THE VALUE OF CLEANER AIR: AN INTEGRATED APPROACH

Policymakers in the legislative and regulatory arenas face increasing public expectations that authorities will both promulgate and implement strict environmental programs. At the same time, the aggregate cost of such programs is rising and is impacting economic sectors previously untouched. In this context, a major study used an integrated interdisciplinary perspective to determine what economic benefits would result from air pollution controls. Specifically, the study developed estimates for the health benefits of reducing ozone and fine particulate matter concentrations in the nation's most polluted region—the South Coast Air Basin centering on Los Angeles. This paper presents the economic methodologies and results of that study. It also discusses how health and atmospheric sciences informed the economic assessment.     

A model for economic analysis

The production process model is proposed as a way to guide economic evaluation of health care projects, programs, technology, or research. The model is illustrated with data from the development of a home care computer intervention.     

BENEFITS AND COSTS OF INTENSIVE FOSTER CARE SERVICES: THE CASEY FAMILY PROGRAMS COMPARED TO STATE SERVICES

The foster care system attempts to prepare children and youth who have suffered child maltreatment for successful adult lives. This study documents the economic advantages of a privately funded foster care program that provided longer term, more intensive, and more expensive services compared to public programs. The study found significant differences in major adult educational, health, and social outcomes between children placed in the private program and those placed in public programs operated by Oregon and Washington. For the outcomes for which we could find financial data, the estimated present value of the enhanced foster care services exceeded their extra costs. Generalizing to the roughly 100,000 adolescents age 12-17 entering foster care each year, if all of them were to receive the private model of services, the savings for a single cohort of these children could be about $6.3 billion in 2007 dollars. ( JEL D61, H75)     

Health services utilization and cost utility analysis of a walking program for residential community elderly

Promoting the health and improving the ability and confidence of the elderly to live independently can reduce health care expenditures and increase the health of society as a whole. However, the evidence to promote physical activity in order to promote health among the aged population is weak, especially in regards to the economic evaluation of a walking program. These researchers confirmed that the cost utility of a 12-week walking training program is acceptable. Therefore, an outpatient clinic-based walking program for older adults is worth promoting. Cost utility analysis is the critical evaluation method in exercise programs. Health professionals are encouraged to apply the integrated indicators such as the Health Utility Index and the Incremental Cost Utility Ratio to clarify the effects of health-promotion interventions.     

公共卫生投资与区域经济增长关系的实证研究

本文利用1990年以来我国公共卫生投资的Pool数据,通过引入公共卫生投资变量的经济增长模型,对公共卫生投资与区域经济增长的关系进行了实证研究。本文的研究结果表明,一方面公共卫生投资与区域经济增长密不可分;另一方面公共卫生投资对区域经济增长的影响呈现出阶段性特征,目前西部地区的公共卫生投资对区域经济增长的贡献最大。     

The 2008/09 Economic Crisis: The Impact on Psychological Well-Being in the USA

The 2008/09 economic crisis has been the worst crisis of capitalism since the Great Depression. The causes and implications of the so-called “Great Recession” have been widely documented, but the effects of the crisis on psychological well-being have only received limited attention. Using state-level data, this paper aims to assess empirically the impact of the 2008/09 crisis on several indicators of mental health in the USA. The results indicate that unemployment and income levels have a significant and detrimental impact on mental health. This implies that social protection systems—and in particular labor market programs—play a paramount role in reducing the adverse impact of the crisis on mental health.     

Fetal Iodine Deficiency and Schooling: A Replication of Field,Robles, and Torero (2009)*

Scholars have theorized that congenital health endowment is an important determinant of economic outcomes later in a person's life. Field, Robles, and Torero (2009, American Economic Journal: Applied Economics 1, 140–169) find large increases in educational attainment caused by a reduction of fetal iodine deficiency following a set of iodine supplementation programs in Tanzania. We revisit the Tanzanian iodine programs with a narrow and wide replication of the study by Field et al. We are able to exactly replicate the original results. We find, however, that the findings are sensitive to alternative specification choices and sample restrictions. We try to address some of these concerns in the wide replication; we increase the sample size fourfold, and we improve the precision of the treatment variable by incorporating new institutional and medical insights. Despite the improvements, no effect is found. We conclude that the available data do not provide sufficient power to detect a possible effect, as treatment assignment cannot be measured with sufficient precision.     

The impact of public investment in medical imaging technology: an interagency collaboration in evaluation

The Canada Foundation for Innovation (CFI) and the Canadian Institutes of Health Research (CIHR) allied to analyze the impact of their investments in medical imaging research. The CFI funds capital and operating programs for research infrastructure, and CIHR's mandate concentrates its funding on research activity. It happens that CIHR-funded research consumes CFI-funded infrastructure as an input in the innovation process. Apart from a few partnered programs, by design there is no coordination between CFI and CIHR funding decisions. Together, these agencies invested $916 million over a 14-year-period. In this paper, we evaluate the economic and health benefits from advancements in one funded area, namely computed tomography perfusion (CTP). CTP is an imaging technique that uses computed tomography to measure blood flow in organs and tissues. It is mostly used to assess acute ischemic stroke. The net social benefits attributable to these investments are substantially positive: the benefit-to-cost ratio is estimated to be between 6.66-to-1 and 9.99-to-1. We review how public investments from multiple funders comingle in the innovation process to deliver social value and improved health outcomes.     

DOES CHINA'S RURAL COOPERATIVE MEDICAL SYSTEM ACHIEVE ITS GOALS? EVIDENCE FROM THE CHINA HEALTH SURVEILLANCE BASELINE SURVEY IN 2001

The Chinese government is in the process of providing health insurance to the uninsured rural population by expanding the rural Cooperative Medical System (CMS) to every rural county. Using the China Health Surveillance Baseline Survey in 2001, we conducted a case study on two CMS pilot programs and investigated whether or not enrolling in these CMS pilot programs has led to an increase in health care utilization and a decrease in the likelihood of catastrophic health spending for rural residents. Matched data sets are produced using propensity score and the instrumental variable (IV) method is used. We have found that the CMS pilot programs have had a significant and positive effect on the probability of seeking medical care and the number of visits. However, the CMS programs did not seem to have had a significant impact on households' out‐of‐pocket health expenditure and on reducing catastrophic spending. The findings generated from the matched data are consistent with those obtained from the full set of data and those obtained from the IV method. (JEL I18)     

Health care expenditure and economic growth: Quantile panel-type analysis

This study uses international total health care expenditure data of 31 countries from 1986 to 2007 for exploring the causality between an increase in health care expenditure and economic growth. The empirical procedure is divided into two parts. The first is the panel regression analysis and the second is the quantile regression analysis. The estimation of the panel regression reveals that, expenditure growth will stimulate economic growth; however, economic growth will reduce expenditure growth. With regard to the estimation of quantile regression, when economic growth is quantile, in countries with low level of growth, the influence of expenditure growth on economic growth is different. In countries with medium and high levels of economic growth, the influence of expenditure growth on economic growth is positive; when health care expenditure growth is quantile, the influence of economic growth on expenditure growth is more different.     

社会医疗保险发展的逻辑:中国城镇职工基本医保覆盖面的跟踪研究

社会医疗保险在发展中国家日益盛行,但有关其发展逻辑的系统研究还比较少。文章采用面板数据追踪了中国城镇职工基本医疗保险扩大覆盖面的过程,时间跨度为1999年至2007年。研究发现:(1)经济发展对职工医保发展具有重要作用;(2)政府的财力和行政能力在职工医保扩面中不可或缺;(3)工会密度与医保覆盖面有着显著的正面关系;(4)税务机构征收医疗保险费更有利于覆盖面的扩大。这些以经验证据为基础的发现可以为其他国家发展社会医疗保险项目提供借鉴。此外,通过以中国为对象,把社会医疗保险的发展置于社会政策相关理论中,也有助于拓宽社会政策发展理论的解释范围。     

The import of hospital rate setting programs on hospital and health care expenditures, 1975–85

To reduce hospital expenditures, many jurisdictions now regulate hospital rates. Prior theoretical work has demonstrated, however, that the effect of rate regulation on total expenditures is a priori unclear. Empirical research has found that hospital rate setting programs have reduced expenditures per diem and per admission, but not necessarily hospital expenditures or total health care expenditure per capita. This study extends this empirical research. It employs pooled cross section-time series data on state level expenditure, regulatory, and demographic variables obrserved annually for 1975–85. The analysis provides little evidence that hospital rate setting programs have reduced hospital expenditures. Some rate setting programs actually are positively and significantly related to hospital expenditures. Overall, this study does not suggest that regulatory programs will reduce hospital expenditures.     

“老龄健康”的经济学研究

"老龄健康"问题是社会发展进程中面临的重大议题,其相关领域的研究已构成各国国家战略的重要组成部分。经济学和其他学科参与研究"老龄健康"问题之前,"老龄健康"问题更多地被作为医学概念,但是,随着经济学和其他学科的交叉与融合,决策者和研究者逐渐认识到跨学科研究的价值,越来越多的学者开始从经济学视角对"老龄健康"问题展开新的探索。关于社会经济、行为、环境、遗传因素及其交互作用与老龄健康关系的跨学科研究,逐渐成为近20年来这一研究领域的主要内容。本文将从宏观和微观两个层面,说明经济学家对"老龄健康"相关领域研究的逻辑、方法、内容、贡献和重点,通过对"老龄健康"经济学研究的讨论,希望对中国经济学科研究领域的拓展和老龄化问题的解决提供有价值的参考。     

Computation of non-linear continuous optimal growth models: experiments with optimal control algorithms and computer programs

In this paper we discuss the use of optimal control methods for computing non-linear continuous optimal growth models. We have discussed various recently developed algorithms for computing optimal control, involving step-function approximations, Runge–Kutta solutions of differential equations, and we suggest that the discretization approach is preferable to methods which solve first-order optimality conditions. We have surveyed some powerful computer programs by : , and for computing such models numerically. These programs have no substantial optimal growth modelling applications yet, although they have numerous engineering and scientific applications. A computer program named by is developed in this study. Results are reported for computing the Kendrick–Taylor optimal growth model using and programs based on the discretization approach. References are made to the computational experiments with and . The results are used to compare and evaluate mathematical and economic properties, and computing criteria. While several computer packages are available for optimal control problems, they are not always suitable for particular classes of control problems, including some economic growth models. The -based and , however, offer good opportunities for computing continuous optimal growth models. It is argued in this paper, that optimal growth modellers may find that these recently developed algorithms and computer programs are relatively preferable for a large variety of optimal growth modelling studies.     

INFLUENCES ON THE TIMING OF FIRST CHILDBEARING

This paper presents evidence that women from different population subgroups respond differently to economic and background influences when timing initial childbearing. Among all groups examined, age at first birth tends to increase as education levels increase, and married women with spouses present tend to be older than other women at first childbirth. Among whites, all economic influences considered–hourly pay rate, nonmarket income, and work during the year prior to childbearing–have a significant influence in deferring first childbirth, but family background does not. Among blacks, family background plays a significant role in determining age at first childbirth, but only one economic influence–the hourly pay rate–is significant. Blacks' response to family background is somewhat greater than their response to hourly pay rate. Race as a separate influence is significant among women age 20 years or under, but that influence disappears among older women. Because of their adverse economic consequences, adolescent pregnancies and unwed motherhood are of mounting concern. This study suggests that, contrary to popular belief, welfare programs do not foster early pregnancy nor do programs to reduce unemployment deter it. Educational achievement, however, serves as a deterrent to early pregnancy among all groups.     

The Impact of Economic Education Courses on the Knowledge and Retention of Knowledge of Secondary and Primary School Teachers

Controlling for other variables, the authors of this study isolate the effect of in-service teacher-training programs on economic knowledge. The effect of lapsed time on retention is also estimated.     

IMF conditionality,export structure and economic complexity:The ineffectiveness of structural adjustment programs

The conditionality requirements of the International Monetary Fund (IMF) have been a source of intense debate since the early 1980s. These conditions, which are attached to IMF lending programs, cover a variety of issues from fiscal and monetary reform to economic liberalization and institutional change. In this paper we empirically examined the effects of IMF programs and conditionality requirements on structural transformation through changes in the technology-and-skill intensity and overall economic complexity of exports. Our empirical methodology accounted for policy and conditionality heterogeneity across country and time and accounts for the endogeneity of IMF programs and conditions. The empirical results suggest that IMF programs and conditionality requirements along a spectrum of policy areas had no robust or significant effect on export structure, economic complexity or export diversification. Overall, we found no evidence of any positive effects of IMF programs or IMF conditionality requirements on the technology-and-skill intensity of exports.     

Gender Disparity in Access to the Rwandan Mutual Health Insurance Scheme

While there is a body of research on the gendered penalties of user fees within health systems in low-income countries, what is less well understood is the gendered experience of community-based health insurance (CBI) programs, which have replaced user fees for basic healthcare. This study examines the uptake of a Rwandan CBI scheme five years after the program was scaled up nationwide. Using the Enquete Intégrale sur les Conditions de Vie des ménages de Rwanda (EICV2) for 2005–6, the study finds evidence that members of female-headed households are less likely than those of male-headed households to be enrolled in the CBI program. Additionally, it finds strikingly different patterns of equity effects of CBI by gender of household head by examining consumption income and wealth. These findings suggest the need for greater attention to equity, particularly gender equity, concerning the way in which voluntary CBI programs are initially implemented and evaluated.     

Physician participation in health insurance plans: evidence on Blue Shield

Various health insurance programs, including Blue Shield, have developed arrangements whereby the physician agrees to accept the insurer's reimbursement as payment in full. Incentives facing the physician to accept an arrangement of this type are reviewed in this study. The empirical work uses data on individual physicians from a 1973 survey. The results indicate that physician willingness to accept insurer reimbursement as payment in full is sensitive to the amount the insurer pays for specific procedures and to other insurance program characteristics. Physicians located in high patient income areas and/or with relatively prestigious credentials are less likely to accept insurer payments as payment in full. The empirical findings are used to generate policy implications pertaining to the Medicare and Medicaid programs, to medical care quality-access tradeoffs, and to national health insurance.     

Gender Pay and Occupational-Attainment Gaps in Costa Rica and El Salvador: A Relative Comparison of the Late 1980s

This study investigates gender occupational attainment and earnings differentials in El Salvador and Costa Rica at the end of the 1980s. During this decade, El Salvador experienced a civil war and an economic depression. Costa Rica was also mired in a recession in the early 1980s, but programs adopted in the mid-1980s led to rapid economic recovery. It is found that the gender pay gap in El Salvador is 30.4% and 23.6% in Costa Rica. The intercountry difference in the gap disappears after accounting for high gender differences in occupational attainment and hours worked in El Salvador.