{"title":"The impact of the Female Secondary School Stipend Program on child health","authors":"Md Shahjahan, Giulia La Mattina, Padmaja Ayyagari","doi":"10.1016/j.jhealeco.2025.103024","DOIUrl":"10.1016/j.jhealeco.2025.103024","url":null,"abstract":"<div><div>In this study, we examine the inter-generational effects of the 1994 Female Secondary School Stipend Program (FSSSP) on child health inputs and child health outcomes in Bangladesh. Prior studies have shown that the FSSSP significantly increased secondary schooling among rural girls. Applying a difference-in-differences model based on differential exposure to FSSSP by birth cohort and rural residence, we find that full immunization rates increased by 4.2 percentage points among children of mothers eligible for a stipend for 5 years relative to children of mothers who were not eligible, but there were no significant effects for children of mothers eligible for a stipend for only 2 years. We also find improvements in other health inputs (e.g., antenatal care) and in child health outcomes (e.g., mortality). We also explore changes in marriage, fertility, autonomy, labor supply, and media exposure, which may contribute to the observed improvements in child health.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"102 ","pages":"Article 103024"},"PeriodicalIF":3.4,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144321994","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":"Attentional processes underlying health state valuation with time trade-off and standard gamble tasks","authors":"Stefan A. Lipman , Thorsten Pachur","doi":"10.1016/j.jhealeco.2025.103026","DOIUrl":"10.1016/j.jhealeco.2025.103026","url":null,"abstract":"<div><div>Time Trade-Off (TTO) and Standard Gamble (SG) tasks are commonly used methods to measure utilities for health states (e.g., diabetes, being in a wheelchair). Importantly, however, the two methods have been shown to typically yield discrepant utilities for a given health state. Here we examine the cognitive processes underlying this <em>utility gap</em> by analyzing individuals’ attentional patterns when evaluating health states in the TTO and SG tasks. In an online experiment, each respondent completed both a TTO and an SG task and we used the process-tracing methodology Mouselab to record respondents’ attention allocation to the tasks’ attributes: health states and their durations (in both TTO and SG), and probabilities (in SG only). In the TTO task, attention was approximately balanced between the health state and duration attributes, whereas in the SG task, attention was focussed on the probability and the health state attributes. Individuals who paid more attention to the task-specific trade-off attribute (i.e., duration and probability in TTO and SG, respectively) seemed to be less willing to make those trade-offs, leading to higher utilities for the health states. Notably, the utility gap was associated with individual differences in attention allocation: respondents who adjusted their attention allocation less to the task-specific trade-offs produced more discrepant utilities between the TTO and SG tasks. Our findings underscore the key role of attentional processes in preference construction, highlighting that differences in the utilities people assign to health states could potentially be influenced by altering attention allocation.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"102 ","pages":"Article 103026"},"PeriodicalIF":3.4,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365488","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}
Dhaval Dave , Yang Liang , Johanna Catherine Maclean , Caterina Muratori , Joseph J. Sabia
{"title":"The Effect of E-Cigarette Taxes on Substance Use","authors":"Dhaval Dave , Yang Liang , Johanna Catherine Maclean , Caterina Muratori , Joseph J. Sabia","doi":"10.1016/j.jhealeco.2025.103022","DOIUrl":"10.1016/j.jhealeco.2025.103022","url":null,"abstract":"<div><div>Public health advocates warn that the rapid growth of legal markets for electronic nicotine delivery systems (ENDS) may generate a “gateway” to marijuana and harder drug consumption, particularly among teenagers. This study explores the effects of ENDS taxes on substance use. Analyses are based on difference-in-differences and event-study methods applied to both survey (Youth Risk Behavior Surveillance System and Behavioral Risk Factor Surveillance System) and administrative (Treatment Episode Data Set) data. Our results imply that a one-dollar increase in ENDS taxes (2023$) is associated with a 1.0 to 1.5 percentage point decline in teen marijuana use and in co-use of ENDS and marijuana. This result is consistent with e-cigarettes and marijuana being economic complements. We also find that youth responses to ENDS taxes, in terms of their ENDS use and spillovers into marijuana use, appear to moderate over the longer term. We find no evidence that ENDS taxes affect drug treatment admissions or consumption of illicit drugs other than marijuana such as cocaine, methamphetamine, or opioids.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"102 ","pages":"Article 103022"},"PeriodicalIF":3.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144571284","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}
Jill R. Horwitz , Austin Nichols , Anthony Yu , Carrie H. Colla , David M. Cutler
{"title":"Technology regulation reconsidered: The effects of certificate of need policies on the quantity and quality of diagnostic imaging","authors":"Jill R. Horwitz , Austin Nichols , Anthony Yu , Carrie H. Colla , David M. Cutler","doi":"10.1016/j.jhealeco.2025.103020","DOIUrl":"10.1016/j.jhealeco.2025.103020","url":null,"abstract":"<div><div>Estimates of the impact of Certificate of Need (CON) laws on medical care have been inconsistent, possibly because not all CON laws apply to all services. Using an original dataset identifying imaging-related CON laws and a regression discontinuity design at state borders, we estimate the effects of CON on the use and quality of diagnostic imaging. Medicare beneficiaries in regulated states are less likely to receive any image and even less likely to receive low-value imaging than beneficiaries in unregulated states. High-value imaging is unaffected. Overall, CON for imaging reduces low-value care and leaves high-value care unchanged.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"102 ","pages":"Article 103020"},"PeriodicalIF":3.4,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144330319","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}
Adeline Delavande , Emilia Del Bono , Angus Holford
{"title":"Imprecise health beliefs and health behavior","authors":"Adeline Delavande , Emilia Del Bono , Angus Holford","doi":"10.1016/j.jhealeco.2025.103003","DOIUrl":"10.1016/j.jhealeco.2025.103003","url":null,"abstract":"<div><div>This paper examines belief imprecision in the context of COVID-19, when uncertainty about health outcomes was widespread. We survey a sample of young adults a few months after the onset of the pandemic. We elicit individuals’ minimum and maximum subjective probabilities of different health outcomes, and define belief imprecision as the range between these values. We document substantial heterogeneity in the degree of imprecision across respondents, which remains largely unexplained by standard demographic characteristics. To assess the behavioral impact of imprecise beliefs, we ask beliefs about future outcomes under hypothetical scenarios that feature different levels of protective behaviors. We find that individuals who expect protective behaviors to reduce not only the subjective probability of a negative health outcome, but also the degree of imprecision associated with it, behave more protectively.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"102 ","pages":"Article 103003"},"PeriodicalIF":3.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144330323","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":"Regression and decomposition with ordinal health outcomes","authors":"Qian Wu , David M. Kaplan","doi":"10.1016/j.jhealeco.2025.103012","DOIUrl":"10.1016/j.jhealeco.2025.103012","url":null,"abstract":"<div><div>Although ordinal health outcome values are categories like “poor” health or “moderate” depression, they are often assigned values <span><math><mrow><mn>1</mn><mo>,</mo><mn>2</mn><mo>,</mo><mn>3</mn><mo>,</mo><mo>…</mo></mrow></math></span> for convenience. We provide results on interpretation of subsequent analysis based on ordinary least squares (OLS) regression. For description, unlike for prediction, the OLS estimand’s interpretation does not require that the <span><math><mrow><mn>1</mn><mo>,</mo><mn>2</mn><mo>,</mo><mn>3</mn><mo>,</mo><mo>…</mo></mrow></math></span> are cardinal values: it is always the “best linear approximation” of a summary of the conditional survival functions. Further, for Blinder–Oaxaca-type decomposition, the OLS-based estimator is numerically equivalent to a certain counterfactual-based decomposition of the survival function, again regardless of any cardinal values. Empirically, with 2022 U.S. data for working-age adults, we estimate a higher incidence of depression in the rural population, and we decompose the rural–urban difference. Including a nonparametric estimator that we describe, estimators agree that 33%–39% of the rural–urban difference is statistically explained by income, education, age, sex, and geographic region. The OLS-based detailed decomposition shows this is mostly from income.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"102 ","pages":"Article 103012"},"PeriodicalIF":3.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144243515","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":"Mental health and mortality trends in the United States","authors":"Christopher J. Ruhm","doi":"10.1016/j.jhealeco.2025.103015","DOIUrl":"10.1016/j.jhealeco.2025.103015","url":null,"abstract":"<div><div>This study investigates whether worsening mental health has played a significant role in the rising mortality rates experienced by some population groups in the early 21st century, a question that has gained prominence with increased attention to so-called “deaths of despair.” The main takeaway is that although declining psychological health has likely contributed to adverse mortality trends—especially among prime-age non-Hispanic Whites—its overall impact is limited and not well captured by standard definitions of “deaths of despair.” Five key findings support this conclusion. First, mental health deteriorated between 1993 and 2019 for all population groups examined. Second, these declines are associated with higher predicted death rates and help explain worsening mortality trends for prime-age non-Hispanic Whites and, to a lesser extent, non-Hispanic Blacks between 1999 and 2019. Third, while these correlations lend some support to the broader idea of “deaths of despair,” the specific causes comprising them appear to be both more expansive and different from those previously emphasized. Fourth, heterogeneity in how worsening mental distress affects mortality—rather than in mental health trends themselves—is more important in explaining Black-White disparities in its overall impact. Finally, in the primary specifications, deteriorating mental health accounts for an estimated 9 % to 29 % of the rise in mortality rates among prime-age Whites in recent years.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"102 ","pages":"Article 103015"},"PeriodicalIF":3.4,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144196460","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":"Living alone and provider behaviour in public and private hospitals","authors":"Luigi Siciliani , Jinglin Wen , James Gaughan","doi":"10.1016/j.jhealeco.2025.103016","DOIUrl":"10.1016/j.jhealeco.2025.103016","url":null,"abstract":"<div><div>Following COVID-19, hospitals in many OECD countries are under pressure to absorb backlogs accumulated due to the suspension of health services. Reductions in length of stay can generate capacity to treat patients and increase efficiency. Personal circumstances, such as living alone, can affect how long patients stay in hospital. We test whether such non-clinical factors affect care received by patients. Several countries are experiencing an increase in the number of elderly people who live alone. Patients who live alone may lack support at home leading to delayed discharges despite being clinically fit. We test whether living alone affects length of stay of publicly-funded patients treated by public and private hospitals requiring hip replacement, a common planned surgery, in England. Private providers have stronger incentives to contain costs, which could reduce the extent to which non-clinical factors such as living alone are taken into account when providers discharge patients. Using administrative data and controlling for a rich set of patient characteristics, and hospital and local supply factors, we provide evidence that living alone increases length of stay. The effect is substantive and larger for public hospitals and older patients. It is similar for patients living in urban and rural areas, and across socioeconomic status. More broadly, the study shows that non-clinical factors can affect the care received by patients.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"102 ","pages":"Article 103016"},"PeriodicalIF":3.4,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144297401","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}
Esther Arenas-Arroyo , Daniel Fernandez-Kranz , Natalia Nollenberger
{"title":"High speed internet and the widening gender gap in adolescent mental health: Evidence from Spanish hospital records","authors":"Esther Arenas-Arroyo , Daniel Fernandez-Kranz , Natalia Nollenberger","doi":"10.1016/j.jhealeco.2025.103014","DOIUrl":"10.1016/j.jhealeco.2025.103014","url":null,"abstract":"<div><div>We exploit variations in fiber optic (FTTH) deployment to assess the impact of high-speed internet access on adolescent mental health. Our findings reveal that FTTH access increases addictive Internet usage and reduces time allocated to sleep, homework, as well as social interactions with family and friends. Access to FTTH increases mental health diagnoses in hospitals and contributes to a notable rise in adolescent suicide rates, particularly among girls. As new platforms and apps gain traction among adolescents, understanding the impact of connectivity improvement becomes important. This is especially relevant given the current FTTH growth replacing older broadband technologies.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"102 ","pages":"Article 103014"},"PeriodicalIF":3.4,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144220819","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":"Legal status and voluntary abortions by immigrants","authors":"Luca Pieroni , Melcior Rosselló Roig , Luca Salmasi , Gilberto Turati","doi":"10.1016/j.jhealeco.2025.103001","DOIUrl":"10.1016/j.jhealeco.2025.103001","url":null,"abstract":"<div><div>We estimate the effect of granting legal status to immigrant women on voluntary abortions. We exploit the 2007 EU enlargement as an exogenous shock to legal status for Romanian and Bulgarian women, considering Italy as a destination country. Using a standard Difference-in-Differences model, we estimate a decline between 60% and 70% in voluntary pregnancy termination (VPT) rates for the new EU citizens from the two Eastern countries. We also introduce a novel framework to separate the total effect of the enlargement into a “citizenship” effect due to (legal or illegal) migrants already present in Italy and a “selection” effect due to new flows of immigrants. We show that the findings are robust to several alternative explanations. The drop in abortions points to legal status as a way to empower immigrant women.</div></div>","PeriodicalId":50186,"journal":{"name":"Journal of Health Economics","volume":"102 ","pages":"Article 103001"},"PeriodicalIF":3.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144196459","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}