Direct and indirect costs of smoking in Vietnam

This study was designed to overcome limitations of two previous investigations by calculating both direct and indirect health costs of five smoking-related diseases that are responsible for almost 75% of all smoking-related deaths in Vietnam: lung cancer, cancers of the upper aerodigestive tract, chronic obstructive pulmonary disease, ischaemic heart disease and stroke. Understanding the healthcare system is crucial for calculating the actual cost of smoking in Vietnam. The total estimated economic cost of smoking for five smoking-related diseases was 24 679.9 billion VND (US$1173.2 million), not taking into account exposure to second hand smoke

Public Policy Effects on Health and Education Outcomes

The role of human capital in fostering economic growth is well recognized in the literature. There are numerous forces that function together to enhance the acquisition of human capital, and public policy have been one of those forces that can have either a positive or negative impact. My dissertation uses quasi-experimental research designs to investigate how three policies – improving access to oral contraceptive for young women, providing eligibility for public health insurance for children, and providing bonus to effective teachers who serve in persistently low performing schools – have affected health and education outcomes. In the first chapter, I examine how providing legal access to birth control pills to young, single women led to an increase in the rate of sexually transmitted diseases (STDs) in the United States. While the impacts of the diffusion of birth control pills on labor, education, and gender equality outcomes have been well documented, the health impact of this policy has been overlooked. In this paper, I use a dynamic difference-in-differences approach that exploits variation in the timing of state laws that expanded legal access to the pill to young, single women in the United States in the period 1960s-1970s, as a quasi-experiment. Using data from the Centers for Disease Control and Prevention, merged with data from the Bureau of Economic Analysis, Current Population and Census Surveys, I find that the early pill access increased STD rates by 1.8% per year, accumulatively for over 10 years. The impact was larger among women (2.1%/year) than men (1.6%/year). My simulation of STD rates in the counterfactual policy scenario indicates that the early pill access explained 14% of the surge in STD rates between 1963 and 1975, when the epidemic was at its peak. Using a separate, individual-level dataset from the National Survey of Young Women 1971, I find evidence that having access to the pill was associated with more sexual acts, more partners, and more unprotected sex, which are likely mechanisms of the effects. The second essay in my dissertation studies the effects of the 2005 health insurance reform in Vietnam on healthcare utilization, out-of-pocket expenditure, and health status. Through this reform, public health insurance was newly offered to non-poor children under six years old, but it required the use of community health facilities. This requirement potentially limited the value of the insurance. Employing difference-in-discontinuities and triple-difference methods and using data from 2002, 2004, and 2006, I show that, despite a nearly three-fold increase in health coverage among non-poor children, there is little or no evidence that the reform significantly increased healthcare utilization, changed care locations from private to public sites, lowered out-of-pocket costs, or improved health status for non-poor young children. My results suggest a “bypassing” phenomenon whereby non-poor families skipped free health care at low-quality facilities. My final dissertation chapter investigates the effects of the Dallas Independent School District reform that provides additional pay for educators in a designated group of the district’s lowest performing schools. The district developed a program that provides educators substantial additional compensation to teachers and principals willing to work in very low-achievement schools. Crucially, the amount of the additional pay depends upon a teacher or principal’s effectiveness in previous years as measured by comprehensive systems of evaluation. Moreover, the district committed to staffing these schools with effective educators. Difference-in-differences estimates reveal dramatic achievement increases in reading and especially mathematics that substantially narrow the gap between students in these schools and the district average, highlighting the potential for targeted compensation programs linked with educator effectiveness to reduce the gap in school quality and achievement. Descriptive analysis using educator evaluations and family survey responses indicate that changes in the composition of teachers accounts for the majority of the improvement, though more effective leadership, higher peer quality, and stronger performance incentives may also have raised the quality of instruction

The effect of imposing a higher, uniform tobacco tax in Vietnam

© 2006 Van Kinh et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Excise tax rates for cigarettes and tobacco products in Vietnam, 1996–2011 (percent).

<p>Sources: Guindon et al 2010.</p

Net Smuggling into Vietnam and Its Share of Domestic Consumption (millions of US dollars).

<p>Sources: United Nations Comtrade Database, Vietnam Tobacco Association 2008.</p

Legal Cigarette Sales, Estimated Consumption, and Illicit Consumption, 1998–2010 (millions of packs).

<p>Sources: Authors’ calculation from VLSS 1998, VNHS 2002, VHLSS 2006, GATS Vietnam 2010 and Vietnam Tobacco Association’s reports.</p