New IZA DPs -- Health
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IZA Publications
Jan 19, 2026, 6:11:08 AMJan 19
to it...@umich.edu
Dear Italo Gutierrez,
These new IZA Discussion Papers are now available online.
DP 18269 - Kerwin/Dorélien/Pandey:
Open Defecation Is Negatively Associated with Reported COVID-19 Deaths in Rural India. Are Shared Toilets the Reason?
DP 18301 - Bietenbeck/Maschmann/Nilsson/Spika:
Cultural Origins of Preventive Health Care Utilization
DP 18304 - Costa-Font/Nicinska:
Long Lasting Health Effects of Soviet Education
DP 18305 - De Vera/Garcia-Brazales/Lin:
The Long Shadow of Labor Market Entry Conditions: Intergenerational Determinants of Mental Health
DP 18316 - Bhattacharya/Chakraborty/Mukherjee:
Demand for Health Insurance: Financial and Informational Role of Informal Networks
DP 18327 - Bhalotra/Clarke/Venkataramani:
The Long Run Economic Effects of Medical Innovation and the Role of Opportunities
DP 18349 - Bhattacharya/Chakraborty/De:
Public Insurance and Demand for Private Healthcare
Please find the abstracts and download links below.
You might also be interested in this World of Labor content:
Key topic: Health, well-being, and happiness in the labor market
IZA DP No. 18269
Jason Kerwin, Audrey M. Dorélien, Divya Pandey:
Open Defecation Is Negatively Associated with Reported COVID-19 Deaths in Rural India. Are Shared Toilets the Reason?
Abstract:
Early in the COVID-19 pandemic, scientists and policymakers advocated for the reduction of open defecation to curb the disease’s spread. However, SARS-CoV-2 is an airborne pathogen that can be transmitted by fecal aerosols, making poorly ventilated shared latrines a potential risk factor. Consequently, open defecation may mitigate COVID-19 transmission. Our study shows that reported COVID-19 deaths in India are negatively, rather than positively, correlated with district-level open defecation rates in rural areas. We also show that access to private toilets is associated with reduced individual-level mortality during the pandemic, but shared toilets do not show the same protective effect. Our results suggest that as with other diseases, private toilets reduce COVID-19 mortality, but the role of shared toilets and open defecation in relation to COVID-19 specifically is more nuanced. More broadly, our results show that public health measures must be targeted to the specific dis ease in question: what works for one disease may fail or even backfire when applied to others.
https://docs.iza.org/dp18269.pdf
IZA DP No. 18301
Jan Bietenbeck, Lukas Maschmann, Therese Nilsson, Devon Spika:
Cultural Origins of Preventive Health Care Utilization
Abstract:
We examine whether culturally transmitted time and risk preferences help explain differences in preventive health care uptake. We combine individual-level survey data from 27 European countries with country-level preference measures from the Global Preferences Survey. To isolate cultural influences from institutional and economic confounders, we focus on second-generation immigrants, who were born and currently reside in the same country -- and thus face the same institutional environment and health care system -- but whose parents originate from culturally distinct countries. We find that descendants of more patient cultures are more likely to use preventive services, while those from more risk-taking cultures are less likely to do so. These associations appear across multiple preventive care outcomes and remain robust to a wide range of socio-demographic and country-of-origin controls. The results highlight the role of culturally shaped preferences as a subtle but systemati c determinant of preventive health behavior.
https://docs.iza.org/dp18301.pdf
IZA DP No. 18304
Joan Costa-Font, Anna Nicinska:
Long Lasting Health Effects of Soviet Education
(forthcoming in: Economica, 7 December, 2025)
Abstract:
Education systems serve various purposes, including the enhancement of later-life health, though its effect can differ by socio-political regime. This paper examines the effects of exposure to communist education, which exposed children to a distinct curcurriculum and ideological content on later-life health. We exploit a novel dataset that collects information on compulsory education reforms in several European countries, with different cohorts exposed and unexposed to Soviet communist education. Using a difference-in-differences (DiD) design, we show that while the extension of compulsory education improved some relevant measures of health, communist education encompassed an additional health-enhancing effect. We document that the effect remains robust when using staggered DiD approaches and various robustness tests, and that it is explained by the priority given to physical education in school curricula, together with an increased likelihood of marriage.
https://docs.iza.org/dp18304.pdf
IZA DP No. 18305
Micole De Vera, Javier Garcia-Brazales, Jiayi Lin:
The Long Shadow of Labor Market Entry Conditions: Intergenerational Determinants of Mental Health
Abstract:
What determines long-term mental health and its intergenerational correlation? Exploiting variation in unemployment rates upon labor market entry across Australian states and cohorts, we provide novel evidence that the mental health of daughters is affected by the labor market entry conditions of their parents. In particular, a one standard deviation shock to the unemployment rate upon parental labor market entry worsens daughters' mental health during adolescence by 11% of a standard deviation. This effect is accompanied by lower levels of satisfaction with their health, financial situation, safety, and overall life. A mediation analysis suggests that a sizable proportion (24%) of the impacts on the descendants' mental health is explained by the worse mental health of their parents at mid-life. We do not detect any systematic impact of parental labor market entry conditions among sons.
https://docs.iza.org/dp18305.pdf
IZA DP No. 18316
Titir Bhattacharya, Tanika Chakraborty, Anirban Mukherjee:
Demand for Health Insurance: Financial and Informational Role of Informal Networks
Abstract:
We study why free public health insurance in India exhibits persistently low utilisation despite high out of pocket health expenses. Using panel data from the Young Lives Survey and the rollout of the Arogyasri scheme in Andhra Pradesh, we distinguish the roles of informal financial and information networks in shaping adoption. Empirically, households embedded in financial networks show higher take-up and utilisation, while information networks have no effect. To explain this pattern, we develop a simple theoretical framework in which informal financial networks act as mutual insurance: because members bear each other’s uninsured losses, the network has an incentive to push all members to enrol when the expected cost of shocks exceeds enrolment transaction costs. This generates corner solutions for network members and interior solutions for non-members, consistent with observed bimodal take-up patterns. The model clarifies why financial—but not informational—ties complement p ublic insurance and highlights community-based mechanisms for increasing adoption.
https://docs.iza.org/dp18316.pdf
IZA DP No. 18327
Sonia R. Bhalotra, Damian Clarke, Atheendar Venkataramani:
The Long Run Economic Effects of Medical Innovation and the Role of Opportunities
Abstract:
We leverage the introduction of the first antibiotic therapies in 1937 to examine the long-run effects of early-childhood pneumonia on adult educational attainment, employment, income, and work-related disability. Using census data, we document large average gains on all outcomes, alongside substantial heterogeneity by race and gender. On average, Black men exhibit smaller schooling gains than white men but larger employment and earnings gains. Among Black men (and women), we identify a pronounced gradient in gains linked to systemic racial discrimination in the pre–Civil Rights era: individuals born in more discriminatory Jim Crow states realized much smaller gains than those born in less discriminatory states. There is no similar gradient among white Americans. Women of both races exhibit smaller education and earnings gains than men on average, consistent with cultural and institutional barriers to women’s work. Our findings highlight the role of opportunities in shaping t he extent to which investments in early-life health translate into longer run economic gains.
https://docs.iza.org/dp18327.pdf
IZA DP No. 18349
Titir Bhattacharya, Tanika Chakraborty, Prabal K. De:
Public Insurance and Demand for Private Healthcare
Abstract:
Establishment of public–private partnerships is an emerging model in health care delivery. This study evaluates a pioneering social health insurance program in India that enables eligible households to access private hospitals for tertiary care services free of cost, but does not build more facilities. Leveraging policy discontinuities at state borders, we identify the program’s causal effects on utilization of private facilities and associated out-of-pocket expenditures. The results indicate a pronounced substitution effect induced by relative price changes: the program substantially increases the incidence of deliveries in private hospitals while significantly reducing out-of-pocket spending. However, we find no statistically significant effects on fertility or a key health outcome, infant mortality. %and may give rise to moral hazard behavior.
https://docs.iza.org/dp18349.pdf
Please click here to change your subscription status.
If you have trouble downloading the papers, or for any other questions regarding the IZA Discussion Paper Series, contact public...@iza.org.
These new IZA Discussion Papers are now available online.
DP 18269 - Kerwin/Dorélien/Pandey:
Open Defecation Is Negatively Associated with Reported COVID-19 Deaths in Rural India. Are Shared Toilets the Reason?
DP 18301 - Bietenbeck/Maschmann/Nilsson/Spika:
Cultural Origins of Preventive Health Care Utilization
DP 18304 - Costa-Font/Nicinska:
Long Lasting Health Effects of Soviet Education
DP 18305 - De Vera/Garcia-Brazales/Lin:
The Long Shadow of Labor Market Entry Conditions: Intergenerational Determinants of Mental Health
DP 18316 - Bhattacharya/Chakraborty/Mukherjee:
Demand for Health Insurance: Financial and Informational Role of Informal Networks
DP 18327 - Bhalotra/Clarke/Venkataramani:
The Long Run Economic Effects of Medical Innovation and the Role of Opportunities
DP 18349 - Bhattacharya/Chakraborty/De:
Public Insurance and Demand for Private Healthcare
Please find the abstracts and download links below.
You might also be interested in this World of Labor content:
Key topic: Health, well-being, and happiness in the labor market
IZA DP No. 18269
Jason Kerwin, Audrey M. Dorélien, Divya Pandey:
Open Defecation Is Negatively Associated with Reported COVID-19 Deaths in Rural India. Are Shared Toilets the Reason?
Abstract:
Early in the COVID-19 pandemic, scientists and policymakers advocated for the reduction of open defecation to curb the disease’s spread. However, SARS-CoV-2 is an airborne pathogen that can be transmitted by fecal aerosols, making poorly ventilated shared latrines a potential risk factor. Consequently, open defecation may mitigate COVID-19 transmission. Our study shows that reported COVID-19 deaths in India are negatively, rather than positively, correlated with district-level open defecation rates in rural areas. We also show that access to private toilets is associated with reduced individual-level mortality during the pandemic, but shared toilets do not show the same protective effect. Our results suggest that as with other diseases, private toilets reduce COVID-19 mortality, but the role of shared toilets and open defecation in relation to COVID-19 specifically is more nuanced. More broadly, our results show that public health measures must be targeted to the specific dis ease in question: what works for one disease may fail or even backfire when applied to others.
https://docs.iza.org/dp18269.pdf
IZA DP No. 18301
Jan Bietenbeck, Lukas Maschmann, Therese Nilsson, Devon Spika:
Cultural Origins of Preventive Health Care Utilization
Abstract:
We examine whether culturally transmitted time and risk preferences help explain differences in preventive health care uptake. We combine individual-level survey data from 27 European countries with country-level preference measures from the Global Preferences Survey. To isolate cultural influences from institutional and economic confounders, we focus on second-generation immigrants, who were born and currently reside in the same country -- and thus face the same institutional environment and health care system -- but whose parents originate from culturally distinct countries. We find that descendants of more patient cultures are more likely to use preventive services, while those from more risk-taking cultures are less likely to do so. These associations appear across multiple preventive care outcomes and remain robust to a wide range of socio-demographic and country-of-origin controls. The results highlight the role of culturally shaped preferences as a subtle but systemati c determinant of preventive health behavior.
https://docs.iza.org/dp18301.pdf
IZA DP No. 18304
Joan Costa-Font, Anna Nicinska:
Long Lasting Health Effects of Soviet Education
(forthcoming in: Economica, 7 December, 2025)
Abstract:
Education systems serve various purposes, including the enhancement of later-life health, though its effect can differ by socio-political regime. This paper examines the effects of exposure to communist education, which exposed children to a distinct curcurriculum and ideological content on later-life health. We exploit a novel dataset that collects information on compulsory education reforms in several European countries, with different cohorts exposed and unexposed to Soviet communist education. Using a difference-in-differences (DiD) design, we show that while the extension of compulsory education improved some relevant measures of health, communist education encompassed an additional health-enhancing effect. We document that the effect remains robust when using staggered DiD approaches and various robustness tests, and that it is explained by the priority given to physical education in school curricula, together with an increased likelihood of marriage.
https://docs.iza.org/dp18304.pdf
IZA DP No. 18305
Micole De Vera, Javier Garcia-Brazales, Jiayi Lin:
The Long Shadow of Labor Market Entry Conditions: Intergenerational Determinants of Mental Health
Abstract:
What determines long-term mental health and its intergenerational correlation? Exploiting variation in unemployment rates upon labor market entry across Australian states and cohorts, we provide novel evidence that the mental health of daughters is affected by the labor market entry conditions of their parents. In particular, a one standard deviation shock to the unemployment rate upon parental labor market entry worsens daughters' mental health during adolescence by 11% of a standard deviation. This effect is accompanied by lower levels of satisfaction with their health, financial situation, safety, and overall life. A mediation analysis suggests that a sizable proportion (24%) of the impacts on the descendants' mental health is explained by the worse mental health of their parents at mid-life. We do not detect any systematic impact of parental labor market entry conditions among sons.
https://docs.iza.org/dp18305.pdf
IZA DP No. 18316
Titir Bhattacharya, Tanika Chakraborty, Anirban Mukherjee:
Demand for Health Insurance: Financial and Informational Role of Informal Networks
Abstract:
We study why free public health insurance in India exhibits persistently low utilisation despite high out of pocket health expenses. Using panel data from the Young Lives Survey and the rollout of the Arogyasri scheme in Andhra Pradesh, we distinguish the roles of informal financial and information networks in shaping adoption. Empirically, households embedded in financial networks show higher take-up and utilisation, while information networks have no effect. To explain this pattern, we develop a simple theoretical framework in which informal financial networks act as mutual insurance: because members bear each other’s uninsured losses, the network has an incentive to push all members to enrol when the expected cost of shocks exceeds enrolment transaction costs. This generates corner solutions for network members and interior solutions for non-members, consistent with observed bimodal take-up patterns. The model clarifies why financial—but not informational—ties complement p ublic insurance and highlights community-based mechanisms for increasing adoption.
https://docs.iza.org/dp18316.pdf
IZA DP No. 18327
Sonia R. Bhalotra, Damian Clarke, Atheendar Venkataramani:
The Long Run Economic Effects of Medical Innovation and the Role of Opportunities
Abstract:
We leverage the introduction of the first antibiotic therapies in 1937 to examine the long-run effects of early-childhood pneumonia on adult educational attainment, employment, income, and work-related disability. Using census data, we document large average gains on all outcomes, alongside substantial heterogeneity by race and gender. On average, Black men exhibit smaller schooling gains than white men but larger employment and earnings gains. Among Black men (and women), we identify a pronounced gradient in gains linked to systemic racial discrimination in the pre–Civil Rights era: individuals born in more discriminatory Jim Crow states realized much smaller gains than those born in less discriminatory states. There is no similar gradient among white Americans. Women of both races exhibit smaller education and earnings gains than men on average, consistent with cultural and institutional barriers to women’s work. Our findings highlight the role of opportunities in shaping t he extent to which investments in early-life health translate into longer run economic gains.
https://docs.iza.org/dp18327.pdf
IZA DP No. 18349
Titir Bhattacharya, Tanika Chakraborty, Prabal K. De:
Public Insurance and Demand for Private Healthcare
Abstract:
Establishment of public–private partnerships is an emerging model in health care delivery. This study evaluates a pioneering social health insurance program in India that enables eligible households to access private hospitals for tertiary care services free of cost, but does not build more facilities. Leveraging policy discontinuities at state borders, we identify the program’s causal effects on utilization of private facilities and associated out-of-pocket expenditures. The results indicate a pronounced substitution effect induced by relative price changes: the program substantially increases the incidence of deliveries in private hospitals while significantly reducing out-of-pocket spending. However, we find no statistically significant effects on fertility or a key health outcome, infant mortality. %and may give rise to moral hazard behavior.
https://docs.iza.org/dp18349.pdf
Please click here to change your subscription status.
If you have trouble downloading the papers, or for any other questions regarding the IZA Discussion Paper Series, contact public...@iza.org.
IZA Publications
Jan 19, 2026, 6:13:03 AMJan 19
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