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This paper examines the causal effect of childcare provision on grandparents’ health in the United States. We use the sex ratio among older adults’ children as an instrument for grandparental childcare provision. Our instrument exploits that parents of daughters transition to grandparenthood earlier and invest more in their grandchildren than parents of sons. We estimate 2SLS regressions using data from the Health and Retirement Study. The results suggest that providing childcare is detrimental to grandparents’ physical functioning and subjective health. We show that these effects increase with the intensity of grandchild care provision, and the effects are driven primarily by grandmothers. [ABSTRACT FROM AUTHOR]

AbstractThe paper examines the relationship between health and economic growth using a dynamic panel with threshold effect and endogeneity. The study uses a sample of 136 countries over the period of 1965–2015 and the results indicate that the relationship between health and economic growth is nonlinear. The findings suggest that the impact of health on economic growth is only positive in countries that have attained minimum benchmarks of health improvement. These findings carry significant policy implications. Low-income countries need a comprehensive approach, encompassing multiple factors, such as education enhancement, productivity boost, and entrepreneurship promotion, that go beyond health promotion to foster substantial economic growth. In countries already attaining satisfactory health outcomes, policies prioritizing improved health outcomes, through directing investments towards Research and Development can serve as an effective means to promote sustainable economic growth.

This paper examines the labour market and health effects of a non-contributory long-term unemployment (LTU) benefit targeted at middle-aged disadvantaged workers. To do so, we exploit a Spanish reform introduced in July 2012 that increased the age eligibility threshold to receive the benefit from 52 to 55. Our results show that men who were eligible for the benefit experience a reduction in injury hospitalisations by 12.9% as well as a 2 percentage points drop in the probability of a mental health diagnosis. None of the results are significant for women. We document two factors that explain the gender differences: the labour market impact of the reform is stronger for men, and eligible men are concentrated in more physically demanding sectors, like construction. Importantly, we also find evidence of a program substitution effect between LTU and partial disability benefits. Our results highlight the role of long-term unemployment benefits as a protecting device for the (physical and mental) health of middle-aged, low-educated workers who are in a disadvantaged position in the labour market. [ABSTRACT FROM AUTHOR]

We provide a comprehensive picture of the health effects of social isolation using longitudinal data from 21 European countries. First, using Cox regressions, we find a significant, strong, and robust association between our social isolation index and mortality. The association is much stronger in Eastern European countries. While all of our pooled countries estimates ranged between a 20 and 30% increase in the mortality hazard for the socially isolated that number jumps to 45% for Eastern European countries. We then estimate linear regressions to study the dynamic "value-added" effects of social isolation on health and other mediator outcomes. We find that social isolation at baseline leads to worsening health in subsequent waves along all of the dimensions observed. Up to 13% of the effect of baseline social isolation on mortality can be attributed to the combined one-wave-ahead impact of social isolation on increased frailty, reduced cognitive function, and increased smoking. [ABSTRACT FROM AUTHOR]

This paper studies the effect of retirement on health and mortality. In response to increased longevity and tighter public budget constraints, the general trend in developed countries is for Social Security systems to be modified to encourage people to remain in the labor force longer. In this paper, I study the 1983 reforms to the United States Social Security System that raised the retirement age for cohorts born after 1937 to estimate the causal effect of retirement on health and mortality. Combining IV and DID methods, I find that retirement has a positive effect on self-reported bad health and decreases the probability of experiencing limitations in daily activities for men. However, retirement increases the mortality rate by 0.46% for men and 1.4% for women. Heart disease contributes most to the effect on mortality. The different effects on health and mortality point to heterogeneous effects. [ABSTRACT FROM AUTHOR]

Mammography guidelines have weakened in response to evidence that mammograms diagnose breast cancers that would never eventually cause symptoms, a phenomenon called "overdiagnosis." Given concerns about overdiagnosis, instead of recommending mammograms, US guidelines encourage women aged 40–49 to get them as they see fit. To assess whether these guidelines target women effectively, I propose an approach that examines mammography behaviour within an influential clinical trial that followed participants long enough to find overdiagnosis. I find that women who are more likely to receive mammograms are healthier and have higher socioeconomic status. More importantly, I find that the 20-year level of overdiagnosis is at least 3.5 times higher among women who are most likely to receive mammograms. At least 36 |$\%$| of their cancers are overdiagnosed. These findings imply that US guidelines encourage mammograms among healthier women who are more likely to be overdiagnosed by them. Guidelines in other countries do not. [ABSTRACT FROM AUTHOR]

The Great East Japan Earthquake of March 2011 and it's massive tidal waves wreaked devastating damage on residences and communities along 400 km of the Pacific coast in Japan. Using the panel data from the Japanese Study of Aging and Retirement, we estimate the effects of this disaster on individual health, finding a significant negative impact on the health of those in the area. In addition, we exploit a discontinuous decrease in copayments for medical care at the age of 70 years and find that the reduction in copayment increased medical and long-term care utilization and significantly reduced health deterioration after the earthquake. [ABSTRACT FROM AUTHOR]

We use an event study approach to examine the economic consequences of hospital admissions for adults in two datasets: survey data from the Health and Retirement Study, and hospitalization data linked to credit reports. For non-elderly adults with health insurance, hospital admissions increase out-of-pocket medical spending, unpaid medical bills and bankruptcy, and reduce earnings, income, access to credit and consumer borrowing. The earnings decline is substantial compared to the out-of-pocket spending increase, and is minimally insured prior to age-eligibility for Social Security Retirement Income. Relative to the insured non-elderly, the uninsured non-elderly experience much larger increases in unpaid medical bills and bankruptcy rates following a hospital admission. Hospital admissions trigger less than 5 percent of all bankruptcies.

This study investigates the effects of socioeconomic status on health among older adults in China. It uses three waves of the nationally representative Chinese Longitudinal Healthy Longevity Survey conducted in 2005, 2008–2009, and 2011–2012. It explores two dependent dummy variables of self-rated health and functional health and employs subjective and objective measures of socioeconomic status. Based on two-stage fixed-effects linear probability modeling, where potential endogeneity bias is accounted for, this study finds that socioeconomic status positively affects both self-rated health and functional health of Chinese older people. The positive impact holds true across different gender and age groups, but it is sensitive to the choice of health and socioeconomic status measures. [ABSTRACT FROM AUTHOR]

We explore how involuntary and voluntary exits from self-employment affect life and health satisfaction. To that end, we use rich longitudinal data from the German Socio-Economic Panel from 1985 to 2017 and a difference-in-differences estimator. We find that while transitioning from self-employment to salaried employment brings small improvements in health and life satisfaction, the negative psychological costs of business failure (i.e., switching from self-employment to unemployment) are substantial and exceed the costs of involuntarily losing a salaried job. Meanwhile, leaving self-employment has no consequences for self-reported physical health and behaviors such as smoking and drinking, implying that the costs of losing self-employment are mainly psychological. Moreover, former business owners fail to adapt to an involuntary self-employment exit even 2 or more years after this traumatic event. Our findings imply that policies encouraging entrepreneurship should also carefully consider the nonmonetary implications of business failure. [ABSTRACT FROM AUTHOR]

Background: Industrial pollution is considered to be a detrimental factor for human health. This study, therefore, explores the link between health status and industrial pollution for the top 20 industrialised countries of the world.Methods: Crude death rate is used to represent health status and CO2 emissions from manufacturing industries and construction, and nitrous oxide emissions are considered to be indicators of industrial pollution. Using annual data of 60 years (1960-2019), an unbalanced panel data estimation method is followed where (Driscoll, J. C. et al. Rev Econ Stat, 80, 549-560, 1998) standard error technique is employed to deal with heteroscedasticity, autocorrelation and cross-sectional dependence problems.Results: The research findings indicate that industrial pollution arising from both variables has a detrimental impact on human health and significantly increases the death rate, while an increase in economic growth, number of physicians, urbanisation, sanitation facilities and schooling decreases the death rate.Conclusions: Therefore, minimisation of industrial pollution should be the topmost policy agenda in these countries. All the findings are consistent theoretically, and have empirical implications as well. The policy implication of this study is that the mitigation of industrial pollution, considering other pertinent factors, should be addressed appropriately by enunciating effective policies to reduce the human death rate and improve health status in the studied panel countries. [ABSTRACT FROM AUTHOR]

This paper investigates whether minimum wage increases affect worker health in China. Using data on low-skilled workers from the 2014 and 2016 China Labor-force Dynamic Survey (CLDS), I find minimum wage increases significantly improve several measures of health, including self-reported health status and the presence of health conditions. When examining the potential channels underlying the relationship between minimum wages and health, I find the health behaviors (smoking, drinking, and regular exercise) of low-skilled workers do not change significantly after minimum wage increases. Minimum wage increases significantly improve the living standards and job satisfaction of low-skilled workers. Finally, I find minimum wage increases play a larger role in improving the health of rural hukou workers and workers aged 35 and above. [ABSTRACT FROM AUTHOR]

Quality-Adjusted Life-Years (QALYs) are typically derived from individual preferences over health episodes. This paper reports the first experimental investigation into the effects of collective decision making on health valuations, using both time trade-off (TTO) and standard gamble (SG) tasks. We investigated collective decision making in dyads, by means of a mixed-subjects design where we control for learning effects. Our data suggest that collective decision making has little effect on decision quality, as no effects were observed on decision consistency and monotonicity for both methods. Furthermore, QALY weights remained similar between individual and collective decisions, and the typical difference in elicited weights between TTO and SG was not affected. These findings suggest that consulting with others has little effect on health state valuation, although learning may have. Additionally, our findings add to the literature of the effect of collective decision making, suggesting that no such effect occurs for TTO and SG. [ABSTRACT FROM AUTHOR]

This paper studies the effects of immigration on the allocation of occupational physical burden and work injury risks. Using data for England and Wales from the Labour Force Survey (2003–2013), we find that, on average, immigration leads to a reallocation of UK-born workers towards jobs characterised by lower physical burden and injury risk. The results also show important differences across skill groups. Immigration reduces the average physical burden of UK-born workers with medium levels of education, but has no significant effect on those with low levels. We also find that that immigration led to an improvement self-reported measures of native workers' health. These findings, together with the evidence that immigrants report lower injury rates than natives, suggest that the reallocation of tasks could reduce overall health care costs and the human and financial costs typically associated with workplace injuries. [ABSTRACT FROM AUTHOR]

Previous research has shown that demographics, beliefs, and self-reported own health influence TTO values. Our hypothesis is that attitudes towards length and quality of life influence TTO values, but should no longer affect a set of related choices that are based on respondents' own TTO scores. A representative sample of 1339 respondents was asked their level of agreement to four statements relating to the importance of quality and length of life. Respondents then went on to value 4 EQ-5D 5L states using an online interactive survey and a related set of 6 pairwise health-related choice questions, set up, so that respondents should be indifferent between choice options. We explored the impact of attitudes using regression analysis for TTO values and a logit model for choices. TTO values were correlated with the attitudes and were found to have a residual impact on the choices. In particular, those respondents who preferred quality of life over length of life gave less weight to the differences in years and more weight to differences in quality of life in these choice. We conclude that although the TTO responses reflect attitudes, these attitudes continue to affect health-related choices. [ABSTRACT FROM AUTHOR]

This study examines the link between health shocks and labor market outcomes in the United Kingdom. For sample periods of up to 9 years, I use longitudinal data from the British Household Panel Survey to test how sudden health shocks affect a number of labor market outcomes, such as labor and household income, employment status, and hours worked. Additionally, the study examines potential mechanisms underlying the link between health declines and labor market outcomes. By estimating propensity score matching difference-in-differences models, the study shows that sudden health declines lead to significant and persistent reductions in earnings. The effects are strongest for individuals experiencing severe health shocks, males, individuals with higher education and those working in managerial jobs. When examining potential channels, I provide evidence that increased health care expenditures and health care usage as well as reduced work productivity can explain the observed effects on labor market outcomes. [ABSTRACT FROM AUTHOR]

We examine the effect of birth weight on health throughout childhood, adolescence, and early adulthood, focusing on two health outcomes: all-cause and cause-specific hospitalizations and sickness absences. The outcomes are important, not only from a health perspective but also from a labor market perspective, as the inability to fully participate in the labor force due to impaired health is known to have important long-term consequences. Our analysis focuses on differences between siblings, using full-population Swedish register data on cohorts born between 1973 and 1994. The relationship between birth weight and health is strongest during infancy, after which it weakens throughout childhood and adolescence. In adulthood, a stronger relationship again appears, suggesting a U-shaped relationship over the examined part of the life course. During childhood and adolescence, birth weight influences all examined disease types with the exception of cancers, with nontrivial effect sizes in relative terms. During adulthood, morbidity due to mental diseases dominates, primarily through conditions with early-age origins. Consequently, we provide new evidence that birth weight matters for both short- and long-term health outcomes and that it is of a dynamic nature in terms of its magnitude and which disease types are affected. Lastly, our results remain robust to a range of sensitivity analyses, including nonlinear specifications of birth weight, and to estimations based on a sample of same-sex twin pairs, allowing us to further reduce the influence of genes. [ABSTRACT FROM AUTHOR]

This study analyses the relationship between information and communication technology (ICT) and population health. The analysis is based on econometric model of population health in 184 countries using panel data spanning over 1990-2014. The analysis is based on fixed effects method on the basis of Hausman test. Besides, to deal with endogenous nature of ICT two stage least squares and system GMM are used in cross-sectional and panel data, respectively. Health is measured by life expectancy at birth and infant mortality rates. In this study, we measure ICT infrastructure using three proxies namely internet users, mobile cellular subscriptions, and fixed telephone subscriptions. The empirical results show a positive and significant impact of ICT on population health. This study recommends that health care programs need to focus on polices which foster digital inclusion. [ABSTRACT FROM AUTHOR]

Previous studies have shown that recessions are typically associated with better health and health behaviors. With the exception of a few recent studies however, these studies focus on sample periods that end prior to the Great Recession. The few exceptions that extend the analysis period beyond the Great Recession suggest that the pro-cyclical relationship between macroeconomic conditions and mortality obtained in earlier studies might have weakened over time. In this paper, we revisited the relationship between state unemployment rate and a large set of outcomes of health and health behaviors using data from the Behavioral Risk Factor Surveillance System (BRFSS) between 1990 and 2014. Overall, our results suggest that state unemployment rate is weakly related to both health and health behaviors as our estimates are too small to have any meaningful implications, although they are largely imprecisely estimated. Finally, we tested whether the Great Recession played a significant role in influencing the pattern in the relationship between unemployment rate and health and health behaviors. Our results from this analysis do not reveal any measurable recession effect, although the estimates are again largely imprecise. [ABSTRACT FROM AUTHOR]

This paper analyses the effects of health on wages in sixteen European countries using production frontier methodology. It is assumed that workers have a potential income/productivity which basically depends on their human capital, but due to several health problems, situations could exist where workers fail to reach their potential income frontier. The estimation of a true-random-effects model allows us to conclude that the potential hourly wage of workers is significantly influenced by their level of education and their job experience. However, health problems, especially those strongly influencing work activities, contribute towards an individual not attaining the potential income which would otherwise be guaranteed by their human capital endowment. Suffering a strong limitation reduces gross wage per hour by 6.1%. This wage reduction is also observed in the case of a weak limitation, but here the wage difference with respect to workers without any limitation is 2.6%. Additionally, other factors, such as being a woman, the economic cycle or having a temporary contract, appear to distance an individual from their wage frontier. [ABSTRACT FROM AUTHOR]

In 2016, an estimated 445,000 deaths and 216 million cases of malaria occurred worldwide, while 70% of the deaths occurred in children under five years old. Changes in climatic exposures such as temperature and precipitation make malaria one of the most climate sensitive outcomes. Using a global malaria mortality dataset for 105 countries between 1980 and 2010, we find a non-linear relationship between temperature and malaria mortality and estimate that the global optimal temperature threshold beyond which all-age malaria mortality increases is 20.8 °C, while in the case of child mortality; a significantly lower optimum temperature of 19.3° is estimated. Our results also suggest that this optimal temperature is 28.4 °C and 26.3 °C in Africa and Asia, respectively - the continents where malaria is most prevalent. Furthermore, we estimate that child mortality (ages 0-4) is likely to increase by up to 20% in some areas due to climate change by the end of the 21st century. [ABSTRACT FROM AUTHOR]

Objectives: The Health-Related Quality of Life Short Form 6D (HRQoL SF-6D) provides utility values for health status. Utilities generated have a number of potentially valuable applications in economic evaluations and not only to ensure comparability between studies. Reference values can be useful to estimate the effect on patients' HRQoL as a result of interventions in the absence of control groups. Thus, the purpose of this study was to provide normative values in the SF-6D in relation to the Chilean population.Methods: A cross-sectional study was conducted evaluating 5293 people. SF-6D utilities were derived from the SF-12 questions.Results: Mean SF-6D utility index for the whole sample was 0.74. It was better for men (0.78) than for women (0.71). The ceiling effect was much higher for men (11.16%) than for women (5.31%). Women were more likely to show problems in any dimension than were men.Conclusions: Chilean population norms for the SF-6D help in the decision-making process around health policies. Men reported higher health status than women in all subcategories analyzed. Likewise, men also reported higher scores than women in overall SF-6D dimensions. [ABSTRACT FROM AUTHOR]

Using panel data from 102 countries in 1975-2010, this paper explores the dynamic interaction among health, education and growth by applying panel VAR techniques. Empirical findings reveal that the predictive pattern among health, education and economic growth is not stable in the cross section of countries. While health has positive contribution to growth for all countries, education has benefited only higher middle income and high-income OECD countries. Economic growth has predictive power for the components of human development in the high-income OECD countries. Further, econometric evidence reveals that bi-directional relationship between health and education should be supported to reap the benefits of human development on economic growth. [ABSTRACT FROM AUTHOR]

We analyze how childhood hunger affects human aging for a panel of European individuals. For this purpose, we use six waves of the Survey of Health, Aging, and Retirement in Europe (SHARE) dataset and construct a health deficit index. Results from log-linear regressions suggest that, on average, elderly European men and women developed about 20 percent more health deficits when they experienced a hunger episode in their childhood. The effect becomes larger when the hunger episode is experienced earlier in childhood. In non-linear regressions (akin to the Gompertz-Makeham law), we obtain greater effects suggesting that health deficits in old age are up to 40 percent higher for children suffering from hunger. The difference of health deficits between hungry and non-hungry individuals increases absolutely and relatively with age. This implies that individuals who suffered from hunger as children age faster. [ABSTRACT FROM AUTHOR]

This study examines the effect of trade openness on the health outcomes of 12 countries in the MENA (Middle East and North Africa) region: Algeria, Bahrain, Egypt, Jordan, Morocco, Kuwait, Oman, Qatar, Saudi Arabia, Tunisia, Turkey, and the UAE. By using a panel data investigation over 1970-2015, we check whether the trade of these countries with developed economies (using the proxy of G7 countries) and the rest of the world affects life expectancy and the infant mortality rate. We also assess the moderating effect of governmental corruption. Our findings show two interesting results. First, trade openness has a positive effect on health in the MENA region as it reduces the infant mortality rate and boosts life expectancy for both men and women. Second, better control over corruption and more focus on trade with developed countries would lead to more technology and information spillovers, which positively affect the health sector. [ABSTRACT FROM AUTHOR]

This paper aims to identify the causal effect of smoking on body mass index (BMI) using data from the Lung Health Study, a randomized trial of smoking cessation treatments. Since nicotine is a metabolic stimulant and appetite suppressant, quitting or reducing smoking could lead to weight gain. Using randomized treatment assignment to instrument for smoking, we estimate that quitting smoking leads to an average long-run weight gain of 1.8-1.9 BMI units, or 11-12 pounds at the average height. Semi-parametric models provide evidence of a diminishing marginal effect of smoking on BMI, while subsample regressions show that the impact is largest for younger individuals, those with no college degree, and those in the lowest quartile of baseline BMI. [ABSTRACT FROM AUTHOR]

This study examines the effect of employment on elderly men's health. A typical OLS analysis yields a positive relationship between employment and health for individuals in their sixties. Causality, however, is difficult to infer because healthier individuals are more capable of working than others. To overcome this endogeneity problem, this paper exploits the increase in the full retirement age for men in Israel from sixty-five to sixty-seven in 2004. After this change, the employment rate of men in this age bracket jumped significantly compared to the last cohort that was able to retire at sixty-five. Using the new retirement law as an exogenous source of variation in the employment status of elderly men, a significant causal relationship in the opposite direction of the correlation is found: employment at older ages impairs health. These findings are found across a broad array of datasets and health outcomes. The results are significantly stronger among less-educated workers, suggesting that employment in physically demanding occupations is more detrimental to health. Placebo analyses using the years preceding the new retirement regime and other health measures unrelated to employment (e.g., dentist visits) reinforce a causal interpretation of my main findings. [ABSTRACT FROM AUTHOR]

This paper investigates the effect of corruption on health outcomes by using cross-country panel data covering about 150 countries for the period of 1995 to 2012. We employ ordinary least squares (OLS), fixed-effects and two-stage least squares (2SLS) estimation methods, and find that corruption significantly increases mortality rates, and reduces life expectancy and immunization rates. The results are consistent across different regions, gender, and measures of corruption. The findings suggest that reducing corruption can be an effective method to improve health outcomes. [ABSTRACT FROM AUTHOR]

We use self-reported health measures, nurse-administered measurements and blood-based biomarkers to examine the concordance between health states of partners in marital/cohabiting relationships in the UK. A model of cumulative health exposures is used to interpret the empirical pattern of between-partner health correlation in relation to elapsed relationship duration, allowing us to distinguish non-causal correlation due to assortative mating from potentially causal effects of shared lifestyle and environmental factors. We find important differences between the results for different health indicators, with strongest homogamy correlations observed for adiposity, followed by blood pressure, heart rate, inflammatory markers and cholesterol, and also self-assessed general health and functional difficulties. We find no evidence of a "dose-response relationship" for marriage duration, and show that this suggests - perhaps counterintuitively - that shared lifestyle factors and homogamous partner selection make roughly equal contributions to the concordance we observe in most of the health measures we examine. [ABSTRACT FROM AUTHOR]

This paper examines the relationship between temperature and hospital usage with a focus on the role of behavioral responses to temperature. I use high-frequency data on the near universe of hospital and emergency department (ED) visits in California between 2005 and 2014 to estimate the effects of temperature on hospital usage patterns. I find that a day with mean temperature under 40°F leads to a 6.1% decrease in ED visits on the day of the event but that total net visits increase by approximately 11.0% above the daily mean after accounting for visits in the weeks that follow. Additionally, I find that a day over 80°F is associated with a same-day increase in ED visits of 3.5% and a total net increase of 5.1%. For both cold and hot temperatures, I provide evidence of the mechanisms—whether biological or behavioral—that explain these patterns. [ABSTRACT FROM AUTHOR]

This paper introduces a framework for modelling the impact that diabetes has on employment status and wages, improving the existing literature by controlling for diabetes-related complications. Using the last wave of the Spanish National Health Survey, we find that 1710 adults out of the original sample of 36,087 have diabetes, reporting higher rates of unemployment. Our empirical results suggest that persons with diabetes, compared with non-diabetic persons, have poorer labor outcomes in terms of length of unemployment and lower income. However, diabetes is not significantly associated with unemployment probabilities, suggesting that the burden of diabetes on employment is mediated by lifestyle factors and clinical and functional complications. In addition, there are mixed outcomes to this econometric approach, depending on age and gender, among other factors. This interesting finding has several implications for research and policy on strategies to get lower health inequalities. [ABSTRACT FROM AUTHOR]

This study examines the relationship between minimum wages and several measures of population health by analyzing data from 24 OECD countries for a time period of 31 years. Specifically, I test for health effects as a result of within-country variations in the generosity of minimum wages, which are measured by the Kaitz index. The paper finds that higher levels of minimum wages are associated with significant reductions of overall mortality rates as well as in the number of deaths due to outcomes that have been shown to be more prevalent among individuals with low socioeconomic status (e.g., diabetes, disease of the circulatory system, stroke). A 10% point increase of the Kaitz index is associated with significant declines in death rates and an increase in life expectancy of 0.44 years. Furthermore, I provide evidence for potential channels through which minimum wages impact population health by showing that more generous minimum wages impact outcomes such as poverty, the share of the population with unmet medical needs, the number of doctor consultations, tobacco consumption, calorie intake, and the likelihood of people being overweight. [ABSTRACT FROM AUTHOR]