Abstract: Demand for preventive health information is low, but it remains unclear whether inattention to future health risks and consequences drives this low demand. Via a randomised online experiment in India, I evaluate the effectiveness of a story about living with diabetes in increasing demand for preventive health information. This intervention is aimed at making the likelihood of developing serious health problems, and their impacts on life and family, feel more relatable and memorable, thereby increasing their salience and sustaining this salience. I then examine whether this intervention influences individuals’ choices to access articles on disease prevention. First, I document that in the control group, demand for a diabetes prevention article is low, even when access is cost-free. The intervention increases this demand by nearly a half. Additionally, I find a spillover effect: the intervention raises respondents’ demand for a second health article unrelated to diabetes or themselves but relevant to their spouses. However, this effect occurs only among individuals who believe their spouses know less about this piece of spouse-related information than they do. My findings suggest that stories that make future health risks and consequences salient should be integrated into health information dissemination campaigns to increase demand.
Abstract: The roll-out of antiretroviral therapy (ART), an HIV treatment, since 2000 has been found to dramatically improve HIV survival and increase adult life expectancy. We exploit the roll-out of ART in rural Malawi and provide national-level evidence on the effects of ART on an extensive array of health and economic outcomes. Combining a nationally representative survey data set with administrative data from Malawi’s Ministry of Health on health clinics, we construct a spatial and temporal variation in ART availability and estimate a difference-in-difference model. We find that access to the life-saving therapy significantly reduced illness-related prime-age mortality and morbidity. ART roll-out explains 60 per cent of the total decline in illness-related prime-age mortality observed in our data between 2004 and 2016. This improved health is accompanied by a significant increase in the work time of casual labour by 22 per cent but not in other activities, such as agriculture. This increase in work time did not change income, total expenditure and assets owned. Despite the null effects on economic well-being, we detect substantial effects on household expenditure on health and education. Our findings suggest that ART availability may have created surplus labour in a mainly rural economy like Malawi so that increased ability to work and human capital investments did not translate into improved economic well-being.
Abstract: Does a public health insurance affect people’s health in low-to-middle-income countries in medium to long term? I exploit the introduction of the New Cooperative Medical Scheme (NCMS) in China to examine its effects on health care utilisation and health conditions at the beginning of the intro- duction and after up to 12 years of coverage. By using a large panel of individuals from the China Health and Nutrition Survey and the staggered county-to-county roll-out of the NCMS, I estimate a difference- in-difference model to identify the effects of the NCMS. I finds that the NCMS had no impact on health outcomes in the short and medium term. This is because, rather than increasing health care utilisation, the NCMS increased out-of-pocket expenditure and slightly decreased outpatient visits. These results, though peculiar, are consistent with the finding in the literature that the NCMS incentivised healthcare suppliers to provide high-margin but non-essential medical services that may drive up user charges.