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Economic Shocks and Infant Health: The Intergenerational Effects of Import Competition in the U.S.
IF 2 3区 医学
Health economics Pub Date : 2025-02-24 DOI: 10.1002/hec.4946
Patralekha Ukil
{"title":"Economic Shocks and Infant Health: The Intergenerational Effects of Import Competition in the U.S.","authors":"Patralekha Ukil","doi":"10.1002/hec.4946","DOIUrl":"https://doi.org/10.1002/hec.4946","url":null,"abstract":"<p><p>This paper investigates the intergenerational health impacts of a persistent negative economic shock faced by individuals residing in the United States. Specifically, the paper examines the impact of economic shocks in local labor markets on infant health by exploiting the increasing import competition from China between 2005 and 2015 on U.S. commuting zones as a plausibly exogenous source of variation in household economic conditions. Using yearly restricted-access data from the Natality Vital Statistics and yearly measures of the U.S local labor markets' exposure to import competition at the per capita level, this paper provides evidence that negative shocks in the form of worsening local labor market conditions are associated with a negative impact on infant health outcomes. Results indicate that increased import penetration from China in U.S commuting zones led to a reduction in the average birthweight and an increase in the incidence of low birthweight. Analyses of transmission mechanisms suggest worsening household economic circumstances as a result of negative labor market outcomes in the form of reduced wages, reduced household income per capita and increased reliance on food stamps, reduced access to healthcare and an increase in mental health declines among women of childbearing age.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of Tobacco-21 Laws on Maternal Smoking Behavior.
IF 2 3区 医学
Health economics Pub Date : 2025-02-23 DOI: 10.1002/hec.4951
Tim Bersak, Makayla Lavender, Lyudmyla Sonchak-Ardan
{"title":"Impact of Tobacco-21 Laws on Maternal Smoking Behavior.","authors":"Tim Bersak, Makayla Lavender, Lyudmyla Sonchak-Ardan","doi":"10.1002/hec.4951","DOIUrl":"https://doi.org/10.1002/hec.4951","url":null,"abstract":"<p><p>This study employs a logit difference-in-differences model to estimate the extent to which raising the tobacco purchasing age to 21 (T-21) reduced the prevalence of smoking among mothers aged 18-20 both before and during their pregnancies. Using United States Vital Statistics data from 2012 to 2019, we estimate that counties which adopted T-21, whether individually or as part of a state-level policy, experienced small but statistically significant decreases in maternal smoking prior to and during their pregnancies. Our estimates also suggest that the decline in smoking during pregnancy is driven by fewer women smoking prior to pregnancy rather than increased quit rates during pregnancy. Finally, our estimation strategy also allows us to focus on the expansions in New York City and California, which are the locations with the largest number of impacted births in our sample. We estimate T-21 decreased maternal smoking both prior to and during pregnancy in California by up to 14% from baseline. Other studies which examined T-21 on a broader set of young adults have found larger reductions in smoking rates, suggesting that the subpopulation of young mothers who choose to smoke may be relatively less responsive to policies that raise the minimum purchase age of tobacco products.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
There Is No Place Like Home: The Impact of Public Home-Based Care on the Mental Health and Well-Being of Older People.
IF 2 3区 医学
Health economics Pub Date : 2025-02-20 DOI: 10.1002/hec.4948
Ludovico Carrino, Erica Reinhard, Mauricio Avendano
{"title":"There Is No Place Like Home: The Impact of Public Home-Based Care on the Mental Health and Well-Being of Older People.","authors":"Ludovico Carrino, Erica Reinhard, Mauricio Avendano","doi":"10.1002/hec.4948","DOIUrl":"https://doi.org/10.1002/hec.4948","url":null,"abstract":"<p><p>Despite a significant policy shift from institutional to home-based care for older adults, evidence on the effectiveness of policies incentivizing home care is limited. This study provides novel evidence on the causal effect of public home-based care on the mental health and well-being of older people. To address endogenous selection, we implement a novel instrumental variable approach that exploits eligibility rules for long-term care as defined in national legislations. We link longitudinal data from the Survey of Health, Aging & Retirement in Europe (SHARE, 2004-2017) to national LTC eligibility rules in France, Germany, Spain and Belgium (disaggregated for Wallonia and Flanders regions) and examine how exogenous variation in the use of long-term care caused by varying eligibility rules impacts depressive symptoms (EURO-D scale), quality of life (CASP scale) and loneliness (R-UCLA scale). We find that receiving formal home-based care significantly reduces depressive symptom scores by 2.6 points (large effect size measured by Cohen's d) and the risk of depression by 13 percentage points. The use of home-based formal care also increases quality of life as measured by the CASP scale, particularly by increasing feelings of control over life. We show that one potential mechanism involves the impact of home-based care on loneliness: we estimate that receiving formal home-based care reduces the risk of loneliness by 6.7 percentage points. Our results provide evidence that an increase in home-based care coverage is justified in terms of improved mental health and well-being outcomes for older people.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Understanding the Demand-Side of an Illegal Market: A Case Study of the Prohibition of Menthol Cigarettes. 了解非法市场的需求方：薄荷香烟禁令案例研究》。
IF 2 3区 医学
Health economics Pub Date : 2025-02-19 DOI: 10.1002/hec.4937
Don Kenkel, Alan Mathios, Grace Phillips, Revathy Suryanarayana, Hua Wang, Sen Zeng
{"title":"Understanding the Demand-Side of an Illegal Market: A Case Study of the Prohibition of Menthol Cigarettes.","authors":"Don Kenkel, Alan Mathios, Grace Phillips, Revathy Suryanarayana, Hua Wang, Sen Zeng","doi":"10.1002/hec.4937","DOIUrl":"https://doi.org/10.1002/hec.4937","url":null,"abstract":"<p><p>Economic research has long focused on illegal markets and the consequences of prohibitions. We provide a case study of the proposed prohibition of menthol cigarettes, which are smoked by almost 19 million people in the U.S. Illegal markets for menthol cigarettes could not only blunt the prohibition's intended consequence to reduce smoking but could also lead to unintended consequences. We use data from a discrete choice experiment. Our mixed logit model predicts a substantial potential consumer demand for illegal menthol cigarettes, especially if menthol e-cigarettes are also illegal.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Marketing Status and Brand-Name Drug Prices: Evidence From Rx-To-OTC Switch.
IF 2 3区 医学
Health economics Pub Date : 2025-02-17 DOI: 10.1002/hec.4952
Lin Lin, Bo Wang
{"title":"Marketing Status and Brand-Name Drug Prices: Evidence From Rx-To-OTC Switch.","authors":"Lin Lin, Bo Wang","doi":"10.1002/hec.4952","DOIUrl":"https://doi.org/10.1002/hec.4952","url":null,"abstract":"<p><p>This study examines the impact of marketing status on brand-name pricing by exploiting Prescription to over-the-counter (Rx-to-OTC) switches between 2001 and 2016. Using a Stacked difference-in-differences design, we find that the retail prices of brand-name drugs reduce substantially following an Rx-to-OTC switch, while accounting for potential confounding factors related to patent expiration and generic entry. We show that the reduction in branded prices is primarily driven by increases in patient price elasticity in the OTC market. These results highlight the need to improve patient price sensitivity to address the rising prices of brand-name prescription drugs in the United States, especially those with characteristics similar to over-the-counter drugs.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Strategic Coding in the Assessment of Long-Term Care Needs: Evidence From France.
IF 2 3区 医学
Health economics Pub Date : 2025-02-11 DOI: 10.1002/hec.4950
Delphine Roy
{"title":"Strategic Coding in the Assessment of Long-Term Care Needs: Evidence From France.","authors":"Delphine Roy","doi":"10.1002/hec.4950","DOIUrl":"https://doi.org/10.1002/hec.4950","url":null,"abstract":"<p><p>There is strong evidence of \"upcoding\" whereby health care providers overstate the severity of disease to increase billing revenue. Much less is known about strategic coding in the assessment of patient eligibility for long-term care. This paper takes advantage of a unique French linked survey dataset to document how patient assessment depends critically on the incentives of the assessing agents. I find that nursing homes assess their patients to be more disabled (thus increasing their revenue) compared to community assessors who seek to minimize disability payments levels. Public hospital-owned long-term care facilities are more likely to overrate disability levels; there is also evidence that cognitively impaired or socially disadvantaged patients exhibit more disability upcoding. In the context of nursing homes, upcoding might be read as \"side-coding,\" driven by flaws in the assessment tool that does not allow the care provider to adequately fund the time they spend on these patients. Conversely, assessors of patients living in the community could downcode disability to shift some of the care tasks to informal caregivers.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Power of Presence: The Impact of Paternity Leave on Child Health in China.
IF 2 3区 医学
Health economics Pub Date : 2025-02-08 DOI: 10.1002/hec.4947
Xiaoman Li, Yu Fu, Ailin Mao
{"title":"The Power of Presence: The Impact of Paternity Leave on Child Health in China.","authors":"Xiaoman Li, Yu Fu, Ailin Mao","doi":"10.1002/hec.4947","DOIUrl":"https://doi.org/10.1002/hec.4947","url":null,"abstract":"<p><p>Based on multi-source data, this study uses a cross-regional and birth-cohort variation to construct a cross-sectional difference-in-differences model analyzing the impact of paternity leave (PL) policies on children's health outcomes, and explores underlying mechanism. The study finds that PL polices significantly improve children's health, with parallel trends tests and placebo tests demonstrating strong robustness of these findings. Further research reveals that PL can improve children's health through three pathways: encouraging fathers' involvement in childcare, increasing medical expenditure, and forming reasonable family labor division. Meanwhile, the policy shows significant heterogeneous effects on children's health outcomes across different family sizes and father's job types. Finally, this study further explores various factors affecting the implementation of PL, aiming to provide empirical evidence for policy-makers.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Spillovers From Medicaid Contraceptive Use to Non-Medicaid Patients: Evidence From New York.
IF 2 3区 医学
Health economics Pub Date : 2025-02-03 DOI: 10.1002/hec.4945
Kevin Callison, Marisa Carlos, Barton Willage
{"title":"Spillovers From Medicaid Contraceptive Use to Non-Medicaid Patients: Evidence From New York.","authors":"Kevin Callison, Marisa Carlos, Barton Willage","doi":"10.1002/hec.4945","DOIUrl":"https://doi.org/10.1002/hec.4945","url":null,"abstract":"<p><p>This study examines spillovers from a 2014 New York Medicaid policy change that increased reimbursement for immediate postpartum long-acting reversible contraceptive (LARC) insertion. Using administrative data on hospital deliveries from 2011 through 2019, we analyze whether physicians who inserted immediate postpartum LARCs for Medicaid patients following the policy change were more likely to subsequently perform the procedure on non-Medicaid patients. We find significant spillovers, as physicians who first perform an immediate postpartum Medicaid LARC insertion following the 2014 payment reform are 9.3 percentage points more likely to perform immediate postpartum non-Medicaid LARC insertions; an association that increases with the physician's share of Medicaid deliveries. To distinguish between physician-specific and hospital-specific factors driving spillovers, we compare physicians within the same hospital-year. Results indicate approximately half the spillover is due to physician-specific factors and half to hospital-specific factors. Our findings highlight how targeted reimbursement policies can have broader impacts beyond the intended population and demonstrate the influence of both individual physician behavior and institutional factors in shaping clinical practice patterns. Understanding these spillover dynamics is important for policymakers and healthcare providers aiming to promote effective and equitable contraceptive care across patient populations.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Drug Decriminalization and Fatal Traffic Crashes: Evidence From BM110 in Oregon.
IF 2 3区 医学
Health economics Pub Date : 2025-01-31 DOI: 10.1002/hec.4944
Christian Gunadi, Yuyan Shi
{"title":"Drug Decriminalization and Fatal Traffic Crashes: Evidence From BM110 in Oregon.","authors":"Christian Gunadi, Yuyan Shi","doi":"10.1002/hec.4944","DOIUrl":"https://doi.org/10.1002/hec.4944","url":null,"abstract":"<p><p>Oregon Ballot Measure 110 (BM 110) reduced the penalties for non-commercial possession of a controlled substance, downgrading them from a felony or misdemeanor to a new Class E violation, punishable by a maximum $100 fine. In this paper, we investigate whether BM 110 was associated with changes in drug-related fatal traffic crashes in Oregon after its implementation in February 2021. To do so, we used Fatality Analysis Reporting System (FARS) data from 2018 to 2021 to calculate population-adjusted state-level drug-related fatal traffic crashes. We also employed a modified synthetic control method to create a \"synthetic\" Oregon, designed to closely resemble the state's pre-policy sociodemographic characteristics and outcome trends while correcting for time-invariant pre-policy differences. The findings show that BM 110 was not associated with changes in drug-related fatal traffic crashes per 100,000 population (0.114, 95% CI: -0.106, 0.334). These results suggest that the implementation of BM 110 did not change drug-related fatal traffic crashes in Oregon in the early period following its adoption.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Effects of Resigning GPs on Patient Healthcare Utilization and Some Implications for Health.
IF 2 3区 医学
Health economics Pub Date : 2025-01-30 DOI: 10.1002/hec.4941
Daniel Monsees, Matthias Westphal
{"title":"The Effects of Resigning GPs on Patient Healthcare Utilization and Some Implications for Health.","authors":"Daniel Monsees, Matthias Westphal","doi":"10.1002/hec.4941","DOIUrl":"https://doi.org/10.1002/hec.4941","url":null,"abstract":"<p><p>We study the effects of general practitioners' (GPs') resignations on their patients' healthcare utilization and diagnoses in an event-study setting. Using claims data from a large German statutory health insurance, we find that after physicians leave, their former patients persistently reduce their primary care utilization, only partially substituting it with specialist visits and hospital care. Because patients find a new GP already 1.1 quarters after the old resigns, on average, the persistent effects must be explained through the new GP. Indeed, the new GP serves more patients but performs less diagnostic testing. Our results reveal a substantial decrease in diagnoses of many relevant chronic conditions (such as congestive heart failure and diabetes), suggesting that disruptions may have adverse consequences for the efficiency of the healthcare system. This indicates that continuity in primary care is pivotal and shows that the GP has an essential role in healthcare delivery, particularly in healthcare systems such as Germany, where GPs often have a high workload and little consultation time.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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