ResearchPad - welfare-economics https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[Women’s empowerment as self-compassion?: Empirical observations from  India]]> https://www.researchpad.co/article/elastic_article_13876 Although ICPD brought about an international consensus on the centrality of women’s empowerment and gender equity as desired national goals, the conceptualization and measurement of empowerment in demography and economics have been largely understood in a relational and in a family welfare context where women’s altruistic behaviour within the household is tied either to developmental or child health outcomes. The goals of this study were twofold: (1) to offer an empirical examination of the household level empowerment measure through the theoretical construct of self-compassion and investigate its association with antenatal health, and (2) to ensure robust psychometric quality for this new measure. Drawing data from the nationally representative, multi-topic dataset of 42, 152 households, India Human Development Survey, IHDS II (2011–2012), the study performed a confirmatory factor analysis followed by an OLS estimation to investigate the association between a self-compassionate based empowerment and antenatal care. Empowerment was shown to be positively and significantly associated with antenatal care with significant age and education gradient. A woman’s married status, her relation to the household head and joint family residence created conditions of restricted freedom in terms of her mobility, decision making and sociality. The empowerment measure showed inconsistent associations with social group affiliations and household wealth. The study provided an intellectual starting point to rethink the traditional formulations of empowerment by foregrounding its empirical measure within the relatively unexplored area of social psychology. In the process it addressed measurement gaps in the empowerment-health debate in India and beyond.

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<![CDATA[The time-varying relationship between economic globalization and the ideological center of gravity of party systems]]> https://www.researchpad.co/article/5c803c63d5eed0c484ad8866

Does economic globalization influence the positioning of parties and, as a consequence, the ideological characteristics of party systems? Answering this question is important because we need to understand the constraints that parties face in formulating policies from which voters have to choose. In our paper, we take a systemic perspective and conceptualize a party system’s ideological center of gravity as the outcome of interest. We define the center of gravity as the weighted mean position of all parliamentary parties in a country that represents the position to which parties gravitate. We start by formulating static hypotheses on the effect of imports and exports on the center of gravity and derive their underlying mechanisms. We further derive dynamic hypotheses stipulating varying effects over time based on the premise that partisan attitudes toward globalization have undergone multiple changes over the last decades. A time-series cross-section analysis of 129 elections in 15 Western European countries from 1974 to 2015 finds evidence for opposite effects of exports and imports in the pooled data. Additionally, a moving-window analysis indicates that the relationship between globalization and the center of gravity varies over time. This is a significant finding because it suggests that economic globalization has an influence on party systems and that it is important to test for time-varying effects.

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<![CDATA[Distinguishing protest responses in contingent valuation: A conceptualization of motivations and attitudes behind them]]> https://www.researchpad.co/article/5c3e4f65d5eed0c484d74dbe

The percentage of protesters in contingent valuation surveys is substantial–about 20% across many studies. This paper seeks to clarify the motivations behind protest responses. In addition, the question whether the estimation of willingness to pay (WTP) is more biased by the exclusion or inclusion of protest bids is yet undecided. Methodological improvements are difficult for three reasons: motivations behind protest responses are largely unclear, definitions of protest differ between studies and often only participants who state a zero WTP are asked for their reasons. Our survey on farm animal welfare (n = 1335) provides detailed motivations, two definitions and includes debriefing of all participants for their WTP. We find that protest bids are not a refusal to answer, they are neither irrational nor driven by lack of understanding. Quite the contrary, a large part of participants is directly motivated by moral reasons. Furthermore, protest responses are not coupled to a zero WTP. In our sample, only 8% out of 32% protesting participants had a zero WTP. Only a small fraction of zero bids (0.4%) are true WTP-statements, i.e. respondents were satisfied with the status quo. This finding has important implications for existing WTP-estimates which might be biased. Finally, we provide detailed estimates of the WTP for animal welfare issues by including and excluding different types of protesters and outliers.

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<![CDATA[Impact of a New Reimbursement Program on Hepatitis B Antiviral Medication Cost and Utilization in Beijing, China]]> https://www.researchpad.co/article/5989da08ab0ee8fa60b76a42

Background

Hepatitis B virus (HBV) infection is a significant clinical and financial burden for chronic hepatitis B (CHB) patients. In Beijing, China, partial reimbursement on antiviral agents was first implemented for the treatment of CHB patients in July 1, 2011.

Aims

In this study, we describe the medical cost and utilization rates of antiviral therapy for CHB patients to explore the impact of the new partial reimbursement policy on the medical care cost, the composition, and antivirals utilization.

Methods

Clinical and claims data of a retrospective cohort of 92,776 outpatients and 2,774 inpatients with non-cirrhotic CHB were retrieved and analyzed from You'an Hospital, Beijing between February 14, 2008 and December 31, 2012. The propensity score matching was used to adjust factors associated with the annual total cost, including age, gender, medical insurance type and treatment indicator.

Results

Compared to patients who paid out-of-pocket, medical cost, especially antiviral costs increased greater among patients with medical insurance after July 1, 2011, the start date of reimbursement policy. Outpatients with medical insurance had 16% more antiviral utilization; usage increased 3% among those who paid out-of-pocket after the new partial reimbursement policy was implemented.

Conclusions

Direct medical costs and antiviral utilization rates of CHB patients with medical insurance were higher than those from paid out-of-pocket payments, even after adjusting for inflation and other factors. Thus, a new partial reimbursement program may positively optimize the cost and standardization of antiviral treatment.

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<![CDATA[The Ecology of Defensive Medicine and Malpractice Litigation]]> https://www.researchpad.co/article/5989da74ab0ee8fa60b960cb

Using an evolutionary game, we show that patients and physicians can interact with predator-prey relationships. Litigious patients who seek compensation are the ‘predators’ and physicians are their ‘prey’. Physicians can adapt to the risk of being sued by performing defensive medicine. We find that improvements in clinical safety can increase the share of litigious patients and leave unchanged the share of physicians who perform defensive medicine. This paradoxical result is consistent with increasing trends in malpractice claims in spite of safety improvements, observed for example in empirical studies on anesthesiologists. Perfect cooperation with neither defensive nor litigious behaviors can be the Pareto-optimal solution when it is not a Nash equilibrium, so maximizing social welfare may require government intervention.

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<![CDATA[Impact of the Non-Contributory Social Pension Program 70 y más on Older Adults’ Mental Well-Being]]> https://www.researchpad.co/article/5989daa3ab0ee8fa60ba6687

Background

In 2007, a non-contributory pension program was launched in rural areas of Mexico. The program consisted in a non-conditional cash transfer of US$40 monthly to all older adults (OA) aged 70 and over. We evaluate the effect of the program on mental well-being of its beneficiaries.

Methods and Findings

Quantitative and qualitative methods were used. For the quantitative component, we used the selection criteria established by the program (age and locality size) to form the Intervention (OA aged 70–74 residing in rural localities, <2500 inhabitants) and Control groups (OA aged 70–74, in localities with 2501–2700 inhabitants). Baseline data collection was conducted in 2007 where 5,465 OA were interviewed. The follow-up survey was conducted in 2008, and it was possible to interview 5,270 OA, with a response rate of 96%. A difference-in-difference linear probability model with individual fixed effect was used to estimate the impact of the program on mental well-being indicators. In 2009 a qualitative component was designed to explore possible causal pathways of such effect.

Results

After a year of exposure, the program had a significant effect on reduction of depressive symptoms (β = −0.06, CI95% −0.12; −0.01) and an increase in empowerment indicators: OA participated in important household decisions (β = 0.09, CI95% 0.03;0.15); and OA participated in household decisions pertaining to expenses (β = 0.11, CI95% 0.05;0.18). Qualitative analysis found a strong trend showing a reduction of sadness, and feeling of increasing empowerment.

Conclusions

These results suggest that a non-conditional transfer in older ages have an impact beyond the economic sphere, impacting even the mental well-being. This effect could be explained because the pension produces feelings of safety and welfare. It is recommendable that governments should invest efforts towards universalizing the non-contributory pension programs in order to ensure a basic income for the elderly.

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<![CDATA[Determinants of Attitude toward the Public Health Spending and Its Relationship with Voting Behavior in the 2012 South Korean Presidential Election]]> https://www.researchpad.co/article/5989da24ab0ee8fa60b80247

This study aimed to identify the factors influencing South Korean voters’ attitudes towards increasing public expenditure on health and to identify whether the issue of healthcare expenditure influenced candidate choice in the 2012 Korean presidential election. The study used the data from a survey conducted by the Institute of Korean Politics at Seoul National University immediately following the 2012 presidential election. The survey was completed by a nationwide sample of 1,200 people aged 19 or over using a face-to-face interview method and proportional quota sampling based on sex, age, and region. About 44.3% of respondents had a positive attitude toward increasing public health expenditure. There was no significant difference by the candidate they supported (conservative Park Geun-hye or liberal Moon Jae-in). In particular, even 44.9% of conservative supporters agreed with more spending. Politically neutral respondents (OR = 1.76, 90% CI 1.22–2.54) and strong conservative party supporters (OR = 1.53, 90% CI 1.05–2.25) were more likely to support public health expenditure increase compared to strong liberal party supporters. Also, respondents who believed that the economic gap in the country was widening were 1.91 times more likely to support an increase in public health expenditures. However, the issue of health expenditure had no influence on voters’ choice of presidential candidates, and in particular no negative effect of choice of the ruling (conservative) party’s candidate. Our results should be interpreted with care; one possible reason for this lack of effect might be that constituents voted along partisan lines regardless of their attitude to the welfare issue; another possible explanation might be the success of the “left click strategy” of the conservative party. That is, the conservatives did not reject economic democratization or social welfare expansion. Further research should be done to explain why attitudes to health spending did not directly affect choice of candidate.

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<![CDATA[Long-Term Sickness Absence Due to Mental Disorders Is Associated with Individual Features and Psychosocial Work Conditions]]> https://www.researchpad.co/article/5989dabfab0ee8fa60bb0106

Aims

Sickness absence is a socioeconomic global burden. In Brazil, mental disorders are the third leading cause of social security benefits payments. The aim of the present study was to compare factors associated with long-term sickness absence between workers who claimed social benefits due to mental disorders or by other causes. We investigated individual features and occupational characteristics. In addition, we evaluated psychosocial factors at work assessed by the Demand-Control-Support (DCS) and Effort-Reward Imbalance (ERI) models, and whether they were associated with long-term sickness absence due to mental disorders (LTSA-MD).

Methods

The present case-control study was conducted in São Paulo, Brazil. The sample (n = 385) included workers on sick leave for more than 15 days. Cases were the participants with disabling psychiatric illnesses, and controls were the ones with other disabling diseases. Interviews were conducted to assess individual features (sociodemographic data, health habits/lifestyle, health conditions) and occupational characteristics. The participants' perception of exposure to dimensions of the DCS and ERI models was also recorded. Multiple logistic regressions were performed to evaluate the association between independent variables and LTSA-MD.

Results

All the regression analyses showed that LTSA-MD was associated with female sex, self-reported white skin color, higher education level, high tobacco consumption, high alcohol intake, two or more comorbidities, exposure to violence at work, high job strain and low social support at work, effort-reward imbalance and high overcommitment to work. LTSA-MD was associated with separate and combined DCS and ERI stress models.

Conclusions

Individual features and work conditions were associated with LTSA-MD. Combined analysis of stress models showed that psychosocial factors at work were significantly associated with LTSA-MD. Resourceful use of this information may contribute to the implementation of preventive actions and strategies to facilitate return to work targeting the populations most susceptible to mental disorders.

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<![CDATA[Inequity of healthcare utilization on mammography examination and Pap smear screening in Thailand: Analysis of a population-based household survey]]> https://www.researchpad.co/article/5989db50ab0ee8fa60bdbedc

Healthcare in Thailand is not equally distributed, and not all people can equally access healthcare resources even if they are covered by health insurance. To examine factors associated with the utilization of mammography examination for breast cancer and Pap smear screening for cervical cancer, data from the national reproductive health survey conducted by the National Statistical Office of Thailand in 2009 was examined. The survey was carried out on 15,074,126 women aged 30–59 years. The results showed that the wealthier respondents had more mammograms than did the lower-income groups. The concentration index was 0.144. The data on Pap smears for cervical cancer also showed that the wealthier respondents were more likely to have had a Pap smear than their lower-income counterparts. The concentration index was 0.054. Determinants of mammography examination were education, followed by health welfare and wealth index, whereas the determinants of Pap smear screening were wealth index, followed by health welfare and education. The government should support greater education for women because education was associated with socioeconomic status and wealth. There should be an increase in the number of screening campaigns, mobile clinics, and low-cost mammograms and continued support for accessibility to mammograms, especially in rural areas and low-income communities.

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<![CDATA[Cognitive Ability and the Demand for Redistribution]]> https://www.researchpad.co/article/5989da0bab0ee8fa60b779b3

Empirical research suggests that the cognitively able are politically more influential than the less able, by being more likely to vote and to assume leadership positions. This study asks whether this pattern matters for public policy by investigating what role a person's cognitive ability plays in determining his preferences for redistribution of income among citizens in society. To answer this question, we use a unique Swedish data set that matches responses to a tailor-made questionnaire to administrative tax records and to military enlistment records for men, with the latter containing a measure of cognitive ability. On a scale of 0 to 100 percent redistribution, a one-standard-deviation increase in cognitive ability reduces the willingness to redistribute by 5 percentage points, or by the same amount as a $35,000 increase in mean annual income. We find support for two channels mediating this economically strong and statistically significant relation. First, higher ability is associated with higher income. Second, ability is positively correlated with the view that economic success is the result of effort, rather than luck. Both these factors are, in turn, related to lower demand for redistribution.

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<![CDATA[Employment history indicators and mortality in a nested case-control study from the Spanish WORKing life social security (WORKss) cohort]]> https://www.researchpad.co/article/5989db5cab0ee8fa60be025a

Employment has transitioned from stable to more flexible schemes. Little is known about the effects of dynamic working lives and mortality. We examined the association of employment, unemployment and inactivity on mortality among workers born in 1926–1988, in a nested case-control study of workers from the Spanish WORKss cohort. Cases were all deaths that occurred during 2004–2013 and controls were living persons, matched for sex and age at the time the case occurred. We had information on employment from 1981 to 2013. Logistic regression was used to measure the associations between the 3 employment history indicators separately by sex. There were 53,989 cases and an equal number of controls (n = 107,978). More than 16 years employed showed a protective effect against mortality in women (OR = 0.88, 95%CI: 0.81, 0.94) and men (OR = 0.76, 95%CI: 0.70, 0.79). The number of spells and time in unemployment and inactivity were significantly related to mortality in men, but not women. Sensitivity analyses by labor relationship showed stronger associations of unemployment (OR = 1.42, 95%CI: 1.13, 1.78) and inactivity (OR = 1.34; 95%CI: 1.09, 1.65) for temporary workers. Employment gaps are detrimental to health and have worse effects if the gaps occur without unemployment benefits or after temporary contracts. These results may drive improvement of labor and social policies that protect workers against the potential negative effects of dynamic work lives.

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