Q51 Q54 |
| Date: | 2026–03 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp18394 |
| By: | Cao, Yaming; Fischer-Weckemann, Björn; Geyer, Johannes; Ziebarth, Nicolas R. |
| Abstract: | In 2001, Germany abolished public occupational disability insurance (ODI)-the second tier of its public DI system-for cohorts born after 1960. Using administrative data, we first document that, in the long run, overall DI inflows declined by roughly one-third. Second, using representative survey data, we document at best modest ODI insurance take-up responses in the private individual, risk-rated market, which lacks guaranteed issue. Third, an equilibrium model incorporating interactions between the public safety net, the first-tier public DI, and the private market reveals that coverage denials and weak insurance demand, driven by complementary social insurance, can explain the modest private ODI take-up response. Coverage gradients by income and health are thus substantial. Finally, counterfactual simulations highlight the limited scope of incremental reforms. |
| Keywords: | occupational disability insurance, individual private DI, coverage denials, risk rating, private information, adverse selection, social safety net |
| JEL: | D14 D82 H53 H55 I14 I18 J14 J26 |
| Date: | 2026 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:zewdip:337485 |
| By: | Halliday, Timothy (University of Hawaii at Manoa); Mazumder, Bhashkar (UC Irvine and NBER); Sinha, Kompal (Macquarie University); Wang, Huixia (Hunan University) |
| Abstract: | We examine health persistence between parents and their adult children in Indonesia using both subjective and objective health measures including biomarkers. Using Principal Components Analysis, we estimate the interegenerational persistence of the combination of these measures to be 0.30, providing some of the first estimates of the transmission of latent health for a middle income country. We also detect a highly significant second principal component suggesting that health has multiple dimensions. We find especially strong associations for biomarkers such as hemoglobin, the pulse rate and hypertension which have typically not been studied in prior intergenerational studies. Transmission is stronger from mothers, and to daughters. We find relatively little variation in intergenerational health transmission by family income or SES. However, we do find strong positive gradients between family SES and the pulse rate and obseity suggesting potential health pitfalls as low and middle income countries further develop. Our findings suggest a potentially important role for policies focused on maternal health in reducing the intergenerational transmission of health. |
| Keywords: | intergenerational persistence, health, biomarkers, Indonesia |
| JEL: | D63 J62 I14 |
| Date: | 2026–02 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp18365 |
| By: | Paolo Nicola Barbieri; Laura Bottazzi; Giuseppe Di Giacomo |
| Abstract: | We investigate how the use of bankruptcy as an implicit health insurance varies across households, focusing on heterogeneity by asset holdings, race, marital status, and educational attainment. Using a difference-in-differences design based on the 2005 bankruptcy reform, we find that the reform modestly increased health insurance coverage among middle-income households unlikely to lose assets under Chapter 7, with stronger effects for married and less educated households. The reform primarily affected White households, suggesting racial disparities in bankruptcy use. Treated households also showed increased healthcare utilization and spending. These heterogeneous effects highlight how the reform may have deepened existing health and financial inequalities. |
| Keywords: | health insurance, bankruptcy reform, consumer protection |
| JEL: | D18 H51 I13 K35 |
| Date: | 2026 |
| URL: | https://d.repec.org/n?u=RePEc:ces:ceswps:_12388 |
| By: | Borgbjerg, Anne Katrine (Aarhus University); Sigaard, Hans (Aarhus University); Svarer, Michael (Aarhus University); Vejlin, Rune (Aarhus University) |
| Abstract: | This paper estimates the effect of a reform-induced increase in the early retirement age (ERA) on labor supply, health, and healthcare utilization using detailed Danish administrative data and a regression discontinuity design. We show that while raising the ERA successfully increased employment, it also led to spillovers into other public transfers and increased the number of self-supporting individuals. We find that the increased ERA led to small and insignificant effects on GP visits and the use of painkillers, as well as borderline significant, small positive effects on the use of antidepressants and CVD medicine. Further analysis shows that individuals who were employed due to the reform had lower pre-reform income and wealth, while the individuals who were not employed despite being affected by the reform were characterized by worse health before the reform announcement. We argue that possibilities for exiting employment serve as a potentially important mitigating mechanism for health and healthcare utilization effects by sorting vulnerable individuals out of employment. |
| Keywords: | retirement reforms, health, healthcare utilization |
| JEL: | I18 J18 J26 |
| Date: | 2026–03 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp18390 |
| By: | Barschkett, Mara (University of Bonn); Tréguier, Julie (DIW Berlin) |
| Abstract: | In this paper, we estimate the causal effect of social security income on mental health. We focus on widowhood, a life event associated with large and persistent mental health declines, and exploit a reform of the Dutch survivor benefits system that introduced cohort-based restrictions in benefit eligibility. Using administrative data, we find that reduced access to survivor benefits increases antidepressant use by 9%, accounting for 35% of the overall rise in antidepressant use following spousal death. A mechanism analysis shows that survivor benefits stabilize mental health by smoothing living standards, highlighting the potential welfare gains from well-targeted income support policies. |
| Keywords: | widowhood, survivor benefits, mental health, antidepressant use, income security |
| JEL: | I12 J14 H55 |
| Date: | 2026–03 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp18385 |
| By: | Alexander Bertermann; Hannah Schildberg-Hörisch |
| Abstract: | This paper provides the first evidence that children’s economic preferences vary systematically with parental mental health. Using experimentally elicited measures of economic preferences from more than 4, 500 children in Bangladesh, we document that children of parents with indications of mental illness are less prosocial but more patient than their peers with mentally healthy parents. Attitudes toward risk remain unchanged. We discuss potential pathways through which parental mental health may influence the formation of children’s preferences, documenting that children of parents with indication of mental illness assume greater responsibilities within the family, experience less parental involvement, and are exposed to a more adverse home environment. |
| Keywords: | mental health, social preferences, risk preferences, patience, origins of preferences, experiments with children, Bangladesh |
| JEL: | C91 D01 D10 I10 |
| Date: | 2026 |
| URL: | https://d.repec.org/n?u=RePEc:ces:ceswps:_12441 |
| By: | Katsuhiko Nishiyama (Osaka School of International Public Policy, The University of Osaka) |
| Abstract: | This paper examines whether insurance sources expanded under the Affordable Care Act (ACA), particularly health insurance marketplaces and Medicaid, compensate for the loss of employer-sponsored health insurance (ESHI) following job displacement. Using monthly data from the 2014--2016 Survey of Income and Program Participation, I estimate duration-specific effects of displacement on each coverage source with a difference-in-differences design. ESHI coverage falls by 15 to 18 percentage points within a few months of displacement, with only slight recovery over the following year. Medicaid enrollment increases modestly, driven entirely by workers in expansion states where coverage increases exceed 7 percentage points. Directly purchased private insurance shows no discernible response despite marketplace availability and premium subsidies, and this holds across income levels. These findings indicate that ACA marketplace reforms in the sample period provide limited protection for displaced workers. |
| Keywords: | Health Insurance, Job Displacement, the Affordable Care Act |
| JEL: | I13 J64 |
| Date: | 2026–02 |
| URL: | https://d.repec.org/n?u=RePEc:osp:wpaper:26e001 |
| By: | Jessamyn Schaller; Mariana Zerpa |
| Abstract: | We examine how the Affordable Care Act (ACA) altered the insurance consequences of involuntary job loss. Using matched event-study models with longitudinal survey data, we estimate the causal effects of displacement on insurance coverage before and after implementation of the ACA’s main provisions. Prior to 2014, job loss reduced coverage by approximately 16 percentage points, with losses persisting for more than a year. After the ACA, declines are smaller—about 10 percentage points—and recovery is faster. Gains reflect higher baseline public coverage and reduced post-displacement losses, with the largest improvements among middle income workers previously most exposed to coverage disruptions. |
| JEL: | C23 I13 I18 J65 |
| Date: | 2026–02 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:34874 |
| By: | Aoki-Beattie, Yu (University of Aberdeen & IZA); Arulampalam, Wiji (University of Warwick, CAGE & IZA); Lloyd, Neil (University of St Andrews); Mathew, Sushil (Imperial College London) |
| Abstract: | We examine the causal effect of exposure to fast-food outlets on adolescent z-BMI using data from the UK Millennium Cohort Study. We develop a novel approach to modelling persistence in adolescent BMI by clustering early childhood BMI trajectories, capturing biologically and behaviourally persistent obesity risk profiles. Including these profiles in the model allows us to separate baseline susceptibility from contemporaneous environmental effects. For identification, we exploit the near-universal transition from primary to secondary school in Great Britain, which creates plausibly exogenous variation in exposure to fast-food outlets around schools. Using this variation, we find that adolescents with at least one major-brand outlet within 400 metres of their school have, on average, a 0.158 standard-deviation higher z-BMI. Effects decline at larger distances, are limited around the home, and do not extend to other food outlets. JEL codes: I12 ; I18 ; L83 |
| Keywords: | Adolescent obesity ; Body mass index ; Fast food ; School food environment |
| Date: | 2026 |
| URL: | https://d.repec.org/n?u=RePEc:wrk:warwec:1601 |
| By: | Sansia Blackmore (African Health Policy Alliance); Renee van Eyden (Professor of Economics, University of Pretoria) |
| Abstract: | Aiming to contribute to the literature on tobacco-harm reduction, this study estimates cross-price elasticities to explore the extent to which excise taxes may, through relative-price effects, induce substitution away from cigarettes towards lower-harm non-combustible alternatives, that is, towards e-cigarettes and heated tobacco products (HTPs). Using data from 33 countries for the period 2018 to 2024, the novel contribution of the study is in its representativity of many world regions in various stages of development, and the inclusion of both the e-cigarette and HTP markets to determine potential substitutability or complementarity. The cross-price elasticity estimates suggest that a rise in cigarette prices may induce a shift from cigarette use towards e-cigarette and HTP use, which would support harm reduction. A price increase in the HTP market may encourage substitution towards cigarette use but has no effect on the e-cigarette market. Changes in the price of e-cigarettes do not induce consumption shifts in the cigarette or HTP markets. Notably, societies' degree of health and harm awareness is significantly and negatively associated with cigarette and HTP sales. Hence, harm-differentiated excise taxes are proposed to catalyse harm-reducing substitutions through two potential conduits, first through price-aware consumers' response to changes in relative affordability and second, through health-conscious consumers' response to the differential harm signals. |
| JEL: | H30 H23 I12 I18 |
| Date: | 2026–02 |
| URL: | https://d.repec.org/n?u=RePEc:pre:wpaper:202606 |
| By: | Wojciech Zawadzki (Faculty of Economic Sciences, University of Warsaw); Henrik Andersson (Swedish National Road and Transport Research Institute (VTI); Toulouse School of Economics, University of Toulouse Capitole); Mikołaj Czajkowski (Faculty of Economic Sciences, University of Warsaw); Arne Risa Hole (Universitat Jaume I) |
| Abstract: | This study investigates how behavioral biases influence stated preference valuation of mortality risk reductions, commonly summarized as the value of a statistical life (VSL). Using a discrete choice experiment (DCE) combined with a contingent valuation double-bounded dichotomous choice and an open-ended follow-up, we elicit individuals’ willingness to pay (WTP) for cardiovascular mortality risk reductions. In a randomized design, we varied the cost attribute across three cost range treatments and manipulated information disclosure and feedback to examine three behavioral phenomena: cost vector effects (whether the range of costs presented affects WTP), scope insensitivity (whether WTP scales appropriately with the magnitude of the risk reduction), and anchoring (whether initial cost cues affect subsequent responses). Our results show that mean VSL estimates can vary by up to ~25% between cost treatments. Furthermore, WTP responses exhibit partial scope insensitivity – larger risk reductions do not proportionally increase WTP – indicating a deviation from theoretical expectations. Importantly, we find no strong evidence of anchoring: neither revealing all attribute levels upfront, nor starting with extreme cost levels, nor providing feedback on quiz questions significantly affected respondents’ choices or WTP. Our findings underscore the need for careful survey design. Even if VSL distributions remain statistically similar across cost frames, substantial shifts in mean magnitudes could be consequential for policy. We call for standardized guidelines on cost attribute selection and survey protocols to mitigate bias, ensuring that stated preference methods yield reliable welfare estimates for health policy decisions. |
| Keywords: | value of statistical life (VSL), stated preference (SP), contingent valuation (CV), behavioral biases, anchoring effect, scope insensitivity, discrete choice experiment (DCE), willingness to pay (WTP), mortality risk reduction, cardiovascular diseases |
| JEL: | I12 D01 D61 Q51 C83 C93 |
| Date: | 2026 |
| URL: | https://d.repec.org/n?u=RePEc:war:wpaper:2026-4 |
| By: | Elisabeth Preyer (University of Bern); Eric Strobl (University of Bern) |
| Abstract: | Despite stagnant economic and living conditions, early 20th-century colonial Jamaica experienced a remarkable increase in life expectancy — a phenomenon referred to as the Jamaica Paradox. One factor believed to be key in this transformation was the Hookworm Campaign (1919-1936), an island-wide, multi-faceted public health initiative to eradicate hookworm, a tropical parasite that can severely weaken the immune system. Using parish-level mortality data and an event study framework, we investigate whether the campaign reduced mortality rates in Jamaica. Results show that infant deaths declined by 10% in the first year, cumulating to 41% within ten years. Mortality among other age groups also fell, although with several years of delay and lower effects. Our estimates suggest that by WWII the hookworm eradication effort increased life expectancy at birth by 5-15 years. A `back of the envelope' cost-benefit analysis reveals that the benefits in terms of spared infant deaths alone were multiple times the campaign costs, where the local population shouldered much of the overall costs. |
| Keywords: | Jamaica, hookworm, public campaign, mortality |
| JEL: | I18 |
| Date: | 2026–02 |
| URL: | https://d.repec.org/n?u=RePEc:hes:wpaper:0297 |
| By: | Vicente, Astrid; Valz Gris, Angelica (Università Cattolica del Sacro Cuore, Rome, Italy); Costa, Cristina; Cardoso, Maria Luis; Costa, Alexandra; Lopes, Fátima; Kannan, Pragathy; Perola, Markus; Pastorino, Roberta; Pezzullo, Angelo |
| Abstract: | There is currently no widely accepted framework to guide decision-making for preventive approaches using genetic and genomic technologies. In the context of the PROPHET project, we developed a multidimensional framework integrating Health Technology Assessment (HTA) and Health Impact Assessment (HIA), complemented by a monitoring phase to assess the impact of policies implementing personalised prevention interventions. This integrated approach links technical, clinical, and societal dimensions, supporting prevention strategies that are effective, equitable and sustainable. The PROPHET framework supports policy makers in the equitable and efficient implementation of personalised prevention policies at scale. |
| Date: | 2026–02–24 |
| URL: | https://d.repec.org/n?u=RePEc:osf:socarx:2nv5e_v1 |
| By: | Ruttenberg, David (University College London) |
| Abstract: | Neurodivergent individuals—particularly autistic adults—face pervasive exclusion across educational, workplace, and community settings due to environments designed for neurotypical sensory and cognitive processing. This conceptual paper advances a comprehensive framework for designing AI-enabled, multi-sensory ethical wearable accommodations that address sensory overload, attentional dysregulation, and mental health vulnerability in real time. Grounded in the Sensory Sensitivity Mental Health Distractibility S²MHD theoretical model and informed by a previously implemented multi-sensory wearable architecture [2][5][39], the framework integrates just-in-time adaptive interventions (JITAI), participatory design, and neurorights principles to ensure autonomy, consent, and data minimization. This paper presents three design archetypes—predictive crisis prevention, contextual environmental filtering, and personalized fatigue modeling—each illustrated through prospective use-case scenarios spanning lecture halls, corporate office environments, and social spaces. The paper articulates eight core ethical design principles and provides implementation guidelines. By reframing wearable accommodations as enablement infrastructure rather than deficit-oriented assistive technology, this work offers a blueprint for transforming systemic exclusion into inclusive opportunity. |
| Date: | 2026–02–17 |
| URL: | https://d.repec.org/n?u=RePEc:osf:socarx:pu6r4_v1 |
| By: | Schneider, Eric B.; Jaramillo-Echeverri, Juliana; Purcell, Matthew; A’Hearn, Brian; Arthi, Vellore; Blum, Matthias; Brainerd, Elizabeth; Capuno, Joseph; Cermeño, Alexandra L.; Challú, Amílcar; Cho, Young-Jun; Cole, Tim J.; Corpuz, Jose; Depauw, Ewout; Droller, Federico; von Fintel, Dieter; Floris, Joël; Galofré-Vilà, Gregori; Harris, Bernard; Hatton, Tim; Heyberger, Laurent; Hurme, Tuuli; Inwood, Kris; Jaadla, Hannaliis; Kok, Jan; Kopczyński, Michał; Lordemus, Samuel; Marein, Brian; Meisel-Roca, Adolfo; Morgan, Stephen; Öberg, Stefan; Ogasawara, Kota; Ortega, José Antonio; Palma, Nuno; Papadimitriou, Anastasios; Pistola, Renato; Quanjer, Björn; Rother, Helena; Saaritsa, Sakari; Salvatore, Ricardo; Staub, Kaspar; Eng, Pierre van der; Roberts, Evan |
| Abstract: | Introduction Child stunting, a measure of malnutrition, is a major global health challenge affecting 148.1 million children in 2022. Global stunting rates have declined from 47.2% in 1985 to 22.3% in 2022; however, trends before the mid-1980s are unclear, including whether child stunting was previously prevalent in current high-income countries (HICs). We conducted a systematic review of child growth studies before 1990 to reconstruct historical rates of child stunting. Methods We included reports of mean height by age and sex for children up to age 10.99 years. We excluded studies that were not representative of the targeted population and data for children under age 2. Stunting rates were computed by converting the means and SDs of height to height-for-age Z-scores (HAZ) using the WHO standard/reference, combining the HAZ distributions for all ages and measuring the share of the combined distribution below the stunting threshold. Results We found 923 child growth studies at the community, regional and national level covering 122 countries from 1814 to 2016. We supplemented these historical studies with stunting estimates from the 1990s onward from the Joint Malnutrition Estimates database. Many current HICs had high levels of child stunting in the early 20th century, similar to low- and middle-income countries (LMICs) today. However, there was heterogeneity: stunting rates were low in Scandinavia, the European settler colonies and in the Caribbean, higher in Western Europe and exceptionally high in Japan and South Korea. Child stunting declined across the 20th century. Conclusion The global child stunting rate was substantially higher in the early 20th century than in 1985, and the reduction of child stunting was a central feature of the health transition. The high stunting rates and subsequent reduction of stunting in HICs suggest that current HICs provide lessons for eradicating child stunting and that all LMICs can eliminate stunting. |
| Keywords: | child stunting; malnutrition; health transition; REF fund 2025/2026 |
| JEL: | I10 |
| Date: | 2026–02–28 |
| URL: | https://d.repec.org/n?u=RePEc:ehl:lserod:131007 |
| By: | Papanicolas, Irene; Wouters, Olivier J.; Sawaya, Tania; Han, Jihye; Wei, Jinru; Naci, Huseyin |
| Abstract: | Factors influencing the timing of regulatory submission for new drugs across countries are poorly understood. We identified all new drugs approved by the Food and Drug Administration (FDA) or European Medicines Agency (EMA) during the period 2014–18 and tracked their regulatory submissions to the US, the European Union, Canada, Japan, and Australia through 2022. We assessed whether disease area, orphan status, therapeutic value, market size, and launch price were associated with submission delays. The FDA received the highest proportion of first submissions (70 percent). Median submission delays ranged from zero months (FDA) to 18.5 months (Australia). The range of median regulatory review times was small (9.2–14.1 months) compared with the range of median submission delays. Drugs with moderate-to-high therapeutic value were associated with a six-month earlier submission time compared to drugs with low therapeutic value, on average. Higher-price drugs were associated with earlier submission, on average. Overall, cross-national differences in drug availability largely reflected differences in submission, not regulatory review, times. Although the US had greater and faster availability of novel therapeutics, the difference was smaller for drugs that offered moderate-to-high therapeutic value. |
| JEL: | R14 J01 |
| Date: | 2026–02–28 |
| URL: | https://d.repec.org/n?u=RePEc:ehl:lserod:137084 |
| By: | Golberstein, Ezra (University of Minnesota); Guth, Daniel (University of Rochester); Slusky, David (University of Kansas) |
| Abstract: | We study political shocks as potential birth outcomes stressors, specifically the unexpected result of the 2016 U.S. presidential election. We investigate this two-sided shock using an innovative data linkage: Colorado voter registrations and birth certificates, matched by sex, birth year, and name. Contrary to our hypotheses, we do not find an effect on birth outcomes. We do find some evidence that stress-related behaviors in pregnancy worsened for Democrats. This research adds new evidence on the effects of in-utero exposure to two-sided stressors, uses a novel data linkage, and expands the new economics area of politics as a determinant of health. |
| Keywords: | elections, birth weight, fetal origins, maternal stress |
| JEL: | D72 I14 J13 |
| Date: | 2026–03 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp18386 |
| By: | Lukas Pohn; Günther G. Schulze |
| Abstract: | We estimate the causal effect of access to clean water sources on educational outcomes in Indonesia. Using the longitudinal Indonesian Family Life Survey (IFLS) panel dataset, which follows the same individuals from 1993 to 2014, and applying household fixed effects allows us to identify the causal effect of access to clean water at different childhood stages on children’s educational performance. We find that lifetime and early childhood access increases strongly the likelihood of completing junior and senior secondary school; later-gained access has no discernible effect on school performance. Our results underscore the need to provide access to clean water very early on. |
| Keywords: | access to tap water, access to improved water, educational outcomes, Indonesia |
| JEL: | I25 O15 Q53 |
| Date: | 2026 |
| URL: | https://d.repec.org/n?u=RePEc:ces:ceswps:_12475 |
| By: | Arnab Basu (Charles H. Dyson School of Applied Economics and Management, Cornell University); Tsenguunjav Byambasuren (Department of Economics, Trinity College Dublin); Nancy Chau (Charles H. Dyson School of Applied Economics and Management, Cornell University) |
| Abstract: | We trace the impact of a temporary ban targeting liquor‐serving bars – from launch to reversal – on alcohol consumption and women's experience with domestic violence in Kerala, India. Decomposing the policy‐induced and reversal effects by employing difference‐in‐differences and event‐study approaches, we identify a significant reduction in alcohol consumption (but only in bars) with an accompanying reduction in intimate partner violence during the policy period. However, both alcohol consumption and domestic violence rebounded to pre‐ban levels after the policy removal. Heterogeneity analysis further reveals these effects to be confined only amongst high‐wealth households. A battery of robustness tests confirms our findings. |
| Keywords: | Alcohol drinking; Domestic violence; Prohibition; Kerala; India |
| JEL: | D04 D12 J16 K42 |
| Date: | 2026–03 |
| URL: | https://d.repec.org/n?u=RePEc:tcd:tcduee:tep0326 |
| By: | David Puelz |
| Abstract: | Whether and how race is used in selective admissions remains a central question in higher education and civil rights law. In Students for Fair Admissions v. Harvard (2023), the Supreme Court held that race-based affirmative action in college admissions violates the Equal Protection Clause, purportedly ending the practice. This report examines admissions at a public medical school in the pre-SFFA period. Using applicant-level data on over 11, 000 applications to Texas Tech University Health Sciences Center Medical School for the 2021 and 2022 cycles, I relate admission decisions to academic merit (MCAT, GPA, science GPA), race, gender, and situational judgment (Casper) scores. Summary statistics, academic-index decompositions, and logistic regression models provide strong evidence of racial preferences: African American and Hispanic applicants are preferred relative to academically similar White and Asian applicants. Counterfactual and preference-removal analyses quantify the magnitude of these disparities. The findings document the kind of race-based preferences that SFFA was meant to address and establish a baseline for assessing whether admissions practice changed after the decision. |
| Date: | 2026–02 |
| URL: | https://d.repec.org/n?u=RePEc:arx:papers:2602.18484 |
| By: | Quentin Batista; Masakazu Emoto; Naoki Maezono; Taisuke Nakata |
| Abstract: | We examine the implications of virus mutation for optimal lockdown policy in an epi-macro model. We consider three ways of modelling mutation---one deterministic setup and two stochastic setups featuring a two-state and three-state Markov process. We find that the effects of mutation on optimal lockdown policy are asymmetric. In particular, a future reduction in the transmission rate increases lockdown intensity by more than a future rise in the transmission rate lowers it. As a corollary to this asymmetry, an increase in uncertainty about future mutation is non-neutral and reduces lockdown intensity under the optimal policy. |
| Date: | 2026–03 |
| URL: | https://d.repec.org/n?u=RePEc:tcr:wpaper:e221 |
| By: | Asako Chiba; Kazuya Haganuma; Taisuke Nakata; Thuy Linh Nguyen; Reo Takaku |
| Abstract: | We conducted an information provision experiment in April 2023 in Japan to investigate how different types of information affect people's subjective assessment of COVID-19 risks. The majority of respondents overestimate infection and fatality risks. Recent infection-related statistics lower risk perceptions if presented as percentages, but do not affect them if presented as levels. A pessimistic narrative about the infection outlook raises risk perceptions. We also find substantial heterogeneity in the response to information provision across various individual characteristics, such as age, gender, education, marital status, health status, COVID-19-related experiences, and vaccination status. |
| Date: | 2026–03 |
| URL: | https://d.repec.org/n?u=RePEc:tcr:wpaper:e222 |
| By: | Schneider, Eric B.; Davenport, Romola |
| Abstract: | This paper uses population smallpox mortality rates in eighteenth-century Sweden and the death toll from the 1707–09 smallpox epidemic in Iceland to estimate plausible ranges for the case fatality rate (CFR) of smallpox (Variola major). We find that smallpox CFRs could be extremely high (43–55 per cent) when smallpox 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, the estimated CFR is only 8–10 per cent: far lower than the consensus CFR of 20–30 per cent. We argue that social factors explain these differences. Where both adults and children were susceptible, smallpox epidemics fundamentally disrupted basic household tasks and nursing of the sick, dramatically increasing the CFR. Thus, when historians and epidemiologists give CFRs for smallpox, they should consider the population and context rather than relying on an implausible intrinsic CFR of 20–30 per cent. |
| Keywords: | smallpox case fatality rate; epidemics; historical demography; social determinants; vaccination |
| JEL: | N0 |
| Date: | 2026–02–16 |
| URL: | https://d.repec.org/n?u=RePEc:ehl:lserod:130496 |
| By: | Weifeng Larry Liu; Richard T. Gray; Guy B. Marks; James M. Trauer; Virginia Wiseman |
| Abstract: | The COVID-19 pandemic has shown that infectious diseases can generate far-reaching, economy-wide impacts that extend well beyond the health sector. This paper highlights the importance of expanding the scope of infectious disease studies to capture the full spectrum of economic impacts, which has significant implications for public health investment. We systematically examine the channels through which infectious diseases can affect the macroeconomy, and outline four broad approaches, both established and novel, to integrating epidemiological models of infectious disease transmission and outcomes into macroeconomic models: (1) basic link: no formal epidemiological models; (2) exogenous link: one-way linkage from epidemiological to macroeconomic models; (3) semi-endogenous link: two-way external linkage between epidemiological and macroeconomic models; and (4) endogenous link: two-way internal linkage between epidemiological and macroeconomic models, each reflecting a different degree of epidemiological-macroeconomic integration. Future research on the macroeconomic modelling of infectious disease impacts would benefit from deeper integration of epidemiological and macroeconomic models through exogenous or endogenous link approaches. This involves a trade-off between technical complexity and model granularity in both epidemiological and macroeconomic components. |
| Keywords: | infectious diseases, epidemiological modelling, macroeconomic modelling, epidemiological-macroeconomic linkages |
| JEL: | I18 E10 C60 |
| Date: | 2026–02 |
| URL: | https://d.repec.org/n?u=RePEc:een:camaaa:2026-16 |
| By: | Hongtao Li; Taisuke Nakata; Hiroki Sakamoto; Hiroyuki Uneya |
| Abstract: | We analyze how hospital capacity affects health and economic outcomes during a pandemic using a macro-SIR model featuring a lockdown policy rule. The rule instructs the government to implement a lockdown when the number of ICU patients exceeds a trigger threshold---motivated broadly by a hospital capacity constraint---and to lift the lockdown when it falls below a lifting threshold. When vaccines are not available, we find that the government can reduce both COVID-19 deaths and economic loss by raising the trigger threshold in some situations. When the vaccine rollout is expected to begin in the near future, we find that the government can reduce both COVID-19 deaths and economic loss by lowering the trigger threshold. |
| Date: | 2026–03 |
| URL: | https://d.repec.org/n?u=RePEc:tcr:wpaper:e223 |