Search

Der Klimawandel und dessen Folgen für die menschliche Gesundheit sind bereits seit einiger Zeit in den Fokus der Forschung und der Regierungen gerückt. Der Beitrag befasst sich mit der Frage, welchen Einfluss die durch den Klimawandel vorhergesagten Folgen auf die Verbreitung von Krankheiten haben wird.

While it seems evident that occupations affect health, effect estimates are scarce. We use a job characteristics matrix in order to characterize occupations by their physical and psychosocial burden in German panel data spanning 26 years. Employing a dynamic model to control for factors that simultaneously affect health and selection into occupation, we find that manual work and low job control both have a substantial negative effect on health that increases with age. The effects of late career exposure to high physical demands and low control at work are comparable to health deterioration due to aging by 16 and 23 months respectively.

In 2010, the Philippines appeared to be on track to attain by 2015 its target for Millennium Development Goals 4 (Reduce child mortality), but less so for Goal 7 (Ensure environmental sustainability). In pursuit of the latter, the government expands its provision of water and services to more households. Applying propensity score matching technique on the data from the four rounds of a nationwide survey, such interventions are found to reduce the incidence of child diarrhea, a persistent top cause of child mortality, though not always. The impact of improved sources of drinking water is 1.3% to 2.6% in 1993 and 2.9% to 4.6% in 2003, but none is found in 1998 and 2008. The impact of improved sanitation is 1.2% to 2.1% in 1993 and 3.1% to 4.7% in 2008; but none is found in 1998 and 2003. In addition to health interventions, the regular monitoring of the quality of water and sanitation at the household level is suggested to achieve Goal 4.

We examine the impact of new medical information on drug safety on preventive health behavior. We exploit the release of the findings of the Women's Health Initiative Study (WHIS) - the largest randomized controlled trial of women's health - which demonstrated in 2002 that long-term Hormone Replacement Therapy increases the risk of heart attacks, stroke, blood clots and breast cancer among healthy post-menopausal women. Because hormone replacement is a therapy exclusive to women, we estimate the spillover effects of the WHIS findings on health behavior by means of a difference-in-differences methodology using men of similar ages as the control group. Using data from the Behavioral Risk Factor Surveillance System for 1998-2007, we find statistically significant small negative spillovers on post-menopausal women's likelihood of having an annual checkup and choice of a healthy diet, as proxied by daily fruit consumption. Our results also indicate that the observed spillover effects of drug safety on health behavior were entirely driven by the less educated. These findings suggest that policies aimed at raising awareness on the safety of medications may have unintended spillover effects on health behavior and that these spillovers may contribute to the existing health disparities by education.

With ageing populations and a stronger reliance on individual financial decision-making concerning asset portfolios, retirement schemes, pensions and insurances, it becomes increasingly important to understand the determinants of cognitive ability among the elderly. Macro-economic recession and boom periods provide a unique opportunity to study the effect of changes in the early life economic environment on late life cognition. In European countries, about three to four economic recession and boom periods can be identified between 1900 and 1945. The timing of these periods differs between the countries, which makes a cross-country study design particularly powerful, as it is insensitive to country-specific confounding factors. We use data from the Survey of Health, Aging and Retirement in Europe (SHARE) among elderly individuals. This survey is homogeneous across countries. We use almost 20,000 respondents from 11 countries. We examine several domains of cognitive functioning at ages 60+ and link them to the macro-economic deviations in the year of birth, controlling for current demographic, socioeconomic and health status. We find that being born during a recession or boom period significantly influences cognitive functioning late in life in various domains. The effects are particularly pronounced among the less educated. Boom periods positively influence numeracy and verbal fluency as well as the score on the omnibus cognitive indicator. The results are robust; controlling for current characteristics does not change effect sizes and significance. We conclude that cognitive functioning late in life is influenced by economic conditions in the year of birth, and we discuss possible causal pathways.

Objectives: To estimate racial/ethnic and education-related disparities and examine trends in uncontrolled cardiovascular (CVD) risk factors among adults with diabetes. Methods: The analysis samples include adults aged 20 and over from NHANES III, 1988- 1994 and NHANES 1999-2008 who self-report having diabetes (n =1,107, NHANES III; n = 1,933, NHANES 1999-2008). Using logistic regression models, we examine correlates of binary indicators measuring: (1) high blood glucose; (2) high blood pressure; (3) high cholesterol; and (4) smoking. Results: Control of blood glucose, blood pressure, and cholesterol improved among diabetics between NHANES III and NHANES 1999-2008, but there was no change in smoking prevalence. In NHANES 1999-2008, racial/ethnic minorities and individuals without some college were more likely to have poorly controlled blood glucose compared to non-Latino whites and those with some college. Also, diabetics with some college were less likely to smoke and had better blood pressure control compared to diabetics without some college. Conclusions: Trends in CVD risk factors among diabetics improved over the past two decades, but racial/ethnic and education-related disparities have emerged in some areas.

We use the compulsory school reforms implemented in European countries after the II World War to investigate the causal effect of education on the Body Mass Index (BMI) and the incidence of overweight and obesity among European females. Our IV estimates suggest that years of schooling have a protective effect on BMI. The size of the estimated effect is not negligible but smaller than the one found in comparable recent work for the US. We depart from the current empirical literature in three main directions. First, we use a multi-country approach. Second, we complement the standard analysis of the causal impact of years of schooling on BMI with one relying on a broader measure of education, i.e. individual standardized cognitive tests, and show that the current focus in the literature on years of schooling as the measure of education is not misplaced. Last, we evaluate whether the current focus on conditional mean effects should be integrated with an approach which allows for heterogeneous responses to changes in compulsory education. Although our evidence based on quantile regressions is mixed, there is some indication that the protective effect of schooling does not increase monotonically from the lower to the upper quantile of the distribution of BMI. Rather, the marginal effect is stronger among overweight (but not obese) females than among females with BMI above 30.

Child care subsidies play a critical role in facilitating the transition of disadvantaged mothers from welfare to work. However, little is known about the influence of these policies on children's health and well-being. In this paper, we study the impact of subsidy receipt on low-income children's weight outcomes in the fall and spring of kindergarten. The goals of our empirical analysis are twofold. We first utilize standard OLS and fixed effects methods to explore body mass index as well as measures of overweight and obesity. We then turn to quantile regression to address the possibility that subsidy receipt has heterogeneous effects on children's weight at different points in the BMI distribution. Results suggest that subsidy receipt is associated with increases in BMI and a greater likelihood of being overweight and obese. We also find substantial variation in subsidy effects across the BMI distribution. In particular, child care subsidies have no effect on BMI at the lower end of the distribution, inconsistent effects in the middle of the distribution, and large effects at the top of the distribution. Our results point to the use of non-parental child care, particularly centerbased services, as the key mechanism through which subsidies influence children's weight outcomes.

In this paper, we focus on the causes and consequences of adolescent obesity from an economic perspective. The paper examines the determinants of obesity and its role in influencing early school leaving amongst adolescents in the province of Salerno in Southern Italy. A simple human capital investment model is employed and this provides a framework within which to analyse the interrelated 'decisions' regarding schooling and overeating, taking into account the importance of time preference and the differential effects of adolescent obesity for males and females. We find that: a) there is a strong and robust positive effect of obesity on early school leaving; b) there are significant gender differences in the nature of this relationship; and, c) although not statistically significant, there is support for the idea that contextual factors - such as the type of school attended - are important in determining the effects of obesity on early school leaving. These findings have important policy implications. In particular, evidence on the positive causal link running from obesity to early school leaving suggests: i) that action aimed at reducing obesity - such as the encouragement of sporting activity - may also have beneficial effects in terms of reducing early school leaving rates; ii) the introduction of financial incentives to encourage educational participation; and, iii) the significant differences identified between young men and young women suggest the adoption of some gender- specific policy measures.

During the postwar period German states pursued policies to increase the share of young Germans obtaining a university entrance diploma (Abitur) by building more academic track schools, but the timing of educational expansion differed between states. This creates exogenous variation in the availability of higher education, which allows estimating the causal effect of education on health behaviors. Using the number of academic track schools in a state as an instrumental variable for years of schooling, we investigate the causal effect of schooling on health behavior such as smoking and related outcomes such as obesity. We find large negative effects of education on smoking. These effects can mostly be attributed to reductions in starting rates rather than increases in quitting rates. We find no causal effect of education on reduced overweight and obesity.

The prevalence and importance of children's physical health problems have been increasingly recognized in recent years. Physical health problems of children such as obesity, motor impairment and chronic diseases cause social costs. Further, they can lead directly to adult physical health problems, which cause additional social costs. This paper examines the intergenerational link and transmission of both maternal and paternal health on children's health in Germany. We investigate this issue using data from the German Socio-Economic Panel (SOEP), making particular use of the mother and child questionnaires. These data allow us to capture a broad set of health measures: anthropometric, self-rated health and "more objective" health measures. The results indicate significant relationships between parental and child health in the first and third year of life. In order to take into account the endogeneity of parental health, we estimate fixed effect models. Overall, we find, controlling for parental income, education and family composition, that parents who experience poor health have children with significantly poorer health. For example, the father's body mass index (BMI) is a predictor for their children's BMI. Mothers who consider their health as good, have also healthier children.

In developed countries, obesity tends to be associated with worse labor market outcomes. One possible reason is that obesity leads to less human capital formation early in life. This paper investigates the association between obesity and the developmental functioning of children at younger ages (2-4 years) than ever previously examined. Data from the German Socio-Economic Panel Study are used to estimate models of developmental functioning in four critical areas (verbal skills, activities of daily living, motor skills, and social skills) as a function of various measures of weight (including BMI and obesity status) controlling for various child and family characteristics. The findings indicate that, among boys, obesity is a significant risk factor for lagged development in verbal skills, social skills, and activities of daily living. Among girls, weight generally does not have a statistically significant association with these developmental outcomes. Further investigations show that the correlations exist even for those preschool children who spend no time in day care, which implies that the correlation between obesity and developmental functioning cannot be due to discrimination by teachers, classmates, or even day care providers.

This paper reviews the extent to which policy interventions can affect risky behaviours such as smoking, drinking and diet. The justification for such intervention is typically a market failure, broadly defined. The types of market failure typically encountered are discussed. First and second best interventions are examined and there is a review of the efficacy of such interventions with respect to Ireland.

Obesity is increasing worldwide for both adults and children. Genetic disposition is responsible for some variation in body weight but cannot explain the dramatic increase in the last two decades. The increase must be due to structural and behavioral changes. One such behavioral change is the increase in working females in the last decades. The absence from the mother reduces potential child care time in the family. Reduced child care time may have adverse effects on the prevalence of obesity in children and adults. This paper analyzes the effect of mother�s labor supply in childhood on young adults probability of being obese in Germany. Using a sample drawn from the German Socio-Economic Panel the results show that a higher labor supply of the mother increases the probability for her child to be obese as young adult. This result underlines the importance of childhood environment on children�s later life outcome and the importance of behavioral changes in explaining the increase in obesity.

Obesity has become a major health issue. Research in economics has provided NEWLINE important insights as to how technological progress reduced the relative price of food and NEWLINE contributed to the increase in obesity. However, the increased availability of food might well NEWLINE have overstrained will power and led to suboptimal consumption decisions relative to NEWLINE people’s own standards. We propose the economics of happiness as an approach to study the NEWLINE phenomenon. Based on proxy measures for experienced utility, it is possible to directly NEWLINE address whether certain observed behavior is suboptimal and therefore reduces a person’s NEWLINE well-being. It is found that obesity decreases the well-being of individuals who report limited NEWLINE self-control, but not otherwise.

Male life expectancy at birth fell by over six years in Russia between 1989 and 1994. Many other countries of the former Soviet Union saw similar declines, and female life expectancy fell as well. Using cross-country and Russian household survey data, we assess six possible explanations for this upsurge in mortality. Most find little support in the data: the deterioration of the health care system, changes in diet and obesity, and material deprivation fail to explain the increase in mortality rates. The two factors that do appear to be important are alcohol consumption, especially as it relates to external causes of death (homicide, suicide, and accidents) and stress associated with a poor outlook for the future. However, a large residual remains to be explained.

This paper deals with the question how to model health effects after the cessation of a randomised controlled trial (RCT). Using clinical trial data on severe congestive heart failure patients we illustrate how survival beyond the cessation of a RCT can be predicted based on parametric survival models. In the analysis we compare the predicted survival and the resulting incremental cost-effectiveness ratio (ICER) of different survival models with the actual survival/ICER. Our main finding is that the results are highly sensitive to the choice of survival model and that extensive sensitivity analysis in the CE analysis is required. We also show that adding the true survival after the end of the clinical study will underestimate the true variability.