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on Health Economics |
| By: | Volker Grossmann; Johannes Schünemann; Holger Strulik |
| Abstract: | Sick pay compensates for income loss during illness. However, it may distort labor supply by affecting gross wages if paid by employers and net wages if financed by social insurance contributions. We develop a dynamic general equilibrium model with endogenous, biologically founded health and aging in an education-stratified society to study how the level and financing of sick pay affect the socioeconomic health gradient, income inequality, life expectancy, and welfare. Our analysis shows that reducing the sick pay replacement rate would significantly raise distributional disparities in income and health in Germany. We also show that the individually preferred sick pay replacement rate decreases with the level of educational attainment and that most individuals prefer employer-funded sick pay over public financing. |
| Keywords: | health deficit accumulation, sick pay, social insurance, socioeconomic health gradient, welfare |
| JEL: | H51 I14 I18 |
| Date: | 2025 |
| URL: | https://d.repec.org/n?u=RePEc:ces:ceswps:_12265 |
| By: | Becker, Sascha O. (University of Warwick and Monash University); Bentzen, Jeanet Sinding (University of Copenhagen); Kok, Chun Chee (Université Catholique de Louvain) |
| Abstract: | This paper provides a survey of the literature on gender differences in religiosity and the influence of religion on gender-related economic and social outcomes. Part I examines why women tend to be more religious than men, discussing central explanations. Part II explores how religion impacts various gender-related outcomes, such as gender norms and attitudes, education, labor market participation, fertility, health, legal institutions and reforms, and discrimination. Within each domain, we distinguish between effects driven by individual religiosity (intensity of religious practice or belief) and those driven by their religious denomination. We synthesize findings from numerous studies, highlighting data sources, measures of religion and gender outcomes, and empirical strategies. We focus on studies with credible causal identification—such as natural experiments, instrumental variable approaches, and policy changes—to uncover the impact of religion on outcomes. Correlational studies are also reviewed to provide context. Across studies, the evidence suggests that religious teachings and participation often reinforce traditional gender roles, affecting women’s education, labor force participation, and fertility choices, although there are important nuances and exceptions. We also document instances where secular reforms or religious movements have altered these outcomes. The survey concludes by identifying gaps in the literature and suggesting directions for future research. An important take-away from our review is that rigorous empirical studies are scarce, leaving room for novel causal studies in this field. |
| Date: | 2025 |
| URL: | https://d.repec.org/n?u=RePEc:wrk:warwec:1588 |
| By: | Sanders, J G; Havermans, A; Pauwels, CGG; Talhout, R |
| Abstract: | Introduction Cigarette brand variant names remain a key marketing tool despite restrictions under Article 13 of the EU Tobacco Products Directive. This study investigates whether variant names of popular cigarette brands evoke associations that violate the Directive's prohibitions on harm and flavour-related claims in the Netherlands Methods 1, 354 participants (younger adult and adult daily smokers, younger adult non-daily smokers, and younger adult non-smokers) offered unprompted and prompted associations with 10 variants from three major brands to explore perceptions of harm and taste. Qualitative responses were coded and analysed, and quantitative comparisons assessed differences across variant types. Results Variant names referring to former ‘mild’ variant names (e.g., “Gold”, “Blue") were perceived as less harmful than full-flavour variants (e.g., “Red"). Variant names referring to former ‘menthol’ variants (e.g., “Green”, “Alpine") elicited strong associations with menthol flavour, particularly among younger participants. Findings indicate systematic misperceptions about harm and flavour, contrary to regulatory intent. Conclusions This study highlights the continued influence of brand variant names on consumer perceptions, particularly among young smokers and non-smokers. Subtle linguistic and colour cues in variant names were found to reinforce these perceptions, undermining efforts to convey the universal harms of smoking. Policymakers could consider stricter regulation, such as mandating neutral numerical naming systems, to mitigate misleading associations and further reduce product appeal. Strengthened oversight can further align tobacco control policies with public health goals, advancing efforts to prevent smoking initiation and achieve a smoke-free generation. Key messages • Colour-cued variant names create predictable harm and flavour associations, particularly amongst young adults and non-smokers. • Young adult smokers more often smoke low tar and menthol variants. |
| JEL: | L81 |
| Date: | 2025–10–27 |
| URL: | https://d.repec.org/n?u=RePEc:ehl:lserod:130060 |
| By: | Lan Song; Ping Lyu |
| Abstract: | Housing conditions have a significant impact on human health. For a long time, the dual urban-rural system of China has led to significant differences in housing between urban and rural areas, and the cumulative impact of housing environment can result in inequality of opportunity in health among the elderly. Based on Roemer's equal opportunity theory and using data from the 2018 China Health and Retirement Longitudinal Study (CHARLS), it was found that the average gap in health opportunities between rural and urban elderly populations is 2.359, accounting for approximately 3.5% of the average health level of rural elderly. The degree of inequality of opportunity in health between urban and rural elderly groups is divided by the Hu line, with higher levels of inequality in the western and northern region. Using the Shapley value method, the specific impact of housing on inequality of opportunity in health was quantified from four dimensions: housing asset value, housing property stability, housing comfort, and housing facility convenience. Their overall contribution was as high as 87%. Based on the above research results, we propose improvement paths from the housing sector: coordinating the promotion of urban and rural environmental transformation for elderly, exploring the new security model “housing(or land)-based eldercare” for rural elderly, and establishing the integration of urban and rural housing security system. |
| Keywords: | Healthy Aging; housing; Opportunity in Health; Urban and Rural |
| JEL: | R3 |
| Date: | 2025–01–01 |
| URL: | https://d.repec.org/n?u=RePEc:arz:wpaper:eres2025_54 |
| By: | Youngsoo Jang (Yonsei University); Svetlana Pashchenko (University of Georgia); Ponpoje Porapakkarm (National Graduate Institute for Policy Studies) |
| Abstract: | Should public policies address inequality due to heterogeneous life expectancy? Intuitively, taking short life as a disadvantage, such policies should favor those with high mortality. Yet, pension systems implicitly redistribute from low-life-expectancy to high-life-expectancy people. Moreover, this direction of redistribution is optimal from the perspective of the standard utilitarian welfare criterion. We study mortality-related redistribution in a more flexible setting. We start by establishing a formal framework for the analysis by clearly distinguishing between the redistribution along mortality and income dimensions, and thus between mortality and income progressivity. We then show that it is optimal to redistribute towards high-mortality people in two cases. First, when welfare criterion features aversion to lifetime inequality which exceeds aversion to consumption inequality. Second, when income and mortality are negatively correlated, and income redistribution tools are limited. |
| Keywords: | Mortality-related redistribution, Welfare criteria, Pensions, Prioritarianism |
| JEL: | D30 D60 D63 H55 |
| Date: | 2024–10 |
| URL: | https://d.repec.org/n?u=RePEc:yon:wpaper:2025rwp-268 |
| By: | Todd Gardner |
| Abstract: | This study examines the relationship between long-term population change and health outcomes in U.S. micropolitan areas, with a focus on life expectancy and mortality disparities. Using a county typology based on the historical population trajectories of micropolitan cores from 1940 to 2020, this analysis reveals that health outcomes are substantially worse in places that experienced sustained decline. These disparities persist even after controlling for demographic and socioeconomic characteristics, suggesting that population loss itself is a key driver of poor public health. Declining micropolitan areas are older, less educated, and report high rates of behavioral risk factors, including smoking, excessive drinking, and physical inactivity. By linking historical demographic trends to tract-level data, this analysis highlights the distinct challenges facing the urban cores of shrinking micropolitan areas. Population decline emerges not only as a demographic trend, but as a marker of structural disadvantage with measurable consequences for community health. |
| Keywords: | Micropolitan, life expectancy, health disparities, population decline, public health geography |
| Date: | 2025–09 |
| URL: | https://d.repec.org/n?u=RePEc:cen:wpaper:25-70 |
| By: | David Crainich (CNRS - Centre National de la Recherche Scientifique, IÉSEG School Of Management [Puteaux], LEM - Lille économie management - UMR 9221 - UA - Université d'Artois - UCL - Université catholique de Lille - Université de Lille - CNRS - Centre National de la Recherche Scientifique) |
| Abstract: | I analyze how genetic testing modifies prevention actions that reduce the health and financial consequences of disease. Specifically, I determine whether individuals adjust their prevention behaviour according to the available genetic information when insurers are allowed to use test results for rate‐making purposes (laissez‐faire) and when they are not (information ban). I show that individuals exploit genetic information in the laissez‐faire regime. In the information ban regime, they do so when separating equilibria prevail, but not in case of a pooling equilibrium. None of these equilibria, however, leads to the maximization of the social welfare function. I, therefore, discuss for each potential scenario the instruments likely to restore optimality. |
| Abstract: | L'auto assurance optimale en présence de tests génétiques et lorsque les utilités sont dépendantes des états de la nature. L'article analyse la façon dont les tests génétiques modifient les actions de prévention qui atténuent les effets d'une maladie sur la richesse et sur l'état de santé des individus. Plus précisément, nous déterminons si les individus adaptent leur comportement de prévention en fonction des informations génétiques disponibles lorsque les assureurs sont autorisés à utiliser les résultats des tests à des fins de tarification (laissez‐faire) et lorsqu'ils ne le sont pas (interdiction stricte). Nous montrons que les individus exploitent l'information génétique dans le régime du laissez‐faire. Dans le régime d'interdiction stricte, ils le font lorsque des équilibres de séparation prévalent, mais pas dans le cas d'un équilibre mélangeant. Aucun de ces équilibres ne conduit toutefois à la maximisation de la fonction de bien‐être social. Nous discutons donc, pour chaque scénario potentiel, les instruments susceptibles de restaurer l'optimalité. |
| Keywords: | Health insurance, Adverse selection, Self-insurance, JEL Classification: D82, I18 Genetic testing, I18 Genetic testing Self-insurance Adverse selection Health insurance |
| Date: | 2024–08–16 |
| URL: | https://d.repec.org/n?u=RePEc:hal:journl:hal-04864674 |
| By: | Dhamija, Gaurav; Gupta, Sagnik Kumar; Ojha, Manini |
| Abstract: | We study the effect of women's exposure to the internet on the incidence of intimate partner violence (IPV) utilizing data from a large-scale nationally representative data for India. Utilizing an instrumental variable approach, we exploit the exogenous variation arising from cellular tower density at the district level as an instrument for internet exposure. We find women who have access to the internet are at a significantly lower risk of exposure to physical, sexual, emotional and any IPV by 17, 5, 9 and 18 percentage points.We provide further indicative evidence that women's attitudes justifying violence works as a channel of our estimated causal impacts. Our results are robust to a host of sensitivity checks, additional controls, alternative definitions and falsification analysis. We document important heterogeneity in the effects across social groups, wealth index, area of residence, and women's education levels. The effects appear to be particularly important for women from wealthier households and those who are more educated. |
| Keywords: | Internet Exposure, Tower Density, Intimate Partner Violence, Physical Violence, Sexual Violence, Emotional Violence, Instrumental Variable, NFHS-5, India |
| JEL: | I31 J12 J16 O12 O33 |
| Date: | 2025 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:glodps:1690 |
| By: | Quang-Thanh Tran (Development and Policies Research Center (DEPOCEN)); Akiomi Kitagawa (Graduate School of Economics and Management, Tohoku University) |
| Abstract: | This paper employs an overlapping generations model to analyze how placing the burden of caring for both elderly parents and children on the working generation shapes fertility and other economic outcomes. In the model, fertility decisions create intergenerational spillovers. When one generation has fewer children, the next generation faces a heavier caregiving burden for its elderly parents, which in turn discourages childbearing. The model reveals sharply different long-run trajectories depending on the time intensity of caregiving. If care demands are moderate, sustainable growth remains feasible despite these externalities. However, when care becomes highly time-intensive, fertility declines, labor supply contracts, and the economy risks falling into a ``nursing hell, " where most time is devoted to caregiving. Policy measures, such as child allowances, can alleviate this dynamic by expanding the number of siblings and reducing the per-capita caregiving burden. Yet if care demands are extremely high from the outset, even such interventions cannot avert structural collapse. |
| Keywords: | dual caregiving, endogenous fertility, overlapping generations, sustainability |
| JEL: | E13 J13 J14 J22 J24 O11 |
| Date: | 2025 |
| URL: | https://d.repec.org/n?u=RePEc:dpc:wpaper:0325 |
| By: | Moshe Hazan (Department of Economics, Monash University, 900 Dandenong Road, Caulfield East VIC 3145); Shay Tsur (Research Department, Bank of Israel, P.O. Box 780, Jerusalem 9100701) |
| Abstract: | We study how shifting intra-household control over resources affects fertility, exploiting a quasi-natural experiment in Israel where some Holocaust survivors began receiving substantial and unexpected reparations in 1957 and others decades later. Using a triple-difference design with heterogeneity by age, we compare fertility outcomes by timing of reparations, gender of the recipient, and age. Households where only the young female partner received reparations early had 0.25–0.4 fewer children than comparable households where only the male was treated. An event study shows that this effect is driven entirely by post-1957 fertility, suggesting a causal link to increased female resource control |
| Keywords: | Fertility Choice, Intrahouseho |
| JEL: | J13 J16 D13 |
| Date: | 2025–11 |
| URL: | https://d.repec.org/n?u=RePEc:mos:moswps:2025-16 |
| By: | Rocha, Fabiana; Diaz, Maria Dolores Montoya; Pereda, Paula Carvalho; Árabe, Isadora Bousquat; Cavalcanti, Filipe; Lordemus, Samuel; Kreif, Noemi; Moreno-Serra, Rodrigo |
| Abstract: | On a global scale, 1 in 3 women experience physical and/or sexual violence in their lifetime, and women of disadvantaged backgrounds are at an even higher risk. Since the outbreak of COVID-19, data have shown that violence against women (VAW) has intensified. In this paper, we review an emerging literature evaluating the impact of stay-at-home measures implemented to curb the spread of COVID-19 on VAW in low and middle-income countries. We classify existing studies into three categories based on the quality of data and reliability of the empirical methodology: “causal”, “less causal” and “not causal. Overall, the most rigorous literature on low- and middle-income countries provides evidence of increases in calls to domestic violence hotlines and drops in police reports. Differences in the types of violence analysed (physical, sexual, psychological, or economic) and the challenges associated with reporting these types of VAW contribute to the mixed results. The main methodological limitations faced by this literature relate to data availability and the ability to distinguish the effects of social isolation from those associated with income and emotional shocks induced by the COVID-19 pandemic. The paper highlights the need for innovative methods and data to better understand the unintended VAW consequences of movement restrictions and reliably effective policy responses to this major social and public health challenge. |
| Keywords: | Covid-19 pandemic; gender-based violence; low and middle income countries; violence against women; Covid-19; coronavirus |
| JEL: | I18 J16 H10 |
| Date: | 2024–02–01 |
| URL: | https://d.repec.org/n?u=RePEc:ehl:lserod:121441 |
| By: | Watteel, Regina N. |
| Abstract: | Background: Canada’s 2021–2022 COVID-19 vaccine mandates and passports were implemented with the stated aim of reducing transmission and hospital burden. In the absence of randomized controlled trial evidence for these endpoints, policymakers relied on vaccinated vs. unvaccinated comparisons from surveillance data and observational studies, as well as ungrounded simulations, despite known methodological limitations that rendered such evidence unreliable for public health policies with rights implications. Methods: We systematically critiqued Canadian public health surveillance reports and advisory briefs (Public Health Agency of Canada, Public Health Ontario, Ontario COVID-19 Science Advisory Table) together with related studies, identifying seven key biases classified by severity (critical/catastrophic), correctability, and scope. Distortions were quantified using published rate corrections, classification rules, time-series data, and population trends. Results: Critical biases included >40% misclassification of early post-vaccination cases as unvaccinated and an 80-fold overestimation of senior unvaccinated hospitalization rates due to denominator errors. Additional critical biases—age-standardization obfuscating low-risk youth trends, testing fluctuations understating breakthrough cases, and misattribution rendering COVID-19 hospitalizations an invalid metric for burden—further distorted policy evidence. Catastrophic biases—selection and cumulative methodology—rendered group comparability invalid. Population trends showed case and hospitalization surges despite >80% vaccination coverage, with vaccinated individuals dominating Omicron-era infections. Simulation studies retroactively justifying mandates contradicted real-world data with ungrounded counterfactuals used to estimate unproven benefits. Conclusions: Pervasive, uncorrected biases in observational comparisons invalidated causal claims of transmission or hospital burden reduction. Progressive reliance on weaker evidence—coupled with expert bodies' lack of transparency in emphasizing unproven benefits while dismissing dissenting views—highlights a systemic failure to meet evidentiary standards for public health policies with rights implications. This analysis underscores the need for greater scientific rigor in interpreting observational data through real-time bias correction, transparent limitation reporting, and risk-stratified approaches to uphold evidentiary standards, ethical proportionality, and accountability. These lessons hold global relevance for evidence-based public health policy. |
| Date: | 2025–11–20 |
| URL: | https://d.repec.org/n?u=RePEc:osf:socarx:uwtzn_v1 |