Vulnerability of households to health shocks: an Indonesian study

We examine the effect of illness and injury shocks on work hours and household consumption in Indonesia. Using indices of activities of daily living to measure health shocks, we find that both labour hours and household consumption are influenced by health shocks to household heads. Further, farm households seem to be more seriously affected than non-farm households by health shocks. However, the magnitude of the health effect on household consumption is small, implying that even farm households are well protected on average by the presence of formal and informal risk-coping mechanisms.     

COVID-19 pandemic,health risks,and economic consequences: Evidence from China

This paper introduces the Susceptible-Infectious-Recovered model into the Bewley-type incomplete market model and uses it to study the impact of the coronavirus disease (COVID-19) pandemic on China's macroeconomics. The calibrated model predicts that the average propensity to consume household wealth will decline, while the demand for money will increase, and these predictions are consistent with the data. Monetary policy is effective because it provides enough liquidity for households to buffer health risks. Monetary stimulus is more effective in an economy with greater health risks and consumption uncertainty. Counterfactual experiments show that abandoning the containment policy too early would avoid a sharp drop in output and employment in the short term, but it would greatly increase mortality and ultimately lead to a decline in social welfare.     

The effect of health insurance reform: Evidence from China

This paper estimates the impact of a health insurance reform on health outcomes in urban China. Using the China Health and Nutrition Survey¹ we find that this reform increases the rate of health insurance coverage significantly among workers in Non-State Owned Enterprises. The double difference (DD) estimations show that the reform also leads to better health outcomes: workers are less likely to get sick and more likely to use preventive care. Using an instrumental variable (IV) approach to look at the causal effect of health insurance, we find those with health insurance use more preventive care but do not report significantly better health outcomes, an increase in health care utilisation, or an increase in out-of-pocket medical expenditure.     

Environmental consequences of fuel price shocks in China

This study investigates the environmental consequences of fuel price shocks, using a rich dataset from the Chinese megacity of Hangzhou. Our identification strategy is mainly aided by instrumenting fuel price using exogenous global oil prices. We find that a 10% increase in fuel price leads to a 10.29%–11.45% decrease in driving demand, reflected by road congestion index, and a 17.6%–20.27% decrease in industrial activities, measured by electricity consumption. The decreases in driving demand and industrial activities are indeed correlated with air quality improvement and decline in major pollutant concentrations. While the findings shed light on the short-term environmental outcomes of price-based measures, the negative effects of fuel price increases on industrial activities may generate undesirable impacts on macroeconomy in the long-term perspective. Despite ample evidence demonstrating that drivers respond to fuel price changes, considerably fewer studies investigate their environmental and economic consequences. This study addresses this gap in the literature and contributes to a better understanding of the effects of fuel price shocks on air pollution and economic activities.     

Retirement and health: Evidence from China

One typical feature of China's pension system is that retirement is mandatory. By exploiting the exogenous change created by this mandatory retirement policy, we use the mandatory retirement age as an instrument for retirement status to examine the effect of retirement on individual health using data from the China Health and Nutrition Survey (CHNS). Our main finding is that the probability of “fair” or “poor” self-reported health among white-collar workers decreases by 34 percentage point after retirement. This result is generally robust to different model specifications, alternative measures of health, and different subsamples. In addition, we deliver evidence that increased health-related exercises and the cultivation of a better lifestyle are two possible channels through which retirement affects health.     

Impacts of an international bridge on households: Evidence from Thailand

This paper empirically investigates the impacts of an international bridge between Thailand and Laos on households in Thailand. Based on the significance of agricultural sectors near the bridge, we investigate how its effect on household income differs between agricultural households and other types of households. We found that the bridge increased the income of agricultural households with agricultural land, especially those near the bridge. In contrast, agricultural households without agricultural land or non-agricultural households with agricultural land did not enjoy such an income increase. We also investigated whether it induced households near the bridge to participate in the agricultural sector, but the results were insignificant. In short, agricultural households in Thailand enjoyed positive gains from establishing the second bridge.     

Macroeconomic effects of uncertainty shocks: Evidence from Korea

This paper proposes a new measure of economic policy uncertainty (EPU) for Korea by fine-tuning the keywords and exploiting information drawn from a wide variety of local newspapers. The uniqueness of our new EPU index lies mainly in the fact that it uses a set of keywords that correspond much more closely to actual language use and better reflect the economic environment of Korea, which is classified as a small open economy. After shocks to EPU being identified, we employ these shocks to estimate the impulse responses using local projections. Unlike the existing measure, our results show that shocks to EPU lead to a significant decline in macroeconomic aggregates such as output, consumption, investment, and employment. Thus our results suggest a refinement of the EPU index in general for other countries accordingly. We also develop policy-specific uncertainty indices and show that they capture important historical events related to the corresponding policies, such as monetary and fiscal measures.     

Impact of urban-rural health insurance integration on health care: Evidence from rural China

In recent years, Chinese local governments have experimented with integrating the social health insurance system segmented between rural and urban areas to unify the administration, policy, and funds of various health insurance programs. In this study, we take advantage of the staggered implementation of the urban-rural health insurance integration across cities over time to examine the impacts of the integration on rural residents' health care utilization and health outcomes. Based on an original city-year level policy dataset and the China Health and Retirement Longitudinal Study (CHARLS) for the years 2011, 2013, and 2015, we find that the integration significantly increases the middle-aged and older rural residents' inpatient care utilization and this positive effect is particularly salient in poor areas. Moreover, we find that the positive policy effect of integration is attributed to enhanced health insurance benefits, such as a higher reimbursement rate for inpatient care. However, the integration has limited impacts on the middle-aged and older rural residents' health outcomes. This study reveals the partial success of urban-rural health insurance integration to reduce health care inequality in China.     

The effect of education on health and health behaviors: Evidence from the college enrollment expansion in China

By exploiting the massive college enrollment expansion in China beginning in 1999, we investigate the effect of higher education on health and health behaviors. Using data from the China Family Panel Studies in 2018 and employing an instrumental variable approach, we find that higher education has a significant effect on health and health behaviors. Each additional year of education increases the probability of reporting good health and having good memory by 1.9 and 3.1 percentage points (pp), respectively. Moreover, it decreases the probability of being overweight, smoking, and drinking by 1.3, 2.3, and 1.2 pp., respectively. By comparing the effect size with the findings in previous literature, we conclude that the effect of education on health is greater at higher levels of education. Further analysis suggests that education may affect health and health behaviors through two channels: the resources acquired by individuals and the prices faced by them.     

Effects of temperature on mental health: Evidence and mechanisms from China

We study how temperature exposure affects mental health in a developing country using data from China Family Panel Studies (CFPS). We find that exposure to high temperatures leads to worse mental health. Specifically, one additional day above 27 °C during the past week would increase individuals' total CESD 8 score by 1.5%, and the likelihood of having severe mental illness by 6.2% relative to a day in the reference temperature bin. We further estimate the potential mitigating effects of air conditioning on the relationship between temperature and mental health. We find that the identified relationship is mitigated by installing air conditioning. We also test some mechanisms through which temperature might impact mental health, including physical health status and sleep. We further discuss the overall health expenditure burden associated with climate change.     

Labor allocation in transition: Evidence from Chinese rural households

Empirical models are developed in this paper to quantitatively analyze households' participation in decisions on hiring labor and supplying labor off the farm, hired labor demand and off-farm labor supply of rural Chinese households. Econometric estimates use micro-level data from Zhejiang province over the period 1995–2002. The main results suggest that the decisions to hire labor and participate off the farm are made jointly and are positively correlated. A household's labor demand decreases with increasing wages for hired labor, whereas the effect of the wages of off-farm workers on a household's labor supply differs significantly depending on the household's kind of labor market participation. The results also indicate that the accumulation of productive assets, the development of livestock production and agricultural prices have increasing effects on labor demand but reducing effects on a household's off-farm labor supply. Land market integration enhances participation significantly but has no significant impact on time allocation. Finally, the results suggest non-separability between hired labor demand and household characteristics, indicating the rural labor market in Zhejiang province is still functioning imperfectly.     

School attendance and economic shocks: Evidence from rural Zimbabwe

Unpredicted shocks such as weather, pests or price changes affect agricultural households negatively or positively. The shocks have two opposite effects (income and substitution) on parents’ investments in the human capital of their children, and it is not predictable from theory whether the income effect or the substitution effect of a shock has a greater impact on the investments. Therefore, it is unknown whether human capital investments (i.e. sending children to school rather than having them work) are procyclical or countercyclical. In this paper we show how hyperinflation may affect investments in the education of children by their parents using three data-sets from Zimbabwe. We find that human capital investments are countercyclical (the substitution effect dominates) in rural areas of Zimbabwe during a shock. Therefore, policymakers in Zimbabwe need to be worried about decreased schooling of children during positive shocks in the rural areas.     

Bank capital shocks and portfolio risk: Evidence from Japan

Despite the downward trend of land prices and the ex post low return on real estate loans, Japanese banks increased their lending to the real estate sector during the 1990s. We argue that this phenomenon can be explained by the risk-shifting incentives of banks and discover that banks with low capital-to-asset ratios and low franchise value chose high-risk assets such as real estate loans. Unlike previous studies, we show that the capital–risk relationship is non-linear and changes from positive to negative as franchise value falls. We also find that a capital adequacy requirement did not prevent risk-taking behavior of under-capitalized banks since they then just issued more subordinated debts to meet this requirement. In contrast, government capital injections led banks to reduce risky loans at the margin. Recapitalization by issuing subordinated debts helped banks recover their capital losses and mitigated the credit crunch, but consequently allowed them to increase their exposure to the real estate sector and worsened the bad loan problems.     

Trends in elderly health by cohort: Evidence from China

China has the world's largest number of older persons and is undergoing rapid demographic and economic transitions. Using longitudinal data from seven waves of the China Health and Nutrition Survey (CHNS) spanning 1991–2009, this study examines trends by birth cohort for persons born during 1912–54 on several dimensions of elderly health—chronic diseases, physical function limitations, and excess weight. A fixed effects specification was used to distinguish trends in health, physical function, and weight common to all adult age groups and differential trends in these measures according to the person's birth year. The empirical results show that while there was a decline in physical function limitations over time, persons born in later years were more likely to experience a stroke and physical function limitations at older ages than were persons born earlier. A similar pattern occurred for stroke, but not for the other heath indicators. These findings are robust after accounting for sample attrition. The secular changes in health and function could have occurred for several reasons. Among the underlying mechanisms the data allow us to analyze, improved access to medical care and expanded health insurance coverage only had minor effects on observed changes in health and physical function.     

Economic policy uncertainty and household consumption: Evidence from Chinese households

We find that households reduce their consumption in response to higher economic policy uncertainty (EPU). Compared with lower income households, high income group is more severely affected which can be explained by the portfolio choice of illiquid asset and liquid asset. In addition, the uncertainty effect is more pronounced among older, wealthier, well-educated and urban households. The impact of EPU on household consumption is also persistent. Holding more liquid asset and commercial insurance represent important channels in mitigating the negative effect of EPU on household consumption.     

The effects of exposure to high temperatures during pregnancy on adolescent mental health: Evidence from China

This paper provides the first study to explore the relationship between exposure to ambient temperatures during pregnancy and adolescent mental health in China. The results show that experiencing one more hot day relative to local historical contemporaneous average values during pregnancy significantly increases the likelihood of mental health disorders in adolescence. The impact is larger in the first and second trimesters. Individuals born in the northern region and whose mothers work in agriculture are more vulnerable to high temperatures. Prenatal exposure to hot days is more harmful to the mental health of older adolescents. Additionally, the adverse effects are similar for both men and women and individuals with rural and urban hukou. Biological effects, income effects, and human capital accumulation might be three operative channels of the impact. These findings add to the evidence on the lasting health effects of early life exposure to climatic shocks and call for policy interventions during pregnancy.     

Negative economic shocks and child schooling: Evidence from rural Malawi

This study investigates the impacts of negative economic shocks on child schooling in households of rural Malawi, one of the poorest countries in sub-Saharan Africa. Both individually-reported and community-level shocks are investigated. There is evidence that community-level shocks negatively impact the school enrolment of children. The point estimates suggest that this effect is larger when shocks and school enrolment are reported by men as compared with women. However, we cannot conclude with statistical confidence that the impact of idiosyncratic shocks is larger when reported by males than when reported by females. Similarly, although the point estimates suggest that the impact of community-level shocks on the school enrolment of children is larger than that of idiosyncratic shocks, we cannot conclude with statistical significance that the impacts of community-level and idiosyncratic shocks are different.     

Economic consequences of war: Evidence from Sri Lanka

We propose a theoretical and econometric framework to evaluate the impact of war on economic growth of a developing country with an open economy. The theoretical framework encompasses both the neoclassical and endogenous growth models. We test this framework using Sri Lankan data. The war had significant and negative effects both in the short and long-run (annual average of 9% of GDP). High returns from investment in physical capital did not translate in sizable positive externalities. Only short-run significant effects of openness on growth are found. Inconsistent politically driven policies towards openness are the likely reason.     

Identifying the effects of migration on parental health: Evidence from left-behind elders in China

This study pioneers the application of the New Economics of Labor Migration theory to outline and estimate two opposite effects of labor loss driven by the migration and remittances of adult children on the health of left-behind elderly parents through the changing rural market constraints. We use China's rural household survey data and simultaneous equation econometric techniques to estimate the effects of migration on the physical and mental health of left-behind elders. Results indicate that the loss of labor due to migration has a significantly negative effect on the health of left-behind elders, but remittances from migrants can compensate for the adverse effect. This study provides a comprehensive understanding that remittances from migration relax the constraints on household resource allocations in undeveloped rural areas with imperfect market conditions. Overall, left-behind elderly parents benefit from migrant children both physically and mentally.     

Large-scale school meal programs and student health: Evidence from rural China

Reducing urban-rural gaps in child health is one of the most difficult challenges faced by many countries. This paper evaluates the impact of a large-scale school meal program in rural China on the health and nutritional status of students aged 6–16 in compulsory education. We use data from the China Health and Nutrition Survey corresponding to four pre-treatment years (2004, 2006, 2009, and 2011) and one post-treatment year (2015) and find that program participation is, on average, associated with a higher child height-for-age. The impacts are larger among students in a better health condition but small or not significant among the most disadvantaged. We do not observe heterogeneous effects across several individual and household characteristics. We also find positive but not significant effects on Body Mass Index-for-age and weight-for-age. The results suggest that NIP partially improved students' health over the first years of implementation, but more support is needed to achieve broader impacts that effectively reach all vulnerable students.