Health Economics http://lists.repec.org/mailman/listinfo/nep-hea Health Economics 2026-04-06 Paid Caregiving Leave Policies and an Update on Paid Parental Leave https://d.repec.org/n?u=RePEc:nbr:nberwo:34997&r=&r=hea Paid leave policies are designed to help workers balance work with caregiving responsibilities, yet research has focused predominantly on parental leave while the literature on non-parental caregiving leave remains nascent. This chapter reviews the evidence on the impacts of paid family leave (PFL) and paid sick leave (PSL) policies, with a focus on non-childbirth-related caregiving. We begin with an overview of the prevalence and challenges of informal caregiving in the US and internationally, followed by a description of the current paid caregiving leave policy landscape. We then review evidence on the impact of these policies on leave take-up, labor market outcomes, caregiver health and well-being, employer outcomes, and utilization of formal care. We find that paid leave policies have successfully increased leave take-up and that PFL improves labor market outcomes for workers with caregiving responsibilities, without adversely affecting employers. There is also some suggestive evidence of improvements in caregivers’ mental health. We additionally provide an update of the paid parental leave literature since it was last reviewed by Rossin-Slater (2018), describing the latest evidence on maternal health, child health and development, parental labor market outcomes, and employer outcomes. We conclude by identifying key gaps in the literature, including the lack of research on the outcomes of (non-child) care recipients, limited evidence on employer responses, and the underexplored role of PSL in supporting caregiving needs. Priyanka Anand Tamar Matiashvili Maya Rossin-Slater 2026-03 The Labor Market Returns to Delaying Pregnancy https://d.repec.org/n?u=RePEc:ces:ceswps:_12586&r=&r=hea We study the labor market impact of unplanned pregnancy among women using long-acting reversible contraceptives to delay pregnancy. While most women successfully delay, some have unplanned pregnancies, providing quasi-random variation in pregnancy timing. Analyzing linked health and labor market data from Sweden, we find that unplanned pregnancies halt women's career progression, resulting in income losses of 19% five years later. We find similar effects of unplanned births among women using short-acting reversible contraceptives. Using pregnancy as an instrument for birth in a dynamic treatment effect framework, effects of unplanned children are more detrimental for younger women and those enrolled in education. Yana Gallen Juanna Schrøter Joensen Eva Rye Johansen Gregory F. Veramendi Juanna Schrøter Joensen labor market costs of motherhood, fertility, contraceptives, unplanned pregnancy 2026 The Impact of Menopause Hormone Therapy on Women’s Health and Employment https://d.repec.org/n?u=RePEc:mub:wpaper:2026-01&r=&r=hea This paper examines the causal effects of Menopause Hormone Therapy (MHT) on health and labor market outcomes among U.S. women aged 40–61. I leverage the MHT treatment arm of the first large-scale randomized evaluation of MHT’s effects on postmenopausal women’s health, which was stopped early due to elevated health risks and publicly announced in July 2002. The announcement led to a rapid global decline in MHT prescriptions, which I use as a quasi-exogenous shock. Using nationally representative U.S. data on prescriptions, health, and labor market outcomes, I apply difference-in-differences, instrumental variables, and fixed-effects approaches. Results show MHT significantly improves physical health, increasing physical functioning scores by up to one standard deviation, but effects on employment and wages are modest and sensitive to specification. Lucia Torres Frasele women’s health; menopause; aging; employment 2026-01 Labor Unions and Deaths of Despair: Evidence from Right-to-Work Laws https://d.repec.org/n?u=RePEc:zbw:glodps:1729&r=&r=hea This paper examines the relationship between union membership and deaths of despair. Using state-level variation in the timing of the adoption of right-to-work (RTW) laws as a natural experiment, I show that right-to-work laws are associated with a decline in union membership and an increase in deaths of despair. Two-way fixed-effects (TWFE) differencein- differences (DiD) estimates suggest that the adoption of a right-to-work law is associated with an approximately 2.6 percentage point reduction in union membership at the state-level and an increase in deaths of despair mortality between 12 and 13 additional persons per 100, 000, suggesting that each percentage point decline in union membership is associated with approximately five additional deaths from suicide, drug overdose, or alcoholic liver disease per 100, 000 persons. I support the TWFE results with state-level estimates from the Callaway and Sant'Anna (2021) estimator and the Borusyak et al. (2024) estimator, which are robust to concerns about treatment effect heterogeneity and variation in treatment timing. Estimates from a county-level specification using the Callaway and Sant'Anna (2021) estimator similarly suggest that RTW laws increase deaths of despair mortality by 6 to 11 additional persons per 100, 000. Petach, Luke Labor Unions, Right-to-Work Laws, Deaths of Despair, Health Economics, Labor Economics 2026 Early-Life Sugar Restrictions Reduce Genetic Disparities in Adult Adiposity https://d.repec.org/n?u=RePEc:nbr:nberwo:35005&r=&r=hea Genetics confer 2–3-fold higher obesity risk through inherited mechanisms affecting appetite and metabolism, with pathways particularly modifiable during the first 1, 000 days of life. We leverage the end of UK sugar rationing in September 1953, a sharp discontinuity in early-life sugar exposure by conception date, to examine whether sugar restriction mitigates genetically determined obesity risk using UK Biobank data linking an obesity polygenic index with adiposity phenotypes. Without rationing, high genetic risk individuals had triple the obesity prevalence of low-risk counterparts. Restriction through age two narrowed this disparity by 40%, operating through visceral rather than general adiposity, and was concentrated among high-risk adults with above-median adiposity levels. Early nutritional environments can alter inherited obesity trajectories, pointing to targeted early-life interventions to reduce genetically determined health inequalities. Tadeja Gracner Claire Boone Patrick Turley Paul Gertler 2026-03 Cash Transfers and Productive Inclusion: Evidence from Bolsa Familia https://d.repec.org/n?u=RePEc:nbr:nberwo:35006&r=&r=hea We study how cash transfers affect work and health. Exploiting an increase in the generosity of the world's largest cash-transfer program for the extremely poor, we show that the reform raised employment by 5 percent while sharply improving health: hospitalization fell 8 percent and mortality 14 percent, saving roughly 1, 000 lives. These findings challenge the view that transfers reduce work. Instead, transfers can relax binding subsistence and health constraints, raise productivity, and expand labor supply. We formalize this mechanism in a model of productive inclusion and use it to evaluate welfare, yielding lessons for antipoverty policy design in low-income settings. Michael C. Best Felipe Lobel Valdemar Pinho Neto 2026-03 This Girl Can? The Effect of Promoting Physical Activity on Health Outcomes https://d.repec.org/n?u=RePEc:iza:izadps:dp18472&r=&r=hea Physical activity likely improves health. Yet, even as health outcomes are positively associated with physical activity, confounding bias exists. We examine a large-scale government campaign to encourage physical activity among women in the United Kingdom as a source of an exogenous increase. Our difference-in-differences estimates confirm a large increase in activity associated with the campaign. We use this as the basis of IV estimation indicating that physical activity leads to a reduction in BMI and a lower chance of obesity, but we find no change in other health conditions over our four-year window. Implications for policy and future research are discussed. Green, Colin Heywood, John Paniagua, Maria public service campaign, physical activity, women’s health 2026-03 Long-Term Trends in Racial and Ethnic Reporting and Representation in US Alzheimer's Clinical Trials https://d.repec.org/n?u=RePEc:zbw:glodps:1728&r=&r=hea Alzheimer's disease (AD) disproportionately burdens racial and ethnic minority populations, yet the extent to which US clinical trials reflect this burden remains poorly understood. We conduct a systematic review of all 88 completed US-based Phase III AD drug trials between 1997 and 2023, using a multi-source approach that integrates the Trialtrove clinical trial database with PubMed, ClinicalTrials.gov, pharmaceutical reports, and conference abstracts. We document three main findings. First, nearly half of published trials (49.3%) reported no data on patient race or ethnicity. Among trials that did report, practices were highly inconsistent in terminology, categorization, and analytical depth. Second, White patients constituted a median of 91.3% of enrollment, while Black patients represented 4.5%-7.2%, Hispanic patients 5.2%, and Asian / Pacific Islander and Native American patients less than 1% - shares that are grossly disproportionate to AD prevalence rates, which are approximately twice as high among non- Hispanic Black older adults and 1.5 times as high among Hispanic older adults relative to non- Hispanic Whites. Third, only 3 trials (4.2%) conducted any subgroup analyses by race or ethnicity, and none reported treatment safety or efficacy stratified by demographic group. Critically, regression models find no evidence of improvement in reporting or representation from 1997 to 2023. These patterns limit the generalizability of existing AD treatment evidence and raise fundamental concerns about health equity. Our findings support strengthening mandatory reporting standards, broadening eligibility criteria, and diversifying trial site selection to ensure emerging AD treatments are evaluated equitably across the populations most affected. Lin, Zhuoer Sun, Ruochen Ross, Joseph S. Lau, Kien Stumpf, Sophia Chen, Xi Alzheimer's disease, dementia, clinical trials, racial and ethnic disparities, health equity, underrepresentation, diversity in clinical research 2026 The Impact of Informal Caregiving on the Well-being of Older Adults in Europe https://d.repec.org/n?u=RePEc:cir:cirwor:2026s-04&r=&r=hea Informal care is a cornerstone of long-term care for older adults but may entail substantial psychological costs for caregivers. Using seven waves (2004–2022) of the Survey of Health, Ageing and Retirement in Europe (SHARE) for 27 countries, we estimate the causal effect of providing regular personal care inside the household on depressive symptoms and quality of life. We estimate dynamic panel instrumental-variable (IV) models with country and wave fixed effects, exploiting the persistence of caregiving and using lagged indicators of caregiving provision as instruments to address reverse causality and unobserved heterogeneity. Our baseline estimates indicate that providing informal care increases depressive symptoms by about 25% and reduces quality of life by roughly 6% relative to non-caregivers. These adverse effects are strongest for spousal caregivers and when caregiving is sustained over time, and they persist even after caregiving ends. Robustness checks using alternative outcomes, subsamples, and specifications suggest that the well-being costs of informal caregiving are sizable and pervasive, underscoring the need for long-term care policies that explicitly account for the mental health burden placed on family caregivers. Les soins informels constituent un pilier de la prise en charge à long terme des personnes âgées, mais peuvent engendrer des coûts psychologiques importants pour les aidants. À partir de sept vagues (2004-2022) de l’enquête sur la santé, le vieillissement et la retraite en Europe (SHARE) menée dans 27 pays, nous estimons l’effet causal de la fourniture régulière de soins personnels à domicile sur les symptômes dépressifs et la qualité de vie. Nous estimons des modèles dynamiques de panel à variables instrumentales (VI) avec effets fixes pays et vague, en exploitant la persistance des soins et en utilisant des indicateurs décalés de la fourniture de soins comme instruments pour traiter la causalité inverse et l’hétérogénéité non observée. Nos estimations de base indiquent que la fourniture de soins informels augmente les symptômes dépressifs d’environ 25 % et réduit la qualité de vie d’environ 6 % par rapport aux personnes ne fournissant pas de soins. Ces effets néfastes sont plus marqués chez les conjoints aidants et lorsque les soins sont prodigués de manière prolongée ; ils persistent même après la fin des soins. Des tests de robustesse utilisant des résultats alternatifs, des sous-échantillons et des spécifications suggèrent que les coûts en matière de bien-être liés aux soins informels sont considérables et généralisés, soulignent la nécessité de politiques de soins de longue durée qui tiennent explicitement compte du fardeau de santé mentale représentant les aidants familiaux. Moïse Drabo Raquel Fonseca Marie-Louise Leroux Informal care, Depressive symptoms, Long-term care, Quality of life, Soins informels, Symptômes dépressifs, Soins de longue durée, Qualité de vie, Personnes âgées 2026-03-30 Replication Report: A comment on "Should Cash Transfers Be Conditional? Conditionality, Preventive Care, and Health Outcomes" https://d.repec.org/n?u=RePEc:zbw:i4rdps:290&r=&r=hea This replication study revisits Attanasio et al. (2015), which examines the effects of conditional cash transfers on preventive health care utilization and child health outcomes in Colombia. Using the original data and replication files, we successfully reproduce all the main tables and figures reported in the paper. We further assess robustness by estimating alternative count-data models for preventive care visits, constructing a health index using a summary-index approach, and modifying the estimation sample. Across these extensions, the main qualitative findings of the original study remain intact, supporting the robustness and credibility of the original conclusions. Hartmann, Sven A. Huang, Yue 2026 Heart Failure's First Shock and Nurse-Led Chronic Care https://d.repec.org/n?u=RePEc:arx:papers:2603.23024&r=&r=hea We study how a first heart-failure hospitalization, an adverse health shock, changes patients' care, and whether a nurse-led chronic-care program sustains those post-shock investments. Using linked population-wide administrative records from Italy's Romagna Local Health Authority (2017-2023), we anchor event time at each patient's first CHF admission and exploit staggered timing to estimate dynamic effects. The shock triggers a sharp post-discharge surge: beta-blocker adherence, cardiology follow-up, and echocardiography rise immediately, while emergency-room use spikes just before admission and then stabilizes. We then estimate the incremental impact of enrollment in the Nurse-led Program for Chronic Patients (NPCP) using the interaction-weighted event-study estimator for staggered adoption. Under conventional difference-in-differences inference, NPCP strengthens long-run preventive engagement, with little detectable change in emergency-room use. HonestDiD sensitivity analysis indicates these gains are economically meaningful but not statistically definitive under modest departures from parallel trends. Moslem Rashidi Luke B. Connelly Gianluca Fiorentini 2026-03 Retrospective Economic Evaluation of Group Testing in the COVID-19 Pandemic https://d.repec.org/n?u=RePEc:arx:papers:2603.28930&r=&r=hea Surveillance of diseases in a pandemic is an important part of public health policy. Diagnostic testing at the individual level is often infeasible due to resource constraints. To circumvent these constraints, group testing can be applied. The economic cost evaluation from the payer's perspective typically focuses only on deterministic costs which overlooks the substantial economic impact of productivity losses resulting from quarantine and workplace disruptions. The objective of this article is to develop a mathematical model for a retrospective economic evaluation of group testing that incorporates both deterministic costs and income-based economic loss. Group testing algorithms are revisited and simulated at optimized pool sizes to determine the required number of tests. Income data from the German Socio-Economic Panel are integrated into a mathematical model to capture the economic loss. Afterward, hybrid Monte Carlo experiments are conducted by evaluating the economic cost in the Coronavirus disease 2019 pandemic in Germany. Monte Carlo experiments show that the optimal choice of group testing algorithms changes substantially when income-based economic losses are included. Evaluations considering only deterministic costs systematically underestimate the total economic cost. Algorithms with a longer quarantine duration are less attractive than shorter quarantine duration if income-based economic loss is accounted for. The findings show that current evaluations underestimate the true economic cost. Group testing algorithms with shorter duration and fewer stages are preferred, even when they require a larger number of tests. These results underscore the importance of incorporating income-based economic loss into a mathematical model. Michael Balzer Kainat Khowaja Christiane Fuchs 2026-03