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on Health Economics |
| By: | Manasi Deshpande; Maxwell Kellogg; Magne Mogstad; Kuan-Ju Tseng |
| Abstract: | After substantial growth in the 1990s and 2000s, enrollment in the U.S. Social Security Disability Insurance (SSDI) program has been declining since 2013. We use detailed administrative data to quantify the contributions of various factors to trends in SSDI enrollment, focusing especially on the decline in the 2010s. A statistical decomposition suggests that the vast majority of the decline in SSDI enrollment since 2013 is attributable to declines in application rates—and, to a lesser extent, award rates—within demographic groups. There is very little contribution from changes over time in demographic characteristics, eligibility, or exit from SSDI. The decline in SSDI enrollment rates is disproportionately driven by low-to-middle-skilled men who, over time, have become less likely to apply for SSDI and more likely to work. Consistent with this descriptive evidence, we present results from a causal analysis suggesting that improved labor market opportunity for less-skilled men is a key explanation for the decline in SSDI enrollment. We also investigate several other popular hypotheses for the decline in SSDI applications, including lower award rates at the appeals level, and find evidence at odds with them. |
| JEL: | I30 J14 J2 |
| Date: | 2026–06 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:35300 |
| By: | Caitlin K. Myers; Ezekiel Hooper |
| Abstract: | The U.S. general fertility rate has fallen by 22% since 2007, a sustained decline not readily explained by economic conditions, contraceptive use, housing or childcare costs, or other commonly cited factors. We assess the potential role of a different shock: the diffusion of the smartphone. The U.S. rollout of the iPhone, the first modern smartphone, provides a natural experiment: from June 2007 through February 2011, the device was sold only on AT&T, allowing us to identify its effect from variation in AT&T’s mobile broadband coverage. Entropy-balanced Poisson and synthetic difference-in-differences event studies imply that access to the iPhone reduced births by 4.5–8.0% at ages 15–19 and 3.2–6.6% at ages 20–24, with statistically significant but smaller declines among older cohorts. Placebo analyses applied to Verizon and Sprint’s pre-2011 coverage footprint are null. Taken together, these cohort effects imply that the diffusion of the iPhone deepened the decline in births among women under 30 while suppressing the rise in births among older women. Overall, the diffusion of the iPhone explains 33–52% of the decline in the general fertility rate among women aged 15–44. National-survey evidence on time use and sexual behavior is consistent with the iPhone reducing in-person interactions, increasing pornography use, and reducing sexual frequency. |
| JEL: | J13 J18 O33 |
| Date: | 2026–06 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:35310 |
| By: | Jakob Moeller (Vienna University of Economics and Business, Austria); Martin Halla (Vienna University of Economics and Business (WU); Institute for the Study of Labor (IZA) at LISER; Rockwool Foundation, Berlin; Austrian Institute of Economic Research (WIFO), Vienna); Tobias Thomas (Austrian Institute of Economic Research (WIFO), Vienna; Graz Schumpeter Centre (GSC), University of Graz; Duesseldorf Institute for Competition Economics (DICE), Heinrich-Heine-University) |
| Abstract: | We study the effect of pre-booked COVID-19 vaccination appointments using a nationwide campaign in Austria. Leveraging administrative microdata on more than 450000 initially unvaccinated adults, we exploit cross-state variation in program participation and staggered appointment timing in a difference-in-differences design. Pre-booked appointments increase vaccination on the appointment day by 0.8 percentage points (8 per 1000), with no evidence of intertemporal substitution. Effects are larger for socio-economically disadvantaged individuals and substantially weaker in areas with stronger vaccine skepticism. The findings suggest that behavioral interventions are effective when low uptake reflects frictions, but have limited impact when driven by entrenched skepticism. |
| Keywords: | Behavioral public policy, behavioral frictions, vaccine hesitancy, nudges, pre-booked appointments, COVID-19, administrative data |
| JEL: | I12 D91 H51 C21 D83 |
| Date: | 2026–06 |
| URL: | https://d.repec.org/n?u=RePEc:grz:wpaper:2026-10 |
| By: | Pol Campos Mercade (Department of Economics, Lund University); Armando N. Meier (Faculty of Business and Economics, University of Basel); Stephan Meier (Columbia Business School, Columbia University); Devin G. Pope (Booth School of Business, University of Chicago); Florian H. Schneider (Department of Economics, University of Copenhagen); Erik Wengstroem (Department of Economics, Lund University) |
| Abstract: | Can monetary incentives improve health behaviors in the long run, and do commonly used surrogate outcomes capture these effects? We study these questions in the context of vaccination using a large-scale eld experiment. The experiment combines commonly used surrogates|vaccination intentions, intermediate behavioral proxies, and short-run vaccination|with long-run administrative vaccination records. We first document that incentives increase vaccination rates in the long run: guaranteed $20 incentives raise COVID-19 booster uptake by 9 percentage points. Lottery-based incentives also increase long-run uptake, while prosocial incentives primarily accelerate vaccination. Second, using surrogacy methods, we study whether surrogates can predict long-run impacts. Although the surrogates are strongly correlated with eventual vaccination, the assumptions required for surrogacy methods are often violated, and they do not accurately predict long-run impacts. Our ndings highlight both the ability of incentives to change behavior and the importance of measuring long-run outcomes rather than relying solely on surrogates. |
| Keywords: | incentives, health behavior, vaccination, surrogates |
| JEL: | C93 D01 D62 I12 I18 |
| Date: | 2026–06–09 |
| URL: | https://d.repec.org/n?u=RePEc:kud:kucebi:2613 |
| By: | Karadja, Mounir (Uppsala University); Khan, Akib (House of Sustainable Society (HoSS)); Martén, Linna (Stockholm University) |
| Abstract: | We study how expatriates cope when conflict breaks out in their homeland. Using Russia’s 2022 invasion of Ukraine as a natural experiment, we identify causal effects using a matched difference-in-differences design, comparing incumbent Ukrainian migrants in Sweden to matched migrants from other countries. We show that Ukrainian expatriates experience immediate and persistent mental health deterioration—a 30 percent increase in psychiatric prescription use that remains elevated three years later—while simultaneously increasing employment and earnings. A simple framework rationalizes this pattern through two channels operating in opposite directions: concern for family safety worsens mental health and raises the disutility of work, while heightened financial responsibilities raise the return to earning income. Consistent with reduced reservation wages, Ukrainians take on secondary jobs, exit unemployment faster into lower-quality jobs, and earn less than comparable coworkers. Earnings effects concentrate among migrants from more war-exposed regions, while mental health effects attenuate in Swedish municipalities with more Ukrainian refugee arrivals. Results replicate in European and US survey data. As global migration and armed conflict both reach historic highs, the findings show that the welfare costs of war extend across borders, shaping the well-being and economic behavior of expatriates worldwide. |
| Keywords: | Migration; Armed conflict; Mental health; Labor supply; Earnings; Refugees; Diaspora populations; Natural experiments |
| JEL: | D74 F22 I12 J61 O15 |
| Date: | 2026–06–02 |
| URL: | https://d.repec.org/n?u=RePEc:hhs:hamisu:2026_002 |
| By: | Oparina, Ekaterina (London School of Economics); Clark, Andrew (Paris School of Economics); Layard, Richard (London School of Economics) |
| Abstract: | We use Gallup World Poll data from over 150 countries from 2009-2019 at both the individual and country levels to revisit the relationship between income and subjective wellbeing. Our inspiration is the paradox first proposed by Easterlin (1974), where higher incomes are associated with greater happiness in cross-sections, yet rising country GDP per head does not necessarily increase its average wellbeing. In our analysis subjective wellbeing (or happiness) is measured by the Cantril ladder on a 0-10 scale. Across individuals, other things equal, one unit of log income raises subjective wellbeing by 0.4 points. In other words, doubling income raises wellbeing by 0.3 points out of 10. Across countries, a crude regression of wellbeing on log per capita income gives a higher coefficient of 0.6. But, once social variables like health and social support are introduced, the picture changes. In rich countries, income no longer has a significant independent effect, either in country cross-sections or in time series. For low-income countries the result is also clear cut – income raises happiness in both cross-section and time series, whether the social variables are controlled for or not. For middle-income countries the result is mixed. |
| Keywords: | subjective wellbeing, income, GDP, Easterlin Paradox, public goods |
| JEL: | E01 H24 H41 I14 I31 O10 |
| Date: | 2026–05 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp18662 |
| By: | Liran Einav; Amy Finkelstein; Yunan Ji; Neale Mahoney; Gideon Moore |
| Abstract: | How much fraud is there in Medicare and who commits it? We provide an answer for Medicare home health, a setting widely considered especially rife with fraud. We define a home health agency (HHA) as fraudulent if it was prosecuted by a federal strike force. Combining Medicare claims data on all HHAs with hand-collected prosecution records from the nine federal judicial districts where strike forces operated between 2009 and 2013, we train a machine learning model to predict, out of sample, the probability that each HHA in the remaining 85 districts would have been prosecuted had a strike force been present. We estimate that in 2008, 3.4% of Medicare home health spending — about $520 million — was billed by fraudulent HHAs. The strike forces were well-targeted: their nine districts contained only 40% of home health spending but 65% of fraudulent spending. Fraudulent HHAs display intuitive characteristics: they are more likely to rely on extremely high-volume referring physicians, to exhibit unusually uniform patterns of care, and to serve healthier-than-average patients. |
| JEL: | H51 I13 K40 |
| Date: | 2026–05 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:35280 |
| By: | Ha Trong Nguyen |
| Abstract: | This study is the first to use population-wide birth registration data spanning 18 years, linked to Census records, to examine the relationship between a comprehensive set of socioeconomic factors and the birth weight of more than 1.2 million children in Australia, both at the mean and across the distribution. Employing some of the most rigorous empirical approaches in the literature, including mother fixed-effects models, the study reports five main findings, several of which offer new insights for the literature. First, both maternal and paternal education are positively associated with children's birth weight, with stronger associations observed for maternal education and at the lower end of the birth weight distribution. Second, parental income exhibits a positive but non-linear association with birth weight, with larger effects among lower-birth-weight children. Third, relative to children living in rental housing, those born into families with mortgaged homes have higher average birth weights, whereas those born into families that own their homes outright have lower average birth weights. However, children from home-owning families exhibit higher birth weights at the lower end of the distribution but lower birth weights at the upper end. Fourth, more favourable local socioeconomic conditions are positively but non-linearly associated with birth weight, with stronger associations at the lower end of the distribution. Fifth, children born to mothers who migrated from low- or middle-income countries have lower birth weights than those born to mothers from high-income countries. |
| Keywords: | Birth Weight, Neonatal Health, Education, Socioeconomic Status, Administrative Data, Census |
| JEL: | I14 I26 J13 J15 R23 |
| Date: | 2026 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:glodps:1765 |
| By: | J. Felipe Montano-Campos; Bryan Tysinger; Dana Goldman; Darius N. Lakdawalla |
| Abstract: | GLP-1 therapies for obesity promise substantial health improvements, but little is known about how their benefits vary across socioeconomic and demographic groups. Using a nationally representative microsimulation model of US adults and Shapely-value decomposition, we estimate the lifetime health and economic benefits of GLP-1 treatment and examine how those gains vary across individuals. The largest differences emerge across education. Individuals with less than a high school education experience experience roughly 14% higher gains in lifetime net social value, 16-17% larger improvements in discounted generalized risk- and severity-adjusted life-years (GRASA-QALYs), and 20% greater increases in life expectancy relative to the cohort mean, whereas individuals with college degrees experience gains 15-27% below the mean across these outcomes. Black and Hispanic individuals also tend to experience larger improvements in health outcomes and social value than White individuals, including larger gains in GRASA-QALYs and life expectancy and larger reductions in diabetes risk and duration. Females likewise experience larger predicted treatment gains than men. These patterns are consistent with the idea that the largest gains arise among populations facing greater socioeconomic constraints in sustaining behavioral weight control. GLP-1 innovation may therefore mitigate inequality in obesity-related disease and survival, advancing equity in population health. |
| JEL: | C63 D63 I12 I14 I18 O33 |
| Date: | 2026–06 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:35296 |
| By: | Lordan, Grace; Mcguire, Alistair |
| Abstract: | Through a cluster randomised field trial, we evaluate the impact of an evidence-based, soft skills curriculum aimed at adolescents, referred to as Healthy Minds, that ran in 35 high schools in England over four years (2013/14 – 2017/18). We find supportive evidence that Healthy Minds positively augments the primary outcome of self-reported physical health in the treated adolescents. Treated pupils have global health attainment that is 0.235 standard deviations higher than children in the control group, resulting in a 10-percentile increase in their measured health status. We also find evidence of positive impacts on behaviour. There is no evidence of impacts on improved emotional wellbeing. We note significant gender differences in the effects found, strongly favouring boys. Overall, we provide strong evidence that a designed, taught life skills curriculum can improve related outcomes during the adolescent years, and that differential learning styles across visible aspects of diversity are worthy of consideration Healthy Minds. |
| Keywords: | health; soft skills; high school curriculum; adolescent education |
| JEL: | I18 I20 |
| Date: | 2026–05–22 |
| URL: | https://d.repec.org/n?u=RePEc:ehl:lserod:128806 |
| By: | Majlesi, Kaveh (Monash University, Lund University, IZA and CEPR); Molin, Elin (Lund University, UCFS, CED and KWC); Roth, Paula (Stockholm School of Economics, UCFS and IFN) |
| Abstract: | We study how fatal and nonfatal health shocks affect households’ ability to meet their financial obligations. We find that fatal shocks substantially increase the likelihood of default and that housing wealth plays a key role as a self-insurance mechanism. Surviving spouses who experience the largest income losses are more likely to sell their homes, and those without housing wealth face a sharply higher risk of debt collection. In the most financially vulnerable families, these shocks even generate intergenerational spillovers. In contrast, nonfatal health shocks lead to only modest increases in default risk. Taken together, our findings suggest that strengthening survivors’ benefits for households with limited resources could improve welfare across generations. |
| Keywords: | Financial Distress; Health shocks; Household Debt; Household Saving; Intergenerational Transmission |
| JEL: | D14 G22 G51 I12 |
| Date: | 2026–01–01 |
| URL: | https://d.repec.org/n?u=RePEc:hhs:ifauwp:2026_011 |
| By: | Manasvini Singh |
| Abstract: | How harmful is stigma in the “real world”? Answers are elusive because stigma is difficult to measure in observational data, and isolating its effects requires exogenous variation in stigma without variation in the stigmatized trait. This study addresses these challenges by focusing on a widespread form of stigma — weight stigma — in the high-stakes setting of inpatient healthcare. BMI categories are displayed prominently to providers in electronic medical records, and obesity is heavily stigmatized socially. Thus, at the "obese" cutoff, stigma may shift discretely while the underlying trait (BMI) does not. Using a regression discontinuity design that exploits this institutional feature, I find a discontinuous increase in in-hospital mortality at this cutoff, though patient health does not change. Two patterns suggest stigma-based discrimination as the mechanism. First, just-obese patients receive less diagnostic effort than almost-obese patients. Second, a physician-validated LLM identifies at the cutoff a rise in stigmatizing language in clinical notes — specifically, language that imposes moral judgment, undermines patient credibility, and stereotypes patients — among the most stigmatizing providers, who also drive the mortality result. Overall, these results suggest that stigma is a powerful social force with potentially life-or-death consequences. |
| JEL: | D91 I11 I14 |
| Date: | 2026–05 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:35277 |
| By: | Kikken, Max (Maastricht University); Künn, Steffen (Maastricht University) |
| Abstract: | This paper studies how short-term variations in fine particulate matter (PM2.5) pollution affects cognitive performance across tasks of varying complexity. While prior work shows that pollution impairs performance in highly demanding cognitive settings, it remains unclear whether these effects extend to simpler tasks. We examine this question using data from official Rubik’s Cube tournaments in the United States and India. Solving different cube sizes provides a natural proxy for task complexity, while solving time measures cognitive performance. To identify causal effects, we exploit exogenous variation in local PM2.5 generated by wind direction. We find that PM2.5 pollution has negligible effects on simple tasks but significantly slows performance on complex ones for tournaments in the United States. In India, where baseline PM2.5 levels are substantially higher, we find similar effect patterns but none of the effects are statistically significant. We show that this pattern is explained by diminishing marginal sensitivity to short-term PM2.5 shocks as baseline PM2.5 pollution levels increase. Our findings provide causal evidence that the cognitive costs of PM2.5 pollution depend critically on task complexity. |
| Keywords: | cognitive performance, air pollution, task complexity |
| JEL: | D64 D91 Z13 P16 |
| Date: | 2026–05 |
| URL: | https://d.repec.org/n?u=RePEc:iza:izadps:dp18656 |
| By: | Giovanni Mellace; Rok Spruk |
| Abstract: | We estimate long-run effects of Cuba's 1961 National Health Service and contemporaneous National Literacy Campaign using synthetic-control methods on newly assembled series for 21 former European colonies in the Americas, 1900--2022. Relative to synthetic Cuba, infant mortality falls 15--29 percent and average years of schooling rise 1.5--2 years; both effects are large, persistent, and robust to augmented SCM, synthetic difference-in-differences, interactive fixed effects, and matrix completion. Life-expectancy gains attenuate after 1990, consistent with the post-Soviet Special Period, suggesting that bundled health and literacy reforms permanently raise early-life survival and human capital, with smaller and less robust effects on adult longevity. |
| Date: | 2026–05 |
| URL: | https://d.repec.org/n?u=RePEc:arx:papers:2605.29785 |
| By: | Chen, Hua; Yuan, Zizhen; Zhang, Zheyuan |
| Abstract: | This paper provides novel evidence on how public disclosure of air pollution information affects private health insurance demand. Exploring the staggered rollout of China's real-time air pollution monitoring and disclosure program as a quasi-natural experiment, we combine household-level survey data with satellite-based pollution measures and estimate a difference-in-differences model. We find that when pollution information becomes publicly available, higher pollution levels significantly increase the likelihood of purchasing private health insurance. A one-unit increase in aerosol optical depth raises insurance coverage by about 2.2 percentage points, an economically meaningful effect given the low baseline coverage rate. The effect is robust to alternative specifications, individual fixed effects, and placebo tests. Mechanism analyses show that the response is driven by heightened pollution risk perception and health concerns rather than income or labor supply effects. The effect is stronger among more risk-averse, less educated individuals and those with lower trust in insurance. The results highlight the role of external information in shaping financial behavior and health risk management decisions. |
| Keywords: | Environmental information, Financial decisions, Private health insurance, Risk perception |
| JEL: | I13 Q53 I18 |
| Date: | 2026 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:glodps:1767 |
| By: | Sevin Kaytan; Stwarth Piedra-Bonilla; Tom Zohar |
| Abstract: | We investigate how information frictions affect the efficacy of contraception provision programs. We study a Costa Rican initiative that combined free access to long-acting reversible contraceptives and a tailored information campaign to correct for baseline misinformation. Using administrative data and geographic variation in the initiative, we find a 16% decrease in the teen birth rate. We show information complements access – an extra year of exposure to the information campaign is equivalent to the effect of contraception access alone. Using surveys on sexual behavior, we show the policy changed the information source from personal networks to healthcare professionals, amending misinformation on sexual health. |
| Keywords: | teen pregnancy, long-acting reversible contraceptives, information frictions, information campaigns, Costa Rica, contraception access, fertility |
| JEL: | I18 J13 O15 I12 |
| Date: | 2026 |
| URL: | https://d.repec.org/n?u=RePEc:ces:ceswps:_12687 |
| By: | Marques, Renan; Maciel, Mateus; Zuchowski, David |
| Abstract: | We study how Venezuelan refugee inflows affect healthcare outcomes and municipal public finances in Brazil's universal, decentralized public healthcare system. For identification, we exploit cross-municipality variation in refugee exposure and use distance to Brazil's only official border crossing with Venezuela as an instrument. A one-percentage-point increase in the local refugee share raises overall mortality by 4.2 percent and infant mortality by up to 9 percent. We show these effects operate through both the poorer baseline health of arriving refugees and congestion in local health facilities. Municipalities increase the share of spending on healthcare, but absent compensating federal transfers, they do so at the expense of education's budget share. These results highlight the limits of decentralized service provision in absorbing the health and fiscal costs of concentrated migration shocks. |
| Keywords: | Forced migration, refugees, public health, Brazil |
| JEL: | H41 H51 H72 I18 O15 |
| Date: | 2025–05 |
| URL: | https://d.repec.org/n?u=RePEc:pra:mprapa:128976 |
| By: | Anuj Gangopadhyaya; Robert Kaestner |
| Abstract: | One way to measure the efficiency of the Affordable Care Act (ACA) is the extent to which gains in publicly supported health insurance reduced uninsured rates. Using data from the 2008–2024 American Community Survey, we examine time trends in rates of uninsured, public insurance coverage, and employer-sponsored insurance (ESI) by groups defined by the ratio of income to the Federal Poverty Line (FPL). We obtain estimates of associations between changes in public coverage and changes in uninsured and ESI exploiting state-by-year variation in ACA implementation. Importantly, we estimate the total effect of the ACA—including both the Medicaid expansion and Marketplace coverage—on uninsured and ESI rates. For adults in households below 150% of the federal poverty level (FPL), increases in public insurance coverage were associated with one-for-one decrease in uninsured and no change in ESI. For adults with incomes between 151%–400% FPL, each percentage point increase in public coverage was associated with about a 0.6 percentage point decrease in uninsured and a 0.4 decrease, or crowd out, in ESI. Crowd-out was larger among groups with higher pre-ACA ESI rates such as parents and married adults. Using variation from the Medicaid expansion alone to evaluate the ACA’s effect on ESI leads to overstating crowd-out among low-income adults (below 150% FPL) and understating crowd-out among higher-income adults (above 250% FPL). Our findings suggest that policies intended to subsidize health insurance of higher income groups, for example, the enhanced premium subsidies, are far less efficient than policies intended to further expand public insurance to low-income groups, for example, in non-expansion states. |
| JEL: | I11 I13 |
| Date: | 2026–05 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:35263 |
| By: | Ji, Zihao; Zhang, Hongru |
| Abstract: | When do labor-market shocks become lasting health inequality? We develop and estimate a continuous-time lifecycle model of wealth, health, and skill in which medical care combines smooth maintenance with threshold-crossing repair. Adverse wage shocks push financially fragile households toward subsistence, increase toxic labor effort, delay repair, and convert temporary earnings losses into persistent biological damage. Estimated with PSID, MEPS, and RAND HRS data, the model shows that skill-biased technical change generates concentrated lower-tail losses in health, survival, and welfare. A meaningful share of this damage reflects endogenous repair failure, and the mechanism remains visible in a parsimonious general-equilibrium environment. |
| Keywords: | Life-Cycle Model, Continuous Time, Health Capital, Lifetime Inequality, Deaths of Despair, Overwork, Skill-Biased Technical Change |
| JEL: | E21 I14 I24 J22 J24 |
| Date: | 2026–03–31 |
| URL: | https://d.repec.org/n?u=RePEc:pra:mprapa:128530 |
| By: | Lena Harris; Eric C. Edwards; Danae Hernandez-Cortes |
| Abstract: | Air pollution from natural sources is often subject to less regulatory oversight, but can still be caused by human activities. Understanding the role for policy requires quantifying the source's pollution contribution, for which there is currently no standard methodological approach. This paper uses the context of the shrinking Great Salt Lake in Utah to model air quality impacts of the highly erodible and growing area of exposed lakebed. Using four common identification strategies in the air pollution literature, and three alternative pollution measurement technologies, we find consistent evidence of meaningful pollution increases attributable to the shrinking lake in non-winter months. Estimates are relatively invariant to measurement technology but vary across identification strategies. Marginal annual costs range from $81 to $175 million per 100 km² of exposed lakebed. Scaling to the area of total exposed lakebed, annual desiccation-related health cost estimates range from $1.1 billion to $2.3 billion. Given the direct relationship between human water use in the basin and exposed lakebed, these results provide evidence for the cost-effectiveness of policies aimed at reducing consumptive water use. |
| JEL: | Q25 Q52 Q53 |
| Date: | 2026–05 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:35270 |
| By: | Delgado-Cubillo, Pablo; Moral-Arce, Ignacio; Martín-Román, Ángel Luis |
| Abstract: | In the context of the growing share of public workers in the Spanish labour force, this paper analyses opportunistic behaviour in sick leave duration and return-to-work probabilities among teachers. We use administrative microdata (2011-2019), transformed into an original monthly spell-level panel. The analysis employs a tailored regression within a difference-in-differences framework exploiting the academic calendar and comparing professional sick leaves among pre-university teachers in public and private schools. Results show that the timing of sick leave endings systematically responds to the school calendar. Public-school teachers display longer sick leave durations and lower return-to-work probabilities than private-school teachers, consistent with ex post moral hazard under more generous employment protection and sick leave coverage. Around the summer break, these differences become more pronounced: public-school teachers extend their leaves further relative to private-school teachers. Simultaneously, the usual gap in return-to-work probabilities temporarily reverses, with public-school teachers becoming more likely to end their leave immediately after summer. These patterns are especially strong among mid-career workers, women, and cases involving more subjective or difficult-to-diagnose injuries. |
| Keywords: | Sickness insurance, Workplace accidents, Absenteeism, Impact evaluation, Moral hazard, Opportunistic behaviour |
| JEL: | K32 I18 J28 I13 |
| Date: | 2026 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:glodps:1773 |
| By: | Nguyen, Ha; Chapman, Bruce; Le, Huong; Royer, Heather; Dearden, Lorraine; Mitrou, Francis |
| Abstract: | This study uses whole-of-population linked census-administrative data to examine gender gaps in educational outcomes from early primary school through early adulthood in Australia and to assess the contribution of socioeconomic factors to these gaps either at the mean and along the distribution of educational outcomes. Leveraging the richness and large size of the linked data and employing some of the most rigorous empirical approaches in the literature, including mother and twin fixed-effects models, we find that females outperform males as early as ages 5–6 across multiple developmental domains, and that this advantage persists through university. The gender gap in favour of females is larger among lower-performing students. We also find that boys benefit more than girls from growing up in more advantaged families, particularly among academically lower-performing boys. However, this advantage is observed only for outcomes measured in the early years of primary school. By contrast, for outcomes measured at the tertiary level, most indicators of socioeconomic advantage confer stronger benefits to females, especially among individuals at the lower end of the educational attainment distribution. Finally, having ruled out gender differences in birth weight—which favour males—we identify gender differences across siblings in school sector choice and early childhood health conditions, both favouring females, as potential mechanisms underlying these patterns. |
| Keywords: | Education; Gender Gap; Socioeconomic Status; Administrative data; Census; Australia. |
| JEL: | I2 I24 I26 J1 J6 R2 |
| Date: | 2026–02 |
| URL: | https://d.repec.org/n?u=RePEc:pra:mprapa:129344 |
| By: | Zhu, Mingyu; Zhao, Qunshan; Jin, Jiayi |
| Abstract: | Urban overheating is increasingly recognised as a major public health challenge under climate change, yet existing frameworks remain heavily focused on acute medical risk and clinically vulnerable populations. This paper introduces \textit{hidden vulnerability} to describe a broader population who remain socially and economically active under ordinary conditions but experience progressive destabilisation during sustained indoor heat exposure. Drawing on a sensor-enhanced longitudinal housing survey in Southwark, London during the summer of 2023, combining indoor environmental monitoring with weekly health and wellbeing questionnaires, the study examines how overheating affects everyday urban life. The findings reveal that impacts extended well beyond thermal discomfort. Participants described cascading disruptions across physical, functional, and psychological domains, sleep loss, exhaustion, impaired self-care, reduced concentration, emotional strain, and increased caring burdens, that interacted and reinforced one another, progressively eroding the capacity to maintain ordinary routines. Critically, these processes were observed not only among participants with chronic conditions but also among those without formally recognised health vulnerabilities, suggesting that the threshold for destabilisation is lower, and more widely distributed, than existing frameworks assume. The paper argues that hidden vulnerability is an urban condition, produced by the intersection of housing quality, social infrastructure, and accumulated disadvantage. The response calls for a conceptual framework for redefining heat vulnerability beyond demographic and clinical categories, and an empirical foundation for a social cure approach to urban heat governance. |
| Date: | 2026–06–05 |
| URL: | https://d.repec.org/n?u=RePEc:osf:socarx:yjebp_v1 |
| By: | Arthur Attema (Erasmus University Rotterdam); Olivier L’haridon (CREM - Centre de recherche en économie et management - UNICAEN - Université de Caen Normandie - NU - Normandie Université - UR - Université de Rennes - CNRS - Centre National de la Recherche Scientifique); Gijs van de Kuilen (Tilburg University [Netherlands]) |
| Abstract: | This study investigates the temporal and contextual stability of social risk preferences across health and wealth, focusing on both gains and losses. Using a large representative Dutch panel, we replicated the experimental design of Attema et al. (2023) which elicited social risk preferences through allocation decisions involving two anonymous recipients under risk. The design allows us to distinguish three dimensions of preferences: risk preferences, inequality aversion, and social risk preferences arising from trade-offs between risk and inequality, corresponding to utilitarian, ex-ante, and ex-post perspectives on social welfare. At the aggregate level, the main patterns documented in the original study are largely replicated: inequality aversion is prevalent and risk aversion is weaker in the loss domain than in the gain domain. At the individual level, however, stability is more limited. Test-retest correlations are positive but modest, and the proportion of identical choices across waves varies across domains and framings. Parametric estimations further reveal substantial heterogeneity in social risk preferences. A latent-class analysis identifies utilitarian preferences as the largest group, followed by ex-post and exante perspectives. Overall, the results highlight the coexistence of persistence, contextual effects, and heterogeneity in social risk preferences |
| Keywords: | social risk, risk apportionment, inequality aversion, ex-post social welfare, ex-ante social welfare |
| Date: | 2026–08 |
| URL: | https://d.repec.org/n?u=RePEc:hal:journl:hal-05632442 |
| By: | Mustafi, Sourish; Roychowdhury, Punarjit |
| Abstract: | This paper examines the effects of early-life exposure to extreme heat on children's learning achievement in India. Exploiting within-district, across-cohort variation in early-life temperature exposure, we find that greater exposure to extreme heat significantly reduces reading, writing, and mathematics achievement in later childhood. These findings remain robust across a battery of robustness checks. We further show that early-life heat exposure adversely affects children's physical development, especially among children from households with limited coping capacity and those exposed to poorer disease environments, suggesting these channels play an important role in shaping later learning achievement. Finally, projections based on future climate scenarios indicate that continued warming is likely to exacerbate human capital losses in India. These findings highlight the persistent influence of early-life climate conditions on human capital formation and underscore the importance of incorporating climate resilience into education and early childhood policy in low- and middle-income countries. |
| Keywords: | Early-life, Human Capital, Heat, Learning Achievement, Temperature, India |
| JEL: | I25 Q54 O15 J13 |
| Date: | 2026 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:glodps:1762 |
| By: | Jeffrey Clemens; Anwita Mahajan |
| Abstract: | At the COVID-19 pandemic's onset, the federal government enacted substantial changes impacting both the revenues and expenditures connected to states' Medicaid programs through a pair of provisions in the March 2020 Families First Coronavirus Response Act. These included a 6.2 percentage point increase in states' Federal Medical Assistance Percentages (FMAP), which raised states' revenues, contingent on adherence to a continuous coverage requirement. The latter provision raised expenditures by preventing the disenrollment of individuals whose eligibility would otherwise have lapsed due to changes in income or other eligibility-relevant circumstances. While these provisions were ex-ante expected to result in expenditures and costs of similar magnitudes, the ex-post realizations remain unquantified. Nationwide, we estimate that states’ share of the continuous coverage provision's costs was $139.2 billion, which is roughly $11.0 billion less than the revenues states received, in aggregate, through increased FMAPs. Revenues and costs varied substantially across states, however, with costs exceeding revenues by as much as $594 per capita, and revenues exceeding costs by as much as $838 per capita. The baseline parameters governing the federal government's share of states' Medicaid expenditures emerge as a key driver of the extent to which the continuous coverage requirement can be viewed as an unfunded federal mandate. |
| JEL: | H70 H72 H75 |
| Date: | 2026–05 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:35268 |
| By: | Laszlo Goerke (Institute for Labour Law and Industrial Relations in the European Union (IAAEU), Trier University); Yue Huang (Institute for Labour Law and Industrial Relations in the European Union (IAAEU), Trier University); Viola Hilbert (Institute for Labour Law and Industrial Relations in the European Union (IAAEU), Trier University); Markus M. Grabka (German Institute for Economic Research (DIW)c and SOEP, Berlin) |
| Abstract: | We investigate the role of industrial relations for working from home during and after the COVID- 19 pandemic in Germany. Using data from the German Socio-Economic Panel (SOEP) for the years 2020 to 2023 and a special COVID sample (SOEP-CoV) for 2020 and 2021, we examine how collec- tive bargaining and plant-level co-determination are associated with the incidence and frequency of working from home. Controlling for worker, firm, occupation, and industry characteristics, we find that employees covered by a collective bargaining agreement are less likely to work from home and do so less frequently than uncovered employees. In contrast, the incidence and frequency of working from home are positively associated with the presence of a works council. |
| Keywords: | co-determination, collective bargaining, COVID-19, industrial relations, SOEP, working from home |
| JEL: | J52 J53 J81 |
| Date: | 2026–06 |
| URL: | https://d.repec.org/n?u=RePEc:iaa:dpaper:202604 |