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What is the relationship between risk attitudes and ambient temperature? Evidence from a large population-based cohort study. 风险态度与环境温度之间有什么关系?一项大型人群队列研究提供的证据。
IF 2.2 3区 医学 Q2 ECONOMICS Pub Date : 2024-09-27 DOI: 10.1016/j.ehb.2024.101436
Adriana N König, Michael Laxy, Annette Peters, Alexandra Schneider, Kathrin Wolf, Lars Schwettmann, Daniel Wiesen

Rising temperatures affect human behavior and risk-taking in several domains. However, it is not yet well understood just how ambient temperature shapes risk attitudes. Using data from the large population-based KORA-Fit study (Cooperative Health Research in the Region of Augsburg) of older people (N=2454), we identify a statistically significant, but very small, positive association between short-term ambient temperature changes and individuals' general willingness to take risks. Health-related risk attitudes, however, show no significant relationship with temperature. These findings support a domain-specific view of risk attitudes, with results remaining consistent for vulnerable individuals with the chronic conditions diabetes, hypertension, and asthma. Overall, our findings suggest that risk attitudes are somewhat stable towards changes in ambient temperature.

气温升高会在多个领域影响人类的行为和冒险行为。然而,人们对环境温度如何影响风险态度还不甚了解。我们利用对老年人(2454 人)进行的大型人群 KORA-Fit 研究(奥格斯堡地区合作健康研究)的数据,发现短期环境温度变化与个人承担风险的一般意愿之间存在统计学意义上的显著正相关关系,但这种关系非常小。然而,与健康相关的风险态度与气温并无明显关系。这些发现支持了风险态度的特定领域观点,对于患有糖尿病、高血压和哮喘等慢性疾病的弱势人群来说,结果是一致的。总之,我们的研究结果表明,风险态度对环境温度的变化具有一定的稳定性。
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引用次数: 0
The role of gene–environment interaction in the formation of risk attitudes 基因-环境相互作用在风险态度形成中的作用
IF 2.2 3区 医学 Q2 ECONOMICS Pub Date : 2024-09-24 DOI: 10.1016/j.ehb.2024.101434
Understanding the formation of risk preferences is crucial for elucidating the roots of economic, social, and health inequalities. However, this area remains inadequately explored. This study employs a risk preference measure directly linked to the labor market to examine whether previous experiences with high unemployment rates influence current risk decision-making among the elderly, and whether this impact varies by genotype. The findings indicate that individuals with low genetic predispositions for risk tolerance are more significantly influenced by historical fluctuations in unemployment rates than those with high genetic predispositions for risk tolerance. Consequently, this paper identifies genetic endowment as a crucial moderating factor that shapes how past experiences impact current decision-making processes. This disparity in how past experiences shape risk preferences based on genetic predisposition may further amplify inequalities in health, wealth, income, and other outcomes associated with risk preferences.
了解风险偏好的形成对于阐明经济、社会和健康不平等的根源至关重要。然而,这一领域的探索仍然不足。本研究采用了一种与劳动力市场直接相关的风险偏好测量方法,以考察以往的高失业率经历是否会影响老年人当前的风险决策,以及这种影响是否因基因型而异。研究结果表明,与风险承受能力遗传倾向高的人相比,风险承受能力遗传倾向低的人受失业率历史波动的影响更大。因此,本文认为遗传禀赋是影响过去经历如何影响当前决策过程的关键调节因素。这种基于遗传倾向的过去经历如何影响风险偏好的差异,可能会进一步扩大健康、财富、收入和其他与风险偏好相关的结果方面的不平等。
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引用次数: 0
Daylight duration and time allocation of children and adolescents 儿童和青少年的日照时间和时间分配。
IF 2.2 3区 医学 Q2 ECONOMICS Pub Date : 2024-09-24 DOI: 10.1016/j.ehb.2024.101435
This study explores the allocation of time, particularly to sleep, among children and adolescents in response to daily daylight variation. Utilising a dataset of over 50,000 time-use diaries from two Australian cohorts spanning 16 years and employing an individual fixed effects estimator, we uncover a substantial causal impact of daily daylight duration on sleep patterns. Our findings reveal that days with longer daylight hours are associated with a decrease in total sleep duration, primarily driven by a later sleep onset time. Additionally, longer daylight hours correspond to reduced time spent on personal care and media activities, with increased dedication to school and physical activities. Furthermore, we identify socio-demographic factors moderating these effects, such as older age and weekend days exerting a stronger influence on sleep duration, while females and children of unemployed mothers exhibit a subtle impact. These insights contribute to our understanding of how environmental factors shape daily routines and offer implications for designing schedules that promote positive developmental outcomes in young individuals.
本研究探讨了儿童和青少年的时间分配,尤其是睡眠时间的分配与每日日照变化的关系。我们利用澳大利亚两个队列中超过 50,000 份时间使用日记(时间跨度长达 16 年)的数据集,并采用个体固定效应估计法,发现了日照时间对睡眠模式的重大因果影响。我们的研究结果表明,日照时间越长,总睡眠时间越短,主要原因是睡眠开始时间越晚。此外,日照时间越长,用于个人护理和媒体活动的时间就越少,而用于学校和体育活动的时间就越多。此外,我们还发现了调节这些影响的社会人口因素,如年龄较大和周末对睡眠时间的影响更大,而女性和失业母亲的子女则表现出微妙的影响。这些见解有助于我们了解环境因素是如何影响日常作息的,并为设计能促进青少年积极发展的作息时间提供了启示。
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引用次数: 0
The geography of healthcare: Mapping patient flow and medical resource allocation in China 医疗地理:绘制中国的患者流和医疗资源分配图
IF 2.2 3区 医学 Q2 ECONOMICS Pub Date : 2024-09-19 DOI: 10.1016/j.ehb.2024.101431
The misallocation of medical resources leads to interregional patient flow in search of better healthcare. Using out-of-pocket medical expenditure data and a delineating method, this paper identifies spatial clusters of medical services in China based on patient flow across cities. Our findings indicate that healthcare resources are more concentrated in northern China, while southern China is divided into several large healthcare clusters at the same threshold. The provincial capital and economically significant cities are more likely to serve as medical cluster centers. We further apply the gravity model to examine the effects of healthcare disparity on cross-city medical expenditure. The results reveal that geographic disparities in high-quality medical resources encourage remote healthcare-seeking behavior, and the shorter the distance between locations, the higher the level of medical consumption. Patients are inclined to seek medical services within their own province and within specific medical clusters identified through delineation methods. This effect is more pronounced among patients from non-central cities. This study highlights healthcare inequality by examining cross-regional medical expenditure, providing valuable insights for future healthcare policy.
医疗资源的错配导致患者为寻求更好的医疗服务而跨区域流动。本文利用自付医疗费用数据和划分方法,根据患者跨城市流动的情况,识别出中国医疗服务的空间集群。我们的研究结果表明,中国北方的医疗资源更为集中,而中国南方则在同一临界点上被划分为多个大型医疗集群。省会城市和经济重镇更有可能成为医疗集群中心。我们进一步运用引力模型考察了医疗资源差异对跨城市医疗支出的影响。结果表明,优质医疗资源的地理差异会鼓励偏远地区的就医行为,地点之间的距离越短,医疗消费水平越高。患者倾向于在本省和通过划定方法确定的特定医疗集群内就医。这种效应在非中心城市的患者中更为明显。本研究通过对跨地区医疗支出的研究,强调了医疗保健的不平等,为未来的医疗保健政策提供了有价值的见解。
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引用次数: 0
Decentralized wage bargaining and health 分散的工资谈判与健康
IF 2.2 3区 医学 Q2 ECONOMICS Pub Date : 2024-09-11 DOI: 10.1016/j.ehb.2024.101433

This study examines the association between decentralized wage bargaining and worker health in Finland. We utilize unique data on collective agreements matched with total population administrative data on mental health disorders and sickness absence for the 2005–2013 period. We find that decentralized wage bargaining is related to mental health among blue-collar workers. Specifically, local wage increase allowances are associated with improved mental health in firms with a high concentration of white-collar employees, whereas this association is reversed in firms where blue-collar workers predominate. No consistent links to sickness absences are observed. Further analyses indicate that higher earnings under local wage agreements may explain the observed improvement in mental health in white-collar intensive firms, whereas decreased employment could partially explain the worsened mental health in blue-collar intensive firms.

本研究探讨了芬兰分散工资谈判与工人健康之间的关系。我们利用 2005-2013 年期间与集体协议相关的独特数据,以及与精神疾病和因病缺勤相关的总人口行政数据进行匹配。我们发现,分散工资谈判与蓝领工人的心理健康有关。具体而言,在白领雇员高度集中的企业中,地方工资增长津贴与心理健康的改善相关,而在蓝领工人占多数的企业中,这种关联则相反。没有观察到与病假的一致联系。进一步的分析表明,当地工资协议下的较高收入可以解释所观察到的白领密集型企业精神健康状况的改善,而就业率的下降可以部分解释蓝领密集型企业精神健康状况的恶化。
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引用次数: 0
The effects of physical activity prescription on mental health: Evidence from primary care 体育活动处方对心理健康的影响:来自初级保健的证据
IF 2.2 3区 医学 Q2 ECONOMICS Pub Date : 2024-09-10 DOI: 10.1016/j.ehb.2024.101432

While the benefits of physical activity on health are well documented, in high-income countries 1 in 3 adults do not reach the recommended levels. Thus, policy makers have developed interventions to promote physical activity. The aim of this research is to evaluate the effectiveness of physical activity prescription on mental health outcomes, by studying an intervention that prescribes physical activity at the primary care level in Catalonia (PAFES). This intervention specifically targets the adult population with high cardiovascular risk. We use data from the Health Survey of Catalonia (2011–2016) and exploit the variation in the number of trained General Practitioners that prescribe physical activity. Our results show that physical activity prescription reduces the probability of suffering from poor mental health. This effect is mainly driven by females within the targeted population. We also explore the main effect (or the output) of the intervention. While PAFES increases the probability of patients undertaking high-level physical activity, it does not affect rates of sedentarism or minutes walked per day. Results are consistent when using alternative mental health outcome measures, including self-reported depression and anxiety. We conclude that the prescription of physical activity not only contributes to the improvement of physical health but is also a useful tool to help preserve mental wellbeing.

虽然体育锻炼对健康的益处有据可查,但在高收入国家,每 3 个成年人中就有 1 人达不到建议的水平。因此,政策制定者制定了促进体育锻炼的干预措施。本研究的目的是通过研究加泰罗尼亚地区基层医疗机构(PAFES)的一项体育锻炼处方干预措施,评估体育锻炼处方对心理健康结果的影响。这项干预措施专门针对心血管风险较高的成年人群。我们使用了加泰罗尼亚健康调查(2011-2016 年)的数据,并利用了开具体育锻炼处方的训练有素的全科医生数量的变化。我们的研究结果表明,开具体育锻炼处方可降低心理健康状况不佳的概率。这一效应主要由目标人群中的女性驱动。我们还探讨了干预措施的主要效果(或产出)。虽然 PAFES 提高了患者进行高水平体育锻炼的概率,但并不影响久坐率或每天步行分钟数。在使用其他心理健康结果测量方法(包括自我报告的抑郁和焦虑)时,结果也是一致的。我们得出的结论是,体育锻炼处方不仅有助于改善身体健康,也是一种有助于保持心理健康的有用工具。
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引用次数: 0
Diverging destinies: How children are faring under demographic transition 不同的命运:人口结构转型期的儿童状况
IF 2.2 3区 医学 Q2 ECONOMICS Pub Date : 2024-08-25 DOI: 10.1016/j.ehb.2024.101429

India reached the replacement level of fertility in 2020. However, the journey of fertility transition is unconventional and heterogeneous within the country and across the different socio-economic groups. The fertility transition is considered to be faster than its socio-economic and health transition in several states. Thus, it has been presumed that the returns to fertility decline are heterogeneous across the states and population sub-groups. Our specific hypothesis is that although rich and poor, and educated and un-educated, everyone had significantly contributed to the fertility decline in response to family planning policies, only those socio-economically better-off have been investing relatively more in their children compared to the poor, and this has led to diverging destinies for children. We tested this supposition using a macro-level panel dataset (1992–2021), fixed and random effects, and IV regression models. The results confirm that child health care and outcomes have diverged while fertility declined from 1992 to 2021. These results are sustained in multiple robustness checks. While fertility is declining with highly state-sponsored family planning programmes, the persistent socio-economic inequalities are leading to unequal progress in health outcomes for children in India.

印度的生育率在 2020 年达到更替水平。然而,在印度国内和不同的社会经济群体中,生育率过渡的历程是非常规的,也是异质的。在一些邦,生育率转型被认为快于其社会经济和健康转型。因此,人们推测生育率下降的回报在各州和人口亚群体之间是不一样的。我们的具体假设是,尽管富人和穷人、受过教育的人和未受过教育的人,每个人都对计划生育政策导致的生育率下降做出了重大贡献,但只有那些社会经济条件较好的人与穷人相比,对子女的投资相对较多,这导致了儿童命运的分化。我们使用宏观面板数据集(1992-2021 年)、固定效应和随机效应以及 IV 回归模型对这一假设进行了检验。结果证实,从 1992 年到 2021 年,在生育率下降的同时,儿童医疗保健和结果也出现了分化。这些结果在多重稳健性检验中得到了证实。虽然生育率在国家高度支持的计划生育计划下有所下降,但持续存在的社会经济不平等导致印度儿童健康成果的进展不均衡。
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引用次数: 0
Beyond the biological prime: Deciphering the link between child survival and maternal age in India 超越生理年龄:解读印度儿童存活率与孕产妇年龄之间的联系
IF 2.2 3区 医学 Q2 ECONOMICS Pub Date : 2024-08-22 DOI: 10.1016/j.ehb.2024.101428

This paper investigates the impact of maternal age at birth on child mortality in India, the world's most populous country burdened with significant neonatal and infant mortality. Utilizing data from the latest National Family Health Surveys, covering around 1 million children, our analysis incorporates models with household and biological-mother fixed-effects to address unobserved heterogeneity. Outcomes include neonatal mortality (<28 days), infant mortality (<12 months), and under-5 mortality. Findings reveal a U-shaped relationship between maternal age and child mortality, with the highest risk for mothers below 17 and above 40 years old. Robustness checks confirm the enduring significance of maternal age even after adjusting for socioeconomic factors and time-variant unobservables. Moreover, models with biological-mother fixed-effects suggest higher risks compared to models that only control for observables, indicating that regressions without controls for time-invariant heterogeneity may underestimate the risks of maternal age at birth.

印度是世界上人口最多的国家,新生儿和婴儿死亡率居高不下,本文研究了印度产妇出生年龄对儿童死亡率的影响。利用最新的全国家庭健康调查(涵盖约 100 万名儿童)数据,我们的分析纳入了家庭和亲生母亲固定效应模型,以解决未观察到的异质性问题。结果包括新生儿死亡率(28 天)、婴儿死亡率(12 个月)和 5 岁以下儿童死亡率。研究结果表明,产妇年龄与儿童死亡率呈 U 型关系,17 岁以下和 40 岁以上的产妇风险最高。稳健性检验证实,即使在调整了社会经济因素和时间变量不可观测因素后,产妇年龄仍具有持久意义。此外,与只控制观察变量的模型相比,具有生物学母亲固定效应的模型表明风险更高,这表明不控制时间变量异质性的回归可能会低估产妇出生年龄的风险。
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引用次数: 0
Loneliness during the COVID-19 pandemic: Evidence from five European countries COVID-19 大流行期间的孤独感:来自五个欧洲国家的证据
IF 2.2 3区 医学 Q2 ECONOMICS Pub Date : 2024-08-20 DOI: 10.1016/j.ehb.2024.101427

We use quarterly panel data from the COME-HERE survey covering five European countries to analyse three facets of the experience of loneliness during the COVID-19 pandemic. First, in terms of prevalence, loneliness peaked in April 2020, followed by a U-shape pattern in the rest of 2020, and then remained relatively stable throughout 2021 and 2022. We then establish the individual determinants of loneliness and compare them to those found in the literature predating the COVID-19 pandemic. As in previous work, women are lonelier, and partnership, education, income, and employment protect against loneliness. However, the pandemic substantially shifted the age profile: it is now the youngest who are the loneliest. We last show that pandemic policies affected loneliness, which rose with containment policies but fell with government economic support. Conversely, the intensity of the pandemic itself, via the number of recent COVID-19 deaths, had only a minor impact. The experience of the pandemic has thus shown that public policy can influence societal loneliness trends.

我们利用来自 COME-HERE 调查的季度面板数据(覆盖五个欧洲国家),分析了 COVID-19 大流行期间孤独体验的三个方面。首先,就流行率而言,孤独感在 2020 年 4 月达到顶峰,随后在 2020 年剩余时间内呈现 U 型模式,然后在整个 2021 年和 2022 年保持相对稳定。然后,我们确定了孤独的个体决定因素,并将其与 COVID-19 大流行之前的文献中发现的因素进行比较。与之前的研究结果一样,女性更孤独,而伴侣关系、教育、收入和就业则可防止孤独。然而,大流行大大改变了年龄分布:现在最孤独的是最年轻的人。我们最后指出,大流行病的政策影响了孤独感,孤独感随着遏制政策的实施而上升,但随着政府的经济支持而下降。相反,通过最近 COVID-19 死亡人数来看,大流行病本身的强度只产生了很小的影响。因此,大流行病的经验表明,公共政策可以影响社会的孤独趋势。
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引用次数: 0
Power to choose? Examining the link between contraceptive use decision and domestic violence 选择的权力?研究使用避孕药具的决定与家庭暴力之间的联系
IF 2.2 3区 医学 Q2 ECONOMICS Pub Date : 2024-08-13 DOI: 10.1016/j.ehb.2024.101416

Contraception is a crucial tool that empowers women to control their bodily autonomy. Concurrently, domestic violence remains a pressing public health issue, depleting women’s autonomy. We establish a causal link between a woman’s contraceptive use decision and the occurrence of intimate partner violence. We use an instrumental variable approach to estimate our causal effects by utilizing nationally representative data for India. Using exogenous variation in the neighbourhood average of women’s exposure to family planning messages via radio, we find that if a woman independently makes the decision to use contraceptives, she is at a significantly higher risk of physical, sexual and emotional domestic violence. We estimate the bounds of our effects by assuming the IV to be plausibly exogenous, where we relax the exogeneity condition. Our findings underscore the importance of reproductive health in initiatives that reduce domestic violence and targeted policies that provide support to younger and employed women and those from backward caste and rural areas.

避孕是赋予妇女控制自己身体自主权的重要工具。与此同时,家庭暴力仍然是一个紧迫的公共卫生问题,它削弱了妇女的自主权。我们建立了妇女避孕决定与亲密伴侣暴力发生之间的因果关系。我们采用工具变量法,利用印度具有全国代表性的数据来估算因果效应。利用妇女通过广播接触计划生育信息的邻近地区平均值的外生变化,我们发现,如果妇女独立做出使用避孕药具的决定,她遭受身体暴力、性暴力和情感家庭暴力的风险就会显著增加。我们通过假定 IV 是看似外生的来估计影响的边界,其中我们放宽了外生性条件。我们的研究结果强调了生殖健康在减少家庭暴力的举措中的重要性,以及为年轻妇女、就业妇女、落后种姓妇女和农村妇女提供支持的针对性政策的重要性。
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引用次数: 0
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