Investigating Treatment Effects of Participating Jointly in SNAP and WIC when the Treatment Is Validated Only for SNAP

The U.S. Department of Agriculture operates several food assistance programs aimed at alleviating food insecurity. We study whether participation in both participation in both SNAP and WIC alleviates food insecurity compared with participation in SNAP alone. We bound underlying causal effects by applying nonparametric treatment effect methods that allow for endogenous selection and underreported program participation when validation data are available for one program (treatment) but not the other. We estimate average treatment effects using data from the National Household Food Acquisition and Purchase Survey (FoodAPS). FoodAPS includes administrative data to validate SNAP participation. Information on local food prices allows us to construct a food expenditure‐based monotone instrumental variable that does not require a typical instrumental variable exclusion restriction. Under relatively weak monotonicity assumptions, we identify that the impact of participating in both programs relative to SNAP alone is strictly positive, suggesting that the programs are nonredundant. This evidence can support improved design and targeting of food programs.     

Life insurance decisions under recursive utility

In this paper, we generalize recursive utility to include lifetime uncertainty and utility from bequest. The generalization applies to discrete-time as well as continuous-time recursive utility, and it is an important step forward in the development of recursive utility. We formalize the problem of optimal consumption, investment, and life insurance choice under recursive utility, and we state a verification theorem with a generalized Hamilton-Jacobi-Bellman equation. Our generalization of recursive utility allows us to study optimal consumption, investment, and life insurance choice under separation of (market) risk aversion, elasticity of inter-temporal substitution, and elasticity of substitution between bequest and future utility. The separation gives rise to hump-shaped consumption patterns as observed in realized consumption.     

Projecting total costs and health consequences of increasing mt-sDNA utilization for colorectal cancer screening from the payer and integrated delivery network perspectives

Abstract

Aims: To evaluate total costs and health consequences of a colorectal cancer (CRC) screening program with colonoscopy, fecal immunochemical tests (FIT), and expanded use of multitarget stool DNA (mt-sDNA) from the perspectives of Integrated Delivery Networks (IDNs) and payers in the United States.

Materials and methods: We developed a budget impact and cost-consequence model that simulates CRC screening for eligible 50- to 75-year-old adults. A status quo scenario and an increased mt-sDNA scenario were modeled. The status quo includes the current screening mix of colonoscopy (83%), FIT (11%), and mt-sDNA (6%) modalities. The increased mt-sDNA scenario increases mt-sDNA utilization to 28% over 10 years. Costs for both the IDN and the payer perspectives incorporated diagnostic and surveillance colonoscopies, adverse events (AEs), and CRC treatment. The IDN perspective included screening program costs, composed of direct nonmedical (e.g. patient navigation) and indirect (e.g. administration) costs. It was assumed that IDNs do not incur the costs for stool-based screening tests or bowel preparation for colonoscopies.

Results: In a population of one million covered lives, the 10-year incremental cost savings incurred by increasing mt-sDNA utilization was $16.2 M for the IDN and $3.3 M for the payer. The incremental savings per-person-per-month were $0.14 and $0.03 for the IDN and payer, respectively. For both perspectives, increased diagnostic colonoscopy costs were offset by reductions in screening colonoscopies, surveillance colonoscopies, and AEs. Extending screening eligibility to 45- to 75-year-olds slightly decreased the overall cost savings.

Limitations: The natural history of CRC was not simulated; however, many of the utilized parameters were extracted from highly vetted natural history models or published literature. Direct nonmedical and indirect costs for CRC screening programs are applied on a per-person-per modality basis, whereas in reality some of these costs may be fixed.

Conclusions: Increased mt-sDNA utilization leads to fewer colonoscopies, less AEs, and lower overall costs for both IDNs and payers, reducing overall screening program costs and increasing the number of cancers detected while maintaining screening adherence rates over 10 years.     

New ventures in Cleantech: Opportunities,capabilities and innovation outcomes

Facing the challenge of climate change, innovations that imply environmental benefits create business opportunities for entrepreneurs. This paper analyzes innovation capabilities of startups in Cleantech and how the innovation outcomes of those startups develop over time. Based on the Mannheim Foundation Panel and applying propensity score matching, a cohort of 567 Cleantech startups is analyzed and compared with a control cohort of non‐Cleantech startups. We find that startups in Cleantech have, on average, higher technological capabilities compared with all other startups. Our econometric evidence shows that Cleantech startups are more likely to combine existing technology in a novel way. Finally, we find that Cleantech startups develop more market novelties in subsequent years when compared with their control group peers.     

Determinants of the Prevalance of Start-ups and High-Growth Firms

The purpose of this study is to identify key institutional determinants of firm emergence and growth. We do this using various types of data from Sweden. A characterization of a number of institutions and policy measures shows that they are likely to have contributed to an environment that discourages entrepreneurial activity and firm growth. Aspects dealt with include: missing arenas for entrepreneurship in the care sectors and for household-related services, taxation of entrepreneurial income, incentives for wealth accumulation, wage-setting institutions and labor market regulations. Using original data, we provide evidence of a low prevalence of nascent entrepreneurs and a small net employment contribution by high-growth firms. We admit that indisputable evidence for the effects of institutional arrangements is almost impossible to establish. However, the consistency of our theoretical arguments and empirical data makes a strong case for the notion that the Swedish case illustrates the costs of giving too little weight to economic renewal in policy making.     

Accounting for the role of habit in behavioural strategies for injury prevention

The limited success of behavioural strategies in injury prevention has been attributed to failure to properly apply behaviour change models to intervention design and the explanation of safety behaviours. However, this paper contends that many health behaviour change interventions do not succeed because they fail to take into account the habitual quality of most health and safety-related behaviour; a more complete model of behaviour change needs to be based on a better understanding of the role of habit. The overall aim is to contribute to better understanding of behavioural strategies for injury prevention. When habits are weak, attitudes and intentions predict behaviours, but as behaviours turn into habits, they become better predictors of future behaviour than attitudes or intentions. Furthermore, where habits are strong, individuals are less likely to act on new information, evaluating counter-habitual information negatively. Integrating the concepts of strong and weak habits with upstream and downstream strategies, a framework is presented for tailoring strategies to the habit strength of the target behaviour.     

Agglomeration, Relative Wage Costs and Foreign Direct Investment—Evidence from Swedish MNCs 1974–1998

This paper examines the relationship between agglomeration economies and relative wage costs in influencing location of multinational corporations. An inflow of firms to certain regions and industries is likely to increase demand for labor. If mobility of labor is low increased costs can be expected to deter additional inflows of firms, albeit agglomeration economies may compensate for higher wages. Despite its important policy implications this relationship has to our knowledge not been exposed to empirical testing. The empirical analysis finds that foreign direct investment has become increasingly sensitive to differences in wage cost across industrialized countries, but also that agglomeration economies related to knowledge externalities positively influences higher costs. The relative strength of these two forces impacts the spatial distribution of production.

Economic analysis of injury prevention--applying results and methodologies from cost-of-injury studies

Injuries pose an economic problem of immense proportion to communities in every society. The economic burden from injuries can be quantified through cost-of-injury studies, using techniques adopted from cost-of-illness research. This study explores the feasibility of applying results and methodologies from existing cost-of-injury studies in economic analyses of injury prevention interventions and programmes. The literature on cost-of-injury studies and economic appraisals of injury prevention efforts was examined to elicit studies that calculated injury costs. Studies were accepted for inclusion if they included an analysis of the costs of all injuries occurring in a geographical area (community, region or country) during a specific time period, employed a societal perspective and an incidence-based costing approach and were conducted in industrialized countries. There were 12 studies that met the inclusion criteria. The average total cost per injury case was USD $3536, while the average share of indirect to total cost per injury case was 71%. However, the cost figures showed wide variation across the studies. Based on the limited similarity of findings from the studies, it was concluded that it is not feasible to apply results and methodologies from existing cost-of-injury studies. The cost estimators described in this study could possibly be adapted for use as reference points in economic analyses of existing programmes, but any other uses should be approached with caution. Locally obtained data are needed for reliable economic analyses of injury prevention interventions and programmes.     

Alienation in corporate America: Fact or fable?

Using NORC annual survey data, the authors selected 21 questions describing respondent attitudes toward job, life in general, and financial status. Respondents were catigorized as management, white collar, blue collar, and those not affiliated with business organizations. Attitudes were compared across the four occupational groups. Little dissatisfaction was found in any but the blue collar group. Management as a group, and men as well as women managers showed high levels of satisfaction, with few significant differences found in responses by men and women. This study does not support the earlier finding of widespread alienation in business firms.Charles B. Sannders is Professor of Business Administration at the University of Connecticut. He has written numerous articles which have been published in various management journals.Hugh M. O'Neill and Oscar W. Jensen are Assistant Professors of Business Administration at the University of Connecticut and the Fairfield University, respectively. Both have written several articles, published in management journals.