A Utility-Theoretic Approach to Measuring Changes in US Rural Residents' Access to Hospital Services from 1980 to 1999

Questions of access to hospital services figure centrally in rural-health policy debates, yet few analyses exist that measure the importance of changes in hospital access in rural areas of the US. Of the studies that measure changes in access to hospital services over time in the literature, none use economic theory as the framework for the analysis. This paper proposes an economic approach based upon revealed preferences to measuring access to hospital services and quantifies the value of changes in hospital access over the period 1980 to 1999 for residents in rural counties in the US. Welfare measures are constructed for the years 1980 and 1999 for rural residents in all the rural counties of the US. On average the lowest levels of hospital access are found in the counties of the West, while Eastern US counties have better access to hospitals in comparison. The changes in hospital-consumer welfare indicate that over the period 1980 to 1999, access to hospital services has declined for rural US residents.Health Economics and Policy,

Effects of Impulsivity and Self-control on Calorie Intake

Neoclassical economic theory models individuals as making consistent choices over time and it assumes these choices are the outcome of rational utility maximization. Recent theoretical developments in the theory of consumer decision-making have drawn evidence from other disciplines such as, neuroscience (McClure et al, 2004) and psychology, and proposed more generalized models in a dual-self framework explicitly accounting for self-control or impulsivity (Gul and Pesendorfer, 2004; Fudenberg and Levine, 2006; and Brocas and Carillo, 2008). This study attempts to understand the dietary choices in a dual-self framework while explicitly identifying calorie intake owing to impulsivity and self-control. We construct standard psychological measures using the responses to the Dutch Eating Behavioral Questionnaire (DEBQ) filled by the respondents of the UK Diet and Nutrition Survey. These measures have been tested for their validity and apply to a broad range of population: of different weights, across gender, ethnicity (Bardone-Cone, and Boyd, 2007) and are used in experiments (Ouwens, 2005).Using panel data methods, we find that impulsivity increases calorie intake and self-control decreases calorie intake. Further, caloric intake is larger than one can restrain and therefore the result of the intrapersonal conflict is positive calories intake on average.Self-control, Nutrition, diet, health, impulsivity, BMI, Consumer/Household Economics, Food Consumption/Nutrition/Food Safety, Health Economics and Policy, Institutional and Behavioral Economics, D12, D03, I00,

Determinants of Nutritional Outcomes of Children in India: A Quantile Regression Approach

In this paper, we use quantile regressions on data from the 2005-06 wave of the Indian National Family Health Survey to study the determinants of child body-mass-index, height-for-age, and hemoglobin at different points of the conditional distribution. Our results show that only considering the conditional mean of the entire distribution can yield misleading results. In light of compelling evidence on sex-selective abortion and infanticide, we use a Heckman correction for our quantile regression to control for the “underreporting” of female births documented by Rose (1999). We find that household maternal health and education have larger effects at the lower end of the distribution than on the upper end, for all three child nutritional indicators. Results show that iron supplements are less effective at increasing hemoglobin levels in the worst-off children. We argue that policy interventions must account for socioeconomic diversity or have little hope of meeting their target.Food Consumption/Nutrition/Food Safety, International Development,

DO HEALTHIER DIETS COST MORE?

Do healthier diets cost more? We estimate a hedonic regression model of the U.S. diet. Given food expenditures and information on dietary intake we infer the marginal cost of improved quality. Meeting the Pyramid recommendations implies decreased expenditures from two of the seven food groups.Food Consumption/Nutrition/Food Safety,

THE EFFECT ON DIETARY QUALITY OF PARTICIPATION IN THE FOOD STAMP AND WIC PROGRAMS

Participants in the Food Stamp Program consume more meats, added sugars, and total fats than they would in the absence of the program, while their consumption of fruits, vegetables, grains, and dairy products stays about the same. Participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) consume significantly less added sugars, which may reflect the substitution of WIC-supplied juices and cereals in place of higher sugar soft drinks and cereals. These findings come from a study of low-income Americans using the Continuing Survey of Food Intake by Individuals.Nutrition assistance programs, food intake, dietary quality, Continuing Survey of Food Intake by Individuals (CSFII), Food Consumption/Nutrition/Food Safety, Food Security and Poverty,

Did Implementing Nutrition Labeling and Education Act (NLEA) of 1990 Improve Diet?

Nutrition labeling, in the words of the then FDA commissioner, David Kessler, was to “help millions of Americans make more informed, healthier choices.” Although the NLEA primarily focused on standardizing the nutrition facts label, its implementation also involved an informational and educational campaign on how to use the new nutrition facts label and the benefits of using it. Evidently label use more than doubled between 1989-91 and 1994-96. Most of the studies provide evidence of the effects of nutrition label use by comparing label users against non-users using data after NLEA was in effect. Using pseudo-panel data method, we find that implementing NLEA did not improve diet quality but use of labels did. Further, label usage showed no improvement in diet quality within a cohort but it did reveal significant differences among or between cohorts. We also test for differences in diet quality between the two periods by comparing individuals of similar characteristics using a non-parametric approach, the Mahalnobis distance matching technique. Differences across the two periods would be tested at different quantiles of the diet quality with an emphasis on label use and education levels.Nutrition, diet, nutrition facts label, Food Consumption/Nutrition/Food Safety,

The Costs of Human Salmonellosis Attributable to Pork: A Stochastic Farm-to-Fork Analysis

Few farm-to-table analyses of the risk pathways for foodborne illnesses exist, and no such analysis exists for the case of salmonellosis and pork products. This paper presents a Monte Carlo simulation model of the US pork system and the transmission pathways of Salmonella. For the year 2000, we estimate the cost of illness attributable to porkborne Salmonella at $45.7 million, with an estimated 43,505 cases of salmonellosis attributable to pork occurring annually.Food Consumption/Nutrition/Food Safety,

DO ANTIBIOTICS REDUCE PRODUCTION RISK FOR U.S. PORK PRODUCERS?

Production risk from live weight variation of market pigs has become a more important concern in U.S. swine production. Packers are concerned about the variation in carcass size because of the demand for standardized cuts and the use of automation in the slaughter process. Swine producers care about standardized pigs because of revenue implications and possible links to animal health and productivity. Pig size variation can be due to various condition and inputs including antibiotics. However, discussions on risk reduction from antibiotic use have generally not been considered. Our work extends previous studies by systematically examining the aspects of production risk reduction and highlights the potential results of banning antibiotics from a risk perspective. Using data from National Animal Health Monitoring System 2000 survey data and PigCHAMP, we identify the relationship between antibiotic use and production risk by an econometric model. Applying production costs for feeder to market pigs and a price matrix, the uncertainty in profits is evaluated. The impacts of risk on the decision making of swine producers are examined under the framework of expected utility and stochastic dominance analysis. Our results show that production risk from weight variability of market hogs is important in determining profits and utility under a pricing system. Production risk (i.e. weight gain variability) is related to the use of sub-therapeutic antibiotics. Swine producers could decrease production risk and enhance utility by adjusting antibiotic use. These results offer some support for optimal use of sub-therapeutic antibiotics.production risk, antibiotics, swine, utility, stochastic dominance, Livestock Production/Industries, Risk and Uncertainty, Q10, Q12, Q14.,

Do health investments improve agricultural productivity?

Determining the causality between health measures and both income and labor productivity remains an ongoing challenge for economists. This review paper aims to answer the question: Does improved population health lead to higher rates of agricultural growth? In attempting to answer this question, we survey the empirical literature at micro and macro levels concerning the link between health investments and agricultural productivity. The evidence from some micro-level studies suggests that inexpensive health interventions can have a very large impact on labor productivity. The macro-level evidence at the country and global level, however, is mixed at best and in some cases suggests that health care interventions have no impact on income, much less on agricultural productivity. At both micro and macro levels, the literature does not provide a clear-cut answer to the question under investigation. Overall, the review reveals a great deal of heterogeneity in terms of estimation methods, definition and measurement of health variables, choice of economic outcomes, single-equation versus multiple-equation approach, and static versus dynamic approach. The actual magnitude of estimated elasticities is difficult to assess in part due to estimation bias caused by the endogeneity of health outcomes. We also found significant gaps in the literature; for example, very little attention is given to demand for health inputs by rural populations and farmers.Agriculture, Growth, health, Investment, Nutrition, productivity,

AN ECONOMETRIC ANALYSIS OF THE ECONOMIC CONTRIBUTION OF SUBTHERAPEUTIC ANTIBIOTIC USE IN PORK PRODUCTION

There is growing concern among public health experts regarding the diminishing efficacy of antimicrobial therapy in human and veterinary medicine, and some have called for a ban on subtherapeutic antibiotic use in pork production. This paper develops an econometric analysis to identify the economic contributions of subtherapeutic antibiotic use in swine production.Livestock Production/Industries,