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  5. Randomized Experiments Worldwide with Implications for Health
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Randomized Experiments Worldwide with Implications for Health

Paper Session

Saturday, Jan. 6, 2024 2:30 PM - 4:30 PM (CST)

Grand Hyatt, Bonham C
Hosted By: International Health Economics Association
  • Chair: John Cawley, Cornell University

The Effect of Activities-Based Subsidy on Fat Loss

Kegon Teng Kok Tan
,
University of Rochester
Andrea Park Chung
,
FTI Consulting
Ta-Cheng Huang
,
National University of Singapore
Noah Lim
,
University of Singapore

Abstract

Obesity is an increasingly important factor in generating medical burden through multiple comorbidities including diabetes, hypertension, coronary heart disease, and cancer. This costly disease is complex and persistent. While the literature has found that cash incentives can work in the short run, these benefits tend not to last in the medium to long term. This study proposes a subsidy-based alternative where health activities are incentivized instead of weight loss. In a randomized controlled trial for overweight women in Singapore over a three month period, we find significant reductions in fat and weight for both cash and subsidy based incentives. However in the subsequent 3 months after the treatment, subsidy incentives significantly outperform the cash group. These findings imply that a subsidy on health activities may lead to more sustained weight loss and pave the way for greater cost effective obesity interventions.

The Effects of Public Housing on Health, Wellbeing, and Healthcare Utilization

Valentina Duque
,
American University
Diana Oquendo
,
University of the Andes
Fabio Sanchez
,
University of the Andes

Abstract

Using a nationwide experiment in Colombia that randomized over 30,000 housing units across highly disadvantaged groups, we investigate the effects of public housing on health and healthcare use. Our findings are as follows: i) using a survey on self-reported health outcomes, we find that lottery winners are less likely to experience health problems and more likely to enjoy mental wellbeing and life satisfaction years after the lottery; ii) leveraging administrative records on doctor visits, emergency room (ER) use, and hospitalizations we find significant declines in doctor visits due to respiratory conditions among children, fewer ER visits due to respiratory problems and infections among adults, and a large decline in the probability of death among the elderly. The program also reduced teen pregnancy. Our results shed light on the protective effect of improved housing conditions on health and wellbeing in developing countries.

Offering Vaccines to Communities: The Impact of Nurse Visits on Vaccination Rate

Elisa Maffioli
,
University of Michigan
Leah Rosenzweig
,
University of Chicago
Michael Kremer
,
University of Chicago
Kevin Carney
,
University of Chicago
Wendy Wong
,
University of Chicago

Abstract

We examine the impact of a vaccination campaign in Kenya inviting adults to obtain a COVID-19 vaccine at a nearby location. We find that these household visits increased vaccination rates by 8-9 percentage points, a 100% and 47% increase over the control vaccination rate at 1 week and 3 months after the intervention, respectively. A machine learning analysis reveals that treatment effects are largest among individuals farther from health centres, those with lower income and who are less educated and more satisfied with government health provision. While household outreach can be resource intensive, a policy targeting these subgroups could improve efficiency. Despite potential concerns, there is no evidence that these household visits create undue social pressure to get vaccinated. We test for social pressure using an approach pioneered by DellaVigna et al. 2012 and 2016 in the contexts of charitable giving and voting. We import this approach to the health domain by randomly announcing the vaccination offer ahead of time, allowing people who do not want to be vaccinated to avoid the household visit without incurring a social cost of declining the offer. The announcement has no effect on whether the individual is found at home but increases the vaccination rate by 4 percentage points. This effect is driven by those over 50 years old, who are at higher risk of severe disease. These results suggest that addressing convenience barriers can have a substantial impact on uptake and that this impact is not a result of undue social pressure.

Discussant(s)
Mariana Carrera
,
Montana State University
Jee-Hun Choi
,
Lehigh University
Laura Grigolon
,
University of Mannheim
Christopher Whaley
,
RAND Corporation
JEL Classifications
  • I1 - Health
  • Y9 - Other