Left-digit bias is a cognitive bias wherein individuals assess the magnitude of numbers by emphasizing the leftmost digit. For instance, people often perceive the difference between $9.99 and $10.00 larger than that betw...Left-digit bias is a cognitive bias wherein individuals assess the magnitude of numbers by emphasizing the leftmost digit. For instance, people often perceive the difference between $9.99 and $10.00 larger than that between $10.00 and $10.01, given the distinct left digits in the former two numbers. This study associates self-reported height with this cognitive bias. Taller stature is frequently associated with desirable attributes such as higher earnings and leadership positions; individuals may aspire to be taller and, consequently, report a height greater than their actual measurement. We posit that this inclination is more pronounced when combined with left-digit bias. In other words, individuals whose actual height ends in nine, such as 169 cm, are more likely to report their height as 170 cm than individuals with an actual height of 170 cm who report it as 171 cm. To conduct this analysis, we used data from an annual health survey of adolescents in grades 7-12. Our findings indicate that male adolescents exhibit a left-digit bias in reporting their height, whereas female adolescents do not. We contribute to the literature by providing new evidence of left-digit bias.
This paper evaluates the effects of economic shocks to current and expected income reduction on mental wellbeing. We use individual-level data from three East Asian countries; China, Japan, and South Korea, during the ea...This paper evaluates the effects of economic shocks to current and expected income reduction on mental wellbeing. We use individual-level data from three East Asian countries; China, Japan, and South Korea, during the early phases of the pandemic when the COVID-induced economic shocks were severe. The findings reveal significant causal effects from current and expected income reduction on different aspects of mental health deterioration, including anxiety, trouble sleeping, boredom, and loneliness. Interestingly, we found that expectations of future income loss have a significantly larger effect on people's mental wellbeing compared to current falls in income. This has significant implications for the design of policies to support income during pandemics.
This paper investigates health impacts at the end of adolescence of prenatal exposure to multiple shocks, by exploiting the unique natural experiment of the Dutch Hunger Winter. At the end of World War II, a famine occur...This paper investigates health impacts at the end of adolescence of prenatal exposure to multiple shocks, by exploiting the unique natural experiment of the Dutch Hunger Winter. At the end of World War II, a famine occurred abruptly in the Western Netherlands (November 1944-May 1945), pushing the previously and subsequently well-nourished Dutch population to the brink of starvation. We link high-quality military recruits data with objective health measurements for the cohorts born in the years surrounding WWII with newly digitised historical records on calories and nutrient composition of the war rations, daily temperature, and warfare deaths. Using difference-in-differences and triple differences research designs, we first show that the cohorts exposed to the Dutch Hunger Winter since early gestation have a higher Body Mass Index and an increased probability of being obese at age 18. We then find that this effect is partly moderated by warfare exposure and a reduction in energy-adjusted protein intake. Lastly, we account for selective mortality using a copula-based approach and newly-digitised data on survival rates, and find evidence of both selection and scarring effects. These results emphasise the complexity of the mechanisms at play in studying the consequences of early conditions.
This paper examines the long-standing and severe public health crisis, the opioid epidemic in the United States, which has been worsening since the mid-1990s. In contrast to previous research, it investigates the broader...This paper examines the long-standing and severe public health crisis, the opioid epidemic in the United States, which has been worsening since the mid-1990s. In contrast to previous research, it investigates the broader impacts of this epidemic, particularly on family members and healthcare systems. Using a comprehensive dataset spanning from 1998 to 2010, the study analyzes opioid use at the three-digit ZIP code level, utilizing data from the Drug Enforcement Agency (DEA) and individual-level data from the Health and Retirement Study (HRS) in a two-way fixed effect model. The findings reveal significant negative effects on family caregivers, notably adult children, due to the opioid epidemic. Additionally, opioid exposure is associated with increased healthcare utilization, including home health care and hospital use. This research contributes to a deeper understanding of the multifaceted consequences of the opioid epidemic.
This paper investigates the causal impact of fetal exposure to PM2.5 on birth outcomes, including birth weight, the incidence of low birth weight (LBW), and small for gestational age (SGA), based on a nationally represen...This paper investigates the causal impact of fetal exposure to PM2.5 on birth outcomes, including birth weight, the incidence of low birth weight (LBW), and small for gestational age (SGA), based on a nationally representative birth record dataset in a developing country setting. We employed thermal inversion as the instrument variable (IV) for PM2.5 and leveraged the distinctive characteristics of rural China in the 1990 s to address identification challenges. Our IV estimates indicate that higher fetal PM2.5 exposure leads to lower birth weight and elevated probabilities of LBW and SGA. Due to the mortality selection in utero, weak male fetuses were more likely to be screened out by PM2.5 exposure, resulting in a comparatively lower vulnerability among the surviving male infants. Furthermore, infants born to less educated mothers exhibited increased susceptibility, a phenomenon not entirely explained by the sorting behaviors associated with the preference for cleaner air based on socioeconomic status.
Using prisoner height data, Moreno-Lázaro (2023) claims that Puerto Rican living standards declined after US annexation and stagnated for decades. This conclusion is not supported by the prisoner data and is inconsistent...Using prisoner height data, Moreno-Lázaro (2023) claims that Puerto Rican living standards declined after US annexation and stagnated for decades. This conclusion is not supported by the prisoner data and is inconsistent with other welfare measures that show dramatic improvement, such as per capita GDP, life expectancy, and literacy.
Secular change in the heights of adult men and women resident in ten rural communities in west-central Poland in four decennial surveys between 1986 and 2016 is considered. The adults were parents of children attending s...Secular change in the heights of adult men and women resident in ten rural communities in west-central Poland in four decennial surveys between 1986 and 2016 is considered. The adults were parents of children attending schools in rural communities in the province of Poznań. During each survey, parents of school children were asked to complete a questionnaire which requested their ages, heights and completed levels of education. Ages were reported in whole years. The self-reported heights were adjusted for the tendency of individuals to overestimate height. Height loss among of individuals 35+ years was estimated with sex-specific equations and was added to the adjusted heights. Secular gains in heights of adult males across the 30 year interval, and across the 1986-1996 and 2006-2016 surveys were, on average, larger than corresponding gains in heights of adult females; the sex difference between 1996 and 2006 surveys was negligible. When heights were regressed on year of birth, heights of males and females born before 1950 (prior to World War II and shortly after) showed minimal and non-significant secular changes, while heights of those born post-1950 showed larger and significant secular gains, more so in males than in females. The results highlight significant secular trends in the heights of rural adults over a 30-year interval. Consistent with other studies in Poland, the positive trends likely reflected political, educational and socio-economic changes and by inference improved nutritional and health conditions across generations.
This paper examines the relationship between a national unconditional cash transfers (UCTs) program, health and savings. We theoretically and empirically show that motives to save can be strong when cash transfers promot...This paper examines the relationship between a national unconditional cash transfers (UCTs) program, health and savings. We theoretically and empirically show that motives to save can be strong when cash transfers promote health outcomes. We first present a theoretical model that considers lifecycle-consumption savings decisions, where households derive utility from consumption and leisure time at working age, as well as old-age consumption and old-age longevity that positively depend on health spending. We then empirically examine the impact of Pakistan's Benazir Income Support Programme on various indicators of savings and provide suggestive evidence on how UCTs influence savings via health. We find that in the short and medium term, UCTs increase the probability that a household decides to save and have significant positive effects on the rates and amounts of household savings. The effects of UCTs are more pronounced on informal compared to formal savings. The results present exploratory and suggestive evidence that health is a mechanism through which UCTs transmit to savings. These findings are consistent with our theoretical predictions.
Econ Hum Biol
· 2024 Apr · PMID 38518546
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This study presents new evidence of the effects of short-term economic fluctuations on suicide, fatal drug overdose, and alcohol-related mortality among working-age adults in the United States from 2003-2017. Using a shi...This study presents new evidence of the effects of short-term economic fluctuations on suicide, fatal drug overdose, and alcohol-related mortality among working-age adults in the United States from 2003-2017. Using a shift-share instrumental variables approach, I find that a one percentage point increase in the aggregate employment rate decreases current-year non-drug suicides by 1.7 percent. These protective effects are concentrated among working-age men and likely reflect a combination of individual labor market experiences as well as the indirect effects of local economic growth. I find no consistent evidence that short-term business cycle changes affect drug or alcohol-related mortality. While the estimated protective effects are small relative to secular increases in suicide in recent decades, these findings are suggestive of important, short-term economic factors affecting specific causes of death and should be considered alongside the longer-term and multifaceted social, economic, and cultural determinants of America's "despair" epidemic.
I investigate the causal effect of education on time preferences. To deal with the endogeneity of education, I exploit exogenous variation in education imposed by a Turkish school reform that raised compulsory education...I investigate the causal effect of education on time preferences. To deal with the endogeneity of education, I exploit exogenous variation in education imposed by a Turkish school reform that raised compulsory education from five to eight years. I find that education causes individuals to make more patient inter-temporal choices but does not induce them to report being more patient. I also provide evidence that the effect of education on patient inter-temporal choices does not operate through changes in financial well-being.
We utilize the timing of India's 2016 demonetization policy to examine whether a negative macroeconomic shock disproportionately affects women's health outcomes relative to men's. Our empirical framework considers women...We utilize the timing of India's 2016 demonetization policy to examine whether a negative macroeconomic shock disproportionately affects women's health outcomes relative to men's. Our empirical framework considers women as the treated group and men as the comparison group. Using data from the National Family Health Survey-4 and a household fixed effects model, we find that the induced income shock leads to a 4% decline in hemoglobin for women as compared to the pre-demonetization level. This corresponds to a 21% increase in the gender gap in hemoglobin. The result is further validated with an event study and a variety of robustness checks. An examination of food consumption suggests that this pattern is possibly driven by a widening male-female gap in the consumption of iron-rich foods.
Aguila E, Dow WH, Menares F
… +3 more, Parker SW, Peniche J, Ryu S
Econ Hum Biol
· 2024 Apr · PMID 38442635
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Progresa, an anti-poverty conditional cash transfer program, has been a model for similar programs in more than 60 countries. Numerous studies have found positive impacts on schooling, the nutritional and health status o...Progresa, an anti-poverty conditional cash transfer program, has been a model for similar programs in more than 60 countries. Numerous studies have found positive impacts on schooling, the nutritional and health status of children and adolescents, and household consumption. However, the effects on the health of older adult beneficiaries have been particularly understudied. In this paper we analyze the effects of Progresa on middle-aged and older adult health, focusing on a high prevalence chronic condition: hypertension. Our results show that Progresa had significant benefits in terms of improved hypertension diagnosis and use of treatment drugs. However, we did not find significant changes in uncontrolled hypertension as measured by systolic and diastolic blood pressure biomarkers in household survey data. Thus, while cash transfer programs may facilitate financial access to healthcare visits and the ability to buy prescribed medicines, by itself the program might not improve hypertension outcomes without complementary healthcare system follow-up to ensure dosage titration and medication adherence.
The human growth process is influenced not only by genetic factors but also by environmental factors. Therefore, regional differences in mean body heights may exist within a population or a state. In the present study, w...The human growth process is influenced not only by genetic factors but also by environmental factors. Therefore, regional differences in mean body heights may exist within a population or a state. In the present study, we described and evaluated the regional trends in mean body heights in the nine Austrian provinces over a period spanning more than four decades. Body height data of 1734569 male conscripts born in Austria with Austrian citizenship between 1961 and 2002 were anonymized and analyzed. From 1961 to 2002 birth cohorts, an overall increase in the mean body height of Austrian recruits was observed, although regional differences were evident. Regions with shorter body heights in the 1961-1963 birth cohorts showed a particularly pronounced increase in mean body heights. Meanwhile, the course of body height growth in the capital city, Vienna, was striking, where the highest body heights were documented for the 1961-1963 birth cohorts. In Vienna, mean body heights continued to decline until the 1984 birth cohort and increased again from the 1988 birth cohorts. In addition to economic factors, increased stress factors in an urban environment and a form of urban penalty are discussed as causes.
The social stress experienced by an individual from having a low relative income or from having a low income-based rank is a derivative of the individual's location in social space, and is the outcome of unfavorable comp...The social stress experienced by an individual from having a low relative income or from having a low income-based rank is a derivative of the individual's location in social space, and is the outcome of unfavorable comparisons with other individuals in that space. (The term social space stands for the set of individuals with whose incomes or with whose income-based ranks the individual compares his income or his income-based rank.) The stress that arises from unfavorable social comparisons can cause physical and mental harm. Essentially, there are three ways to thwart unfavorable income-related comparisons experienced by an individual: to operate on the individual's income or on a characteristic (an attribute) of the individual's income; to operate on the incomes or on a characteristic of the incomes of the individual's comparators; or to modify the individual's social space. The first two approaches feature extensively in the existing literature. The third does not. In this communication, I analyze this third approach, keeping in mind its application as a policy tool for lowering social stress.
This study investigates the impact of marriage on the body mass index (BMI) of individuals aged 18-45 in China. We used data from ten rounds of the China Health and Nutrition Survey spanning from 1989 to 2015, and applie...This study investigates the impact of marriage on the body mass index (BMI) of individuals aged 18-45 in China. We used data from ten rounds of the China Health and Nutrition Survey spanning from 1989 to 2015, and applied Difference-in-Differences (DID) model to examine the impact of marriage on BMI. Our findings reveal that marriage has a significant positive effect on BMI, especially among males, with post-marriage elevation of male BMI continuing to increase over time. Moreover, marriage is associated with a 5.2% increase in the prevalence of overweight and a 2.5% rise in the incidence of obesity among males. While energy intake levels for Chinese women did not undergo significant changes after marriage, nor did their energy expenditure levels, men experienced a marked alteration in energy balance, characterized by an increase in caloric intake and a decrease in physical activity. Furthermore, our study confirms significant period differences in the effect of marriage on BMI, with post-marriage elevation of male BMI continuing to rise over time. In contrast, there was no clear trend for female BMI after marriage. Our research highlights the importance of promoting physical fitness and health management within families while fostering intimate relationships through marriage. Public health policies should consider the potential impact of marriage as an intervention window for addressing individuals' weight management needs. Distinct post-marriage body management plans should be designed for both genders.
We use longitudinal electronic clinical data on a large representative sample of the Italian population to estimate the lifetime profile costs of different BMI classes - normal weight, overweight, and obese (I, II, and I...We use longitudinal electronic clinical data on a large representative sample of the Italian population to estimate the lifetime profile costs of different BMI classes - normal weight, overweight, and obese (I, II, and III) - in a primary care setting. Our research reveals that obese patients generate the highest cost differential throughout their lives compared to normal weight patients. Moreover, we show that overweight individuals spend less than those with normal weight, primarily due to reduced expenditures beginning in early middle age. Our estimates could serve as a vital benchmark for policymakers looking to prioritize public interventions that address the obesity pandemic while considering the increasing obesity rates projected by the OECD until 2030.
Women's decision-making is a phenomenon in children's nutritional outcomes. This study investigated the causal effect of women's decision-making on child nutritional outcomes using a panel dataset from the South African...Women's decision-making is a phenomenon in children's nutritional outcomes. This study investigated the causal effect of women's decision-making on child nutritional outcomes using a panel dataset from the South African National Income Dynamic Survey (NIDS) from 2014/15-2017. The child's nutritional outcomes comprised three anthropometric measurements, which included weight-for-height, weight-for-age, and height-for-age. The study used variables, which include daily expenditure, large purchases, where children attended school, who lived with the family, and where the household lived, to create a decision-making index using Multiple Correspondence Analysis (MCA). A control function approach (CFA) was used to control for endogeneity issues. Using this approach, the findings suggested that women's decision-making had a significant positive effect on the child's nutritional outcomes. While women's decision-making improves a child's weight-for-age and weight-for-height, the result was inconclusive on the child's height-for-age. The policy implications of these findings indicate that the role of women's empowerment is important and could significantly help in achieving better child nutritional outcomes. Overall, the findings suggest the evaluation of policies that ameliorate gender inequality and children's health and well-being.
During the early outbreak phase of COVID-19 in China, lockdowns prevailed as the only available policy tools to mitigate the spread of infection. To evaluate the impact of lockdown policies in the context of the first ph...During the early outbreak phase of COVID-19 in China, lockdowns prevailed as the only available policy tools to mitigate the spread of infection. To evaluate the impact of lockdown policies in the context of the first phase of COVID-19 pandemic, we leverage data on daily confirmed cases per million people and related characteristics of a large set of cities. The study analyzed 369 Chinese cities, among which 188 implemented lockdowns of varying severity levels from January 23 to March 31, 2020. We use nationwide Baidu Mobility data to estimate the impact of lockdown policies on mitigating COVID-19 cases through reducing human mobility. We adopt a heterogeneous treatment effect model to quantify the effect of lockdown policies on containing confirmed case counts. Our results suggest that lockdowns substantially reduced human mobility, and larger reduction in mobility occurred within-city compared to between-city. The COVID-19 daily confirmed cases per million people decreased by 9% - 9.2% for every ten-percentage point fall in within-city travel intensity in t+7 timeframe. We also find that one city's lockdowns can effectively reduce the spillover cases of the traveler's destination cities. We find no evidence that stricter lockdowns are more effective at mitigating COVID-19 risks. Our findings provide practical insights about the effectiveness of NPI during the early outbreak phase of the unprecedented pandemic.
Econ Hum Biol
· 2024 Apr · PMID 38340649
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Retirement, a major transition in the life course, may affect many aspects of retirees' well-being, including health and health care utilization. Leveraging differential statutory retirement age (SRA) by occupation for C...Retirement, a major transition in the life course, may affect many aspects of retirees' well-being, including health and health care utilization. Leveraging differential statutory retirement age (SRA) by occupation for China's urban female workers, we provide some of the first evidence on the causal effect of retirement on hospitalizations attributable to mental illness and its heterogeneity. To address endogeneity in retirement decisions, we take advantage of exogeneity of the differing SRA cut-offs for blue-collar (age 50) and white-collar (age 55) female urban employees. We apply a Fuzzy Regression Discontinuity Design (RDD) around the SRA cut-offs using nationally representative hospital inpatient claims data that cover these workers. We show that blue-collar females incur more hospitalizations for mental illness after retirement, while no similar change is found for white-collar females. Conditional on blue-collar females being hospitalized, probabilities of overall and ER admissions due to mental illness increase by 2.3 and 1.2 percentage points upon retirement, respectively. The effects are primarily driven by patients within the categories of schizophrenia, schizotypal and delusional disorders; and neurotic, stress-related and somatoform disorders. Moreover, the 'Donut' RDD estimates suggest that pent-up demand at retirement unlikely dominates our findings for blue-collar females. Rather, our results lend support to their worsening mental health at retirement. These findings suggest that occupational differences in mental illness and related health care utilization at retirement should be considered when optimizing retirement policy schemes.
We develop a model of rational self-medication in which individuals use potentially dangerous or addictive substances (e.g., alcohol) to manage symptoms of illness (e.g., depression) outside of formal medical care. A mod...We develop a model of rational self-medication in which individuals use potentially dangerous or addictive substances (e.g., alcohol) to manage symptoms of illness (e.g., depression) outside of formal medical care. A model implication is that the emergence of better treatments reduces incentives to self-medicate. To investigate, we use forty years of longitudinal data from the Framingham Heart Study and leverage the exogenous introduction of selective serotonin reuptake inhibitors (SSRIs). We demonstrate an economically meaningful reduction in alcohol consumption when SSRIs became available. Our findings illustrate how the effects of medical innovation operate, in part, through changes in behavior.