Do New Drugs Increase Life Expectancy? A Critique of a Manhattan Institute Paper

A recent study published by the Manhattan Institute “Why Has Longevity Increased More in Some States than in Others? The Role of Medical Innovation and Other Factors,” purported to show that the more rapid adoption of new drugs has substantial benefits in the form of increased life expectancy, higher productivity and lower non-drug health care expenditures. This study has been cited as evidence supporting the more rapid acceptance of new drugs in Medicaid, Medicare, and other public programs and has helped to shape public debate on the value of new drugs. This analysis questions the key conclusions of the study. It points out that the key statistical regressions appear to be misspecified, since they show anomalies such as a negative correlation between income growth and life expectancy and find no relationship between education and productivity growth. Methodological flaws addressed include lack of adjustment for infant mortality rates; inadequate proxy measures of health status; lack of adjustment for ages of individuals and other sociodemographic factors; inherent problems with the definition of drug age, or ‘vintage;’ and the failure to consider reverse causation as an obvious explanation for several findings. The Manhattan Institute study does not provide reliable evidence for favoring adoption of newer drugs in either public or private health care programs

Macro-Economic Conditions and Infant Health: A Changing Relationship for Black and White Infants in the United States

We study whether the relationship between the state unemployment rate at the time of conception and infant health, infant mortality and maternal characteristics in the United States has changed over the years 1980-2004. We use microdata on births and deaths for years 1980-2004 and find that the relationship between the state unemployment rate at the time of conception and infant mortality and birthweight changes over time and is stronger for blacks than whites. For years 1980-1989 increases in the state unemployment rate are associated with a decline in infant mortality among blacks, an effect driven by mortality from gestational development and birth weight, and complications of placenta while in utero. In contrast, state economic conditions are unrelated to black infant mortality in years 1990-2004 and white infant mortality in any period, although effects vary by cause of death. We explore potential mechanisms for our findings and, including mothers younger than 18 in the analysis, uncover evidence of age-related maternal selection in response to the business cycle. In particular, in years 1980-1989 an increase in the unemployment rate at the time of conception is associated with fewer babies born to young mothers. The magnitude and direction of the relationship between business cycles and infant mortality differs by race and period. Age-related selection into motherhood in response to the business cycle is a possible explanation for this changing relationship

Parental Leave policies, gender equity and family well being in Europe: a comparative perspective

Leave policies and the protection of working parents' rights have changed significantly in Europe during the last few decades. While policies introduced immediately after World War II were largely based on a male-breadwinner model, the post-1970s policies have recognised the increase in maternal employment, the growing diversity of work/family arrangements and working parents' needs for state support in caring for young children. Paid maternity leave and paid or unpaid parental leave are now available throughout Europe - Western, Central and Eastern - and policy developments have encouraged more gender-neutral leaves and longer periods of paid leave (Deven and Moss 2005)

Female labour market outcomes and the impact of maternity leave policies

ABSTRACT: This paper shows how family policies aimed at reconciling the pressures of family and work generate substantial variation in labour market outcomes across developed countries. We use a life-cycle model of female labour supply and savings behaviour, calibrated to the US economy, to assess the effect of introducing to the US a maternity leave policy similar to Scandinavian-type policies. We focus on the impact on gender differences in participation and in wages. We distinguish between the effect of the job protection offered by maternity leave and the effect of income replacement. Job protection leads to substantial increases in participation of mothers with children under 6, but with little long term effects. The effects on wages are minimal, with negative selection effects offsetting the reduced human capital depreciation. Income replacement has a limited impact on participation or wages.Virginia Sánchez-Marcos thanks the Spanish Ministry of Science and Technology for Grant ECO2009-09614 and RecerCaixa for financial support

The impact of economic recession on maternal and infant mortality: lessons from history

<p>Abstract</p> <p>Background</p> <p>The effect of the recent world recession on population health has featured heavily in recent international meetings. Maternal health is a particular concern given that many countries were already falling short of their MDG targets for 2015.</p> <p>Methods</p> <p>We utilise 20^thcentury time series data from 14 high and middle income countries to investigate associations between previous economic recession and boom periods on maternal and infant outcomes (1936 to 2005). A first difference logarithmic model is used to investigate the association between short run fluctuations in GDP per capita (individual incomes) and changes in health outcomes. Separate models are estimated for four separate time periods.</p> <p>Results</p> <p>The results suggest a modest but significant association between maternal and infant mortality and economic growth for early periods (1936 to 1965) but not more recent periods. Individual country data display markedly different patterns of response to economic changes. Japan and Canada were vulnerable to economic shocks in the post war period. In contrast, mortality rates in countries such as the UK and Italy and particularly the US appear little affected by economic fluctuations.</p> <p>Conclusions</p> <p>The data presented suggest that recessions do have a negative association with maternal and infant outcomes particularly in earlier stages of a country's development although the effects vary widely across different systems. Almost all of the 20 least wealthy countries have suffered a reduction of 10% or more in GDP per capita in at least one of the last five decades. The challenge for today's policy makers is the design and implementation of mechanisms that protect vulnerable populations from the effects of fluctuating national income.</p

can we call it a revolution women the labour market and european policy

In the USA the change in women's role in the economy over the last quarter-century has been likened to 'a quiet revolution'. Can we also talk of a quiet 'revolution' in Europe? The present article addresses this question by reviewing key developments in women's labour market position at EU level over the last 20 years. Full integration of women in the labour market was a focal point of European Employment Strategy, based on the understanding that it is an essential ingredient of gender equality; but it recently lost priority in favour of human rights and anti-discrimination goals. Policy responses to the financial crisis accelerated this change in priorities together with the perception that men are the real losers of the crisis. However, a stock-taking of women's integration into the labour market at EU level shows that two large obstacles stand in the way of full integration: regional imbalances and the secondary earner question. Female employment recently outperformed male employment, but fiscal consolidation policies currently hinder advancement in countries like the so-called GIPSI group, where progress is needed most. Meanwhile differences with respect to men in pension income or total earnings remain high at around forty percent. Reconciliation policy at EU level – leave design and care service provisioning in particular – had not consistently helped rebalance the gender division of labour within households. It needs recasting for a truly revolutionary change in women's role in the economy to materialize

Will the Public's Health Fall Victim to the Home Foreclosure Epidemic?

Gary Bennett and colleagues discuss the ways in which the dramatic rise in home foreclosures, particularly in the US, may have health consequences