期刊-NBER美国国民经济研究局-spring2004_60页_714kb

NBER Spring 2004 Summary

Core Content

The NBER Reporter Spring 2004 issue provides an overview of the latest research from the NBER's Program in Health Economics. It highlights studies on substance use, alcohol abuse, illegal drug use, obesity, schooling and health, unemployment, welfare reform, and the cost of medical care.

Main Research Topics and Findings

1. The Economics of Substance Use

• Cigarettes:

  • Cigarette tax increases are effective in reducing smoking, particularly among pregnant women.
  • A 10% increase in cigarette prices leads to a 10% increase in quit rates.
  • A 30-cent tax increase has the same effect as prenatal smoking cessation programs.
  • Price hikes also encourage young adult smokers to quit and discourage teenagers from starting.

• Alcohol Abuse:

  • Alcohol taxes and price changes affect binge drinking, violent behavior, and risky sexual behavior.
  • A $1 increase in the real price of a drink reduces the likelihood of transitioning to binge drinking by 33%.
  • A 10% increase in beer prices reduces binge drinking among high school students by 2–5%.
  • Alcohol advertising encourages underage drinking, especially among females.
  • Eliminating alcohol advertising could reduce binge participation from ~12% to ~7%.

• Illegal Drug Use:

  • Marijuana use is sensitive to price changes, with a 10% price increase leading to a 2% decrease in use.
  • The rise and fall of marijuana use correlate with media campaigns highlighting its harms.
  • Alcohol and marijuana are complements, with price increases in alcohol leading to reduced use of both.

2. The Economics of Obesity

• Obesity has become a major public health concern, with the percentage of obese adults doubling since the late 1970s and children tripling.
• Factors contributing to the obesity epidemic include:
  • The growth of fast-food and full-service restaurants.
  • Reductions in real food prices.
  • Technological advances lowering the time cost of home meal preparation.
• Studies suggest that the rise in obesity may be an unintended consequence of economic progress.

3. Determinants of Health and Schooling

• Formal schooling is strongly correlated with better health outcomes.
• Schooling and Health:
  • Additional years of schooling reduce the probability of death by 1.3–3.6 percentage points.
  • More educated individuals respond more quickly to new health information and medical technologies.
  • The negative effects of schooling on mortality are most pronounced for diseases and cancers with rapid progress in treatment.

4. Unemployment and Health

• Unemployment and Health Indicators:
  • Health indicators improve during recessions, even though unemployment rises.
  • A 1% decrease in the unemployment rate is associated with a 0.4% rise in total mortality.
  • This may be due to increased physical activity and reduced smoking and obesity during downturns.

5. Welfare Reform and Health Outcomes

• PRWORA (1996) introduced work requirements, time limits, and family caps, affecting welfare recipients.
• Health Impacts:
  • Welfare reform did not significantly reduce non-marital childbearing among high-risk women.
  • It had limited effects on prenatal care and infant health.
  • However, it may have improved certain healthy behaviors, such as reducing binge drinking and increasing physical activity.

Key Information

• NBER's National Presence: The Health Economics Program has expanded nationally and grown significantly in research scope.
• Funding Sources: Research is supported by various federal agencies and private foundations.
• Free Data Service: NBER offers a free email service to receive links to U.S. government data releases.
• Research Techniques: Program members use methods like instrumental variables, fixed effects, and natural experiments to explore causality in health-related studies.
• Healthcare Costs: The cost of medical care is heavily influenced by hospital inputs, particularly the interest rates on tax-exempt hospital bonds.
• Bond Market Competition:
  • Issuer competition increases interest rates by 22 basis points.
  • Underwriter competition could reduce interest rates by 54 basis points.
  • These changes could lead to significant savings in healthcare costs.

NBER Organization and Leadership

• President and CEO: Martin Feldstein
• Vice President for Administration and Budget: Susan Colligan
• Controller: Kelly Horak
• Board of Directors includes prominent economists from various institutions and organizations.
• Directors by Appointment: Some members are appointed by external organizations, reflecting the NBER's broad influence in economic research.

Conclusion

The NBER Spring 2004 issue underscores the program's expanding research scope and the significant role of economic factors in shaping health outcomes. It provides insights into how policies related to taxation, education, and welfare reform influence behaviors such as smoking, drinking, and drug use, as well as broader health and economic indicators. The studies also highlight the importance of understanding causality in social sciences and the potential for economic tools to improve public health.