Hit where it hurts – Healthcare access and intimate partner violence

We exploit a change in the public healthcare entitlement of undocumented migrants in Spain to investigate the causal link between withdrawal of healthcare and changes in help-seeking behaviour of women experiencing intimate partner violence (IPV). We contribute to the new literature modelling domestic violence by taking a novel look at the role of human capital in decisions to seek help when in violent relationships. We use a difference-in-differences (DiD) methodology to compare the number of foreign applicants for protection orders before and after the reform using Spanish applicants as the counterfactual. The impact of the reform was immediate; foreign applicants decreased by 16% after the health policy reform was introduced and this drop amounts to 19% in areas with stronger enforcement of the reform. We perform several robustness checks including addressing potential bias from migration changes after the reform. Our findings are important for current policy discussions on granting/limiting access to public programs for the undocumented population. We provide evidence that restricted access to the healthcare system can have unintended negative consequences for the most vulnerable groups of the population with potentially important spill-over effects to the next generation

COVID-19 and help-seeking behavior for intimate partner violence victims

Using detailed data at the local level on the number of calls to the domestic violence emergency hotline in Spain, we study the effect of the COVID-19 outbreak and the quarantine measures imposed on the help-seeking behavior of intimate partner violence victims. Our analysis focuses on Spain, which is one of the European countries that was most affected by the COVID-19 pandemic and, as a consequence, implemented one of the strictest quarantine policies in Europe. We find that the implementation of the lockdown policy was associated with a 41 percentage point increase in the number of calls to the emergency hotline compared to the pre-policy period. This effect was stronger during the strict confinement period but persisted in the medium term, after quarantine was lifted. Using detailed mobile phone data to measure mobility levels, we document stronger effects in provinces whose effective mobility reduction was more intense. Our results are crucial from a policy perspective, as many countries are faced with a second wave of the pandemic

If sick-leave becomes more costly, will I go back to work? Could it be too soon?

We investigate the impact on work absence of a massive reduction in paid sick leave benefits. We exploit a policy change that only affected public sector workers in Spain and compare changes in the number and length of spells they take relative to unaffected private sector workers. Our results highlight a large drop in frequency mostly offset by increases in average duration. Overall, the policy did reduce number of days lost to sick leave. For some, return to work may have been premature as we document very large increases in both the proportion of relapses and the working accidents rate

Terrorist attacks, Islamophobia and newborns’health [WP]

Islamophobia has increased in recent years which can be partly attributed to terrorist attacks perpetrated by jihadist groups. Islamophobia might be a source of stress, being problematic for pregnant (Muslim) women. We examine how stress generated by the 2017 Catalonia (Spain) attacks affected the health of newborns whose mothers are from a Muslim country (as the perpetrators). We use a difference-in-differences-in-differences model comparing newborns whose mothers come from a Muslim country and are residing in a municipality directly affected by the attacks, to other newborns, before-after the attacks. Results show that the share of low-birth-weight babies and deliveries with complications raise significantly by 23.77%, and 13.02%. We document a significant increase in Islamophobia and in emotional distress in our treated group. We conclude that one of the channels contributing to the deterioration of those newborns health is the stress faced by their mothers that resulted from the increase in Islamophobia

Is changing the minimum legal drinking age an effective policy tool?

In year 1991, regional governments in Spain started a period of implementation of a law that rose the minimum legal drinking age from 16 to 18 years old. To evaluate the effects of this change on the consumption of legal drugs and its related morbidity outcomes, we construct a regional panel dataset on alcohol consumption and hospital entry registers and compare variation in several measures of prevalence between the treatment group (16-18 years old) and the control group (20-22 years old). Our findings show important differences by gender. (...

The impact of temporary contracts on suicide rates

The number of suicides has increased in the last decades in several developed countries. For instance, Spain has experienced a gradual but steady increase in suicides since the 80's and it is currently the leading external cause of death in the country. At the same time, the dualisation of the labor market, with a strong and persistent incidence of temporary contracts, has increased the instability of employment conditions. Both developments have a stronger incidence for individuals with lower levels of education. Therefore, in this paper we use rich administrative data in order to estimate the impact of the wide spread use of temporary contracts on suicides. In order to do that we exploit a reform that liberalised the use of fix-term contracts in Spain in 1984. Our results show strong long-term effects of the reform, which increased the suicide mortality rate of affected cohorts (those entering the labor market just after the liberalisation) by at least 25.3%. We believe that this result has important policy implications and should be taken into account in the design of the national suicide prevention plans

Is changing the minimum legal drinking age an effective policy tool? [WP]

In year 1991 regional governments in Spain started a period of implementation of a law that rose the Minimum Legal Drinking Age from 16 to 18 years old. This process was fully completed in year 2015. To evaluate the effects of this change on consumption of legal drugs and its related morbidity outcomes, we construct a regional panel dataset on alcohol consumption and hospital entry registers and compare variation in several measures of prevalence between the treatment group (16-18 years old individuals) and the control group (20-22 years old individuals). Our findings show important differences by gender. Firstly, our main result regarding overall drinking prevalence show reductions ranging from -11.57% for the subsample including both genders to -14.31% for the subsample of males. Secondly, effects on males are driven mainly by reductions in beer with alcohol consumption (-8.98%). Thirdly, effects on wine and/or cava drinking prevalence range from -12.62% for the subsample including both genders to -9.65% for the subsample of females. No effects regarding overall smoking prevalence are found. Fourthly, we do not find evidence that these reductions in alcohol consumption are translated into hospitalizations related to alcohol overdose. To our knowledge, this is the first paper providing evidence on gender-based differences to policies aimed at reducing alcohol consumption. Our results have important policy implications for countries currently considering changes in the Minimum Legal Drinking Age

Bar opening hours, alcohol consumption and workplace accidents

It is widely proven that individuals that consume more alcohol are also much more likely to suffer from a working accident. However, this observed correlation may be due to other unobserved factors affecting both alcohol consumption and working accidents (such as the type of job). Thus, in this paper we establish the causal impact of alcohol consumption on working accidents by exploiting a reduction in Spanish bar opening hours that was introduced progressively throughout regions and time. We first show that the policy effectively reduced working accidents. Although there may be many channels by which bar closing hours affect working accidents, we provide evidence that alcohol consumption, which stands as one of these potential channels, is also reduced after the introduction of the policy. Our paper is the first one to provide evidence that stricter closing times for bars causally reduce accidents at work. This is important from a policy point of view as working accidents stand as a very important determinant of productivity levels and entail very high costs in terms of health and disability

Job competition in civil servant public examinations and sick leave behavior

In several countries the entry system to access public service positions is the traditional public examination procedure. In this setting, candidates have to take passing exams that require a huge load of material to study, and therefore time. Candidates who are working while preparing the public exam may find it difficult to devote enough time to both tasks. Thus, they might experience increased stress/anxiety related to high stakes civil service recruitment testing. In this paper, we investigate the impact of new openings of civil servant positions on sickness absences. Using a unique administrative dataset on the universe of sickness absences and civil servant positions offered in Spain from 2009 to 2015, we find a significant increase in health-related absences several months before the examination date. In particular, this effect is stronger for individuals working in the educational sector as well as for calls offering a large number of positions. This effect is mostly driven by stress related absences. Finally, using data on medical visits (GP and specialist) we find evidence consistent with a deterioration in public sector workers’ health. Our results are important from a policy perspective as they highlight the existence of important negative consequences of the civil service recruitment process that have been previously overlooked

Linking Mediterranean diet and lifestyle with cardio metabolic diseases and depressive symptoms: A study on the elderly in Europe

Against a backdrop of an aging population in Europe, promoting health in older adults becomes a pressing issue. This study aimed to explore if correlations exist between the adherence to the Mediterranean diet and specific health outcomes such as the incidence of chronic cardio metabolic illnesses and experiencing depressive symptoms for elderly individuals. We also looked into probable links between regularly engaging in vigorous physical activities and these health outcomes. Our goal was to clearly demonstrate these relationships while controlling for several individual characteristics and socio-demographic factors on a cross-national scale within Europe. Using the Survey of Health, Aging and Retirement in Europe (SHARE) data for adults aged 50 years and above, we found that following the Mediterranean diet was negatively correlated with the incidence of chronic illnesses, as well as with levels of depressive symptoms. These results were robust to the inclusion of a number of individual and socio-demographic controls. We also showed that regular participation in sports and other strenuous physical activities were associated with lesser chronic disorders and lower levels of depressive symptoms. These findings may have important implications in formulating preventive interventions on ensuring the quality of life of the older populatio