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on Health Economics |
| By: | Carolina Caetano; Gregorio S. Caetano; Débora Mazetto; Meghan Skira |
| Abstract: | This paper documents video consumption among school-aged children in the U.S. and explores its impact on human capital development. Video watching is common across all segments of society, yet surprisingly little is known about its developmental consequences. With a bunching identification strategy, we find that an additional hour of daily video consumption has a negative impact on children’s noncognitive skills, with harmful effects on both internalizing behaviors (e.g., depression) and externalizing behaviors (e.g., social difficulties). We find a positive effect on math skills, though the effect on an aggregate measure of cognitive skills is smaller and not statistically significant. These findings are robust and largely stable across most demographics and different ways of measuring skills and video watching. We find evidence that for Hispanic children, video watching has positive effects on both cognitive and noncognitive skills—potentially reflecting its role in supporting cultural assimilation. Interestingly, the marginal effects of video watching remain relatively stable regardless of how much time children spend on the activity, with similar incremental impacts observed among those who watch very little and those who watch for many hours. |
| JEL: | C24 D12 I20 J13 |
| Date: | 2025–11 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:34466 |
| By: | Janet Currie; Lucy G. Hackett; Fernanda Marquez-Padilla |
| Abstract: | Many low and middle-income countries are working to expand health insurance to previously uncovered people by creating health insurance programs intended for low-income people who would otherwise lack insurance coverage. Two concerns have been raised about these programs. First, people may be “crowded out” of private facilities and into public ones, increasing public expense and possibly degrading care through crowding. Second, public insurance could encourage informality by reducing the gap in compensation between formal sector and informal sector workers. We examine these questions in the context of Mexico’s Seguro Popular (SP) using longitudinal administrative data on childbirth. We focus on women with more than one observed birth and ask how SP affects the choice of provider for those whose first observed birth was in a public hospital, a private hospital, or a separate system of hospitals serving formal sector workers. We also look at how SP affects the utilization of care and newborn health. Because SP enrollment is endogenous, we instrument it using the rollout of a second program, SMSXXI, that provided health care for young children and enrolled other family members in SP. We find that the expansion of SMSXXI increased SP coverage of pregnant women. This in turn led to a higher probability of delivering in a public hospital, especially among those who had previously delivered in a private hospital. We find little impact of SP enrollment on the utilization of care or newborn health, with the notable exception that women who previously delivered in a private hospital were more likely to start prenatal care in the first trimester when they switched to SP, indicating a greater willingness to seek preventive care when it is free. |
| JEL: | I13 |
| Date: | 2025–11 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:34465 |
| By: | Vanya Horneff; Raimond Maurer; Olivia S. Mitchell; Julius Odenbreit |
| Abstract: | Nursing home costs in the United States now exceed $100, 000 per year, and government assistance programs such as Medicaid help out only when retirees are largely destitute. Moreover, health shocks driving the need for such care can arise suddenly in old age, are frequently permanent in nature, and can be associated with declining mental and physical abilities. These facts raise the important question of how households can best prepare to finance this final phase of life. Building on past research, we determine how retirees should manage payouts from defined contribution plans to balance trade-offs between consumption and health care cost shocks, using both retirement plan assets and annuitization. Our analysis explicitly integrates the role of taxes, required minimum distributions, bequest motives, and the possibility of retiree insolvency. We conclude that payout annuities, especially deferred and variable annuities, can be quite valuable for retirees, even when they face health shocks in later life. |
| JEL: | D15 G11 G51 G53 |
| Date: | 2025–11 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:34460 |
| By: | Janet Currie; Jessica Van Parys |
| Abstract: | The Low Income Housing Tax Credit (LIHTC) Program is the largest federal affordable housing program in the U.S. Yet, little is known about its impacts on children and families. This paper shows how LIHTC exposure during childhood affects women’s health outcomes in early-adulthood, as well as the health of their infants. Using geocoded Florida Natality data for 1980-2024 and addresses for LIHTC units we study women born to mothers without any college education between 1980-1999. We use a matching model to compare women born into Census tracts that receive LIHTC during their childhoods to women born into Census tracts without LIHTC during their childhoods. These women and their infants are then observed in adulthood when they first give birth in Florida. We find that a standard deviation increase in childhood LIHTC exposure improves the maternal health index and the infant health index by a small but statistically significant 0.007 standard deviations, and improves an index of maternal SES by 0.005 standard deviations. Given that the average treated tract in our sample has only 0.023 LIHTC units per resident, there is considerable room for increasing exposure. LIHTC exposure during childhood improves outcomes the most for Black women, consistent with Black women being more likely to live in LIHTC units, and also more likely to live in Census tracts that receive LIHTC. |
| JEL: | I38 R29 |
| Date: | 2025–11 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:34464 |
| By: | Jesse Bruhn; Jacob Fabian; Luke Gallagher; Matthew Gudgeon; Adam Isen; Aaron R. Phipps |
| Abstract: | We study the causal effect of different early career occupational experiences on labor market outcomes. To do so, we pair over two decades of administrative tax data with internal personnel records from one of the largest employers of young adults in the United States: the US Army. Enlistees work in a diverse and varied set of occupations, including non-combat roles like mechanics, legal services, financial specialists, cooks, dental hygienists, police officers, and network/computer specialists. Occupational eligibility is determined by test score cutoffs which we leverage in a series of 35 regression discontinuity designs. We find that a typical early career occupational experience generates a substantial amount of path dependence, with point estimates that suggest a 19p.p. increase in the likelihood of being observed in an identical or closely related occupation as much as 20 years later. The corresponding impact of different occupations on earnings are highly heterogeneous, yet predictable: long-run changes in the average earnings of the occupations applicants are pushed into, and pulled out-of, can explain over 60% of the causal variation across cutoffs, with point estimates that suggest improvements in occupational earnings premia translate dollar-for-dollar into economic success. Taken together, our results highlight the importance of early career occupational experience as a key channel for promoting long-run well-being among young adults who are not college bound. |
| JEL: | J20 J24 J3 J38 J4 J45 |
| Date: | 2025–11 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:34463 |
| By: | Ersoy, Erkal (Heriot-Watt University, Edinburgh); Karimli, Javid (Heriot-Watt University, Edinburgh); Tealdi, Cristina (Heriot-Watt University, Edinburgh) |
| Abstract: | This paper evaluates the impact of Minimum Unit Pricing (MUP) on alcohol consumption in the UK using a difference-in-differences (DiD) framework, leveraging rich individual-level survey data. We estimate Average Treatment Effects on the Treated (ATET) using both standard and staggered DiD approaches. Although we find no significant change in the share of individuals drinking at least monthly following MUP implementation, we document meaningful reductions in drinking intensity: binge drinking declined by up to 18 percentage points among younger cohorts, and the share of individuals consuming more than two drinks on a typical day also fell significantly. Among those under 25, average weekly alcohol consumption decreased by nearly 34%. These results suggest that while MUP had a limited impact on drinking frequency, it was effective in curbing harmful patterns of alcohol use, particularly among younger individuals. |
| Date: | 2025–11 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp18249 |
| By: | Dan Anderberg; Gloria Moroni; Alexander Vickery |
| Abstract: | We use a dynamic latent factor model to study how exposure to intimate partner violence (IPV) affects young children's accumulation of cognitive and socio-emotional skills. The model allows for both a direct effect of exposure as well as indirect effects via changes in parental investments and mother's mental health. IPV has adverse effects on both skills, with more immediate and larger effects for socio-emotional skills and with the skill deficits growing in exposure duration. The indirect effects dominate for both skills. Early interventions that support parental investment and mother's mental health have potential for offsetting the adverse IPV-effects but only if subsequent IPV exposure is eliminated. |
| Keywords: | intimate partner violence, skill development, mental health, ALSPAC |
| JEL: | J12 J13 J24 |
| Date: | 2025 |
| URL: | https://d.repec.org/n?u=RePEc:ces:ceswps:_12239 |
| By: | Bertrand Gruss; Eric Huang; Andresa Helena Lagerborg; Diaa Noureldin; Galip Kemal Ozhan |
| Abstract: | This paper provides new cross-country evidence on healthy aging—the extent to which populations age in better health across successive birth cohorts—and how this shapes labor market outcomes for older workers. Using harmonized microdata on individuals aged 50 and above in 41 countries over 2000-22, we document that physical, cognitive, and mental health have improved systematically across cohorts. To estimate causal effects, we instrument individual health with chronic disease incidence. Better health increases labor supply along both the extensive and intensive margins and raises labor earnings and labor productivity. The results are economically significant: a decade of cohort health gains in cognitive abilities raised older individuals’ labor force participation by about 20 percentage points, weekly hours by around 6, productivity by roughly 30 percent, and total labor earnings by roughly 35 percent. These results suggest that healthy aging can meaningfully bolster labor supply and productivity among older workers, mitigating demographic headwinds for growth and public finances. |
| Keywords: | Population aging; demographic change; healthy aging; labor markets |
| Date: | 2025–11–07 |
| URL: | https://d.repec.org/n?u=RePEc:imf:imfwpa:2025/229 |
| By: | Marcello Antonini; Joan Costa-i-Font |
| Abstract: | Health status can alter individuals’ social preferences, and specifically individuals' preferences regarding fairness in the access to and financing of health care. If individuals follow a healthy self-interested rationale, health improvements are expected to weaken individuals' support for fairer health care financing and access, as they perceive reduced need for healthcare services. Conversely, if healthier people face a higher opportunity cost of deteriorating health, they may endorse fairer financing and access in anticipation of future health challenges—which we label as the 'unhealthy self-interest' hypothesis. We draw on a dataset of 73, 452 individuals across 22 countries and a novel instrumental variable strategy that exploits variation in health status resulting from cross-country exposure to the national childhood Bacillus Calmette–Guérin (BCG) vaccination schedules. We document causal evidence consistent with the unhealthy self-interest hypothesis, which indicates that better health increases preferences for a fairer health care system. We estimate that a one-unit increase in self-reported health increases support for fair health care access by 11% and the willingness to support fair financing by 8%. Our findings suggest that improving population health, they may give rise to stronger support for interventions to improve equitable health system access and financing. |
| Keywords: | health status, preferences for healthcare financing fairness, willingness to pay, social preferences, BCG vaccine, instrumental variables |
| JEL: | I13 I14 I38 |
| Date: | 2025 |
| URL: | https://d.repec.org/n?u=RePEc:ces:ceswps:_12243 |
| By: | Bernice Hua Ma (Centre for Health Economics, Monash University, Centre for Research Excellence in Disability and Health, Health Economics Group, School of Public Health and Preventive Medicine, Monash University); Samia Badji (Centre for Health Economics, Monash University, Centre for Research Excellence in Disability and Health); Dennis Petrie (Centre for Health Economics, Monash University, Centre for Research Excellence in Disability and Health); Gang Chen (Centre for Health Economics, Monash University, Cancer Health Services Research, University of Melbourne) |
| Abstract: | This study examines the impact of enhanced social care provided through the Australian National Disability Insurance Scheme (NDIS) on subsided healthcare utilisation for people with disability. Using linked administrative datasets from 2011 to 2020, we employed a Difference in Difference model and the staggered rollout of the NDIS to assess its effects on healthcare services, focusing on visits to general practitioners (GP), mental healthcare providers, allied health professionals, specialists, and mental health prescriptions. The results show that the NDIS reduced subsidised mental health services and allied health services in the six quarters after enrolment. However, it did not significantly affect visits to GP, specialists, or mental health prescriptions. These effects were most pronounced among individuals aged 0-24 years, males, and those living in major cities. The findings suggest that services available from NDIS may substitute for subsided healthcare services by providing non-clinical care through social care channels. Further research is needed to investigate the long-term effects and health outcomes of the NDIS. |
| Keywords: | Healthcare, social care, NDIS, disability, mental health |
| JEL: | I11 I18 I38 |
| Date: | 2025–11 |
| URL: | https://d.repec.org/n?u=RePEc:mhe:chemon:2025-19 |
| By: | Luisito Bertinelli (DEM, Université du Luxembourg); Evie Graus (DEM, Université du Luxembourg); Jean-François Maystadt (UC Louvain, B); Silvia Peracchi (UC Louvain, B) |
| Abstract: | This paper examines the causal impact of road access on child health in Sub-Saharan Africa between 1980 and 2012 by combining geolocated data on child anthropometric outcomes with spatial data on road networks. To address endogeneity, we employ an instrumental variable approach based on the inconsequential units framework, constructing hypothetical road networks that connect historical cities and active mines. Our results show that closer proximity to paved roads significantly improves child health. The main mechanisms operate through improved healthcare access and utilization, higher household wealth, early signs of structural transformation, and cropland expansion. We find no evidence that these gains are offset by adverse environmental or epidemiological effects of improved road access. Overall, the findings underscore the role of road infrastructure in fostering development across Sub-Saharan Africa. |
| Keywords: | roads, Sub-Saharan Africa, child health, causal analysis. |
| JEL: | O15 I15 O18 O55 |
| Date: | 2025 |
| URL: | https://d.repec.org/n?u=RePEc:luc:wpaper:25-18 |
| By: | Giovanna Pavlovic Quintão; Luiz Guilherme Scorzafave |
| Abstract: | This study investigates the long-term effects of early-life health on intergenerational mobility in Brazil. Using the first cohort in Brazil, conducted in Ribeirão Preto city in 1978-79, linked to administrative income records, we study the effects of low birth weight on upward mobility and income inequality, conditional on several confounding factors. We find that individuals born with low birth weight have 13.5 percentage point chance to surpass their parents' income by at least 10 percentiles. The penalty for having poor early health remains if we use other measures of early health. |
| Keywords: | Intergenerational Mobility, Health, Children, Income inequality, Education, Inequality and Well-being |
| Date: | 2025 |
| URL: | https://d.repec.org/n?u=RePEc:unu:wpaper:wp-2025-76 |
| By: | Barreto, Yuri (Bocconi University); Britto, Diogo (University of Milan Bicocca); Carrillo, Bladimir (Universidade Federal de Pernambuco); Da Mata, Daniel (São Paulo School of Economics-FGV); Emanuel, Lucas (Universidade Federal de Pernambuco); Sampaio, Breno (Universidade Federal de Pernambuco) |
| Abstract: | Worsening climatic conditions and water scarcity pose major threats to rural livelihoods and to the economic development of arid regions. This paper evaluates a large-scale, low-cost climate adaptation program that built one million rain-fed water storage cisterns in Brazil’s poorest and most drought-prone areas. Using novel individual-level administrative data and a difference-in-differences design, we show that the program substantially improved both economic and health outcomes, benefiting adults and children alike. Within ten years, household dependency on cash transfers fell by up to 34%, while formal labor income increased by 20%. Hospitalizations due to waterborne diseases declined by 16% among adults and 37% among children, and compliance with cash transfer conditionalities on child health and education improved. Additional evidence suggests that these gains were driven by a relaxation of time constraints: cisterns markedly reduced the time burden of water collection, enabling beneficiaries to allocate more time to productive activities. A cost-benefit analysis indicates a high marginal value of public funds relative to a broad range of public policies. |
| Keywords: | water, cisterns, labor market, climate adaptation, health |
| JEL: | Q54 Q25 Q58 J01 |
| Date: | 2025–11 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp18250 |
| By: | Aimable Nsabimana; Michael Kilumelume |
| Abstract: | The COVID-19 pandemic created global job losses and altered work conditions, as government mitigation measures such as lockdowns led many firms to adopt work-from-home practices. This shift had substantial impacts on labour demand and job opportunities. Using unique administrative firm job records from South Africa spanning 2018-22, we investigate the effects of the pandemic on labour demand and job opportunities, and document three main findings. First, the pandemic induced a significant reduction in employment opportunities in South Africa, with notable variations between economic sectors. |
| Keywords: | COVID-19, Pandemic, Unemployment, Working conditions, South Africa |
| Date: | 2025 |
| URL: | https://d.repec.org/n?u=RePEc:unu:wpaper:wp-2025-77 |
| By: | Joan Costa-Font; Nicolo Gatti (Università Cattolica del Sacro Cuore; Dipartimento di Economia e Finanza, Università Cattolica del Sacro Cuore); Gilberto Turati (Università Cattolica del Sacro Cuore; Dipartimento di Economia e Finanza, Università Cattolica del Sacro Cuore); Daniel Wiesen |
| Abstract: | We study the extent to which exposure to COVID-19 has affected the prosociality of healthcare professionals. Drawing on evidence from an incentivized experiment and a companion survey of healthcare professionals (N = 194) at a large Italian hospital, we find that exposure to COVID-19 predicts their altruistic motivation. Healthcare professionals who either worked in COVID-19 wards or had a close relative or friend severely affected by the virus exhibited a higher propensity to prioritize patient welfare over personal gain. Controlling for demographic characteristics and personality traits, our estimates indicate a 5 percentage point increase in prosociality among exposed individuals. Conversely, personally contracting COVID-19 is related to a 6 percentage point decline in prosociality. Our results highlight that experiences of need shape prosocial preferences in hospital settings. |
| Keywords: | COVID-19, provider altruism, healthcare professionals, medical decision-making, prosocial behavior, experiment. |
| JEL: | C91 D64 D81 I12 |
| Date: | 2025–10 |
| URL: | https://d.repec.org/n?u=RePEc:ctc:serie1:def145 |