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This paper evaluates the short-term health effects of in utero drought shock using repeated cross-section household data on Malawi. The main finding reveals that the effects of in utero harvest variability caused by rainfall shocks on child growth indices are driven by the deleterious effects of negative rainfall deviations, namely droughts. Negative rainfall deviation during the agricultural season prior to the gestational period of a child leads to a 21.8 per cent average local level reduction in age-standardized height scores, with the counterpart positive rainfall deviation having no apparent effect. The paper also uses harvest and consumption patterns to establish an important link between early-life malnutrition and growth serving as a precursor for the fetal period programming hypothesis in the literature. The direct impact of embryonic period shocks on growth provides supportive evidence on potential interaction between nutritional and environmental pathways.
Immigration has changed the United States from having a predominantly white to a more ethnically diverse population. People who move to the U.S. may initially have diets unlike native-born Americans but gradually adopt eating patterns more like them. Using NHANES data and a censored gamma regression model, this study estimated the daily consumption of major food products among groups of immigrants and the corresponding groups born in the U.S. Results show that immigrants had lower consumption of meat and higher consumption of fruits and vegetables, and immigrants’ consumption converged towards a less healthy American diet after five years in the U.S.
We use household scanner data, paired with rich demographics and merged with self-reported measures of obesity and body mass index (BMI), to investigate the potential effects of fruit and vegetable purchasing behavior on adult obesity and body weight. We find that increasing household fruit and vegetable expenditure shares by one percentage point decreases the multiyear incidence of adult obesity by approximately 9 percent and average adult BMI by 1.4 percent, controlling for a host of potential confounding factors and measures of lifestyle choices. The results are robust to specification choice, although estimated impacts differ by gender. Our findings help quantify the potential impacts of government efforts aimed at increasing fruit and vegetable intake.
Concern has been expressed that human papillomavirus (HPV) vaccination programs might promote risky sexual behavior through mechanisms such as risk compensation, behavioral disinhibition, or perceived endorsement of sexual activity. This study assesses whether HPV vaccination status is associated with any differences in selected sexual behaviors among young sexually-active women in the US. Our dataset includes young, adult female respondents from questionnaire data collected in the National Center for Health Statistics' National Health and Nutrition Examination Survey from 2007 to 2014. The empirical approach implements a doubly robust estimation procedure, based on inverse probability of treatment weighting. For robustness, we implement several specifications for the propensity model and the outcomes model. We find no consistent association between HPV vaccination and condom usage or frequency of sex. Specifically, we find no evidence that HPV vaccination is associated with condom usage or with whether a person had sex more than 52 or more than 104 times per year. We find inconsistent evidence that HPV vaccination is associated with a person having sex more than 12 times per year. As in previous research, HPV vaccination does not appear to have a substantive effect on sexual behavior among young sexually-active women in the US.
We examine the birth order effects on health status for a sample of children aged 1–18 years in South Africa. Using a mother fixed-effects specification, we observe children's height-for-age z-score decreases with birth order. We investigate potential mechanisms underlying the birth order effect including those related to biology, parental preferences, and resource dilution. We also look at whether these effects are due to selection into families of different sizes. We find that the magnitude of the effect is larger in poorer and rural households and in larger families – suggesting that the birth order effect is largely due to resource dilution in economically constrained households.
This article provides the first series of adult male height for 19th-century Chile. Our aim was not only to assess the trends indicated by height during this period, but also the relationship between stature and both GDP per capita and exports. Having analysed our data, our primary conclusion is that there was a reduction in height for cohorts born in the 1850s and 1860s with respect to cohorts born between 1820 and 1840. Height stagnated thereafter, with small to no improvement towards the end of the 19th century, in line with other Latin American countries for which there is comparable evidence. The increase in per capita GDP and exports during the second half of the century did not result in better biological welfare, as was the case in other Latin American countries during similar export booms.
We investigated labor force and health outcomes in cities experiencing fiscal difficulties to assess how those difficulties might impact their employees. We matched 23 cities with bond downgrades and 31 cities with stable bond ratings to sampling units in the Medical Expenditure Panel Survey. Starting the year before the downgrade and for the four subsequent years, the rate of separation from local public employment fell in the cities with downgrades relative to the comparison group. Self-reported health may have worsened, but there were no statistically significant effects on health care use or spending.
Examination of estimates of the income elasticity of the value of a statistical life based on international stated preference studies yields an average between 0.94 and 1.05 overall and 0.65 and 0.80 after controlling for covariates. Quantile regression estimates indicate that the income elasticity is about 0.55 for more affluent countries and 1.0 for lower income nations, i.e., those countries that have estimates of the value of a statistical life below $2 million or per capita income levels below $3212. The estimates distinguish the values of the income elasticity across country either by income level or by the value of a statistical life. These elasticities are similar to those found in revealed preference labor market studies. The estimates are robust, controlling for possible sample selection bias and the influence of covariates, such as the type of risk.
Selection of the best estimates of economic parameters frequently relies on the “best estimates” or a meta-analysis of the “best set” of parameter estimates from the literature. Using an all-set dataset consisting of all reported estimates of the value of a statistical life (VSL) as well as a best-set sample of the best estimates from these studies, this article estimates statistically significant publication selection biases in each case. Biases are much greater for the best-set sample, as one might expect, given the subjective nature of the best-set selection process. For the all-set sample, the mean bias-corrected estimate of the VSL for the preferred specification is $8.1 million for the whole sample and $11.4 million based on the CFOI data, while for the best-set results, the whole sample value is $3.5 million, and the CFOI data estimate is $4.4 million. Previous estimates of huge publication selection biases in the VSL estimates are attributable to these studies’ reliance on best-set samples.
Countries throughout the world use estimates of the value of a statistical life (VSL) to monetize fatality risks in benefit-cost analyses. However, the vast majority of countries lack reliable revealed preference or stated preference estimates of the VSL. This article proposes that the best way to calculate a population-average VSL for countries with insufficient or unreliable data is to transfer a base VSL from the United States calculated using labor market estimates from Census of Fatal Occupational Injuries data, coupled with adjustments for differences in income between the United States and the country of interest. This approach requires estimation of two critical inputs: a base U.S. VSL and the income elasticity of the VSL. Drawing upon previous meta-analyses that include adjustments for publication selection biases, we adopt a base VSL of $9.6 million. We utilize a sample of 953 VSL estimates from 68 labor market studies of the VSL covering fourteen lower-middle income to high income nations. We estimate the income elasticity of the VSL within the United States to be from 0.5 to 0.7 and to be just above 1.0 for non-U.S. countries. Quantile regression reveals that much of the disparity in income elasticities is attributable to income differences between the United States and other countries, as the income elasticity increases for lower income populations. Using income classifications from the World Bank, we calculate average VSLs in lower income, lower-middle income, upper-middle income, and upper income countries to be $107,000, $420,000, $1.2 million, and $6.4 million, respectively. We also present VSL estimates for all 189 countries for which World Bank income data are available, yielding a VSL range from $45,000 to $18.3 million.
The setting and use of targets in the public sector has generated a growing amount of interest in the UK. This has occurred at a time when more analysts and policymakers are grasping the nettle of measuring performance in and of the public sector. We outline a typology of performance indicators and a set of desiderata. We compare the outcome of a performance management system — star ratings for acute hospital trusts in England — with a productivity measure analogous to those used in the analysis of the private sector. We find that the two are almost entirely unrelated. Although this may be the case for entirely proper reasons, it does raise questions as to the appropriateness of such indicators of performance, particularly over the long term.
We attempt to value health risks by combining traditional demand impact analysis with direct elicitation of individuals' risk perceptions of food safety. We examine the impact of multiple risks of related goods on consumption of a risky good. We argue that the consumption of a risky good depends on both its absolute risk level and its relative risks to other risky goods. Seafood consumption in eastern North Carolina was studied. We elicited, in a survey, individual perceived risks as reference points to derive the economic value of reducing health risk in seafood consumption. Revealed and stated data were combined to trace out demand changes in response to absolute and relative risk reductions. Our results show that seafood consumption is affected by the perceived absolute risk and by the relative risk to poultry and that individuals react to the multiple risks in a nonlinear way, as was suggested by our analytical model.
Historical studies show that the average height of Western European children began its secular growth in 1850 only after a period of decline and stagnation which had started around 1750. We argue that the initial downturn in heights is related to the demographic transition, and show that an extension of the neoclassical model of economic growth can explain the observed phenomena. We test whether the predictions of the model hold for a cross-section of contemporary countries, and we find that stature is indeed negatively associated with income per capita and fertility for countries with an income per capita below a given threshold. As a final exercise, we ask whether these cross-country estimates explain the improvement in children's height observed in the last hundred and fifty years.
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