| 1. |
- Christensen, Darin, et al.
(författare)
-
BUILDING RESILIENT HEALTH SYSTEMS : EXPERIMENTAL EVIDENCE FROM SIERRA LEONE AND THE 2014 EBOLA OUTBREAK
- 2021
-
Ingår i: Quarterly Journal of Economics. - : Oxford University Press (OUP). - 0033-5533 .- 1531-4650. ; 136:2, s. 1145-1198
-
Tidskriftsartikel (refereegranskat)abstract
- Skepticism about the quality of health systems and their consequent underuse are thought to contribute to high rates of mortality in the developing world. The perceived quality of health services may be especially critical during epidemics, when people choose whether to cooperate with response efforts and front-line health workers. Can improving the perceived quality of health care promote community health and ultimately help to contain epidemics? We leverage a field experiment in Sierra Leone to answer this question in the context of the 2014 West African Ebola crisis. Two years before the outbreak, we randomly assigned two interventions to government-run health clinics-one focused on community monitoring, and the other conferred nonfinancial awards to clinic staff. Prior to the Ebola crisis, both interventions increased clinic utilization and patient satisfaction. Community monitoring additionally improved child health, leading to 38% fewer deaths of children under age five. Later, during the crisis, the interventions also increased reporting of Ebola cases by 62%, and community monitoring significantly reduced Ebola-related deaths. Evidence on mechanisms suggests that both interventions improved the perceived quality of health care, encouraging patients to report Ebola symptoms and receive medical care. Improvements in health outcomes under community monitoring suggest that these changes partly reflect a rise in the underlying quality of administered care. Overall, our results indicate that promoting accountability not only has the power to improve health systems during normal times, but can also make them more resilient to emergent crises.
|
|
| 2. |
- de Quidt, Jonathan, et al.
(författare)
-
Depression through the Lens of Economics : A Research Agenda
- 2018
-
Ingår i: The Economics of Poverty Traps. - Cambridge, MA : University of Chicago Press. - 9780226574301
-
Bokkapitel (refereegranskat)abstract
- Major depressive disorder (MDD) is one of the most prevalent mental illnesses worldwide. Existing evidence suggests that it has both economic causes and consequences, such as unemployment. However, depression has not received significant attention in the economics literature, and existing work is almost entirely empirical. We see great potential for traditional, theoretical economic analysis to both develop new insights about depression, and to form new connections to other areas of economics. In this paper, we begin with an overview of the canonical symptoms of depression, identifying a set of key facts that lend themselves well to economic analysis. We illustrate these facts with descriptive analysis of data from Indonesia. We then discuss what we see as fruitful avenues for new theoretical work, building on those facts.
|
|
| 3. |
- de Quidt, Jonathan, et al.
(författare)
-
Measuring and Bounding Experimenter Demand
- 2018
-
Ingår i: The American Economic Review. - : American Economic Association. - 0002-8282 .- 1944-7981. ; 108:11, s. 3266-3302
-
Tidskriftsartikel (refereegranskat)abstract
- We propose a technique for assessing robustness to demand effects of findings from experiments and surveys. The core idea is that by deliberately inducing demand in a structured way we can bound its influence. We present a model in which participants respond to their beliefs about the researcher's objectives. Bounds are obtained by manipulating those beliefs with "demand treatments." We apply the method to 11 classic tasks, and estimate bounds averaging 0.13 standard deviations, suggesting that typical demand effects are probably modest. We also show how to compute demand-robust treatment effects and how to structurally estimate the model.
|
|
| 4. |
- Egger, Dennis, et al.
(författare)
-
Falling living standards during the COVID-19 crisis : Quantitative evidence from nine developing countries
- 2021
-
Ingår i: Science Advances. - : American Association for the Advancement of Science (AAAS). - 2375-2548. ; 7:6
-
Tidskriftsartikel (refereegranskat)abstract
- Despite numerous journalistic accounts, systematic quantitative evidence on economic conditions during the ongoing COVID-19 pandemic remains scarce for most low- and middle-income countries, partly due to limitations of official economic statistics in environments with large informal sectors and subsistence agriculture. We assemble evidence from over 30,000 respondents in 16 original household surveys from nine countries in Africa (Burkina Faso, Ghana, Kenya, Rwanda, Sierra Leone), Asia (Bangladesh, Nepal, Philippines), and Latin America (Colombia). We document declines in employment and income in all settings beginning March 2020. The share of households experiencing an income drop ranges from 8 to 87% (median, 68%). Household coping strategies and government assistance were insufficient to sustain precrisis living standards, resulting in widespread food insecurity and dire economic conditions even 3 months into the crisis. We discuss promising policy responses and speculate about the risk of persistent adverse effects, especially among children and other vulnerable groups.
|
|
| 5. |
- Egger, Dennis, et al.
(författare)
-
General Equilibrium Effects of Cash Transfers : Experimental Evidence From Kenya
- 2022
-
Ingår i: Econometrica. - 0012-9682 .- 1468-0262. ; 90:6, s. 2603-2643
-
Tidskriftsartikel (refereegranskat)abstract
- How large economic stimuli generate individual and aggregate responses is a central question in economics, but has not been studied experimentally. We provided one-time cash transfers of about USD 1000 to over 10,500 poor households across 653 randomized villages in rural Kenya. The implied fiscal shock was over 15 percent of local GDP. We find large impacts on consumption and assets for recipients. Importantly, we document large positive spillovers on non-recipient households and firms, and minimal price inflation. We estimate a local transfer multiplier of 2.5. We interpret welfare implications through the lens of a simple household optimization framework.
|
|
| 6. |
- Haushofer, Johannes, et al.
(författare)
-
Stress, Ethnicity, and Prosocial Behavior
- 2023
-
Ingår i: Journal of Political Economy. - : University of Chicago Press. - 0022-3808 .- 1537-534X .- 2832-9368 .- 2832-9376. ; 1:2, s. 225-269
-
Tidskriftsartikel (refereegranskat)abstract
- While observational evidence suggests that people behave more prosocially towards members of their own ethnic group, many laboratory studies fail to find this effect. One possible explanation is that coethnic preference only emerges during times of stress. To test this hypothesis, we pharmacologically increase levels of the stress hormone cortisol, after which participants complete laboratory experiments with coethnics and noncoethnics. We find mixed evidence that increased cortisol decreases prosocial behavior. Coethnic preferences do not vary with cortisol. However, in contrast to previous studies, we find strong and robust evidence of coethnic preference.
|
|
| 7. |
- Haushofer, Johannes, et al.
(författare)
-
Stress may increase choice of sooner outcomes, but not temporal discounting
- 2021
-
Ingår i: Journal of Economic Behavior and Organization. - : Elsevier BV. - 0167-2681 .- 1879-1751. ; 183, s. 377-396
-
Tidskriftsartikel (refereegranskat)abstract
- Recent work in behavioral economics has shown that stress increases choices of smaller, sooner gains relative to larger, later monetary gains. The simplest model that explains these findings is one in which stress increases the discount rate or present bias. A sharp test of this model is provided by intertemporal choices in the losses or effort domain: this model predicts that stress should lead to increased choice of larger, later losses or effortful tasks relative to smaller, earlier ones. Here we show suggestive evidence for the opposite result: using a laboratory experiment with 578 participants from informal settlements in Nairobi, Kenya, we find that stress increases choices of smaller, sooner outcomes across domains. Specifically, we show that the effect is present in monetary gains and losses, and effortful tasks; and for both a psychosocial stressor (Trier Social Stress Test), and the pharmacological elevation of stress hormone levels using hydrocortisone. Importantly, the results are statistically robust only in the absence of clustering, and should thus be regarded as tentative. However, they are at least initially consistent with a model in which stress increases discounting in the gains domain but decreases it in the losses and effort domains; or with a model in which stress decreases the utility of any future outcome. Thus, stress may affect intertemporal choice, but may do so through mechanisms other than a simple increase in discount rates or present bias.
|
|
| 8. |
- Hensel, Lukas, et al.
(författare)
-
Global Behaviors, Perceptions, and the Emergence of Social Norms at the Onset of the COVID-19 Pandemic
- 2022
-
Ingår i: Journal of Economic Behavior and Organization. - : Elsevier BV. - 0167-2681 .- 1879-1751. ; 193, s. 473-496
-
Tidskriftsartikel (refereegranskat)abstract
- We conducted a large-scale survey covering 58 countries and over 100,000 respondents between late March and early April 2020 to study beliefs and attitudes towards citizens’ and governments’ responses at the onset of the COVID-19 pandemic. Most respondents reported holding normative beliefs in support of COVID-19 containment measures, as well as high rates of adherence to these measures. They also believed that their government and their country’s citizens were not doing enough and underestimated the degree to which others in their country supported strong behavioral and policy responses to the pandemic. Normative beliefs were strongly associated with adherence, as well as beliefs about others’ and the government’s response. Lockdowns were associated with greater optimism about others’ and the government’s response, and improvements in measures of perceived mental well-being; these effects tended to be larger for those with stronger normative beliefs. Our findings highlight how social norms can arise quickly and effectively to support cooperation at a global scale.
|
|
| 9. |
- Koppel, Lina, 1988-
(författare)
-
Pain, Touch, and Decision Making : Behavioral and Brain Responses to Affective Somatosensory Stimulation
- 2020
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Stimulation of sensory nerves can give rise to powerful affective experiences. Noxious stimuli can give rise to pain, an unpleasant experience which, in turn, causes suffering and constitutes a major societal burden. Touch, on the other hand, can feel pleasant and plays an important role in social relationships and well-being. Slow, gentle stroking of the skin in particular has been shown to activate C-tactile (CT) afferents, which are thought to signal affective and socially relevant aspects of touch. However, little is known about how pain and affective touch influence everyday decision making.In Paper I, we investigated the effect of acute physical pain on risk taking and intertemporal choice. Participants (n = 109) performed a series of economic decision-making tasks, once while experiencing acute thermal pain and once in a no-pain control condition. Results indicated that pain increased risk taking for monetary gains but not for equivalent losses, and increased impatience.In Paper II, we investigated the effect of affective touch on betrayal aversion, altruism, and risk taking. Participants (n = 120) performed a series of economic decision-making tasks, once while being stroked on the forearm at CT-optimal speed using a soft painter’s brush and once in a no-touch control condition. Results indicated no effect of affective touch on any of the outcome measures.In Paper III, we investigated how the ability to affect an upcoming painful event via voluntary action influences cortical processing of ongoing somatosensory stimulation. fMRI data was collected from 30 participants while they performed a task that involved pressing a response button to reduce the duration of upcoming thermal stimuli. Whole-brain analyses revealed no significant task-related effects in brain regions typically involved in pain, except activation in a cluster in anterior cingulate cortex (ACC) was greater when upcoming stimulation was painful than when it was nonpainful. However, region-of-interest analyses in anterior insula (AI) and midcingulate cortex (MCC) indicated that the noxious nature of the upcoming stimulation, as well as the ability to affect it, influenced processing of ongoing stimulation in both of these regions. Activation in MCC, but not AI, also correlated with response times.Taken together, these studies contribute to the broader understanding of everyday decision making, and of how affective experiences such as pain and touch shape everyday decisions and behaviors.
|
|
| 10. |
- Sheen, Justin K., et al.
(författare)
-
The required size of cluster randomized trials of nonpharmaceutical interventions in epidemic settings
- 2022
-
Ingår i: Statistics in Medicine. - : Wiley. - 0277-6715 .- 1097-0258. ; 41:13, s. 2466-2482
-
Tidskriftsartikel (refereegranskat)abstract
- To control the SARS-CoV-2 pandemic and future pathogen outbreaks requires an understanding of which nonpharmaceutical interventions are effective at reducing transmission. Observational studies, however, are subject to biases that could erroneously suggest an impact on transmission, even when there is no true effect. Cluster randomized trials permit valid hypothesis tests of the effect of interventions on community transmission. While such trials could be completed in a relatively short period of time, they might require large sample sizes to achieve adequate power. However, the sample sizes required for such tests in outbreak settings are largely undeveloped, leaving unanswered the question of whether these designs are practical. We develop approximate sample size formulae and simulation-based sample size methods for cluster randomized trials in infectious disease outbreaks. We highlight key relationships between characteristics of transmission and the enrolled communities and the required sample sizes, describe settings where trials powered to detect a meaningful true effect size may be feasible, and provide recommendations for investigators in planning such trials. The approximate formulae and simulation banks may be used by investigators to quickly assess the feasibility of a trial, followed by more detailed methods to more precisely size the trial. For example, we show that community-scale trials requiring 220 clusters with 100 tested individuals per cluster are powered to identify interventions that reduce transmission by 40% in one generation interval, using parameters identified for SARS-CoV-2 transmission. For more modest treatment effects, or when transmission is extremely overdispersed, however, much larger sample sizes are required.
|
|
