Do wealth shocks affect health? New evidence from the housing boom

We exploit wealth shocks arising from housing wealth gains to examine the relationship between wealth and health. In UK household panel data positive housing wealth gains lower the likelihood of home owners exhibiting a range of non-chronic health conditions with no effect on renters. For owners housing wealth gains change health behaviours: increasing use of private health care, reducing hours of work (especially for women) and increasing time dedicated to exercise. Housing wealth gains, unlike income gains, do not increase risky health behaviours such as smoking and drinking. Furthermore, house prices highly pro-cyclical. The positive health effects of housing wealth gains on home owner health over the business cycle offset the negative health effects of labour market conditions and work intensity

The response to nutritional labels:Evidence from a quasi-experiment

This paper evaluates a UK policy that aimed to improve dietary information provision by introducing nutrition labelling on retailers’ store-brand products. Exploiting the differential timing of the introduction of Front-of-Pack nutrition labels as a quasi-experiment, our findings suggest that labelling led to a reduction in the quantity purchased of labelled store-brand foods, and an improvement in their nutritional composition. More specifically, we find that households reduced the total monthly calories from labelled store-brand foods by 588 kcal, saturated fats by 14 g, sugars by 7 g, and sodium by 0.8 mg

An analysis of households' credit markets in Ethiopia and Malawi.

The aim of this thesis is to analyse formal and informal credit in Ethiopia and Malawi. As credit markets in developing economies are dominated by informal institutions, the analysis of the interaction between formal and informal institutions is crucial to understanding how welfare improvements can be achieved. The thesis begins with an explanation of the motives for demanding credit. It then focuses on analysing the existence, diffusion and persistence of informal nance in developing economies. Much research on this topic remains hamstrung by the quality and availability of data and by the lack of empirical models, constraining the meaningful identification of the characteristics of the localities where informal institutions operate. The central idea of the first essay is to develop an empirical model that explains the determinants of participation in informal credit arrangements. We adopt an endogenous switching regression model of access to informal credit where the availability of a particular type of informal arrangement varies across clusters in rural Ethiopia. This strategy allows for taking into account substitutability between sources as well as household and cluster socioeconomic characteristics. The second essay exploits the idea that banks can crowd out informal borrowing in Malawi by creating microfinance institutions that acquire information in innovative ways. We adopt propensity score matching and find that the creation of a specific microfinance programme reduces informal borrowing. The third essay uses the credit limit variable to test liquidity constraints and the spillover hypotheses in Malawi. A ten percent increase in the informal credit line increases households' demand for informal credit by more than nine percent. We also find that a 10 percent increase in the credit limit of a microfinance programme reduces the informal demand by four percent, partly explaining the coexistence of formal and informal credit institutions

The effect of cash transfers on mental health – New evidence from South Africa

Mental health and poverty are strongly interlinked. There is a gap in the literature on the effects of poverty alleviation programmes on mental health. We aim to fill this gap by studying the effect of an exogenous income shock generated by the Child Support Grant, South Africa’s largest Unconditional Cash Transfer (UCT) programme, on mental health. We use biennial data on 10,925 individuals from the National Income Dynamics Study between 2008 and 2014. We exploit the programme’s eligibility criteria to estimate instrumental variable Fixed Effects models. We find that receiving the Child Support Grant improves adult mental health by 0.822 points (on a 0-30 scale), 4.1% of the sample mean. Our findings show that UCT programmes have strong mental health benefits for the poor adult population

Maternity leave take-up in UK academia. Why are they hurrying back?

In this paper we explore the effects of terms of maternity leave policy on the duration of leave taken by mothers, focusing on the higher education sector in the United Kingdom, where there is a wide variation in financial coverage of the packages offered by employers. We use unique newly collected individual level data for over 13,000 academic and professional services staff at Higher Education Institutions (HEI) in the UK and add to it data on university characteristics from the Higher Education Statistics Agency and area-level characteristics from the Office for National Statistics. Using an instrumental variable approach, we find that on average academics take 2 additional weeks of leave for every additional week of full pay provided within the maternity leave package, when professional services staff take 2.7 additional weeks.Academics respond positively to the financial terms of the policy in departments with a lower proportion of teaching-only contracts, higher proportion of female employees and in institutions with above median generosity of the maternity leave package. These results may suggestthe culture, research and teaching environment withi

The effect of cash transfers on mental health – New evidence from South Africa

Background Mental health and poverty are strongly interlinked. There is a gap in the literature on the effects of poverty alleviation programmes on mental health. We aim to fill this gap by studying the effect of an exogenous income shock generated by the Child Support Grant, South Africa’s largest Unconditional Cash Transfer (UCT) programme, on mental health. Methods We use biennial data on 10,925 individuals from the National Income Dynamics Study between 2008 and 2014. We exploit the programme’s eligibility criteria to estimate instrumental variable Fixed Effects models. Results We find that receiving the Child Support Grant improves adult mental health by 0.822 points (on a 0–30 scale), 4.1% of the sample mean. Conclusion Our findings show that UCT programmes have strong mental health benefits for the poor adult population

Does Patient Health Behaviour respond to Doctor Effort?

Incentive pay systems have been introduced in public sectors such as education and health care. In these sectors the output (education or health respectively) depends on the actions of different agents and it is unclear what the effects of such incentive systems are on the behaviour of untargeted agents. In this study we focus on patient health, modelled as a joint product of patient effort (through lifestyle and behaviour) and doctor effort (through diagnosis and treatment). Patient response to doctor effort is shown to be a priori ambiguous and depends on the degree of complementarity or substitution between doctor and patient effort. We build an empirical model to estimate the effect of doctors’ treatment effort on patient behaviour. To address the endogeneity of doctor effort we exploit a change in payments to doctors in the U.K. that led to incentive changes that varied by practice, depending on their prior performance levels. We use panel data on the physical activity, drinking and smoking behaviours of over 2,000 cardiovascular disease patients aged over 50 in England and link these data to their primary care practice performance data. Our results indicate that primary care practices increased the proportion of patients with controlled disease from 76% to 83% in response to the payment change. Patients responded by reducing the frequency of drinking alcohol and their cigarette consumption, suggesting that patient efforts are complements to doctor effort. Understanding such complementarities has implications for assessing the design and effectiveness of pay-for-performance schemes which encourage higher doctor effort

Does Patient Health Behaviour respond to Doctor’s Effort?

Incentive pay systems have been introduced in public sectors such as education and healthcare. In these organisations where the outcome (health or education) is a joint product between different agents, it is unclear what the effects of these incentives are onto the behaviour of untargeted agents. We focus on patient health as a joint product of patient effort, through lifestyle and behaviour, and doctor effort, through diagnosis and treatment. Patient response to doctor effort is a priori ambiguous and depends on the degree of complementarity or substitution between doctor and patient effort. We use data on the physical activity, drinking and smoking behaviours of over 2,000 patients aged over 50 with cardiovascular diseases in England. Through a new data linkage and an instrumental variable approach, we test whether changes in doctors’ treatment efforts triggered by changes in their payment system between 2004 and 2006 had an impact on patient behaviour. Doctors working in primary care practices increased the proportion of patients with controlled disease from 76% to 83% in response to the payment change. Patients responded by reducing the frequency of drinking alcohol and their cigarette consumption. This suggests that patient efforts are complements to doctor effort. The results have implications for the effectiveness of pay-for-performance schemes which encourage higher doctor effort, and the design of such incentive schemes