Short- and long-run estimates of the local effects of retirement on health

We explore the existence of short- and long-term effects of retirement on health. Short-term effects are estimated with a regression discontinuity design which is robust to weak instruments and where the underlying assumptions of continuity of potential outcomes are uncontroversial. To identify the long-term effects we propose a parametric model which, under strong assumptions, can separate normal deterioration of health from the causal effects of retirement. We apply our framework to the British Household Panel Survey and find that retirement has little effect on health. However, our estimates suggest that retirement opens the gate to a sedentary life with an impoverished social component and this is a channel through which retirement could indirectly affect health in the long run

Do obese patients stay longer in hospital? Estimating the health care costs of obesity

Increasing obesity rates are a major public health concern in many countries, as the obese have significantly higher risks of developing serious illnesses such as type II diabetes, cardiovascular disease, osteoarthritis, and various cancers. While it might be assumed that higher levels of obesity in the community must therefore translate to longer and more expensive hospital stays, this study shows that obese patients stay longer in some specialties, but shorter in others. This means it cannot simply be assumed that it is more costly to treat obese patients on average

Labour supply and informal care supply: The impacts of financial support for long-term elderly care

We investigate the impact of a policy reform, which introduced free formal personal care for all those aged 65 and above, on caregiving behaviour. Using a difference-indifferences estimator, we estimate that the free formal care reduced the probability of co-residential informal caregiving by 12.9%. Conditional on giving co-residential care, the mean reduction in the number of informal care hours is estimated to be 1:2 hours per week. The effect is particularly strong among older and less educated caregivers. In contrast to co-residential informal care, we find no change in extraresidential caregiving behaviour. We also observe that the average labour market participation and the number of hours worked increased in response to the policy introduction

Does It Matter Who Cares for You? The Effect of Substituting Informal with Formal Personal Care on the Care Recipients’ Health

We show that a Scottish policy reform, which introduced free formal personal home care for those aged 65 and above, reduced the probability and the hours of receiving informal personal care. Moreover, we find that the group of individuals that most benefited from the policy introduction, i.e. women aged 75 and above, experienced the largest fall in informal care. We go on to investigate whether such reductions in informal and increases in formal personal care impacted on the care recipients' health outcomes. Our results demonstrate that switching from informal to formal care does very little to the recipients' hospital usage and health outcomes

An Analysis of a Sample of County Welfare Families with a Record of Pregnancy Causing Increases in Welfare Expenditures

This is a study of families that had pregnancies while they were recipients or potential recipients of public assistance

Longer opening hours, alcohol consumption and health

Two related issues in public policy with respect to alcohol are how increased availability influences consumption and what effect excess consumption has on individual health outcomes. This paper examines one particular source of variation in availability, bar opening hours, and how this influences alcohol consumption, physical and mental health. We focus on the extension of opening hours in England and Wales that occurred in 2005. We demonstrate a marked increase in consumption, which appears to be concentrated in heavy drinking. This increase in consumption is subsequently demonstrated to lead to deterioration in both individual physical and mental health outcomes. This has important policy implications for the regulation of alcohol availability

Estimating the eect of retirement on mental health via panel discontinuity designs

This article explores the potential effects of retirement on mental health and health care utilisation isolating sources of potential heterogeneity in treatment effect. To estimate the effects of retirement, we devise a new identifying strategy that combines kink and regression discontinuity designs with panel data methods. Our method is then applied to the British Household Panel Survey, a rich representative longitudinal survey. It is found that retirement has a small impact on primary care use, but overall has little effect on mental health

Estimating the eect of retirement on mental health via panel discontinuity designs

This article explores the potential effects of retirement on mental health and health care utilisation isolating sources of potential heterogeneity in treatment effect. To estimate the effects of retirement, we devise a new identifying strategy that combines kink and regression discontinuity designs with panel data methods. Our method is then applied to the British Household Panel Survey, a rich representative longitudinal survey. It is found that retirement has a small impact on primary care use, but overall has little effect on mental health

Response-scale heterogeneity in the EQ-5D

This paper discusses two types of response-scale heterogeneity, which may impact upon the EQ-5D. Response-scale heterogeneity in reporting occurs when individuals systematically differ in their use of response scales when responding to self-assessments. This type of heterogeneity is widely observed in relation to other self-assessed measures but is often overlooked with regard to the EQ-5D. Analogous to this, preference elicitation involving the EQ-5D could be subject to a similar type of heterogeneity, where variations across respondents may occur in the interpretations of the levels (response categories) being valued. This response-scale heterogeneity in preference elicitation may differ from variations in preferences for health states, which have been observed in the literature. This paper explores what these forms of response-scale heterogeneity may mean for the EQ-5D and the potential implications for researchers who rely on the instrument as a measure of health and quality of life. We identify situations where they are likely to be problematic and present potential avenues for overcoming these issues

Sustainability of Donor-Supported HIV Prevention Services : A Mixed Methods Study of the Ability and Willingness to Pay for Voluntary Medical Male Circumcision in Uganda

Uganda faces a generalised HIV epidemic, with about 1.2 million people living with HIV and AIDS. Uganda’s HIV response is primarily donor funded, with 88% of funds from international donors. This PhD thesis focused on identifying potential alternative sources of funding for voluntary medical male circumcision (VMMC), which is one of the WHO-approved HIV prevention interventions. A systematic review of the willingness to pay (WTP) for HIV and AIDS in Africa was conducted as part of the thesis, and it revealed that there was an opportunity to fund the HIV response through out-of-pocket payments more sustainably. Informed by the systematic review, a mixed-methods, cross-sectional study was conducted with three objectives. The first was to determine the factors associated with the ability to pay (ATP) for VMMC, and it revealed that increasing age and having a university-level education are positively associated with the ability to pay while residing in a rural area and having high perceived behaviour control are negatively associated with the ATP for VMMC. The second objective was to determine the factors associated with WTP for VMMC. The findings revealed that 76% of the respondents were willing to pay for VMMC. The factors positively influencing WTP for VMMC are the ability to pay and belonging to the Muslim faith. Residing in a rural area, having no education and increasing perceived behaviour control are negatively associated with WTP for VMMC. The third and final objective was to identify the factors that inform WTP decisions. Twenty-nine qualitative interviews were completed, revealing mixed findings for and against paying for VMMC. This PhD contributes to the knowledge of willingness to pay for HIV services and documents key considerations for the successful introduction and implementation of fee-for-service VMMC. Further, the study improves the use of WTP methodology in health research. Overall policy implications are drawn in the Conclusion