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on Health Economics |
| By: | Ahammer, Alexander (Department of Economics, Johannes Kepler University Linz, Austria; and Institute for the Study of Labor (IZA)); Halla, Martin (Department of Economics, Vienna University of Economics and Business, Austria; Institute for the Study of Labor (IZA); Austrian National Public Health Institute (GOEG); Rockwool Foundation Berlin; and Austrian Institute of Economic Research (WIFO)); Heckl, Pia (ifo Institute; Ludwig Maximilian University of Munich; and CESifo); Winter-Ebmer, Rudolf (Department of Economics, Johannes Kepler University Linz, Austria; Institute for the Study of Labor (IZA); Institute for Advanced Studies (IHS); Rockwool Foundation Berlin, Centre for Economic Policy Research (CEPR)) |
| Keywords: | Long-term unemployment among older workers is particularly difficult to overcome. We study the impacts of a large-scale job guarantee program that offered up to two years of fully subsidized employment to long-term unemployed individuals aged 50 and above. Using a sharp age-based discontinuity in eligibility, we find that participation increased regular, unsubsidized employment by 43 percentage points two years after the program ended. The gains are driven by transitions into new firms and industries, rather than continued subsidized employment, and we find no evidence of displacement effects for non-participants or spillovers to family members. The program had no measurable short-run health effects. |
| JEL: | J64 J08 J78 I14 H51 |
| Date: | 2026–03 |
| URL: | https://d.repec.org/n?u=RePEc:ihs:ihsdps:number1 |
| By: | Dennis Guignet; Anna Silva |
| Abstract: | We conduct a meta-analysis of hedonic studies examining the effects of potable water contamination on home values. We assess the robustness of the results to alternative weights, test for publication bias, and estimate meta-regressions to assess price effect heterogeneity. We find that the adverse effects on home values are similar across public versus private water sources, and that declines in home values persist for more than 10 years, on average. When contamination is detected the average decrease in home values is about 4-5%; and this effect increases to a 12-13% depreciation when contamination levels exceed regulatory or health-based standards. Key Words: benefit transfer, drinking water, groundwater, hedonic, housing value, property value, meta-analysis |
| JEL: | Q51 Q53 |
| Date: | 2026 |
| URL: | https://d.repec.org/n?u=RePEc:apl:wpaper:26-06 |
| By: | Keiser, David A; Mazumder, Bhashkar; Molitor, David; Shapiro, Joseph S |
| Abstract: | Since the 1974 Safe Drinking Water Act, the U.S. has spent \$2 trillion to provide safe drinking water, yet drinking water for 10--20 percent of Americans violates standards. We study trends, causes, and consequences of U.S. drinking water pollution, using 266 million readings on 1, 250 pollutants over decades that we obtained from 48 states via dozens of Freedom of Information Act and associated requests. We link pollution to administrative Medicare data on older Americans' health outcomes. Three findings emerge. First, U.S. drinking water pollution has declined rapidly; the share of readings exceeding current health standards fell by half from 2003--2019. Unregulated pollutants declined more slowly. Low-income areas have higher pollution; Black and Hispanic communities have more complex patterns. Second, loans provided by the Safe Drinking Water Act to water systems reduce pollution. At the estimated average loan cost-effectiveness, these loans could eliminate pollution above health standards for \$46 annually per person. Third, these loans reduce mortality rates of older Americans. Although fiscal federalism cautions against federal funding of local public goods with few inter-jurisdictional externalities like drinking water, we estimate large benefits from Safe Drinking Water Act loans. |
| Keywords: | Social and Behavioral Sciences, Drinking water, pollution, health |
| Date: | 2026–05–26 |
| URL: | https://d.repec.org/n?u=RePEc:cdl:agrebk:qt4gs6358n |
| By: | Daniel Gallardo-Albarrán (Wageningen University); Kalle Kappner (HU Berlin) |
| Abstract: | European countries paved the way for modern economic growth in the 19th century with large-scale reforms facilitating human capital accumulation. The literature has looked at the role of elites in broad education investments, but less attention has been devoted to reforms promoting workers' health, a key component of human capital. This paper studies the impact of the 1866 cholera outbreak on modern waterworks construction in the German Empire to test the hypothesis whether concerns about workers' health may have compelled elites to invest in health-enhancing public goods. We find that the epidemic raised the annual probability of building waterworks by about 35%. Exogenous variation relying on the cholera-spreading effect of military movements during the Austro-Prussian War in 1866 further underpins this result. Quantitative and qualitative evidence indicates that non-agricultural elites employing more productive capital and better-skilled workers pushed for reform to avoid the costly prospect of future labour shocks. Long-term analyses show sizeable and persisting effects of the epidemic on public health and development outcomes shortly before the First World War. |
| Keywords: | political economy; public goods; sanitation; cholera; elites; |
| JEL: | H41 H54 I18 N33 N93 |
| Date: | 2026–05–19 |
| URL: | https://d.repec.org/n?u=RePEc:rco:dpaper:573 |
| By: | Rafat Mahmood; Pushkar Maitra |
| Abstract: | Natural disasters are a growing global threat, yet their consequences for gender-based violence (GBV) in high-income countries with strong institutional protections remain largely unknown. We address this gap using administrative crime records linked to disaster declarations at the Local Government Area level in Australia. Applying staggered difference-in-differences estimation techniques, we find that disasters cause short-run increase family, domestic and sexual violence with effects concentrated in the first one to three months following a disaster. Strikingly, these effects are larger in urban and affluent areas, an outcome that is difficult to reconcile with a pure economic-stress mechanism, and is more consistent with institutional strain and differential reporting environments. To probe the underlying pathway, we draw on complementary household survey evidence, which points to mental health deterioration and increased intra-household conflict as individual-level mechanisms. Together, our findings suggest that even well-resourced institutional settings offer only incomplete protection against disaster-induced violence against women |
| Keywords: | Natural Disasters, gender based Violence, Event Study, Australia |
| JEL: | Q54 J12 J16 I18 K42 |
| Date: | 2026–05–01 |
| URL: | https://d.repec.org/n?u=RePEc:mos:moswps:paper_1777943539577_709 |
| By: | Noel Del Castillo; Harold Cuffe; Ilan Noy |
| Abstract: | Evidence on the long-run mental health effects of disasters remains limited. This study estimates the causal effects of exposure to extreme weather events (EWEs) on mental health treatment among working-age adults in New Zealand. Unlike much of the existing literature, which focuses on single disasters, short-term outcomes, and self-reported distress, we use longitudinal administrative population data within a staggered difference-in-differences framework to exploit variation in the timing and frequency of exposure across individuals and regions. The analysis distinguishes between moderate and severe mental health conditions and estimates effects on both the probability of receiving treatment and the number of treatment days. We find no statistically significant population-level effects of EWE exposure on treatment of either moderate or severe mental illness. However, subgroup analyses indicate some heterogeneity, particularly among individuals in the lowest income tercile and younger adults for moderate outcomes. Overall, the findings suggest that increases in psychological distress documented in the broader disaster literature do not necessarily translate into broad-based or sustained changes in formal mental health treatment. The study provides new evidence on how climate-related shocks shape realised mental healthcare utilisation over time. |
| Keywords: | mental health, disasters, extreme weather, staggered difference-in-differences, extended two-way fixed effects |
| JEL: | I10 Q54 |
| Date: | 2026 |
| URL: | https://d.repec.org/n?u=RePEc:ces:ceswps:_12705 |
| By: | Omar Martin Fieles-Ahmad; Selina Schulze Spuentrup |
| Abstract: | We study how the diffusion of illicit synthetic opioids affected the supply of deceased organ donors in the United States after 2012. As fentanyl spread rapidly from east to west, it produced sharp, uneven increases in overdose mortality across states. We first study the arrival of fentanyl as a dichotomous shock in a difference-in-differences framework at the organ procurement organization (OPO) level, contrasting regions east and west of the Mississippi River due to drug-market segmentation. We then turn to the intensive margin using a state-level IV approach that leverages the westward diffusion of fentanyl over time, with exposure measured using fentanyl mortality. Both approaches show that fentanyl exposure caused large increases in overdose-driven donor supply and transplanted organs, revealing how a lethal epidemic reshaped the availability of transplantable organs. |
| Keywords: | organ donation, opioids, fentanyl, overdose mortality |
| JEL: | I11 I18 |
| Date: | 2026–05 |
| URL: | https://d.repec.org/n?u=RePEc:mag:wpaper:26011 |
| By: | Mark Bryan (School of Economics, University of Sheffield, Sheffield S10 2TU, UK); Andrew Bryce (School of Economics, University of Sheffield, Sheffield S10 2TU, UK); Jennifer Roberts (School of Economics, University of Sheffield, Sheffield S10 2TU, UK); Cristina Sechel (School of Economics, University of Sheffield, Sheffield S10 2TU, UK) |
| Abstract: | The last decade has seen a significant worsening of health in the UK, driven by an increase in mental health conditions, with a consequent increase in the number of disabled people. At the same time overall employment growth has been strong and the employment rate of disabled people has grown faster than that of non-disabled people. How can we reconcile this apparent paradox of declining health and growing employment? Using detailed observational data for 2014-2022 from a large survey of the UK population we employ counterfactual analysis to explore this puzzle. We present three key findings. First, the rise in the employment rate of disabled people and the narrowing of the disability employment gap (DEG) cannot be attributed to changes in the health of the disabled population. Second, the narrowing of the DEG is predominantly associated with a parallel reduction in the education attainment gap between disabled and non-disabled people. Finally, despite increased employment among disabled people, the growing size of the disabled population has reduced the growth of the overall employment rate. Our work has a number of implications for policy targeted at improving the employment outcomes of disabled people. While the DEG has narrowed, disability prevalence has increased, leading to lower employment rates than would otherwise have prevailed. Hence, there is still a crucial role for the health care sector in improving labour market outcomes and thus overall welfare levels in the UK. Moreover, the interdependence of health and employment status requires joined up health care and labour market policy making. |
| Keywords: | disability, employment, education, mental health, physical health |
| JEL: | I14 J14 J21 J70 |
| Date: | 2026–05 |
| URL: | https://d.repec.org/n?u=RePEc:shf:wpaper:2026004 |
| By: | Bertoli; P.;; Grembi; V.; |
| Abstract: | As COVID-19 pandemic accelerated the digitalization of healthcare, prompting large public investments in the sector, it remains unclear whether the initial shock generated a stable adoption of digital health tools and the full exploitation of their functionalities. Using the case of the Electronic Health Records (EHR) in Italy, we show that a remarkable increase in its use in the aftermath of the pandemic is not necessarily associated to an equal understanding of its scope and functions by potential patients. Exploiting a 2020 reform and variation in pandemic exposure, we show that a one-standard- deviation increase in exposure increased EHR reported use by 39%, driven by records feeding and medical needs. We then leverage a December 2024 national media campaign on the EHR to conduct an original survey focused on its adoption. Among the main evidence is that the acknowledgment of the EHR existence does not translate into effective knowledge, access, or regular use. Engagement is more strongly associated with trust and digital attitudes than with most traditional socio-economic factors. Progress along the adoption chain depends on perceived needs, institutional confidence, and willingness to engage with digital tools. To provide an understanding of how to increase perceived benefits and willingness to engage with the EHR, we randomize information treatments based on the Technology Acceptance Model. Overall, our findings suggest that the effectiveness of large-scale digital health investments depends critically on citizens’ awareness, trust, and engagement, and that more tailored information campaigns are needed to improve the general literacy of digital tools once they are introduced or potentiated. |
| Keywords: | electronic health records; policy knowledge;digital skills; digital health skills; |
| JEL: | H51 H75 I12 |
| Date: | 2026–05 |
| URL: | https://d.repec.org/n?u=RePEc:yor:hectdg:26/06 |
| By: | Diya Abraham (Department of Economics, University of Reading); Ondrej Krcal (Department of Economics, Masaryk University, Brno); Jonathan Stäbler (Department of Economics, Masaryk University, Brno) |
| Abstract: | Primary healthcare systems in many developed countries are under strain, partly due to unrestricted patient demand. In response, policymakers have introduced measures to curb unnecessary GP visits, including (i) instituting a small upfront fee for GP visits, (ii) implementing a self-report based triage system, and (iii) providing more information to patients about their condition before they make an appointment with their GP. We evaluate the effectiveness of these approaches using two online experiments with a representative sample of UK adults. The first experiment involves induced monetary incentives in a laboratory-style study while the second is a health-framed vignette study. We find that while all three interventions are effective in the laboratory study, only the intervention that provides patients with more information about their condition reduces low-priority demand in the vignette study. We discuss implications for policy and for the study of health-related decision-making. |
| Keywords: | health care systems, common pool dilemma, type uncertainty, online experiment |
| JEL: | C90 D23 D91 J53 |
| Date: | 2026–05–26 |
| URL: | https://d.repec.org/n?u=RePEc:rdg:emxxdp:em-dp2026-04 |
| By: | Fabiola Alba-Vivar (Wake Forest University); Eduardo Campillo-Betancourt (CRI Foundation, Boston MA); Jose Luis Flor-Toro (Independent Researcher, Lima Peru) |
| Abstract: | We estimate the causal effect of exclusionary citizenship policies on communicable disease transmission. In 2013, the Dominican Republic's Constitutional Court Ruling 168-13 retroactively revoked citizenship from roughly 10 percent of the population—primarily individuals of Haitian descent—thereby restricting their access to healthcare. Leveraging municipality-level variation in exposure within a difference-in-differences framework as well as individual administrative data, we identify a two-stage dynamic in dengue incidence. In the short run, reported cases decline by 13.5 percent in high-exposure municipalities, consistent with healthcare avoidance among affected populations. This decline reverses after six months, as untreated infections generate spillover transmission to non-Haitian populations, increasing cases by 16.7 percent. Overall, the findings demonstrate that restricting healthcare access through citizenship policy imposes substantial public health costs that extend beyond the targeted population. |
| Keywords: | citizenship; communicable diseases; dengue; Dominican Republic |
| JEL: | I18 J15 F22 I14 O15 C23 |
| Date: | 2026–05–01 |
| URL: | https://d.repec.org/n?u=RePEc:ris:wfuewp:022596 |
| By: | Manon Hämmerli; Ricarda Milstein; Michael Mueller |
| Abstract: | Improving the efficient use of scarce resources is a key priority in many OECD countries to ensure the long-term sustainability of health spending. One option is to address the demand side by incentivising patients’ care-seeking behaviour. In this context, gatekeeping – a policy tool through which general practitioners (GPs) or other primary care physicians control access to specialist care, and cost-sharing – arrangements requiring patients to contribute financially to the cost of care, are two instruments frequently discussed. Both policy tools are widely applied across the OECD and may also pursue objectives beyond improving efficiency. Focusing on the outpatient sector, this Working Paper provides a stocktake of which OECD countries have these policies in place and how they are designed. It also reviews evidence on how these policies affect health care spending, efficiency and health outcomes. This is complemented by six country case studies that describe the implementation of gatekeeping and cost-sharing arrangements in detail and identify factors that can influence their impact on health system performance. These include the availability of GPs, how GPs are incentivised to deliver services, and whether patients can bypass gatekeeping pathways. |
| JEL: | I11 I13 I18 H51 |
| Date: | 2026–05–29 |
| URL: | https://d.repec.org/n?u=RePEc:oec:elsaad:196-en |
| By: | Kate Prickett (Motu Economic and Public Policy Research) |
| Abstract: | Adolescence and young adulthood are sensitive periods for the development of mental distress, and timely support can prevent early signs of distress from escalating. This review examines the effectiveness of early intervention and secondary prevention approaches for supporting the mental health and wellbeing of young people and rangatahi aged 12-24 years, with a particular focus on those experiencing low to moderate distress. The review draws on a structured scan of published and grey literature, identifying 20 evaluation papers covering 16 interventions across therapy-based brief interventions, community-based services, e-therapy, digital tools, and family-integrated approaches. Overall, the evidence suggests that many early intervention and secondary prevention supports, including brief and low-intensity approaches, can reduce distress and improve wellbeing, functioning, and coping. Effects were most consistent for broad outcomes such as distress, wellbeing, and functioning, while findings for anxiety and depressive symptoms were more mixed. Accessibility, youth-friendly delivery, sustained engagement, and co-design with young people emerged as important enablers of effectiveness. Culturally appropriate, co-designed, and Indigenous-led approaches also appear important for improving acceptability and engagement for rangatahi Māori. However, the evidence base remains uneven, with a need for stronger evaluation of what works best, for whom, and under what delivery conditions. |
| Keywords: | Youth mental health; rangatahi Māori; early intervention; secondary prevention; mental distress; wellbeing; digital mental health; e-therapy; co-design; culturally responsive services; Aotearoa New Zealand. |
| JEL: | I10 I12 I18 J13 H51 |
| Date: | 2026–06–02 |
| URL: | https://d.repec.org/n?u=RePEc:mtu:wpaper:26_07 |
| By: | Priscila Radu; Conchi Biurrun; Meindert Boysen; Melanie Whittington; Chris Skedgel |
| Abstract: | In this Whitepaper, we describe different perspectives that can be adopted in Health Technology Assessment (HTA), and some of the advantages and disadvantages of these different perspectives. Drawing a panel session at the 2024 European meeting of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR), including patient, clinical, and health economics representatives, we argue for a broader perspective on costs and outcomes when assessing the value of new treatments, especially when a health condition or its treatment has significant health or economic impacts beyond the patient. In the context of Health Technology Assessment (HTA), perspective refers to the ‘point… |
| JEL: | I1 |
| Date: | 2026–03–03 |
| URL: | https://d.repec.org/n?u=RePEc:ohe:whipap:002528 |
| By: | Sam Large; Joe Trim; Ella Barker; Louis Zanden; Phill O’Neill; Chris Sampson |
| Abstract: | Inflation reshapes the economic landscape in which new treatments are evaluated. Yet cost-effectiveness thresholds tend to remain fixed over time. This report examines how inflation in NHS healthcare costs associated with resource use affects the estimation of incremental costs in health technology assessment (HTA), and what this means for the cost‑effectiveness and commercial viability of new technologies when decision thresholds do not adjust accordingly. Throughout this paper, we distinguish between intervention costs (e.g. the price of treatments) and background NHS costs (i.e. healthcare resource use associated with delivering care related or unrelated to an intervention). Annual publications of NHS unit… |
| JEL: | I1 |
| Date: | 2026–06–04 |
| URL: | https://d.repec.org/n?u=RePEc:ohe:conres:002533 |
| By: | Coll-Black, Sarah; Hamandi, Ali; Beitman, Aaron; Tretyak, Andrey; Arias Salvador, Valeria |
| Abstract: | This working paper explores strategies and interventions that LTC systems in ECA could adopt to strengthen the climate resilience of people with functional limitations and their caregivers. After a short section on methodology and conceptual framing, the paper introduces the IPCC climate risk framework and outlines the main climate hazards projected for ECA, noting their varying frequency and intensity across the region. It then examines how individual vulnerability shapes the impact of these hazards, with a focus on older people and people with disabilities, whose functional limitations and care needs increase their susceptibility. The analysis considers biological and health factors, social circumstances, and structural conditions that heighten vulnerability to both climate shocks and gradual changes such as rising temperatures. The paper then turns to international experience, highlighting approaches from selected OECD countries that have modified their LTC systems or introduced innovations to protect people with care needs—and, in some cases, a broader population of older people and people with disabilities from climate risks. Building on these case studies and a wider literature review, the paper identifies a set of strategies across LTC system functions t hat ECA countries could apply before, during, and after climate hazards to maintain essential care, address emerging needs, and extend support to groups not currently covered. The paper concludes with questions for further research and analysis. |
| Date: | 2025–09–01 |
| URL: | https://d.repec.org/n?u=RePEc:wbk:hdnspu:204708 |
| By: | Payson, Steven; Dwyer, Debra; Payson, Emanuel |
| Abstract: | The Value of a Statistical Life (VSL) serves as the definitive metric for allocative efficiency in Health Economics and Benefit-Cost Analysis (BCA). However, the production and application of VSL estimates have become stratified into four distinct groups-econometric producers, practitioner appliers, scholarly supporters, and scholarly objectors-that largely operate in isolation. This paper argues that this lack of cross-disciplinary discourse has allowed foundational assumptions to persist without adequate scrutiny, compromising the scientific validity of the VSL. This study provides a critical methodological re-evaluation of the hedonic wage models used to derive VSL. The central contribution is a microeconomic examination of labor demand elasticity. Standard VSL regression analyses presume that observed wage differentials between "safe" and "risky" sectors accurately reflect the worker's risk premium. This paper demonstrates, through a partial equilibrium framework, that this equality holds true only under the highly specific condition of perfectly inelastic labor demand. By relaxing this assumption to reflect the reality of elastic labor demand, the analysis shows that observed wage differentials systematically underestimate the true compensation workers require for risk. Furthermore, the paper identifies an "information paradox" in current VSL theory. Standard models assume workers possess perfect knowledge of occupational risks to price them into their wages . Yet, regulatory agencies commission epidemiologists and engineers to identify these same risks, premised on the fact that they are unknown to the layperson. If workers already possessed the knowledge assumed by VSL producers, such expert analysis would be redundant. The analysis also challenges the "job-desperation effect, " where low-income workers with limited bargaining power accept high-risk positions at lower wages. This "missing variable" of risk awareness occasionally results in data showing negative risk premiums that defy economic intuition. The paper further critiques the assumption of risk neutrality, arguing that extrapolating small risk probabilities linearly to a full statistical life creates logical inconsistencies. If preferences were truly linear, individuals would logically accept wagers involving high probabilities of death for proportional monetary gains-a conclusion that contradicts observed human behavior. Additionally, the paper introduces the "Regulatory Indifference Paradox." If standard VSL assumptions were strictly accurate-specifically that wages perfectly compensate for risk-then workers, on average, should be economically indifferent to safety regulations. According to the model, any safety improvement would be offset by an exactly proportional reduction in wages, neutralizing the net benefit to the worker. Finally, the paper addresses the issue of false precision. It argues that the "statistical" label is a semantic shield used to deflect ethical scrutiny regarding life valuation. Moreover, the reliance on calculating the median of widely divergent study results creates an illusion of scientific consensus that masks the unreliability of the underlying estimates. The paper concludes by proposing a framework that integrates insights from behavioral economics to restore scientific integrity to the valuation of life. |
| Keywords: | VSL, Value of a Statistical Life, Cost-Benefit Analysis, Wages, Risk, Health and Safety |
| JEL: | J28 D61 I18 D73 E24 |
| Date: | 2026 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:glodps:1771 |
| By: | Noy, Itay; Heinemann, Alessandra |
| Abstract: | Women around the world face a heavier care burden than men, restricting their participation in the labor force. At the same time, the shortage of quality, accessible, and affordable care services undermines human development and well-being. Limited investment in early childhood care and education reduces children’s learning and future earnings potential. Similarly, inadequate elderly care undermines health, independence, and well-being among older adults. Investing in care is, therefore, important not only for closing gender gaps but also for boosting human capital outcomes. It also makes a compelling economic case for investment, given the care economy’s potential to drive growth and create jobs in the context of ongoing demographic shifts. This note discusses how public works programs (PWPs) may reduce care burden, increase the provision of care services for those in need, and build skills for the care economy. Drawing on examples of World Bank-supported PWPs that provide childcare, the note explores how such programs can be designed and implemented, and what potential benefits and challenges early evidence reveals. |
| Date: | 2025–11–30 |
| URL: | https://d.repec.org/n?u=RePEc:wbk:hdnspu:207143 |
| By: | Priyanshu Pokhrel; Abigail S. Hornstein (Department of Economics, Wesleyan University) |
| Abstract: | In high-inequality states the opportunity cost of delayed fertility do not resonate with youth, undermining the effectiveness of sex education. Teen fertility remains high despite widespread mandates for school-based sex education, perhaps due to heterogeneous topic coverage and variation in classroom implementation. Social inequality affects teens’ need for school-based education and response to the content. Using staggered difference-indifferences estimation that is reversal-robust, we find that teen fertility rises in highinequality states when sex education is required in schools. We conclude that policy design and implementation are distinct dimensions of sex education, and they must be tailored to local social conditions. |
| Keywords: | sex education, teen fertility, inequality, policy mandate, policy implementation |
| JEL: | I18 I12 J13 I14 I28 |
| Date: | 2026–06 |
| URL: | https://d.repec.org/n?u=RePEc:wes:weswpa:2026-008 |
| By: | Aldén, Lina (Department of Economics and Statistics, Linneaus University); Boschini, Anne (Swedish Institute for Social Research (SOFI), Stockholm University); Tallås Ahlzén, Malin (IFAU - Institute for Evaluation of Labour Market and Education Policy) |
| Abstract: | Fathers’ parental leave uptake remains low in many advanced economies despite substantial policy efforts. We study a setting where financial and eligibility barriers are minimal: employed, native-born first-time fathers entitled to generous, non-transferable leave benefits. Using Swedish population register data for 1995–2015, we document three key facts: (i) low uptake follows a persistent U-shaped income gradient, (ii) its determinants vary across the distribution—economic constraints at the bottom and top, workplace norms in the middle—and (iii) these constraints have grown more salient over time. Quota reforms increased uptake on average but did not narrow differences in low uptake between constrained and unconstrained fathers. Using quasi-random sibling-sex composition, we show that exposure to traditional gender-role environments increases the likelihood of low uptake in recent cohorts. The results highlight the limits of financial incentives and point to workplace and household norms as central barriers to equal parental leave participation. |
| Keywords: | Men; parental leave; gender norms; father’s quota |
| JEL: | D13 J13 J16 J18 |
| Date: | 2026–05–12 |
| URL: | https://d.repec.org/n?u=RePEc:hhs:ifauwp:2026_009 |
| By: | Omar Martin Fieles-Ahmad; Selina Schulze Spuentrup |
| Abstract: | We examine the effects of introducing prompted choice on organ donation behavior. Applying a generalized difference-in-differences design, we take advantage of the gradual roll-out of a policy in Italy that integrated the question of organ donation preference into the process of identity card renewal. Our findings show that municipalities prompting the question saw a significant increase in consent registrations, although individuals retained the option to abstain from making a choice. We also provide novel evidence that regions with higher levels of registered consent have higher cadaveric organ donation rates. |
| Keywords: | organ donation, organ donor registry, prompted choice, health policy |
| JEL: | I18 D70 |
| Date: | 2026–05 |
| URL: | https://d.repec.org/n?u=RePEc:mag:wpaper:26010 |
| By: | Magdalena Rath (University of Graz, Austria); Patrick Mellacher (University of Graz, Austria) |
| Abstract: | We develop an agent-based model to study how the Covid-19 pandemic may have affected the distribution of paid and unpaid work in families. The behavior of the agents in our model is informed by theories from psychology and sociology, as well as by economic considerations. We study two channels which were important during the pandemic: changes in time availability, resulting from an increase in unemployment and short-time work, and increased care work, triggered by the closure of kindergartens and schools, among others. Starting from a baseline scenario which is empirically calibrated with Austrian data on time use, we show that, on its own, each channel only exerts marginal post-pandemic effects. In combination, however, the model suggests that these channels promote a small, but significant egalitarian redistribution of paid and unpaid work. Social influence plays a crucial role in these results. A sensitivity analysis suggests that long-run regressive effects would also be possible, but only if the increased time availability fell to a much stronger extent on women, which seems to be empirically implausible. |
| Keywords: | opinion dynamics, gender norms, agent-based model, lockdown, care work |
| JEL: | C63 D13 J16 J22 |
| Date: | 2026–06 |
| URL: | https://d.repec.org/n?u=RePEc:grz:wpaper:2026-09 |