Benjamin Hansen , Joseph J. Sabia , Drew McNichols , Calvin Bryan
{"title":"Do tobacco 21 laws work?","authors":"Benjamin Hansen , Joseph J. Sabia , Drew McNichols , Calvin Bryan","doi":"10.1016/j.jhealeco.2023.102818","DOIUrl":"10.1016/j.jhealeco.2023.102818","url":null,"abstract":"<div><p>Tobacco 21 (T-21) laws raise the minimum legal purchasing age for all tobacco products to 21. This study is the first to examine the impact of statewide T21 laws on teenage and young adult cigarette and electronic cigarette (e-cigarette) use. Using survey data from the Behavioral Risk Factor Surveillance System (BRFSS) and a difference-in-differences approach, we find that statewide adoption of a T-21 law is associated with a 2-to-4 percentage-point decline in smoking participation among 18-to-20-year-olds. Supplemental analyses using the State Youth Risk Behavior Surveys (YRBS) show that frequent e-cigarette use among 18-year-olds also fell following the adoption of T21 laws, though this effect was partially because teens turned to informal social sources to obtain e-cigarettes (i.e., borrowing or bumming). Finally, we find that T-21 laws generate spillover effects, including (2) reductions in cigarette use among 16-to-17-year-olds, a group that relies heavily on informal social markets in high school, and (2) reductions in marijuana use and days of alcohol use among some teens.</p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"92 ","pages":"Article 102818"},"PeriodicalIF":3.5,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89720334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Undral Byambadalai , Ching-to Albert Ma , Daniel Wiesen
{"title":"Changing preferences: An experiment and estimation of market-incentive effects on altruism","authors":"Undral Byambadalai , Ching-to Albert Ma , Daniel Wiesen","doi":"10.1016/j.jhealeco.2023.102808","DOIUrl":"10.1016/j.jhealeco.2023.102808","url":null,"abstract":"<div><p><span>This paper studies how altruistic preferences are changed by markets and incentives. We conduct a laboratory experiment with a within-subject design. Subjects are asked to choose health care qualities<span><span> for hypothetical patients in monopoly, </span>duopoly, and quadropoly. Prices, costs, and patient benefits are experimental incentive parameters. In monopoly, subjects choose quality by trading off between profits and altruistic patient benefits. In duopoly and quadropoly, subjects play a simultaneous-move game. Uncertain about an opponent’s </span></span>altruism, each subject competes for patients by choosing qualities. Bayes-Nash equilibria describe subjects’ quality decisions as functions of altruism. Using a nonparametric method, we estimate the population altruism distributions from Bayes-Nash equilibrium qualities in different markets and incentive configurations. Competition tends to reduce altruism, but duopoly and quadropoly equilibrium qualities are much higher than monopoly. Although markets crowd out altruism, the disciplinary powers of market competition are stronger. Counterfactuals confirm markets change preferences.</p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"92 ","pages":"Article 102808"},"PeriodicalIF":3.5,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41172903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Patient and peer: Guideline design and expert response","authors":"Jane Greve , Søren Rud Kristensen , Nis Lydiksen","doi":"10.1016/j.jhealeco.2023.102806","DOIUrl":"10.1016/j.jhealeco.2023.102806","url":null,"abstract":"<div><p><span>We examine how patients’ medical expertise influences adherence to clinical guidelines for a treatment that is common, costly, and rationed by the clinical guidelines. Using administrative data on </span>prenatal diagnostic testing (PDT), we compare the testing rates of medically trained patients (experts) and non-medically trained patients (non-experts) on the margin of eligibility thresholds in clinical guidelines. We find that experts are 9 percentage points more likely to receive PDT than non-experts when they are not eligible for testing and that more than 80% of the difference can be attributed to medical expertise. Our results suggest that the design of clinical guidelines is important for adherence and that having medical expertise as a patient affects treatment, when there is room for a deviation from the guideline.</p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"92 ","pages":"Article 102806"},"PeriodicalIF":3.5,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41146314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Panka Bencsik , Timothy J. Halliday , Bhashkar Mazumder
{"title":"The intergenerational transmission of mental and physical health in the United Kingdom","authors":"Panka Bencsik , Timothy J. Halliday , Bhashkar Mazumder","doi":"10.1016/j.jhealeco.2023.102805","DOIUrl":"10.1016/j.jhealeco.2023.102805","url":null,"abstract":"<div><p>As health is increasingly recognized as a key component of human welfare, a new line of research on intergenerational mobility has emerged that focuses on broad measures of health. We extend this research to consider two key components of health: physical health and mental health. We use rich survey data from the United Kingdom linking the health of adult children at around age 30 to their parents. We estimate that the rank–rank slope in health is 0.17 and the intergenerational health association is 0.19 suggesting relatively rapid mobility compared to other outcomes such as income. We find that while both mental and physical health have a similar degree of intergenerational persistence, parents’ mental health is much more strongly associated with broad measures of adult children’s health than parents’ physical health. We also show that the primacy of parent mental health over physical health on children’s health appears to emerge during early adolescence. Finally, we construct a comprehensive measure of welfare by combining income and health and estimate a rank–rank association of 0.27. This is considerably lower than the comparable estimate of 0.43 from the US suggesting that there is greater mobility in welfare in the UK than in the US.</p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"92 ","pages":"Article 102805"},"PeriodicalIF":3.5,"publicationDate":"2023-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41105866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Long-Term Health Benefits of Occupational Licensing: Evidence from Midwifery Laws","authors":"Hamid Noghanibehambari , Jason Fletcher","doi":"10.1016/j.jhealeco.2023.102807","DOIUrl":"10.1016/j.jhealeco.2023.102807","url":null,"abstract":"<div><p>During the late 19<sup>th</sup> and early 20<sup>th</sup><span> century, several states mandated midwifery<span><span> licensing requirements to improve midwives’ knowledge, education, and quality. Previous studies point to the health benefits of midwifery quality improvements for maternal and infant health outcomes. This paper exploits the staggered adoption of midwifery laws across states using event-study and difference-in-difference frameworks. We use the universe of death records in the US over the years 1979-2020 and find that exposure to a midwifery licensing law at birth is associated with a 2.5 percent reduction in cumulative mortality rates and an increase of 0.6 months in longevity during adulthood and old age. The effects are concentrated on deaths due to infectious </span>diseases, neoplasm diseases, and suicide mortality. We also show that the impacts are confined among blacks and are slightly larger among males. Additional analyses using alternative data sources suggest small but significant increases in educational attainments, income, measures of socioeconomic status, employment, and measures of height as potential mechanism channels. We provide a discussion on the economic magnitude and policy implication of the results.</span></span></p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"92 ","pages":"Article 102807"},"PeriodicalIF":3.5,"publicationDate":"2023-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10673046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Helen H. Jensen , Brent E. Kreider , John V. Pepper , Oleksandr Zhylyevskyy , Kimberly A. Greder
{"title":"Causal effects of mental health on food security","authors":"Helen H. Jensen , Brent E. Kreider , John V. Pepper , Oleksandr Zhylyevskyy , Kimberly A. Greder","doi":"10.1016/j.jhealeco.2023.102804","DOIUrl":"10.1016/j.jhealeco.2023.102804","url":null,"abstract":"<div><p>Although mental health conditions are known to be associated with socioeconomic hardships, their causal effects remain largely unexplored. Using a sample of low-income families in the National Health Interview Survey (NHIS), we assess causal effects of serious mental illness (SMI) and related mental health conditions on family food security. We apply partial identification methods to account for fundamental endogeneity and measurement identification problems in a unified framework. To implement these methods, we combine a proxy measure of SMI in the NHIS with an estimate of the true rate of SMI from the Substance Abuse and Mental Health Services Administration. We also develop an innovative approach to approximate true prevalence rates when only self-reported prevalence rates are available. Applying relatively weak monotonicity assumptions on latent food security outcomes, we find that alleviating SMI would improve the food security rate by at least 9.5 percentage points, or 15 %.</p><p><em>JEL codes:</em> C21, I10, I38</p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"92 ","pages":"Article 102804"},"PeriodicalIF":3.5,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41180396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Health outcomes and provider choice under full practice authority for certified nurse-midwives","authors":"Lauren Hoehn-Velasco , Diana R. Jolles , Alicia Plemmons , Adan Silverio-Murillo","doi":"10.1016/j.jhealeco.2023.102817","DOIUrl":"10.1016/j.jhealeco.2023.102817","url":null,"abstract":"<div><p>Full practice authority grants non-physician providers the ability to manage patient care without physician oversight or direct collaboration. In this study, we consider whether full practice authority for certified nurse-midwives (CNMs/CMs) leads to changes in health outcomes or CNM/CM use. Using U.S. birth certificate and death certificate records over 2008–2019, we show that CNM/CM full practice authority led to little change in obstetric outcomes, maternal mortality, or neonatal mortality. Instead, full practice authority increases (reported) CNM/CM-attended deliveries by one percentage point while decreasing (reported) physician-attended births. We then explore the mechanisms behind the increase in CNM/CM-attended deliveries, demonstrating that the rise in CNM/CM-attended deliveries represents higher use of existing CNM/CMs and is not fully explainable by improved reporting of CNM/CM deliveries or changes in CNM/CM labor supply.</p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"92 ","pages":"Article 102817"},"PeriodicalIF":3.5,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41179140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Overweight grandsons and grandfathers’ starvation exposure","authors":"Dora L. Costa","doi":"10.1016/j.jhealeco.2023.102796","DOIUrl":"10.1016/j.jhealeco.2023.102796","url":null,"abstract":"<div><p>Much of the increase in the prevalence of overweight and obesity has been in developing countries with a history of famines and malnutrition. This paper is the first to examine overweight among adult grandsons of grandfathers exposed to starvation during developmental ages. I study grandsons born to grandfathers who served in the Union Army during the US Civil War (1861-5) where some grandfathers experienced severe net malnutrition because they suffered a harsh POW experience. I find that male-line but not female-line grandsons of grandfathers who survived a severe captivity during their growing years faced a 21% increase in mean overweight and a 2% increase in mean BMI compared to grandsons of non-POWs. Male-line grandsons descended from grandfathers who experienced a harsh captivity faced a 22%–28% greater risk of dying every year after age 45 relative to grandsons descended from non-POWs, with overweight accounting for 9%–14% of the excess risk.</p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"91 ","pages":"Article 102796"},"PeriodicalIF":3.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10593129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10629485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The rise and fall of SES gradients in heights around the world","authors":"Elisabetta Aurino , Adriana Lleras-Muney , Alessandro Tarozzi , Brendan Tinoco","doi":"10.1016/j.jhealeco.2023.102797","DOIUrl":"10.1016/j.jhealeco.2023.102797","url":null,"abstract":"<div><p>We use data from a large sample of low- and middle-income countries to study the association (or “gradient”) between child height and maternal education. We show that the gap in height between high- and low-SES children is small at birth, rises throughout childhood, and declines in adolescence as girls and boys go through puberty. This inverted U-shaped pattern is consistent with a degree of catch-up in linear height among children of low- relative to high-SES families, in partial contrast to the argument that height deficits cannot be overcome after the early years of life. This finding appears to be explained by the association between SES and the timing of puberty and therefore of the adolescent growth spurt: low-SES children start their adolescent growth spurt later and stop growing at later ages as well.</p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"91 ","pages":"Article 102797"},"PeriodicalIF":3.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10649847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sumedha Gupta , Thuy Nguyen , Patricia R. Freeman , Kosali Simon
{"title":"Competitive effects of federal and state opioid restrictions: Evidence from the controlled substance laws","authors":"Sumedha Gupta , Thuy Nguyen , Patricia R. Freeman , Kosali Simon","doi":"10.1016/j.jhealeco.2023.102772","DOIUrl":"10.1016/j.jhealeco.2023.102772","url":null,"abstract":"<div><p><span>A significant concern in the policy landscape of the U.S. opioid crisis is whether supply-side controls can reduce opioid prescribing without harmful substitution. We consider an unstudied policy: the federal Controlled Substance Act (CSA) restrictions placed in August 2014 on tramadol, the second most popular opioid medication. This was followed seven weeks later by CSA restrictions for hydrocodone<span> combination products, the leading opioids on the market. Using regression discontinuity design (RDD) models, based on the timing of the (up-)scheduling changes, to explore </span></span>spillover effects, we find that tightening prescribing restrictions on one opioid reduces its use, but increases prescribing of close competitors, leading to no reduction in total opioid prescriptions.This suggests that supply restrictions are not effective in reducing opioid prescribing the presence of close substitutes that remain unrestricted.</p></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"91 ","pages":"Article 102772"},"PeriodicalIF":3.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10286591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}