Brandyn F. Churchill, Bijesh Gyawali, Joseph J. Sabia
{"title":"Anti-Bullying Laws and Weight-Based Disparities in Suicidality","authors":"Brandyn F. Churchill, Bijesh Gyawali, Joseph J. Sabia","doi":"10.1002/hec.70015","DOIUrl":"10.1002/hec.70015","url":null,"abstract":"<div>\u0000 \u0000 <p>Appearance-based bullying is common among teenagers and may inflict substantial psychological harm on its victims. Overweight and obese students are both more likely to be bullied at school and more likely to engage in suicidal behaviors than their healthy-weight counterparts. This study is the first to explore how anti-bullying laws (ABLs) affect disparities in suicidality between overweight and obese U.S. high school students compared to their and healthy-weight counterparts. Using data from the National and State Youth Risk Behavior Surveys and a difference-in-differences approach, we find that ABL adoption is associated with a 6–19 percent reduction in suicidal behaviors among overweight or obese teens; estimates for healthy-weight teens are considerably smaller in magnitude and statistically insignificant. Weight-based disparities in suicidal behaviors are reduced most by ABLs among obese teenage girls. An exploration of mechanisms suggests that improvements in the quality of peer interactions in school—rather than ABL-induced changes in body weight (sample selection) or students' own-weight perception—generate disparate mental health gains for at-risk youth. We conclude that curbing targeted bullying based on appearance yields important health benefits.</p>\u0000 </div>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"34 11","pages":"1977-2003"},"PeriodicalIF":2.4,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626046","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}
Maria José Gil-Moltó, Arne Risa Hole, Henrik Andersson, Geir Godager
{"title":"The Impact of Incentives on Valuing Health Risks","authors":"Maria José Gil-Moltó, Arne Risa Hole, Henrik Andersson, Geir Godager","doi":"10.1002/hec.70011","DOIUrl":"10.1002/hec.70011","url":null,"abstract":"<p>Recent research has found that health risk values elicited using Discrete Choice Experiments (DCEs) may be inadequately sensitive to the magnitude of the risk reduction, a phenomenon referred to as insensitivity to scope. This paper investigates the use of DCEs to estimate the value of a statistical life (VSL) under different experimental conditions. In particular, we use an experimental design where in one experimental arm we carry out a standard unincentivised DCE as in the existing literature, while in the other experimental arm we carry out an incentivized version of the DCE with real payments. Our findings suggest that the incentive has an impact on the results, in the sense that the VSL estimates are higher in the unincentivised arm of the experiment. However, we find evidence of external insensitivity to scope in both experimental arms and only weak evidence of stronger internal sensitivity to scope in the incentivized arm. Hence, our results suggest that a lack of scope sensitivity is unrelated to the hypothetical nature of the payments in stated-preference valuations of health risks.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"34 10","pages":"1907-1920"},"PeriodicalIF":2.4,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hec.70011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144617147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Adolescent Mental Health: Impact of Introducing Earlier Compulsory School Grades","authors":"Anna Linder, Ulf-G. Gerdtham, Gawain Heckley","doi":"10.1002/hec.4982","DOIUrl":"10.1002/hec.4982","url":null,"abstract":"<p>We examine how the earlier introduction of compulsory school grades affects the likelihood of receiving a mental disorder diagnosis among Swedish adolescents. We exploit a school reform that shifted the introduction of grades from grade 8 to grade 6, resulting in first exposure to grading at different ages between cohorts. Our results show that girls exposed to earlier grading are more likely to be diagnosed with internalizing disorders, such as depression and anxiety, by the end of compulsory school. This effect is particularly pronounced among students with low to moderate academic achievement. We also find suggestive evidence that both girls and boys exposed to earlier grading face an increased risk of being diagnosed with alcohol-related disorders. These findings highlight that early exposure to grading may have unintended adverse effects on adolescent mental health. Education systems should acknowledge these potential risks and consider implementing complementary mental health support when revising grading policies.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"34 9","pages":"1731-1746"},"PeriodicalIF":2.4,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hec.4982","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sick of Robots—Heterogeneous Effects of Industrial Robots on Sickness Absence","authors":"Janis Umblijs, Kjersti Misje Østbakken","doi":"10.1002/hec.70010","DOIUrl":"10.1002/hec.70010","url":null,"abstract":"<p>This paper studies how the introduction of industrial robots affects sickness absence among workers in the manufacturing sector in Norway. We use data on the imports of industrial robots at the firm level, combined with employee-firm linked register data, to investigate the impact of robotization on the duration of sick leave (SL). We find that robotization leads to a statistically significant increase in SL duration of approximately 1.7 days. Workers in blue-collar occupations are especially negatively affected, and among this group those with routine tasks experience even higher levels of SL following robotization, with an average increase of around 5 days. We conduct additional analyses looking at different categories of diagnoses across various occupation groups and find heterogeneous effects. Our results suggest that for blue-collar and routine workers robotization leads to increased musculoskeletal SL, while we only observe an increase in injuries for STEM workers, with maintenance engineers especially negatively affected. Our findings suggest several mechanisms that differ by type of occupation, ranging from musculoskeletal diagnoses caused by repetitive strain to an increase in injuries resulting from working directly with the newly installed industrial robots.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"34 10","pages":"1882-1906"},"PeriodicalIF":2.4,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hec.70010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Education and Mental Health in Young Adulthood: New Evidence From Genetic Markers","authors":"Alex Xingbang Weng","doi":"10.1002/hec.70012","DOIUrl":"10.1002/hec.70012","url":null,"abstract":"<div>\u0000 \u0000 <p>This paper presents new evidence on the impact of education on depression in young adults. Utilizing data from the National Longitudinal Study of Adolescent to Adult Health, I employ family fixed-effect regressions and an instrumental variable approach using genetic scores. I find having a college degree is associated with a reduction in depression symptoms by 0.4–0.5 standard deviations and a decrease in the probability of experiencing major depression by 8%–12%. These findings are robust when exclusion restriction assumptions of the instrument are relaxed. A college degree appears to have a stronger protective effect on mental health for LGB individuals compared to heterosexuals. I find that education could affect mental health outcomes from better labor market outcomes and improved health behaviors. These results suggest that bolstering educational attainment could be an effective way to battle the high rate of depression.</p>\u0000 </div>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"34 10","pages":"1869-1881"},"PeriodicalIF":2.4,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575356","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}
{"title":"Income and Health Care Consumption: Evidence From Mortgage Payment Shocks","authors":"Hong Lee, Deokrye Baek, Joseph R. Mason","doi":"10.1002/hec.70009","DOIUrl":"10.1002/hec.70009","url":null,"abstract":"<p>During the Great Recession, monetary stimulus had asymmetric impacts on mortgages with different interest rate structures, leading to a significant and unexpected reduction in mortgage payments for adjustable-rate mortgage (ARM) borrowers, which in turn increased their disposable income. Leveraging this quasi-experimental setup, our analysis reveals that healthcare expenditures and medical service utilization increased in counties with a higher prevalence of ARMs. The heterogeneity between ARM and fixed-rate mortgage (FRM) borrowers, combined with the more pronounced economic decline observed in counties densely populated with ARMs, allows our study to provide conservative lower bound estimates of the effects of income shocks on household healthcare consumption.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"34 10","pages":"1853-1868"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hec.70009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lise Desireé Hansen, Trine Kjær, Dorte Gyrd-Hansen
{"title":"The Citizens' Distributional Preferences for Health Care Resource Allocations: The Non-Negligible Role of Option Value","authors":"Lise Desireé Hansen, Trine Kjær, Dorte Gyrd-Hansen","doi":"10.1002/hec.70006","DOIUrl":"10.1002/hec.70006","url":null,"abstract":"<p>The stated preference literature on equity in health aims to enhance our understanding of the public's preferences for allocation of health resources to promote fairness and justice in the distribution of healthcare. This paper explores how different elicitation approaches impact on the elicited distributional preferences in the context of health. We randomly allocated respondents to one of two elicitation approaches: the <i>ex post</i> social decision maker perspective and the private <i>ex ante</i> insurance perspective. Respondents were asked to make choices between healthcare resource allocation distributions that follow different priority rules regarding maximization and equality. We find that preferences differ across the two approaches with the health maximization objective receiving less support under the <i>ex ante</i> perspective. The contribution of this paper is to demonstrate that option value, in addition to inequality aversion, provides an important argument for average citizens' distributional preferences, and that both sets of preferences may represent important inputs to policy making.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"34 10","pages":"1773-1781"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hec.70006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Social Comparisons and Adolescent Body Misperception: Evidence From School Entry Cutoffs","authors":"Christopher S. Carpenter, Brandyn F. Churchill","doi":"10.1002/hec.4980","DOIUrl":"10.1002/hec.4980","url":null,"abstract":"<div>\u0000 \u0000 <p>We provide novel evidence on the role of social comparisons in shaping adolescent body misperception. Using an instrumental variables approach leveraging variation in relative age generated by school entry cutoff months and data from the Health Behaviour in School-Aged Children study, we show that relatively younger students are more likely to describe their bodies as lighter than the clinically relevant BMI category implied by their reported heights and weights compared to their same-age counterparts who are relatively older within their respective classrooms. This result is driven by relatively younger students who are classified as normal weight for their age describing themselves as “too thin.” We then show that relatively younger students are more likely to desire to gain weight, consume more calorie-dense foods, and report lower levels of physical activity. Overall, our results suggest that relatively younger students base their weight-related expectations and behaviors on their older peers.</p>\u0000 </div>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"34 9","pages":"1691-1730"},"PeriodicalIF":2.4,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527634","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}
{"title":"Deploying Differential Distance as an Instrumental Variable: Alternative Forms, Estimators, and Specifications","authors":"Donghoon Lee, Anirban Basu","doi":"10.1002/hec.70003","DOIUrl":"10.1002/hec.70003","url":null,"abstract":"<div>\u0000 \u0000 <p>Despite well-established econometric theory, less attention is paid to the type of treatment effects being estimated using alternate instrumental variable (IV) approaches and the support for IV in the health literature. We illustrate this case using a commonly used IV—differential distance (DD). We summarize the literature and find that DD was used as an IV in various forms and approaches in the literature, leading to the estimation of different identified parameters, which were not always explained. We illustrate the sources of these differences using theoretical reasoning and a case study to evaluate the causal effects of going to a for-profit (FP) hospital versus a not-for-profit (NFP) hospital on the total cost of psychiatric inpatient stay. We find that estimates of treatment effects differ considerably when using two-stage least squares with binary versus continuous DD. In contrast, two-stage residual inclusion (2SRI) approaches using binary or continuous DD yield similar estimates of the treatment effects when we adequately model the control function. Both the 2SRI estimates are close to the average treatment effect estimate generated by local IV approaches, which can illustrate the extent of selection into FP versus NFP hospitals through marginal treatment effect heterogeneity.</p>\u0000 </div>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"34 10","pages":"1832-1852"},"PeriodicalIF":2.4,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527633","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}
{"title":"A Simple Measure of Catastrophic Health Expenditures","authors":"Tomson Ogwang, Germano Mwabu","doi":"10.1002/hec.70007","DOIUrl":"10.1002/hec.70007","url":null,"abstract":"<p>In this paper, we propose a simple Watts-type measure of catastrophic health expenditure (CHE) which is an adaptation of the classic Watts poverty measure. The appeal of the proposed measure stems from the fact that it is both additively decomposable (i.e., it provides information on the contributions of the various population subgroups of interest, e.g., as categorized by gender, race, region, etc., to the overall level of CHE), and multiplicatively decomposable (i.e., it enables identification of three key drivers of CHE, namely, CHE incidence, CHE intensity and CHE inequality). We also describe how the Watts-type CHE measure can be estimated and additively decomposed using the widely available ordinary least squares regression packages. The empirical example provided shows the policy value of the Watts-type CHE measure, which makes it a useful supplement to the Foster-Greer-Thorbecke type measures of CHE recently proposed by Ogwang and Mwabu. Temporal dynamics in the Watts-type CHE measures are also introduced.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"34 10","pages":"1821-1831"},"PeriodicalIF":2.4,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hec.70007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144495945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}