I am a research fellow at the Center for Primary Care and Public Health in Lausanne, affiliated to the Lausanne Center for Health Economics, Behavior, and Policy (LCHE) at the University of Lausanne.
My research interests are in the fields of Health Economics and Economics of Conflict, with a focus on applied questions. My ORCID profile can be found here: Nathalie Monnet (0000-0001-5939-4057) - ORCID.
Contact: nathalie.monnet@unisante.ch
The Policy Exposome of Dementia: Gaps, Opportunities, and a Research Agenda to Integrate Policy Analysis into Dementia Research. with Kieny C, Bourgeois M, Marks G, Atshan S, Brayne C, Dow W, Glymour M, Knapp D, Livingston G, Papanicolas I, Platt EA, Rehkopf D, Sadana R, Suvarna A, Vargas Lopez F, Wallace L, Walsh S, Wenner M, Avendano M. Alzheimer's & Dementia (2026). Link
The Impact of Education on Dementia? Causal Evidence from Compulsory Schooling Reforms in England. With Mauricio Avendano, Clémence Kieny and Emma Nichols. Social Science & Medicine (2026). Link
Shutdown Policies and Worldwide Conflict. With Nicolas Berman, Mathieu Couttenier & Rohit Ticku. [Latest Version + Online Appendix] [Covid Economics: Vetted and Real-Time Paper - CEPR Press 16, May 2020] Journal of Comparative Economics, Volume 50, Issue 1, March 2022, p. 240-255. Link
Conflict in Times of Covid-19. With Nicolas Berman, Mathieu Couttenier & Rohit Ticku.
CEPR e-book COVID-19 in Developing Economies, Chapter 9, June 2020.
French publication: Les conflits à l'heure de la Covid-19, Revue internationale de politique de développement.
Digital Mental Health at Scale: Impacts on Education, Economic Outlook, and Mental Health of Vulnerable Young Adults
with Mauricio Avendano, Armando N. Meier, Clémence Kieny, Martha Escobar Lux, Fabio Idrobo, Laura Torres-Cuéllar, Andrea Carolina Bello-Tocancipá, Juan Vargas-Nieto, Gustavo Adolfo Perdomo Patino, Ricardo Araya, Naomi Koerner
Submitted
[Abstract ▾] [Pre-Analysis Plan] [AEA RCT registration] [Data] [Replication package]
Poor mental health may hinder the success of low-income young adults, but most have no access to mental health and well-being support. While small-scale trials suggest that digital mental health support technologies hold promise, there is no largescale trial assessing their causal impacts on both mental health and economic outcomes. This preregistered experiment (n = 14,688) was embedded at scale in an existing nationwide public program providing educational subsidies to over 360,000 vulnerable university and vocational or technical training students in Colombia. The 10-week self-guided transdiagnostic intervention, grounded in cognitive behavioral therapy, was developed by psychologists and co-designed with vulnerable students and government officials. The unique combination of rich administrative and survey data allows us to study whether and how access to the digital technology affected mental health symptoms, educational performance, future orientation, including self-control, and economic outlook. Using prespecified analyses, we find reduced symptoms of depression and anxiety (p<0.001) with effects lasting 3 months. The effects are larger for those with worse mental health and users of the technology. The effects mirror improvements in targets of the intervention: higher behavioral activation and sleep satisfaction. On the other hand, there is no improvement in educational attainment, except for students who completed all platform modules, where we observe higher grades and lower dropout. We find no impacts on self-control, aspirations, or economic outlook. In sum, digital mental health at scale reduces symptoms, but alone does not guarantee better education. Our experiment shows that government social programs can benefit from incorporating mental health support and identifies success factors.
Project website: https://unil.ch/youthwellbeing/
The Burden of Inaction: A Cost-of-Illness and Return-on-Investment Analysis of Child and Adolescent Overweight and Obesity in Indonesia
with Antoine Habib, Giulio Cisco, David Colozza, Joachim Marti, Mauricio Avendano, Siti Nadia Tarmizi.
R&R
[Abstract ▾] [Replication package]
Child and adolescent overweight and obesity impose substantial long-term health and economic burdens. In Indonesia, the prevalence of overweight and obesity is rising rapidly, yet evidence quantifying their lifetime economic consequences and the potential returns of preventive policies remains limited. We apply a Cost-of-Illness framework to estimate the lifetime economic burden attributable to overweight and obesity in a cohort of Indonesian children and adolescents. The model incorporates direct healthcare costs, indirect productivity losses (through labor market and schooling), and health losses measured in disability-adjusted life years (DALYs), monetised at GDP per capita. We assess three evidence-based interventions, sugar-sweetened beverage (SSB) taxation, front-of-pack nutrition labelling (FOPNL) and marketing restrictions, individually and as a combined package, and calculate their return on investment (ROI). Without intervention, overweight and obesity are projected to cost Indonesia USD 268 billion (95% uncertainty interval [UI] 188–450) over the cohort’s lifetime (2022-2097, discounted, 2023 prices), equivalent to USD 9.0 billion per year or 0.7% of 2023 GDP. Monetised DALYs account for 83% of this burden, and healthcare and productivity costs for USD 47 billion (17%). The combined package generates USD 24 billion in gains (USD 3.8 billion in healthcare and productivity) and averts 4.2 million DALYs (95% UI 2.1–9.4). The SSB tax is the most cost-effective intervention, returning USD 1,363 (95% UI 616–3,427) per dollar invested (USD 175 from healthcare and productivity gains alone), and the package USD 305 (95% UI 149–696; USD 48). It remains the most cost-effective policy in all deterministic sensitivity analyses and in 99.4% of probabilistic simulations. Preventive action targeting childhood overweight and obesity yields substantial health and economic benefits in Indonesia. These gains strongly support implementing fiscal, informational and regulatory measures as part of a national obesity prevention strategy.
The Aggregate Cost of Local Conflict
with Mathieu Couttenier and Lavinia Piemontese
[Previously circulated as The Economic Costs of Conflict: a Production Network Approach, CEPR Discussion Paper No DP16984, Feb. 2022]
Submitted
[Abstract ▾]
We develop a novel approach for estimating the economic costs of conflict, using the production network as the primary mechanism through which the disruptive effects of localized conflict spread to peaceful areas. Applying this approach to the Maoist insurgency in Eastern India from 2000 to 2009, we quantify the overall impact of conflict, taking network propagation into account. Our key finding reveals that a one percentage point increase in conflict-induced distortion is associated with an average annual decrease of 0.236% in aggregate output. Notably, 73% of the total output loss can be attributed to network propagation.
Hit them in the Wallet! An Analysis of the Demonetization as a Counter-Insurgency Policy
with Edoardo Chiarotti
[Abstract ▾] [Latest Version + Online Appendix] [IHEID Working Paper]
This paper investigates the causal link between the cash nature of the finances of organized armed groups and their subsequent violent activities. We use the sharp cash shortage that followed the 2016 Indian Banknote Demonetization as a natural experiment. The severity of the shortage in different districts is measured using the spatial distribution of demonetized and newly introduced notes. We construct a unique and rich dataset on daily violent events, fatalities and surrenders of the Maoist insurgents in India between 2006 and 2018. Our results suggest that there is a general reduction in violence after the policy in districts experiencing more severe cash shortage, and a positive impact on surrenders of Maoist extremists. Second, we find that the increase in the trend of surrenders is mitigated where Maoists have higher abilities to raise funds, through three traditional sources of revenue, i.e. the extortion of public work contractors, mineral and forest resources. This paper provides the first study on the importance of cash in illegal activities and an ex-post evaluation of a policy countering illicit cash flows.
Ceasefires during Armed Conflict and Mental Health Service Utilization: A Difference-in-differences Study of the Colombian Peace Agreement
with Maria Camila Garcia Duran, Crick Lund, Mauricio Avendano
R&R
[Abstract ▾]
A temporary ceasefire, a common feature of peace negotiations, may affect mental health care service utilisation in opposing ways: it may improve access to care while reducing the need for care. We estimate the effect of the unilateral ceasefire declared by the Revolutionary Armed Forces of Colombia (FARC) in December 2014 on mental health service utilisation, using municipality-level administrative records for 1,121 Colombian municipalities between 2012 and 2020. We apply a difference-in- differences design, comparing changes in utilisation between municipalities with higher and lower pre-ceasefire exposure to FARC violence, before and after the ceasefire. Our findings show that mental health service use increased more slowly in municipalities with greater conflict exposure relative to less affected municipalities, corresponding to a shortfall in utilisation growth. In our preferred specification, this differential increase was 30.9 cases per 100,000 population lower (95% CI -51.8 to - 10.0), a 4.0% reduction relative to the pre-ceasefire average. The effect emerged gradually after the ceasefire and persisted when the COVID-19 period was excluded. Possible explanations include the relocation of health workers out of formerly conflict-affected areas once mobility restrictions eased, persistent distrust between communities and state services, and, potentially, a reduction in underlying need. These findings suggest that conflict de-escalation alone may not increase the utilisation of mental health services. Understanding whether this is the result of reduced underlying need or a reduction in the supply of mental health services is essential to the design of effective policies to address the mental health care needs of populations affected by war and conflict.
COVID-19 Containment Policies, Time Use and the Mental Health of Older Adults during the COVID-19 Pandemic: Longitudinal Evidence from Europe.
with Jeanne Berche, Joachim Marti, Mauricio Avendano
Submitted
[Abstract ▾]
We study the causal impact of COVID-19 containment measures on the mental health of older adults using longitudinal data from the Survey of Health, Ageing and Retirement in Europe. Exploiting quasi-random variation in interview timing and estimating individual fixed-effects models, we identify within-person changes in mental health outcomes attributable to cumulative exposure to containment policies. Stricter containment measures are associated with statistically significant reductions in the probability of reporting depressive symptoms and sleeping troubles, while no robust effect is found for loneliness. A one-standard-deviation increase in cumulative containment exposure is associated with a 10.4 percentage-point reduction in depression and a 4.6 percentage-point reduction in sleeping troubles. We further show that these mental health benefits attenuate with longer exposure duration. We examine heterogeneity in these effects by pre-pandemic daily activity patterns. The protective association between containment exposure and depression is significantly stronger among individuals who devoted more time to paid work and commuting prior to the pandemic. For sleeping troubles, stronger protective effects are observed among individuals with higher pre-pandemic leisure time, whereas those with higher baseline sleep time experience worse sleep outcomes as restrictions accumulate. Overall, our findings challenge the view that containment measures uniformly harmed mental health. For older adults, stricter restrictions did not lead to systematic mental health deterioration and may have conferred psychological benefits and these effects are shaped by individuals’ pre-pandemic routines.
The Long-Run Impact of Primary Education on Women's Late-Life Cognitive Function in India. (with Mathéo Bourgeois, Clémence Kieny, Mauricio Avendano)
A Note on the Economics of Philanthropy. with Ugo Panizza. Prepared for the Conference Rethinking global philanthropy: Can philanthropy bridge the development gap?, October 12, 2017. Media Coverage: Le Temps. [Working paper] [Data]
Domestic Violence and the Labor Market: Evidence from Switzerland. [Working paper]