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ABSTRACT Low birth weight and preterm birth are key indicators of neonatal health, influencing both immediate and long‐term infant outcomes. While low birth weight may reflect fetal growth restrictions, preterm birth captures disruptions in gestational development. Ignoring the potential interdependence between these variables may lead to an incomplete understanding of their shared determinants and underlying dynamics. To address this, a copula distributional regression framework is adopted to jointly model both indicators as flexible functions of maternal characteristics and geographic effects. Applied to female birth data from North Carolina, the methodology identifies shared factors of low birth weight and preterm birth, and reveals how maternal health, socioeconomic conditions and geographic disparities shape neonatal risk. The joint modeling approach provides a more nuanced understanding of these birth metrics, offering insights that can inform targeted interventions, prenatal care strategies and public health planning.
ABSTRACT This study investigates the impact of the Earned Income Tax Credit (EITC) on work disability and Social Security Disability Insurance (DI) claims among Americans. Utilizing the Panel Study of Income Dynamics, we examine the effects of EITC exposure from birth to mid‐adulthood on work disability risk before retirement. Our analysis reveals that EITC exposure during adulthood significantly reduces the likelihood of work disability, potentially influencing DI trends. Specifically, a $10,000 increase in cumulative EITC exposure is associated with about a 1.25 percentage‐point lower probability of any work limitation at ages 50–61 (a 0.94 percentage‐point reduction in the likelihood of chronic/severe limitations) and a 0.84 percentage‐point reduction in DI receipt, highlighting the EITC's potential role in reducing DI dependency and its broader implications for public policy and social welfare.
The cover image is based on the article Long‐Term Care at Advanced Ages: The Effect of Spousal Bereavement on Institutional Care Needs by Chantal Schouwenaar et al., https://doi.org/10.1002/hec.70043 .
ABSTRACT In France, the Couverture Maladie Universelle Complémentaire (CMU‐C) scheme is a means‐tested, state‐financed, complementary health insurance program that fully covers healthcare. Using administrative claims data and a staggered difference‐in‐differences approach, we estimate the impact of enrollment in the program on healthcare utilization. To address selection into the program, we use health shocks at the family level to exogenize individual enrollment. The findings indicate that access to free healthcare significantly increases healthcare utilization at both intensive and extensive margins. This effect is driven primarily by individuals who are uninsured before enrolling in the CMU‐C. Moreover, individuals with severe or chronic illnesses, who already receive additional public coverage for their conditions, experience significant gains from the CMU‐C coverage. Finally, these effects persist throughout the coverage period.
ABSTRACT This study estimates the effects on perinatal mental health of the state's minimum wage and earned income tax credit (EITC), controlling for other policies and state‐level factors. Using data from the Pregnancy Risk Assessment Monitoring System for 2012–2018 births we find robust evidence that minimum wages and EITC levels reduce depression before pregnancy and suggestive evidence of minimum wages reducing postpartum depression, at least for married respondents. Our estimates suggest that a one dollar increase in the minimum wage ($100 increase in the state EITC) reduces pre‐pregnancy depression by roughly 8.5% (1.5%). These findings stand up to standard robustness and falsification tests, including event study analyses, a wide array of alternative specifications, and finding no effect for those unlikely to benefit (e.g., college‐educated respondents). A supplementary analysis using data from the Behavioral Risk Factor Surveillance System suggests that state EITC levels may reduce mental distress during pregnancy. We investigate possible mechanisms by providing a descriptive analysis of the income and work behavior of such households, which shows the wide reach of these policies, and investigating a broad set of outcomes from the PRAMS, such as financial stressors, health insurance and birth outcomes.
ABSTRACT We investigate how disability insurance (DI) generosity affects DI take‐up and labor market participation in a setting where benefits can be cumulated with substantial labor earnings. Using rich administrative data on Italian private‐sector workers and a Regression Discontinuity in Time design, we find a large behavioral response to DI generosity, with an elasticity of 1.26 in DI take‐up, while employment effects are minor and concentrated among immigrants. Our identification strategy exploits a major social security reform that reduced the expected DI replacement rate and generated a clear income effect. To address unobserved heterogeneity and the unobservability of underlying disability, we focus on individuals affected by acute cardiovascular shocks whose DI eligibility is plausibly exogenous. Overall, our results suggest that when earnings cumulability is extensive, DI is widely perceived as a complement to labor income. This has important implications for the design of labor‐inclusive DI schemes.
ABSTRACT This paper quantifies physician agency in China's prescription drug market by exploiting the structural shift created by the Zero‐Markup Drug Policy. We find that physicians' prescribing decisions are about three times more sensitive to the hospital's profit margin than to the retail price faced by patients. The study provides several key findings. First, government policy exerts a strong influence on drug prices. Second, branded drugs are generally preferred over generics and display lower price elasticity. Third, the policy accounts for more than half of the observed decline in average wholesale prices. Finally, while the policy improves patient welfare, it reduces pharmaceutical firms' sales and profits, and a partial restoration of drug markups could increase overall social welfare.
ABSTRACT Annually, countries allocate hundreds of millions of dollars to subsidize fossil fuels, often at the expense of public health and environmental sustainability. This undermines progress toward Sustainable Development Goals (SDG) 3 (Good Health and Well‐Being) and 13 (Climate Action). Despite this, the impact of fossil fuel subsidies (FFS) on social protection expenditure, including health, remains poorly quantified. This study aimed to determine whether FFS crowd out health expenditure globally, using panel data from 126 countries covering the period 2015–2019. An instrumental variable approach, relying on countries' exposure to international energy trade and fluctuations in crude oil price, was employed to capture exogenous variation in FFS and estimate a causal relationship. The analyses revealed that in 2019, 17 countries spent more than five percent of GDP on FFS, with FFS expenditure exceeding health expenditure in 15 of those countries. Specifically, a 1% increase in FFS per capita, driven by rising international oil prices and weighted by countries' exposure to international energy trade, led to a 0.05% (95% CI −0.08% to −0.02%) decrease in domestic health expenditure per capita. These findings underscore the detrimental impact of FFS on health expenditure, presenting another reason to eliminate FFS to achieve SDG3 in addition to avoiding further dangerous climate heating.
ABSTRACT We extend the Rothshild and Stiglitz (1976) model to two sources of risk –inpatient and outpatient risk– to better proxy real‐world health insurance markets. We uncover an interesting theoretical possibility: Take individuals A and B, who are low risks in, say, the inpatient dimension but A is riskier in the outpatient dimension. Then, A may enjoy less coverage than B in the inpatient dimension (coverage reversal). This phenomenon indicates that when testing for adverse selection in a given dimension, one has to treat individuals who differ in the other dimension separately. With this insight in mind, we adapt the Chiappori and Salanié (2000) positive correlation test to this multi‐dimensionality and use it to test for adverse selection using individual‐level claims data for the privately insured in Chile. This empirical analysis indicates that overlooking the aforementioned need of separating samples can potentially lead to biased conclusions.