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on Health Economics |
| By: | Joseph J. Doyle Jr.; Natalia Emanuel; Raimundo Eyzaguirre |
| Abstract: | Foster care placement is a far-reaching intervention that can have substantial long-term effects on children and families. Lifetime prevalence estimates are based on synthetic cohort life tables, which rely on a stationarity assumption that age-specific rates are stable over time. This paper uses a birth cohort life table approach for the 2000-2002 cohorts, where data from birth to 18 years allows us to observe lifetime prevalence of foster care placement directly. We find that 5.0% of children born in these cohorts were placed in foster care, including 10% of Black children and 12% of Native American children, with considerable heterogeneity across U.S. states. By comparing both methods, we see that synthetic cohort estimates were 17% higher than birth cohort estimates because placement rates for teenagers were higher at the point of synthetic cohort estimation than during their actual teenage years. We extend synthetic cohort estimates to 2019 and find similar placement rates by sex over time, increasing shares of placements due to neglect and substance abuse, decreasing shares due to child behavioral issues, and an increasing share of placements into kinship foster care. These patterns are similar regardless of the approach. |
| JEL: | H73 J13 |
| Date: | 2025–07 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:34069 |
| By: | Sonia Bhalotra (Department of Economics, University of Warwick); N.Meltem Daysal (Department of Economics, University of Copenhagen); Mircea Trandafir (Rockwool Foundation Research Unit) |
| Abstract: | Mental health disorders tend to emerge in childhood, with half starting by age 14. This makes early intervention important, but treatment rates are low, and antidepressant treatment for children remains controversial since an FDA warning in 2004 that highlighted adverse effects. Linking individuals across Danish administrative registers, we provide some of the first evidence of impacts of antidepressant treatment in childhood on objectively measured mental health indicators and economic outcomes over time, and the first attempt to investigate under- vs overtreatment. Leveraging conditional random assignment of patients to psychiatrists with different prescribing tendencies, we find that treatment during ages 8-15 improves test scores at age 16, particularly in Math, increases enrollment in post-compulsory education at age 18, and that it leads to higher employment and earnings and lower welfare dependence at ages 25–30. We demonstrate, on average, a reduction in suicide attempts, self harm, and hospital visits following AD initiation. The gains to treatment are, in general, larger for low SES children, but they are less likely to be treated. Using a marginal treatment effects framework and Math scores as the focal outcome, we show positive returns to treatment among the untreated. Policy simulations confirm that expanding treatment among low SES children (and boys) generates substantial net benefits, consistent with under-treatment in these groups. Our findings underscore the potential of early mental health treatment to improve longer term economic outcomes and reducing inequality. |
| Keywords: | Antidepressants, mental health, education, test scores, human capital, Denmark, physician leniency, marginal treatment effects |
| JEL: | I11 I12 I18 J13 |
| Date: | 2025–09–08 |
| URL: | https://d.repec.org/n?u=RePEc:kud:kucebi:2509 |
| By: | Lindsay Jacobs; Suphanit Piyapromdee |
| Abstract: | Partial and reverse retirement are two key behaviors characterizing labor force dynamics for individuals at older ages, with half working part-time and over a third leaving and later re-entering the labor force at some point. The high rate of exit and re-entry is especially puzzling when considering the flat and declining wage profiles observed at older ages and uncertainty about future re-employment. Using Health and Retirement Study (HRS) data, we document the timing and prevalence of these behaviors and show that reverse retirees resemble permanent retirees across many observables, but differ notably in reported job stress and polygenic scores linked to stress sensitivity. To understand what drives these behaviors, we develop and estimate a dynamic model of retirement that incorporates uncertainty in wages and health, along with a novel “burnout-recovery†process representing the accumulation and dissipation of work-related stress. The model replicates key patterns in the data, accounting for over two-thirds of reverse retirement and 40 percent of transitions to part-time work—patterns that cannot be explained by health or wealth shocks alone. Our findings suggest that reverse retirement is largely a predictable response to recoverable stress rather than a reaction to shocks. Policy simulations show that part-time subsidies and sabbaticals enhance labor force attachment and welfare by reducing burnout, while eliminating the Retirement Earnings Test raises re-entry but also increases stress exposure. Together, these findings highlight the central role of stress dynamics in shaping retirement behavior and inform the design of policies to support work at older ages. |
| Keywords: | Retirement; Mental Health; Burnout |
| JEL: | J26 I12 |
| Date: | 2025–09 |
| URL: | https://d.repec.org/n?u=RePEc:pui:dpaper:238 |
| By: | Batinti, Alberto; Costa-Font, Joan; Shandar, Vasuprada |
| Abstract: | We study the effect of royal status—a historically rooted legal privilege enjoyed by hereditary monarchs and their families—on human longevity, a proxy of individuals' health capital. We disentangle the effect of royal status that encompassed serving as heads of state, and hence being subject to status, from that of other family members and compare it to their contemporary countrymen. We have constructed and exploited a dataset containing relevant demographic data and specifically the lifespan (age at death) of European royals and their families spanning the past three centuries (1669–2022) from the sixteen European countries. The dataset includes information records of 845 high‐status nobility and alongside monarchs, which we compare to otherwise similar countrymen by adjusting for relevant confounders. We document robust evidence of a statistically significant longevity advantage, showing that monarchs live, on average, 5.2 to 7.1 years longer than both other members of the royal family and the general population of their time. However, while such longevity advantage between royals and the population has narrowed, the advantage of ruling monarchs persists over time. These effects persist despite improvements in population health, and the role of major sociopolitical transformations including the emergence of both liberal democracy and the advent of Constitutional monarchies in Europe. The latter suggests that “power status” ‐ and specifically the so‐called eustress or positive stress ‐ may be driving the longevity advantage of ruling monarchs. |
| Keywords: | royal family; monarchy; life expectancy; health inequality; social determinants of health; healthy lifestyles; universal health insurance; age at death |
| JEL: | I18 N13 P00 |
| Date: | 2025–09–04 |
| URL: | https://d.repec.org/n?u=RePEc:ehl:lserod:128983 |
| By: | Nadja van 't Hoff; Giovanni Mellace; Seetha Menon |
| Abstract: | This paper is the first to provide causal evidence of gender differences in healthcare utilisation to better understand the male-female health-survival paradox, where women live longer but experience worse health outcomes. Using rich Danish administrative healthcare data, we apply a staggered difference-in-differences approach that exploits the randomness in treatment timing to estimate the causal impact of adverse health shocks, such as non-fatal heart attacks or strokes, on healthcare use. Our findings suggest that men consistently use more healthcare than women, highlighting the underlying factors driving gender disparities in health outcomes. These insights contribute to the broader discourse on healthcare equity and inform policy interventions aimed at addressing these imbalances. |
| Date: | 2025–09 |
| URL: | https://d.repec.org/n?u=RePEc:arx:papers:2509.01310 |
| By: | Yang, Tianli (Renmin University of China); Zhao, Zhong (Renmin University of China) |
| Abstract: | This paper examines the impact of Long-Term Care Insurance (LTCI) policy on the development of elderly care enterprises in China. Employing a policy shock and a difference-in-differences design, we find that the implementation of LTCI significantly promotes the the number of new entries and survival rate of elderly care enterprises, particularly for individual businesses, enterprises in the health and social work industry, and those located in eastern regions. Notably, service-only LTCI policy exhibits stronger effect on the development of elderly care enterprises compared to policy combining service and cash benefits. Mechanism analysis suggests that LTCI stimulates market demand for formal elderly care services and increases government expenditures on social security and healthcare, both of which drive the development of elderly care enterprises. We also find that LTCI policy boosts labor demand in the elderly care industry. Overall, our empirical findings suggest that LTCI can help address the shortage of long-term care services and enhance family welfare. |
| Keywords: | elderly care enterprises, long-term care insurance, China |
| JEL: | H55 I28 J14 J26 |
| Date: | 2025–09 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp18104 |
| By: | Valz Gris, Angelica (Università Cattolica del Sacro Cuore, Rome, Italy); Cristiano, Antonio; Di Berardino, Francesco; Giacobini, Erika; Tricomi, Vittoria; Pezzullo, Angelo; Cecchin, Erika; Conti, Valeria; Filippelli, Amelia; Gurrieri, Fiorella |
| Abstract: | Pre-emptive pharmacogenetic (PGx) testing involves identifying genetic variants associated with drug response prior to prescribing medication, with the aim of guiding potential future drug selection or dosing to reduce adverse drug reactions and improve treatment outcomes. Despite decreasing costs and growing feasibility of multi-gene panels, implementation pre-emptive pharmacogenetic testing strategies remains limited across Europe. This study explores the potential impact and barriers to implementation in Italy, combining a review of current evidence with multistage consultations with Italian experts in related fields (pharmacology, laboratory medicine, genetics, clinical care, and public health). Our analysis supports the clinical utility, economic sustainability, and feasibility of pre-emptive PGx testing. However, key barriers persist, including limited real-world data, unclear reimbursement mechanisms, insufficient laboratory and IT infrastructure, poor clinician training, and patient concerns related to privacy and data protection. To address these challenges, we propose strategic actions across six areas: regulatory alignment, research investment, professional training and result interpretation, public awareness and consent, laboratory infrastructure, and IT systems and data governance. |
| Date: | 2025–08–28 |
| URL: | https://d.repec.org/n?u=RePEc:osf:socarx:7vtxp_v1 |
| By: | Bedük, Selçuk (University of Oxford); Yong, Anna |
| Abstract: | While any experience of child poverty can affect life chances, longer exposure is particularly concerning due to its lasting effects on education, health and earnings. This study adopts a life-course perspective, tracking poverty from birth to age 10 for cohorts born in Britain between 1991 and 2017. On average, 17% of children spent at least half of their childhood in poverty. Long-term poverty affected 25% of those born in the early 1990s, markedly declined to 13-14% for cohorts born after the 1997 welfare reforms, and substantially increased again to 23% for children born following the 2013 austerity reforms. Decomposition analysis shows that cross-cohort changes are driven more by shifts in the penalties associated with work and family risk factors than by changes in their prevalence. These shifts in penalties reflect broader changes in redistribution and predistribution. The early decline in long-term poverty was largely due to rising employment and earnings in low-income households, while the post-austerity increase stems mainly from reduced redistribution. For cohorts born in the 2000s, social transfers played a substantial role in containing long-term poverty despite worsening predistribution. Overall, the findings show that long-term childhood poverty remains a significant challenge in Britain and highlight the need for both stronger redistribution and improved predistribution to address it. |
| Date: | 2025–08–26 |
| URL: | https://d.repec.org/n?u=RePEc:osf:socarx:e7pkj_v1 |
| By: | Dietz, Simon; Bodirsky, Benjamin; Crawford, Michael; Kanbur, Ravi; Leip, Debbora; Lord, Steven; Lotze-Campen, Hermann; Popp, Alexander |
| Abstract: | The global food system provides nourishment to most of the world’s eight billion people, generates trillions of dollars of goods and services, and employs more than one billion people. On the other hand, it generates substantial dietary health costs and environmental harms. Policymakers are asking about the overall contribution of the global food system to social welfare and how much larger it might be on a sustainable path. This paper describes our efforts to answer these questions. We couple multiple domain-specific models into a large-scale integrated assessment modelling framework capable of quantifying the outcomes of different food-system scenarios for incomes, health and the environment up to 2050, at a highly disaggregated level. We take these multi-dimensional outcomes and value them using a system of nested utility functions, building on recent work in environmental economics. We find that, relative to current trends, the bundle of measures in a Food System Transformation scenario would provide a large boost to global social welfare equivalent to increasing global GDP by about 7%. Changes in income, environment and health all contribute positively. Measures to change diets are particularly beneficial, although a caveat is that our welfare estimates exclude possible consumer disutility from dietary changes. The results are robust to changes in key utility/damage parameters. |
| Keywords: | global food system; sustainable development; social welfare; integrated assessment modelling; food policy |
| JEL: | Q01 Q18 Q24 Q56 Q57 |
| Date: | 2026–01–31 |
| URL: | https://d.repec.org/n?u=RePEc:ehl:lserod:129161 |
| By: | Bhunia, Soumyajit; Sircar, Debadrita |
| Abstract: | The rise of social media use among adolescents has sparked growing concerns regarding its potential impact on both physical health and academic performance. This paper is trying to explore the intricate relationship between social media scrolling time and two major student developmental outcomes: Quetelet index and Test scores in the Madhyamik (10-th board) examination. Primary data has been collected through a structured questionnaire (Pro-goti) survey administered to 300 students across four administrative blocks in West Bengal. We apply multivariate regression model estimation to account for interdependent educational and health outcomes. Preliminary findings suggest that higher social media use is negatively associated with both well-being and academic performance. The association with Quetelet index, while weaker, is contextually relevant due to the behavioural and lifestyle implications of prolonged screen exposure. Regression results indicates that higher levels of parental education contributing significantly to improved test scores, underscoring the intergenerational transmission of educational advantages. Children from joint families and larger households tend to perform worse, possibly due to divided attention, limited resources, or less conducive study environments. Religious disparities are also evident, with students from the Muslim community recording significantly lower test scores compared to their Hindu counterparts. The results provide valuable early evidence to inform policy discussions around screen time regulation, digital education literacy, and school-based behavioural interventions. |
| Keywords: | Screen time, Quetelet index, Test scores, OLS |
| JEL: | C50 I0 I1 I10 O1 O10 O2 |
| Date: | 2025–05–06 |
| URL: | https://d.repec.org/n?u=RePEc:pra:mprapa:125842 |
| By: | Halleröd, Björn; Ekbrand, Hans; Zhang, Mary |
| Abstract: | The risk of experiencing intimate partner violence (IPV) is closely tied to attitudes justifying IPV at individual, couple and societal levels. We analysed how women’s IPV risk varies with their own and their spouse’s attitudes, local community acceptance and country-level gender equality. Using data from 148, 421 couples across 30 low- and middle-income countries and 34 Indian states, we estimated Bayesian regression models via Markov Chain Monte Carlo with uninformative priors. IPV justification and IPV experience varied significantly across and within countries. Women’s risk was more strongly associated with their own attitudes than with their husbands’ attitudes. Community-level justification independently increased risk, while higher country-level gender equality was linked to lower IPV exposures. The association between neighbourhood norms and women’s risk was moderated by spousal attitudes, with the association strongest among couples in which neither partner justified IPV. Country-level gender equality consistently reduced women’s risk regardless of couples’ attitudes. These findings suggest that focusing solely on couples where husbands perpetrate IPV is insufficient. Sustainable prevention efforts must also address community norms and structural gender inequality. |
| Date: | 2025–09–11 |
| URL: | https://d.repec.org/n?u=RePEc:osf:socarx:47sa6_v1 |
| By: | Poole, Lucy Margaret (University of Southern Denmark, DaCHE - Danish Centre for Health Economics); Oxholm, Anne Sophie (University of Southern Denmark, DaCHE - Danish Centre for Health Economics); Jensen, Ulrich Thy (Arizona State University); Jacobsen, Christian Bøtcher (Aarhus University, Department of Political Science); Pedersen, Line Bjørnskov (University of Southern Denmark, DaCHE - Danish Centre for Health Economics) |
| Abstract: | Many healthcare systems struggle with recruitment and retention of physicians for specific specialities or in certain locations. One solution may be to design policies that appeal to their work motivations. Recent studies show that physicians’ motivations vary and also link with their behaviour. However, little is known about whether physicians’ motivations are stable over time. We exploit a major shock to physicians’ working conditions to investigate stability in their motivations. Using unique survey data on a balanced panel of 448 general practitioners (GPs) in Denmark, this study examines GPs’ motivations before, during, and after the COVID-19 pandemic. We examine GPs’ intrinsic motivation, extrinsic motivation, user orientation, and public service motivation to capture both their self-centred and pro-social motivations. A series of fixed effects and quantile regression models show that each type of motivation follows a distinct pattern with regards to the timing and direction of changes during the study period. However, across all motivations the magnitude of these changes appears small. Subgroup analyses suggest that older GPs and male GPs exhibit higher stability in some motivations, and that practice and area characteristics do not affect motivation trends. Our results support that physicians’ motivations are fairly stable overall and thereby may serve as useful inputs to policy design. Policymakers can thus better align the goals of the healthcare system with those of its workers, serving to promote a more sustainable and productive healthcare workforce. |
| Keywords: | Physicians; motivation; intertemporal stability; pandemic; general practice; Denmark |
| JEL: | I10 I12 |
| Date: | 2025–06–12 |
| URL: | https://d.repec.org/n?u=RePEc:hhs:sduhec:2025_001 |
| By: | Artz, Benjamin (University of Wisconsin, Oshkosh); Siemers, Sarinda (University of Wisconsin, Oshkosh); Li, Tianfang (University of Kentucky) |
| Abstract: | This study explores preferences for work-from-home (WFH) among U.S. wage and salaried workers in the post-COVID era with a focus on gender and managerial heterogeneity. Using data from the Survey of Working Arrangements and Attitudes collected between April 2023 and January 2024, we analyze how demographic and work-related factors influence WFH preferences. Our findings reveal that women generally express a stronger preference for WFH than men. However, a nuanced picture emerges for female managers, particularly those aged 40 and older, who prefer fewer WFH days compared to non-manager women. Furthermore, we find that higher education, the presence of children, higher incomes, and racial minority groups (specifically Black and Hispanic individuals) are positively associated with a greater desire for WFH. These findings underscore the complex interplay among individual circumstances, the pursuit of work-life balance, leadership approaches, and persistent gender norms within households and workplaces that shape WFH preferences. Understanding these factors is crucial for organizations to design inclusive workplace policies and cultures that benefit both employees and the organization. |
| Keywords: | work from home preferences, remote work, work from home, attitudes toward working from home |
| JEL: | J16 |
| Date: | 2025–08 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp18089 |
| By: | Kelly, Elish (ESRI, Dublin); Maitre, Bertrand (ESRI, Dublin) |
| Abstract: | The COVID-19 health pandemic had a profound impact on labour markets worldwide, disproportionately affecting subgroups of the population, including individuals with disabilities. Despite extensive research on the broader impacts of the pandemic, there remains a notable gap in the literature concerning the labour market impact of COVID-19 on people with disabilities. This paper attempts to fill this gap for Ireland by examining the impact of the pandemic on disabled peoples’ unemployment status. The paper finds that individuals with disabilities were 2.7 percentage points more likely to be unemployed during the pandemic compared to those without disabilities. Even in 2023, people with disabilities remained more likely to be unemployed. However, our year interaction models revealed that the impact of disabilities on unemployment risk remained largely stable during and after the pandemic. |
| Keywords: | Unemployment Risk, Disabilities, COVID-19, Ireland, OLS |
| JEL: | J01 J14 J18 J64 J68 |
| Date: | 2025–08 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp18088 |