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on Health Economics |
| By: | Sonia Bhalotra (University of Warwick); N.Meltem Daysal (Department of Economics, University of Copenhagen); Louis Fréget (Paris-Dauphine PSL University); Jonas Cuzulan Hirani (VIVE); Priyama Majumdar (University of Warwick); Mircea Trandafir (Rockwool Foundation); Miriam Wüst (Department of Economics, University of Copenhagen); Tom Zohar (CEMFI) |
| Abstract: | Using Danish administrative data linked to two independent, validated postpartum depression screenings, we study how postpartum mental health shocks shape womens labor market trajectories. Event-study estimates show no pre-birth differences in trends between depressedand non-depressed mothers, but persistent employment gaps that widen immediately after birth. Health-care utilization patterns indicate that these differences reflect acute mental health shocks rather than pre-existing trends. The penalties are concentrated among less educated mothers and those in less family-friendly jobs. Our results highlight postpartum depression as a meaningful and unequal contributor to the motherhood penalty. |
| Keywords: | Postpartum depression, motherhood penalty, labor market inequality |
| JEL: | I12 J13 J16 |
| Date: | 2026–01–29 |
| URL: | https://d.repec.org/n?u=RePEc:kud:kucebi:2601 |
| By: | Rowan Cherodian; Guy Tchuente |
| Abstract: | We study instrumental-variable designs where policy reforms strongly shift the distribution of an endogenous variable but only weakly move its mean. We formalize this by introducing distributional relevance: instruments may be purely distributional. Within a triangular model, distributional relevance suffices for nonparametric identification of average structural effects via a control function. We then propose Quantile Least Squares (Q-LS), which aggregates conditional quantiles of X given Z into an optimal mean-square predictor and uses this projection as an instrument in a linear IV estimator. We establish consistency, asymptotic normality, and the validity of standard 2SLS variance formulas, and we discuss regularization across quantiles. Monte Carlo designs show that Q-LS delivers well-centered estimates and near-correct size when mean-based 2SLS suffers from weak instruments. In Health and Retirement Study data, Q-LS exploits Medicare Part D-induced distributional shifts in out-of-pocket risk to sharpen estimates of its effects on depression. |
| Date: | 2026–01 |
| URL: | https://d.repec.org/n?u=RePEc:arx:papers:2601.16865 |
| By: | Schneider, Eric B.; Davenport, Romola |
| Abstract: | This paper uses population smallpox mortality rates in eighteenth-century Sweden and the death toll from the 1707-9 smallpox epidemic in Iceland to estimate plausible ranges for the case fatality rate (CFR) of the deadly form of smallpox, Variola major, in both its endemic (Sweden) and epidemic (Iceland) form. We find that smallpox CFRs could be extremely high (40-53%) when smallpox was epidemic and attacked a population where both children and adults were susceptible as in Iceland. However, where smallpox was endemic and therefore a disease of childhood, as in Sweden, a better estimate of the CFR is 8-10%. This is far lower than the consensus CFR of 20% to 30%. Part of the differences between the CFRs studied here could be due to differences in the inherent virulence of smallpox in the two contexts. However, we argue that social factors are more likely to explain the differences. Where both adults and children were susceptible to smallpox, smallpox epidemics fundamentally disrupted household tasks such as fetching water and food preparation and prevented parents from nursing their sick children, dramatically increasing the CFR. Thus, when historians and epidemiologists give CFRs of smallpox, they should consider the population and context rather than relying on an implausible intrinsic CFR of 20% to 30%. |
| Keywords: | smallpox; epidemics; case fertility rate; historical demography |
| JEL: | N30 J10 |
| Date: | 2025–05–11 |
| URL: | https://d.repec.org/n?u=RePEc:ehl:wpaper:128854 |
| By: | Schneider, Eric B. |
| Abstract: | There is strong evidence that exposure to atmospheric pollution is detrimental to health. However, most current and historical research has focussed on the shortrun consequences of exposure to pollution on health, and historical researchers have not been able to assess the effects of pollution on a wide range of health indicators. This paper uses fog events at a daily level as a proxy for acute extreme pollution events in historical London (1892-1919). It tests whether exposure to fog at birth and at the time of sickness influenced a wide range of indicators of child health in the short and long term, including birth outcomes (birth weight, length, stillbirth, premature birth and neonatal death), mortality risk (mortality before age 15), growth outcomes (heights and weights in infancy, childhood and adolescence), and morbidity outcomes (incidence, prevalence and sickness duration from respiratory diseases and measles). Being born on a fog day did not have strong effects on birth or growth outcomes or on morbidity outcomes for upper respiratory diseases. However, being born on a fog day increased mortality risk from respiratory diseases and increased incidence, prevalence and sickness duration from measles, influenza and other lower respiratory diseases. I also find short-run effects of fog on sickness duration from influenza and measles. Overall, the mixed results suggest that atmospheric pollution caused significant ill health in historical London but only for limited dimensions of health. |
| Keywords: | ambient air pollution; morbidity; child growth; respiratory disease; health transition |
| JEL: | N33 I12 Q53 |
| Date: | 2025–06–26 |
| URL: | https://d.repec.org/n?u=RePEc:ehl:wpaper:128850 |
| By: | de Bromhead, Alan; Lyons, Ronan C.; Ohler, Johann |
| Abstract: | Poor housing conditions, and the negative effects of Household Air Pollution (HAP) in particular, remain one of the most pressing global public health challenges. While the association between poor housing and health has a long history, evidence of a direct link is lacking. In this paper, we examine a rare example of a public housing intervention in rural areas, namely the large-scale provision of high-quality housing in Ireland in the late 19th and early 20th centuries. We exploit a novel dataset of deaths-by-disease and deaths-by-age-and-sex over the period 1871–1919, to test the impact of the intervention on mortality. Our difference-in difference estimates indicate that improved housing conditions reduced mortality by as much as 1 death per 1000. This effect is driven by reductions in deaths from respiratory diseases. We propose a likely mechanism that is consistent with the pattern of results we observe: a reduction in Household Air Pollution through improved housing quality and better ventilation. A cost-benefit analysis reveals that the scheme was a highly cost-effective intervention. |
| Keywords: | Ireland; Labourers Act; household air pollution; health transition; social housing; infectious disease |
| JEL: | N33 N93 Q53 O18 J10 |
| Date: | 2025–10 |
| URL: | https://d.repec.org/n?u=RePEc:ehl:wpaper:129884 |
| By: | Pablo Álvarez-Aragón (Development Finance and Public Policies, University of Namur); Jean-Marie Baland (Development Finance and Public Policies, University of Namur); Catherine Guirkinger (Development Finance and Public Policies, University of Namur); Paola Villar (Centre d'Économie de la Sorbonne, Université Paris 1 Panthéon-Sorbonne) |
| Abstract: | This paper examines the long-term impact of Catholic missionary nuns on women’s human capital in the Democratic Republic of Congo. By using newly digitized historical data on Christian missions, recent demographic surveys, and administrative data on schools and healthcare facilities, we analyze the lasting effects of the missionaries' presence, focusing on gender-specific outcomes. While both Catholic and Protestant missions influenced educational attainment, the presence of Catholic nuns significantly enhanced these effects, especially for girls. Proximity to Catholic missions is also associated with better health outcomes. Beyond education and health, exposure to missions with nuns delays marriage, reduces polygamy, and increases women’s decision-making power within households. However, the negative effects on female labor force participation likely reflect the enduring influence of the “Christian household” model promoted during the colonial period. Overall, Catholic missionary nuns played a decisive role in shaping women’s outcomes, with effects that remain visible more than a century later. |
| Date: | 2026–02 |
| URL: | https://d.repec.org/n?u=RePEc:nam:defipp:2601 |
| By: | Ah-Reum Lee; Jacqueline M. Torres; Jinkook Lee |
| Abstract: | Higher education has expanded worldwide, with women outpacing men in many regions. While educational attainment is consistently linked to better physical health, its mental health effects - particularly for women - remain underexplored, and causal evidence is limited. We estimate the impact of college completion on depression among middle-aged women in South Korea, leveraging the 1993 higher education reform, which raised women's college attainment by 45 percentage points (pp) over the following decade. We use two nationally representative datasets to triangulate evidence, including the Korea National Health and Nutrition Examination Survey (KNHANES, 2007-2021) for physician-diagnosed depression, and the Korean Longitudinal Survey of Women and Families (KLoWF, 2007-2022) to validate findings using self-reports of depressive symptoms. We implement two-stage least squares (2SLS) with a birth-cohort instrument based on exposure to the reform (within 3 years of the cutoff in KNHANES and within 1 to 3 years in KLoWF). In KNHANES, college completion lowers physician-diagnosed depression by 2.4 pp, attenuating to 1.6 pp after adjusting for income, employment, and physical health. In KLoWF, college completion improves self-reported mental health. The weekly depressive-symptoms composite declines by 17.4 pp, attenuating to 16.4 pp after covariate adjustment. Placebo tests on unaffected cohorts yield null results. This study contributes to the growing quasi-experimental literature on education and mental health with convergent evidence across clinical diagnoses and self-reported depressive symptoms in South Korea. By focusing on college education in a non-Western setting, it extends the external validity of existing findings and highlights educational policy as a potential lever to reduce the burden of midlife depression among women. |
| Date: | 2026–01 |
| URL: | https://d.repec.org/n?u=RePEc:arx:papers:2601.20976 |
| By: | Audrey Bousselin; Anne Solaz |
| Abstract: | This paper adopts a child-centered perspective to study how children perceive their family’s economic situation. Using linked survey and administrative data for all children aged 8 to 12 living in Luxembourg, we compare children’s self-reported assessments of financial hardship with objective monetary indicators. While child-perceived and income-based financial situations are positively associated, there are substantial discrepancies. At a given level of monetary poverty, children living in single-parent households or in migrant families report higher levels of financial concern. Conditional on socio-demographic characteristics, monetary poverty and income insecurity explain little of the variation in perceived financial hardship. In contrast, the relative income position within schools and child-specific deprivation—particularly limitations in shared family activities—are strongly associated with higher level of financial worries. An analysis of discordance reveals an asymmetry. Overestimation of hardship among non-poor children is more likely for non-natives, those growing up in a lone family or who are poorer than their schoolmates, whereas underestimation among poor children shows weaker and less systematic correlates. These perception gaps matter: children who report perceived financial hardship display lower life satisfaction and worse self-rated health even when they are not monetarily poor, whereas poor children who do not report perceived hardship show well-being levels closer to those of non-poor peers. Overall, the findings indicate that children’s perceptions of economic hardship extend beyond their material living conditions and also reflects their social and emotional environment. |
| Keywords: | Child, Poverty, Income, Child well-being, Social comparison, Economic insecurity, Luxembourg, CONDITIONS ECONOMIQUES / ECONOMIC CONDITIONS, DEVELOPPEMENT DE L'ENFANT / CHILD DEVELOPMENT, CONDITIONS DE VIE / LIVING CONDITIONS, LUXEMBOURG / LUXEMBOURG, ENFANT / CHILDREN, PAUVRETE / POVERTY, REVENU / INCOME, BIEN-ETRE / WELL-BEING |
| Date: | 2026 |
| URL: | https://d.repec.org/n?u=RePEc:idg:wpaper:b98y65sb0lquuda1-wse |
| By: | Loebach, Janet; Rahai, Rouzbeh; Natekal, Asiya; Parker, Cory; Kweon, Byoung-Suk; Owens, Patsy Eubanks |
| Abstract: | Economic inequality in the U.S. has risen sharply over the past three decades, overlapping with persistent racial, ethnic, and spatial segregation to produce entrenched neighborhood-level disparities in health. Youth are especially vulnerable to these neighborhood effects, facing disproportionate risks from adverse environmental conditions. This study examines whether neighborhood disadvantage is associated with both increased prevalence of youth health risks and lower provision of green infrastructure across four U.S. cities (Houston, TX; Minneapolis, MN; Prince George’s County, MD; San Francisco, CA). We further test whether green space moderates the relationship between disadvantage and youth health. Census-tract analyses show that neighborhood disadvantage is strongly correlated with higher prevalence of obesity, asthma, and poor mental health among youth. Disadvantaged neighborhoods had significantly less park space and tree canopy cover, and areas with limited green space showed higher risks for all three health concerns. Greater tree canopy was specifically associated with reduced obesity risk. Crucially, interaction analyses revealed that higher proportions of park space substantially weakened the negative effects of disadvantage across all health outcomes. Findings underscore systemic underinvestment in green infrastructure in disadvantaged neighborhoods and highlight the protective potential of urban green space as a public health strategy for vulnerable youth. |
| Date: | 2026–02–03 |
| URL: | https://d.repec.org/n?u=RePEc:osf:socarx:k23z7_v1 |
| By: | Bejarano, Hernan; Busso, Matías; Santos, Juan Francisco |
| Abstract: | We study how individuals in six Latin American countries value public versus private provision of education and healthcare using a survey experiment. Respondents were randomly assigned to vignettes that vary income, service quality, and provider type. Perceived quality is the main driver of choices: the probability of selecting a private provider roughly doubles when public quality falls from 80 to 20 percent, while income has a smaller effect. Higher institutional trust lowers the likelihood of switching to private providers but does not affect willingness to pay once individuals choose private provision. The multi-country design supports external validity and reveals similar behavioral responses across contexts. The results show that improving service quality and rebuilding institutional trust can reduce reliance on private provision. |
| Keywords: | Stated Preferences;willingness to pay;Public versus Private Provision;service quality |
| JEL: | D12 H42 I21 I18 O54 |
| Date: | 2026–01 |
| URL: | https://d.repec.org/n?u=RePEc:idb:brikps:14477 |
| By: | Hubbell, Bryan (Resources for the Future); Krupnick, Alan (Resources for the Future) |
| Abstract: | The Trump administration’s US Environmental Protect Agency (EPA) has decided to stop quantifying and monetizing human health benefits when analyzing the impacts of federal regulations, overturning decades of established and peer-reviewed conventions. Instead, only the costs incurred by companies for complying with a regulation will be quantified when implementing regulatory decisions, leading to an unbalanced assessment of impacts. The EPA’s arguments for not quantifying and monetizing benefits are unsupported and out of step with the best available science and established practice. We provide a point-by-point rebuttal to these arguments and conclude that by failing to include quantified and monetized benefits in economic impact analysis, EPA has chosen to abandon adherence to economic principles, decades of guidance from experts, its own economic analysis guidelines, and guidance from the Office of Management and Budget. |
| Date: | 2026–01–30 |
| URL: | https://d.repec.org/n?u=RePEc:rff:report:rp-26-04 |