Many observers believe that pharmaceutical firms prefer to invest in drugs to treat diseases rather than vaccines. This column presents an economic rationale for why such a pattern may emerge for diseases like HIV/AIDS. The population risk of such diseases resembles a Zipf distribution, which makes the shape of the demand curve for a drug more conducive to revenue extraction than for a vaccine. Based on revenue calibrations using US data on HIV risk, the revenue from a drug is about four times greater.
Michael Kremer, Christopher Snyder, Natalia Drozdoff, 29 January 2016
Resul Cesur, Pınar Güneş, Erdal Tekin, Aydogan Ulker, 18 January 2016
The goal of universal health coverage has been pursued by countries in a number of ways, most notably through demand-side policies. In 2005, Turkey extended basic healthcare services to its entire population under a free-of-charge, centrally administered system. This column examines the impact of this supply-side programme on mortality and birth rates. Results show that the program was successful in lowering both mortality and birth rates across provinces, particularly for the most vulnerable populations. These findings provide compelling evidence in favour of providing accessible healthcare services to all citizens.
Janet Currie, 15 January 2016
Studies of the effects of economic fluctuations on health have come to wildly different conclusions. This may be because the effects are different for different groups. Using US data, this column looks at the health consequences of the Great Recession on mothers, a sub-population that has thus far been largely neglected in the literature. Increases in unemployment are found to have large negative health effects and to increase incidences of smoking and substance abuse among mothers. These effects appear to be concentrated on disadvantaged groups such as minorities, and point to short- and long-term consequences for their children.
Asha Abdel-Rahim, Dany Jaimovich, Aleksi Ylönen, 13 December 2015
One of the most important effects of armed conflicts is the forced displacement of large numbers of civilians. When conflicts end, many who have left their homes return, facing the challenge of rebuilding their lives in post-conflict areas. This column analyses the outcomes of returning households during a short-lived interwar period in the Nuba Mountains of Sudan. Returning households, particularly those that are female-headed, face worse economic conditions. But returnees fare better on various health indicators, likely related to changes in sanitary habits picked up during displacement.
Jan van Ours, Ali Palali, 16 October 2015
A major aim of cigarette taxes and tobacco control policies is to encourage smokers to quit. It is therefore important to understand the dynamics of quitting decisions in two-smoker couples. This column uses Dutch data to examine whether spousal peer effects exist for smoking cessation decisions. After controlling for the fact that couples are more likely to be similar to begin with, no evidence is found of one partner’s decision to quit affecting their spouse’s decision.
Leandro Prados de la Escosura, 26 July 2015
How does Latin American well-being compare to the advanced nations? This column presents a new historical index of human development that allows for analyses of trends in Latin American development since 1870. The results unearth a number of puzzles that pit rising income against flagging developments in well-being.
Anne Case, Angus Deaton, 18 July 2015
High suicide rates are often cited as evidence of social failure. Despite this, some countries and regions that do very well in terms of happiness have among the highest suicide rates. This column explores this paradox using global data on suicide and self-reported life satisfaction. Although the paradox is confirmed for Eastern European and wealthy countries, inconsistent patterns emerge when other demographic factors are taken into account. This might reflect the empirical difficulty of explaining suicide, but might also be indicative of the unreliability of self-reports of happiness.
Matthew Kahn, Cong Sun, Siqi Zheng, 08 July 2015
China’s cities suffer from extremely high levels of air pollution, and Chinese consumers spend more than $US100 million on anti-smog products per year. Using recent internet sales data, this column explores how investing in such self-protection products varies for consumers with different income brackets. The urban poor are shown to be less likely to engage in this health-improving strategy. This suggests that cross-sectional income comparisons understate lifetime inequality.
Áureo De Paula, John Lynham, Timothy Halliday, 22 June 2015
For policy to target air pollution optimally, a thorough understanding of its harms is required. However, disentangling the health effects of specific pollutants has proved challenging, as multiple chemicals tend to co-occur in industrial pollution. This column exploits volcanic emissions in Hawaii to examine the health impact of a specific pollutant – airborne particulates. Short-term exposure to particulate pollution is found to increase pulmonary-related hospitalisations and expenditures, particularly among very young children.
Dora Costa, Matthew Kahn, 27 April 2015
Newspapers report good and bad news, but the reporting doesn’t always match reality. This column presents evidence from turn-of-the-century America that news reports of typhoid tracked mortality patterns, but the reporting was biased. Spikes in death rates led to bigger jumps in media coverage when death rates were low. This could be due to the idea that deviations from Kahneman and Tversky’s ‘reference points’ are more newsworthy, or due to the possibility that bad news is more valuable to readers when things seem to be going well.
Rena Conti, Ernst Berndt, David Howard, 25 March 2015
Total US prescription drug spending rose 13% in 2014, the biggest increase in a decade. Driving this trend is spending on branded specialty drugs, which rose an unprecedented 31%. This column discusses recent research into the relationship between inflation-adjusted launch prices and survival benefits and approval year for 58 anticancer drugs approved in the US between 1995 and 2013. The authors find that launch prices are going up by $8,500 per year, approximately 12% year over year.
Nezih Guner, Yuliya Kulikova, Joan Llull, 19 January 2015
Married couples are healthier than singles. This column works to determine the direction of causality by exploiting panel data. In line with the evolutionary psychology literature, healthier individuals seem to be more desirable and are thus more likely to sort into marriage; but there also exists a ‘protective’ health value to marriage. It seems that couples encourage each other to take precautions.
Lucia Corno, Áureo De Paula, 13 January 2015
Addressing the HIV/AIDS epidemic requires an understanding of how risky sexual behaviours change over time. This column observes that, whereas the accuracy of self-reported data depends on the likelihood of people telling the truth, the likelihood of risky behaviours being detected in tests for sexually transmitted infections is equal to the disease transmission rate. Self-reported data may therefore be a more reliable measure of risky behaviours than the prevalence of sexually transmitted infections when the probability of transmission is low.
Richard Dobbs, Corinne Sawers, 13 December 2014
Obesity has a similar impact on global GDP as smoking, and around 60% of obese people are in developing countries. This column discusses the seriousness of the problem, and argues that more policy action is warranted – particularly in the form of low-risk, low-cost behavioural interventions.
Antonio Cabrales, Juan Dolado, Ricardo Mora, 05 December 2014
The negative consequences of dual labour markets have been extensively documented, but so far little attention has been paid to their effects on workers’ on-the-job training and cognitive skills. This column discusses evidence from PIAAC – an exam for adults designed by the OECD in 2013. Temporary contracts are associated with a reduction of 8–16 percentage points in the probability of receiving on-the-job training, and this training gap can explain up to half of the gap in numeracy scores between permanent and temporary workers.
Amir Attaran, Roger Bate, Ginger Jin, Aparna Mathur, 09 October 2014
There is a perception amongst pharmaceutical experts that some Indian manufacturers and/or their distributors segment the global medicine market into portions that are served by different quality medicines. This column finds that drug quality is poorer among Indian-labelled drugs purchased inside African countries than among those purchased inside India or middle-income countries. Substandard drugs – non-registered in Africa and containing insufficient amounts of the active ingredient – are the biggest driver of this quality difference.
Charles Manski, 01 October 2014
Clinical practice guidelines recommend treating all patients with similar attributes the same way. This column argues that, under conditions of uncertainty or ambiguity, this may be bad advice. Treating similar patients differently provides two benefits. The first is diversification – assigning similar patients to different treatments limits the consequences of choosing an inappropriate treatment. The second benefit is that randomly assigning treatments helps clinicians learn which ones are most effective.
Sandra Black, Paul Devereux, Kjell Salvanes, 20 August 2014
Adverse health or nutrition shocks to pregnant women can have significant and often long-lasting effects on the outcomes of their children, but much less is known about the effects of psychological stresses. This column discusses recent research on the effect of stress induced by the death of a parent while pregnant on the short- and long-run outcomes of children in Norway. Maternal bereavement has small but statistically significant adverse effects on birth outcomes – especially for boys – but there is no evidence of any long-run adverse effects.
Brandon Restrepo, Matthias Rieger, 16 July 2014
Artificial trans fat is omnipresent in the global food chain, but the medical consensus is that it increases the risk of developing cardiovascular diseases such as heart disease and stroke. Between 2007 and 2011, New York City and six other county health departments implemented bans on trans fat in restaurants. This column presents the first evaluation of the effect of these bans on cardiovascular disease mortality rates.
Holger Görg, Olivier Godart, Aoife Hanley, Christiane Krieger-Boden, 08 July 2014
Many firms are replacing traditional working hours with more flexible arrangements, reflecting new thinking on employee motivation. This column presents evidence from Germany that trust-based working time is associated with increased innovation. However, trust-based working hours also contribute to the blurring of workers’ professional and private lives, and may lead to excessive overtime. Careful design of trust-based working arrangements is required to reap the innovations gains while avoiding the health pitfalls.