Health economics最新文献

Over the past decade, single mothers have experienced increasing work requirements both in the UK and in other developed countries. Our aim was to examine if increasing job hours are associated with mental health of single mothers compared to partnered mothers. Using 13 waves of the Understanding Society Survey (2009-2023), we estimated the relationship between changing job hours and mental health using difference-in-difference event study design, accounting for differential treatment effects across time and individuals. We also investigated the role of potential mechanisms, including role strain and additional income. Our findings suggest that increasing job hours from part-time to full-time is associated with an instantaneous decrease in mental health of 0.19 standard deviations for single mothers [95% CI: -0.37;-0.01], with no effect for partnered mothers. Further analyses suggest increased role strain for single mothers as a mechanism helping explain these differences. The negative effects of increasing job hours and increased role strain should be considered when developing future welfare policies for single mothers, to ensure that greater work requirements do not undermine the mental health of the already vulnerable population group.

The market for heated tobacco products (HTPs) has grown rapidly in recent years, and many governments have started to include HTPs in tax codes to regulate their use. Currently, the evidence on how HTP prices impact tobacco use behaviors or whether consumers consider them as economic substitutes for cigarettes is lacking. This study is the first to answer these questions with a unique database to assess the own- and cross- price elasticities of HTP and cigarette demand. We collect a unique database of quarterly retail prices and sales of heated tobacco units and comparable scale cigarettes from 2014 to 2022, available for most countries where both HTPs and cigarettes are sold, and estimate the own- and cross- price elasticities of cigarette and HTP demand using a seemingly unrelated regression model. We find that HTP demand is price elastic (i.e., sensitive to prices) and has an own-price elasticity of -1.2 to -1.3, about four times greater than the own-price elasticity of cigarettes, which is about -0.3. We also find that cigarettes and HTPs are weak economic substitutes: while HTP demand is responsive to higher cigarette prices, cigarette demand is not sensitive to HTP prices. Our results suggest that tax policies that increase HTP and cigarette prices simultaneously will reduce HTP consumption without increasing cigarette consumption.

The call for "health and wellbeing in all policies" requires a preference-based measure that collapses multi-dimensional health and wellbeing into a single index, such as equivalent income. We aim to elicit preferences of the UK general public to estimate a value set for a suite of seven commonly used wellbeing indicators including health, income, and other dimensions, in terms of equivalent income. Secondly, we examine heterogeneous preferences by gender, by age, and by income. Thirdly, we explore the stability of preferences, since the survey took place amid the pandemic, possibly affecting preferences over health and wellbeing. Effects of attrition and of time are distinguished. Data were collected online across two waves using Discrete Choice Experiments through an internet panel (N1 = 3362; and N2 = 3357). The regression coefficients for all the ordered attribute levels have the expected sign, are significant, and ordered. Equivalent income was found to vary up to 10% by gender and by age (both significant) and 4% by income (not significant), while the effect of time was up to 16% (significant). The study facilitates the calculation of overall wellbeing in terms of equivalent income based on the preferences of the UK public, where the relevant wellbeing indicators are available.

The health production function of the canonical health-capital model is generalized to allow the state of health to affect the total and marginal products of health investment. If the total and marginal products of health investment are nonincreasing functions of the state of health, then the solution of the generalized model is locally qualitatively identical to that of the canonical model. Moreover, and in contrast to the canonical model, the generalized model is able to rationalize the cycling of the state of health and health investment observed in some individuals. The necessary conditions on the health production function for cyclical behavior are identified as well.

Using three waves of the China Health and Retirement Longitudinal Study, this paper examines whether financial transfers from adult children to elderly parents affect the latter's mental health. Both OLS and instrumental variable (IV) estimates show that financial transfers significantly attenuate depressive symptoms of elderly individuals, with a much larger size of the IV estimates. We also examine the income and cultural channels through which intergenerational transfers work and further discuss the explanatory powers of these two channels through a decomposition analysis. The results suggest the cultural channel accounts for a larger proportion of the financial transfer effect. This means that the unique beneficial impact of intergenerational financial transfers on the mental health of older adults cannot be fully substituted in the foreseeable future.

Our study examines the causal effect of rural hospital closures on nearby hospitals' nurse staffing levels and health care utilization. We use data from the 2014-2019 American Hospital Association Survey on nurse staffing level outcomes including licensed practical or vocational nurses (LPNs), registered nurses (RNs), and advanced practice nurses (APNs); and health care utilization outcomes, including inpatient and outpatient surgical operations and emergency department (ED) visits. Using propensity score matching and difference-in-differences (DID) methods, we find that rural hospital closures lead to an average increase of 37.3% in the number of nurses in nearby rural hospitals during the 4 years following the closure. This increase is found across all categories of nurses, including LPNs, RNs, and APNs. We also find a substantial increase in the provision of inpatient and outpatient surgical operations but there is no change in ED visits. We do not find any effects for nearby urban hospitals. Our study suggests that a large proportion of the nursing workforce relocates to nearby hospitals after a rural hospital closure, which mitigates the negative consequences of such closures and allows these nearby hospitals to provide a larger volume of highly profitable services.

To evidence the impact of air pollution on the health of urban populations, several studies use natural experiments that shift commuting from public transport to cars (or vice-versa). However, as public transport use declines, reduced interpersonal contact may lead to slower virus spread and thus lower respiratory morbidity. Using a difference-in-differences strategy, we show that respiratory hospitalisations are both positively affected by air pollution and negatively affected by viral spread following partial unavailability of public transport due to strikes in the ten most populated French cities during the period 2010-2015. Our results are in line with studies in other countries that have found a significant increase in urgent respiratory hospitalisations following a public transport strike, most likely due to car pollution, but we also find a detectable interaction with viral spread, which should not be overlooked when interpreting these studies.

Medical innovations may lessen the perceived risk of disease which can decrease the take-up of healthy behaviors, a phenomenon known as risk compensation. In contrast, a diagnosis provides updated information about the state of one's health which may motivate positive behavior change. In this paper, I consider how behavior changes in response to a diagnosis of cardiovascular disease (CVD) before and after the FDA approval of new classes of drugs to treat high blood pressure and high cholesterol in 1973. I find that individuals diagnosed with CVD are more likely to follow a diet and decrease body-mass index in response to the diagnosis, irrespective of medication approvals. Nonsmoking is a notable exception. Prior to medication availability, there is no change in smoking behavior in response to a CVD diagnosis. Conversely, when medication is available, there is a significant decline in smoking. The empirical complementarity of medication and smoking cessation may be driven by increased exposure to medical professionals (who emphasize the harms of smoking) or because medication decreases the risk of CVD death which heightens the importance of investing in future health.

Evidence is mixed on whether increased access to insurance, specifically through the ACA's Medicaid expansion, exacerbated the opioid public health crisis through increased opioid prescribing. Using survey data on retail prescription drug fills from 2008 to 2019, we did not find a significant relationship between Medicaid expansion and opioid prescribing in the newly eligible Medicaid population. It may be that the dangers of opioids were known well enough by the time of the Medicaid expansion that lack of access to care was no longer a binding constraint on opioid prescription receipt.