The Causal Impact of Fear of Unemployment on Psychological Health

We analyze the eff ect of job insecurity on psychological health. We extend the group of people being aff ected to employees who have insecure jobs to account for a broader measure of the mental health consequences of potential unemployment. Using panel data with staff reductions in the company as an exogenous source of job insecurity, we fi nd that an increase in fear of unemployment substantially decreases the mental health status of employees. Quantile regression results yield particularly strong eff ects for individuals of already poor mental health.Fear of unemployment; mental health; job insecurity; labor market dynamics

The Eff ect of Self-assessed Job Security on the Demand for Medical Rehab

The interdependence of labor market conditions and the demand for health care has been addressed by several theoretical and empirical analyses. We contribute to the debate by empirically examining the eff ect of a decrease in self-perceived job security on health care utilization. That is, employees at risk of losing their job might postpone or even try not to use non-acute rehab measures in order to reduce their individual risk of being laid off by avoiding absenteeism and signaling good health. We use individual-level data from the German Socioeconomic Panel for the years 2003, 2004, and 2006. The identifi cation strategy rests on an instrumental variable approach where the county unemployment rate and its relative change compared to the previous year serve as instruments for the employees’ self-assessed risk of losing their jobs. Contrary to the hypothesis, we have evidence for job insecurity increasing the demand for medical rehab. This finding is robust to various model variants.Rehab; unemployment; health care utilization; job worries; absenteeism; sick leave

When outcome heterogeneously matters for selection: a generalized selection correction estimator

The classical Heckman (1976, 1979) selection correction estimator (heckit) is misspecified and inconsistent, if an interaction of the outcome variable with an explanatory variable matters for selection. To address this specification problem, a full information maximum likelihood (FIML) estimator and a simple two-step estimator are developed. Monte Carlo (MC) simulations illustrate that the bias of the ordinary heckit estimator is removed by these generalized estimation procedures. Along with OLS and ordinary heckit, we apply these estimators to data from a randomized trial that evaluates the effectiveness of financial incentives for reducing obesity. Estimation results indicate that the choice of the estimation procedure clearly matters

When outcome heterogeneously matters for selection

The classical Heckman (1976, 1979) selection correction estimator (heckit) is misspecified and inconsistent if an interaction of the outcome variable and an explanatory variable matters for selection. To address this specification problem, a full information maximum likelihood estimator and a simple two-step estimator are developed. Monte-Carlo simulations illustrate that the bias of the ordinary heckit estimator is removed by these generalized estimation procedures. Along with OLS and the ordinary heckit procedure, we apply these estimators to data from a randomized trial that evaluates the effectiveness of financial incentives for weight loss among the obese. Estimation results indicate that the choice of the estimation procedure clearly matters

The Causal Link Between Financial Incentives and Weight Loss – An Evidence-based Survey of the Literature

Obesity and overweight are linked to diseases that cost society a significant amount of resources. While behavior modification can reduce the problem, instigating such lifestyle changes is an uneasy task. One potential way to reduce the problem is through the use of financial incentives. In this survey, we review the available evidence with a significant emphasis on studies that yield credible estimates of the effect of financial incentives on weight loss. We find that the scientific literature on the subject has not yet satisfactorily settled whether such a mechanism is effective at eliciting the desired behavioral and health outcomes. We therefore advocate a rigorous large-scale randomized experiment to provide reliable estimates of the effect.Financial incentives; weight loss; obesity; randomized experiment; survey

Faktenbuch Medizinische Rehabilitation 2011

Als Teil des Gesundheitswesens übernimmt die medizinische Rehabilitation die Aufgabe, die Teilhabe von chronisch kranken Menschen am Leben in der Gesellschaft und ihre Selbstbestimmung nachhaltig zu fördern, indem sie den Folgen einer Krankheit in Form von Fähigkeitsstörungen und sozialen Beeinträchtigungen (Behinderung, Erwerbsunfähigkeit, Pflegebedürftigkeit) vorzubeugen, sie zu beseitigen, zu bessern oder deren wesentliche Verschlechterung abzuwenden versucht. Damit leistet sie einen Beitrag dazu, dass Arbeitnehmer länger am Arbeitsleben teilnehmen können, Frühverrentungen und Pflegebedürftigkeit vermieden und so auch Beiträge für die Sozialversicherungsträger geleistet werden. Vor diesem Hintergrund möchte das vorliegende Faktenbuch Medizinische Rehabilitation 2011 einen Überblick über die medizinische Rehabilitation in Deutschland, ihre Grundlagen und ihre Wirksamkeit geben. Auf fünf wichtige Datenquellen kann dazu derzeit zugegriff en werden: Daten der Rehabilitationsträger Deutsche Rentenversicherung (DRV), Gesetzliche Krankenversicherung (GKV) und Gesetzliche Unfallversicherung (GUV), Grund- und Diagnosedaten der Rehabilitations-und Vorsorgeeinrichtungen des Statistischen Bundesamtes sowie Jahresabschlussdaten von Rehabilitationseinrichtungen

Weight Loss and Sexual Activity in adult Obese Individuals: Establishing a Causal Link

Obesity may not only be linked to undesirable health outcomes but also to limitations in sexual life. The present paper aims to assess whether there is a relationship between weight change and sexual activity in obese individuals. To address the endogeneity of weight loss that is likely to result in biased estimation results, the analysis is based on data from a randomized controlled trial. In this experiment financial weight-loss rewards were randomly offen and to a subgroup of participants and can be used as exogenous source of weight variation in an instrumental variables approach. Estimation results indicate that for obese males loosing weight increases both the probability for being involved in a sexual relationship. Conditional on having already lost some weight, a further reduction of obesity also increases the frequency of sexual intercourse

Can mass media campaigns increase demand for renewable energy? Experimental evidence from Senegal

This paper examines public investment in mass media campaigns aimed at stimulating market-led growth within the renewable energy sector in a developing country setting. We run a randomized field experiment to estimate the impact of a large-scale information campaign on the adoption of renewable energy technology, which includes clips broadcasted on national radio and print materials distributed in rural villages in Senegal. While the radio campaign primarily influences the number of renewable energy products owned by existing users (intensive margin), the combination of radio and print significantly increases the number of new adopters (extensive margin). However, when scaled nationally, we calculate a meaningful advantage of the radio clips over the print materials in terms of the cost per additional sales of solar lamps. The study further introduces an innovative methodological approach for examining nationally broadcasted information campaigns, offering valuable insights for future research and policy evaluations

The Effect of a Bonus Program for Preventive Health Behavior on Health Expenditures

This paper contributes to the analysis of policy measures that attempt to reduce health care expenditures of insurers. We examine the impact of a cash bonus program for preventive health behavior of a German health insurer on prevention eff ort and health care expenditures using a unique administrative dataset that covers all insurants of the health insurer between 2003 and 2008. We fi nd that the program has been successful in both increasing individual prevention eff ort and achieving net savings every year since its implementation in 2004. However, while the estimated eff ect on health care expenditures is statistically signifi cant in the fi rst year, the effects for the second, third, and fourth years turn insignifi cant. In the fi fth year, results for net savings are sensitive in terms of statistical signifi cance when accounting for dynamic selection into the treatment.Diese Studie untersucht die Wirkungen eines Bonusprogramms für gesundheitsbewusstes Verhalten auf das individuelle Präventionsverhalten und die Gesundheitsausgaben von teilnehmenden Versicherten einer deutschen gesetzlichen Krankenversicherung. Die Analyse stützt sich auf einen einzigartigen, administrativen Datensatz, der zwischen 2003 und 2008 die Gesundheitsausgaben aller Versicherten dieser Krankenkasse enthält. Die Ergebnisse zeigen, dass das Bonusprogramm seit der Einführung in 2004 jedes Jahr aufs Neue die individuellen Präventionsanstrengungen der Teilnehmer erhöht und die Gesundheitsausgaben reduziert hat. Während der Effekt auf die Gesundheitsausgaben im ersten Jahr statistisch signifikant ist, werden die Effekte für das zweite, dritte und vierte Jahr jedoch insignifikant. Die Ergebnisse hinsichtlich der Nettoprogrammeinsparungen sind im fünften Jahr sensitiv gegenüber der Berücksichtigung von dynamischen Selektionseffekten

The evolution of the COVID-19 pandemic through the lens of google searches

Real-time data is essential for policymakers to adapt to a rapidly evolving situation like the COVID-19 pandemic. Using data from 221 countries and territories, we demonstrate the capacity of Google search data to anticipate reported COVID-19 cases and understand how containment policies are associated with changes in socioeconomic indicators. First, search interest in COVID-specific symptoms such as “loss of smell” strongly correlated with cases initially, but the association diminished as COVID-19 evolved; general terms such as “COVID symptoms” remained strongly associated with cases. Moreover, trends in search interest preceded trends in reported cases, particularly in the first year of the pandemic. Second, countries with more restrictive containment policies experienced greater search interest in unemployment and mental health terms after policies were implemented, indicating socio-economic externalities. Higher-income countries experienced a larger increase in searches related to unemployment and a larger reduction in relationship and family planning keywords relative to lower-income countries. The results demonstrate that real-time search interest can be a valuable tool to inform policies across multiple stages of the pandemic