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  3. 2022
  4. Preliminary Program
  5. Non-Pandemic Infectious Disease in Developed Countries
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Non-Pandemic Infectious Disease in Developed Countries

Paper Session

Saturday, Jan. 8, 2022 10:00 AM - 12:00 PM (EST)

Hosted By: American Economic Association
  • Chair: David Cutler, Harvard University

The Role of Socio-Economic Position in Determining Mortality: Evidence from Four Decades of Flu Epidemics

Jérôme Adda
,
Bocconi University
Thomas Le Barbanchon
,
Bocconi University

Abstract

The recent COVID epidemic put emphasis on the importance of infectious diseases, especially for an aging population. While cardiovascular and cancer deaths are well recorded, deaths from respiratory diseases such as flu-like illnesses are difficult to characterize and are often poorly classified. The consequence is that most countries have only an educated guess of its importance, and little is known about the socio-economic drivers of these types of illnesses. A priori, diseases afflict poorer individuals more. However, as age is a key trigger of mortality for this type of disease in an elderly population, individuals with high SES are proportionally more numerous and more likely to be victims. To make progress, this paper exploits three different datasets. The main one is the universe of deaths certificates in France over a period of 50 years, where full names and birth date are public information. Namely, the registers contain the first name which is associated with socio-economic status. We then use labor force surveys which contain both first names and socio-economic markers, to compute a set of socio-economic indicators for each birth cohort and first name cell. Finally, we exploit high frequency data on the prevalence of successive flu epidemics at the local level over many decades. We develop a methodology to infer the role of age and socio-economic position on the likelihood of flu-like related deaths, based on duration models stratified by first names and calendar years.

When Externalities Collide: Influenza and Pollution

Joshua Graff Zivin
,
University of California-San Diego
Matthew Neidell
,
Columbia University
Nicholas Sanders
,
Cornell University
Gregor Singer
,
London School of Economics

Abstract

Influenza and air pollution each pose significant public health risks with large global economic consequences. The common pathways through which each harms health presents an interesting case of compounding risk via interacting externalities. Using instrumental variables based on changing wind directions, we show increased levels of contemporaneous pollution significantly increase influenza hospitalizations. We exploit random variations in the effectiveness of the influenza vaccine as an additional instrument to show vaccine protection neutralizes this relationship. This suggests seemingly disparate policy actions of pollution control and vaccination campaigns jointly provide greater returns than those implied by addressing either in isolation.

Worth a Shot? Measuring Off-Target Effects of Measles Vaccination on Human Capital in the United States

Alex Becker
,
Stanford University
Caroline Chuard
,
University of St. Gallen
Masahiko Haraguchi
,
Kyoto Research Institute for Humanity and Nature
Hannes Schwandt
,
Northwestern University

Abstract

This paper analyzes the long-term consequences of the near-elimination of measles in the 1960s on societal outcomes in the United States. Measles infections are known to erase the immune memory obtained in prior disease exposure, leading to episodes of heightened non-measles mortality and disease in the years following an infection. We use historic state-level counts of measles cases and an accounting model based on the SIR model to estimate the share of individuals ever infected with measles by state and birth cohort. This measure of measles burden is then related to medium-term mortality and long-term human capital and labor market outcomes. We find that reductions in measles exposure does not only decrease measles mortality but also mortality due to other diseases. In the long run, less exposed cohort have more education, higher incomes, and lower disability rates. Our estimates suggest that the benefits of these off-target effects of measles vaccination strongly exceed the direct benefits of a reduction in measles cases.

Diversity of Investigators and Willingness to Participate in Vaccine Trials

Marcella Alsan
,
Harvard University
Romaine Campbell
,
Harvard University
Tomi Ojo
,
Harvard University
Lukas Leister
,
Harvard University
Nick Shankar
,
Harvard University

Abstract

Increasing the diversity of investigators has been suggested to improve recruitment of underrepresented groups in trials. We survey the extent to which diverse investigators would increase the willingness to participate in a clinical trial among Black and White men. We randomized survey participants to view images of either Black or White medical experts and assessed their willingness to engage in a vaccine clinical trial. We find that survey participants were twice as likely to participate in vaccine clinical trial research if the lead investigator was perceived to be a Black physician. Our findings support advocacy to bolster financial support for STEM pipeline programs targeting Black and African American students, increased NIH funding for Black scientists and highlight the need for interventions that address investigator-level factors influencing diverse research participation.

Discussant(s)
Douglas Almond
,
Columbia University
Atheendar Venkataramani
,
University of Pennsylvania
Aline Bütikofer
,
Norwegian School of Economics
Casper Worm Hansen
,
University of Copenhagen
JEL Classifications
  • I1 - Health