Essays in Health Economics

Abstract

[eng] Health across the life cycle is an important component of well-being and quality of life. Bad health is linked to negative child and adulthood socioeconomic outcomes such as educational achievement, future health, and earnings (Almond et al., 2005; Black et al., 2007; Almond and Currie, 2011; Currie and Vogl, 2013). This thesis contributes to two research lines in the field of health economics. The first line, with two chapters, focuses on health at birth outcomes, and the second one, also with two chapters, explores changes in workers' health and how health shocks can affect women’s labor market outcomes. With respect to the first research line, health outcomes at all stages of life are of relevance both for individuals and societies. There is vast literature showing that good health, especially health at birth, is associated with better outcomes in terms on wages, education attainment and human capital development. Health at birth can be influenced by many factors, for instance, stress during pregnancy that, according to the medical literature, has been demonstrated to have detrimental effects on newborns’ health (Rondó et al., 2003; Beydoun and Saftlas, 2008; Torche, 2011; Khashan et al., 2008). Economic literature assessing the effects of exogenous sources of stress (earthquakes, bombs, terrorist attacks) on birth outcomes is not very rich and has focused only on the general pregnant women population. The second chapter of this thesis focuses on assessing the effect of in-utero exposure to stress, generated by terrorist attacks, on the health of newborns of Muslim mothers. Another factor that can affect health at birth is mother's substance use/abuse. Chapter 3 explores how a public policy aimed at not criminalizing drug use may be linked to increased women's drug use and bad newborn's health. The results from these two chapters point to detrimental health at birth. Thus, Chapter 2 finds that in-utero exposure to stress is linked to low birth weight and complications during pregnancy. Likewise, Chapter 3 finds that the share of low birth weight and very low birth weight newborns raises significantly in provinces initially more exposed to drugs as a possible consequence of a policy that established maximum permissible amounts of possession of illicit substances for personal consumption in Ecuador. In addition, this chapter shows evidence that supports an increase in neonatal hospitalizations to medical conditions related to maternal drug use/abuse. With respect to the second research line, in Chapter 4, this dissertation explores how the traditional civil servant recruitment process, that uses public examinations as means of access, may affect workers sick leave behavior. In this setting, candidates have to take passing exams that require a huge load of material to study, and therefore time. Candidates working while preparing for public exams may find it difficult to spend enough time on both tasks. Thus, they might experience increased stress/anxiety related to public service entrance exams. Using novel administrative data, this chapter finds a significant increase in health-related work absences several months before the examination date. This effect is stronger for individuals working in the education sector as well as for calls offering a large number of positions. This effect is mostly driven by stress-related absences. This chapter also finds evidence consistent with a deterioration in public sector workers’ health. Finally, the last empirical chapter of this dissertation examines whether lockdown policies during the first wave of the Covid-19 pandemic differently hit formal employment for women as compared to those of men in the Ecuadorian labor market. The results show that the lockdown policy is associated with an increase in the number of unemployment spells of women working in the restricted economic activities, during the first wave of the Covid-19. In sum, this dissertation contributes to the literature studying the impact that exogenous events may have on health, with a particular focus on newborn's and worker's health.