Identity and Behaviors in the Presence of Social Mobility Barriers
Abstract: Do social mobility barriers matter to explain the systematic lower outcomes of marginalized communities? I approach the question theoretically, developing a model of identity transmission, with the presence of entry and exit costs. The intensity of identity of minority agents influence their compliance to the community prescribed behavior, which obstacles the undertaking of actions that are beneficial to one's well-being. Firstly, agents maximizes their intensity of identity. The results suggest that the higher the share of individuals going against the prescribed behavior, the lower will be the optimal intensity. Social mobility barriers mitigate this effect, with exit costs having a more important role in influencing the choice of the agents. For sufficiently high levels of social mobility barriers, the totality of the individuals will follow the community norm. Regarding the parental choice of behavior transmission, in the absence of social mobility barriers, the effort depends both on the actual share of agents that undertake the same action and on the expected future composition of the community. With the introduction of mobility costs, the optimal effort of socialization is systematically lower, leading faster to the corner solution for which all the agents follow the community norm and do not undertake any effort.
Health-Seeking Responses to Malaria under National Control Policies: Evidence from Burkina Faso
Abstract: Malaria remains one of the most significant public health challenges in Burkina Faso, with high incidence and mortality rates persisting over time. To address this burden, the government has implemented two major health policies: the Seasonal Malaria Chemoprevention (SMC) strategy, progressively rolled out between 2014 and 2018 and achieving full national coverage in 2019, and the introduction of free healthcare in 2016 for children under five years of age and pregnant women. This study aims not only to evaluate the impact of these two policies on malaria incidence and mortality, leveraging the staggered nature of their implementation. In addition, it explores the factors that may limit the full effectiveness of these interventions, focusing on sociodemographic disparities, the influence of cultural practices on preventive health behaviors, and the ongoing conflict events that have affected the country since 2015. The analysis combines multiple data sources, including Malaria Atlas Project (MAP) data on malaria incidence, mortality, and insecticide-treated net (ITN) use (at 5 km × 5 km resolution) from 2000 to 2021, several geolocated waves of the Demographic and Health Surveys (2003, 2010, 2014, 2017-2018, and 2021), ACLED conflict data and health facility locations retrieved from OpenStreetMap
Does social exclusion influence health disparities? Comparative analysis of Roma and non-Roma communities in the Balkans, with Laetitia Duval (CES) and Nathan Green (UCL)
Abstract: Roma communities represent the largest and most marginalized ethnic group in Europe. They experience a lower life expectancy, higher rates of communicable and non-communicable diseases, insufficient immunization, and unequal access to health services compared to non-Roma. This paper aims to empirically assess the impact of social exclusion on healthcare access, comparing Roma and non-Roma individuals. The analysis uses data from the Western Balkans collected in the 2017 UNDP-WB-EC Regional Roma Survey, one of the most current available sources of information on Roma communities. Our findings indicate that non-conforming attitudes to mainstream values negatively affect the access to medical screenings. The results remain robust after balancing baseline characteristics and adjusting for confounding through various matching methods. Furthermore, the impact of social exclusion is significantly stronger for Roma communities, representing one of the main contributors to health disparities. In fact, once investigating the potential mechanisms, Roma who conform more to mainstream values have greater trust in conventional medical care, assign a higher importance to their own health, and have a stronger demand for insurance coverage. The findings suggest a required attention for policy makers on the peculiar features of Roma communities, which could undermine the effectiveness of targeted policies if they are solely aimed at bringing the sociodemographic levels of Roma up to the level of the mainstream society.
Assessing the Impact of Health Mediators on the Well-Being of Roma Communities in Europe: A Pathway to Improved Health Equity
Abstract: Roma Health Mediation (RHM) Programs have been deployed gradually since 2004 in numerous countries, regions and municipalities throughout Europe. RHMs are Roma individuals who are trained to represent a bridge between the community and the mainstream society, assessing the needs of the families, offering assistance to set up medical appointments and providing health education. By employing a multiple time periods Difference-in-Differences (DiD) estimator it is possible to disentangle the effect of the Health Mediator Programs both on the strength of community norms and on healthcare access, by comparing Roma individuals that have been treated with those not treated or not-yet treated.