Health economics最新文献

This paper examines the impacts of maternal education on her children's nutritional status in Kenya, utilizing six waves of nationally representative data from KDHS. To mitigate potential endogeneity issues and derive a causal relationship, we employ a change in the educational regime in 1985 as an instrument variable. The key findings can be summarized as follows. First, women under the new structure enhance their education by an average of 1.8 years. Second, an additional year of education attained by a mother is shown to have an impact on reducing the likelihood of her child experiencing stunting, underweight, and wasting by approximately 3.8, 2.6, and 1.2 percentage points, respectively. These findings withstand rigorous testing through a battery of robustness checks. Finally, to elucidate the underlying mechanisms behind these results, our study delves into various factors, encompassing women's fertility, female labor force engagement, women's information exposure, and their involvement in decision-making.

Antimicrobial resistance (AMR) has been increasing rapidly in the United States despite government efforts to contain its spread. Both under-utilization and overuse of prescribed antimicrobials contribute to rising resistance. The introduction of Medicare Part D in 2006 expanded prescription drug coverage for the elderly, including coverage for antimicrobial medications. If cost barriers had previously led to under-utilization of prescriptions, then Medicare Part D could have mitigated AMR by improving access to antimicrobials. However, if Medicare Part D also encouraged excessive antibiotic use, it may have inadvertently contributed to greater resistance. Using data from the Nationwide Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality for January 2001 to September 2008, I estimate the causal impact of Medicare Part D on AMR-related hospital discharges using a difference-in-differences identification strategy. My findings suggest that Medicare Part D led to a slower increase in AMR-related inpatient discharges among the Medicare-eligible population.

In Japan, female suicide increased during the COVID-19 pandemic. This study evaluated how pandemic-related home confinement affected female suicide. We employed a shift-share instrumental variable design to assess whether differential exposure to the pandemic caused changes in suicide incidence. We found that suicide increased among females under 20 years of age as more people stayed at home. Counterfactual analyses showed that at least 35% of these suicides were attributed to home confinement. Our results suggest that a substantial part of the suicide increase among young females was driven by lifestyle changes during the pandemic.

We examine public funding for health research through the United States National Institutes of Health Fogarty International Center's AIDS International Training and Research Program, which sought to strengthen scientific capacity in AIDS-endemic countries by providing African researchers with training opportunities in the U.S. We use a difference-in-differences framework with information on scientists who participated in the program and the research activities of African scientists working at their home institutions in adjacent topics of neglected tropical diseases. Relative to comparable scientists, those at institutions with returning trainees subsequently publish more on HIV-related topics, receive more grant funding, engage in more clinical trials, and their work contributes to a greater number of policy documents. These patterns suggest that following the Fogarty program, research, innovation, and health policy related to the AIDS epidemic in African countries became more active.

We extend the Rothshild and Stiglitz (1976) model to two sources of risk -inpatient and outpatient risk- to better proxy real-world health insurance markets. We uncover an interesting theoretical possibility: Take individuals A and B, who are low risks in, say, the inpatient dimension but A is riskier in the outpatient dimension. Then, A may enjoy less coverage than B in the inpatient dimension (coverage reversal). This phenomenon indicates that when testing for adverse selection in a given dimension, one has to treat individuals who differ in the other dimension separately. With this insight in mind, we adapt the Chiappori and Salanié (2000) positive correlation test to this multi-dimensionality and use it to test for adverse selection using individual-level claims data for the privately insured in Chile. This empirical analysis indicates that overlooking the aforementioned need of separating samples can potentially lead to biased conclusions.

How does individuals' health status evolve over time? Is this evolution characterized by any socio-economic gradient? To answer these questions, this paper proposes a new intuitive and normatively grounded criterion to assess and compare health dynamics over time accounting for population heterogeneities. Implementing this criterion to European data, this paper provides the first pan-European evidence on health dynamics and related heterogeneities from 2005 to 2019. It shows that socio-economic gradients have played an important role in shaping the health dynamics experienced by the European population. These dynamics appear progressive with respect to the pure economic status of individuals determined by their level of income. This feature is reverted when the economic conditions of individuals are widened to include non-pure monetary aspects such as professional condition and parental background.

Annually, countries allocate hundreds of millions of dollars to subsidize fossil fuels, often at the expense of public health and environmental sustainability. This undermines progress toward Sustainable Development Goals (SDG) 3 (Good Health and Well-Being) and 13 (Climate Action). Despite this, the impact of fossil fuel subsidies (FFS) on social protection expenditure, including health, remains poorly quantified. This study aimed to determine whether FFS crowd out health expenditure globally, using panel data from 126 countries covering the period 2015-2019. An instrumental variable approach, relying on countries' exposure to international energy trade and fluctuations in crude oil price, was employed to capture exogenous variation in FFS and estimate a causal relationship. The analyses revealed that in 2019, 17 countries spent more than five percent of GDP on FFS, with FFS expenditure exceeding health expenditure in 15 of those countries. Specifically, a 1% increase in FFS per capita, driven by rising international oil prices and weighted by countries' exposure to international energy trade, led to a 0.05% (95% CI -0.08% to -0.02%) decrease in domestic health expenditure per capita. These findings underscore the detrimental impact of FFS on health expenditure, presenting another reason to eliminate FFS to achieve SDG3 in addition to avoiding further dangerous climate heating.

Health and well-being in the family context can be affected by care giving arrangements. Following parental care and daycare, grandparents are the third most important care givers for children in many Western societies. Despite the relevance of grandparental care, there is little evidence on the causal effects of this care mode on the next generations' health and well-being. In this paper, we fill this gap by investigating the causal impact of regular grandparental care on the self-reported health and (domain-specific) satisfaction of both parents and children. To do so, we exploit geographic distance to grandparents as a source of arguably exogenous variation and use representative German panel data for families with children under the age of 11. Our results suggest positive effects on parental satisfaction with the child care situation, as well as mothers' satisfaction with their leisure time. However, we also find negative effects on children's health, particularly for elementary school aged children and for boys.

We investigate how disability insurance (DI) generosity affects DI take-up and labor market participation in a setting where benefits can be cumulated with substantial labor earnings. Using rich administrative data on Italian private-sector workers and a Regression Discontinuity in Time design, we find a large behavioral response to DI generosity, with an elasticity of 1.26 in DI take-up, while employment effects are minor and concentrated among immigrants. Our identification strategy exploits a major social security reform that reduced the expected DI replacement rate and generated a clear income effect. To address unobserved heterogeneity and the unobservability of underlying disability, we focus on individuals affected by acute cardiovascular shocks whose DI eligibility is plausibly exogenous. Overall, our results suggest that when earnings cumulability is extensive, DI is widely perceived as a complement to labor income. This has important implications for the design of labor-inclusive DI schemes.