Embedded Files
Rong Fu, Yunkyu Sohn, Yichen Shen, & Haruko Noguchi. (2026). Invisible Threat, Tangible Harm: Radiation Anxiety and Birth Outcomes After Fukushima. Journal of Health Econoimics.
Abstract
Identifying causal effects of prenatal psychological stress on birth outcomes is challenging because stressful events typically bundle psychological stress with material disruptions. The 2011 Fukushima nuclear accident provides a unique setting to overcome this challenge: while physical radiation exposure was geographically limited and well-documented, fear of radiation spread nationwide. We exploit this geographic separation to examine how maternal anxiety independently affects fetal development. Using universal Japanese birth records linked to census data, combined with a novel Google Trends-based measure of radiation-specific anxiety, we employ three complementary identification strategies: population-level comparisons of in-utero exposed versus unexposed cohorts, within-family sibling analysis controlling for time-invariant family characteristics, and dose-response estimation exploiting geographic variation in anxiety intensity. Experiencing the accident during pregnancy increased preterm births by 17% and reduced birth weights by 22–26 grams. Birth outcomes exhibit a clear dose-response relationship with anxiety intensity, with radiation-specific anxiety accounting for 72–79% of the overall preterm birth effects and 28–37% of the overall birth weight effects. Effects are concentrated among socioeconomically disadvantaged mothers and during first-trimester exposure, with the most severe impacts on already-vulnerable infants in the very low and extremely low birth weight categories. Our findings indicate that invisible threats generate measurable intergenerational health impacts through psychological stress pathways, with implications for disaster preparedness and risk communication during contemporary crises from pandemics to climate change.
Yichen Shen. (2025). Does education affect fertility timing? Evidence from Taiwan. China Economic Review.
Abstract
This study investigates the causal effect of Taiwan's 1968 compulsory schooling laws (CSLs) on fertility timing for women using a fuzzy regression discontinuity approach. I demonstrate that the CSLs have delayed women's fertility timing. The estimates reveal that the CSLs reduced the probability of women having children for first and second births at a young age and increased the probability of having children at an older age for first and second births, implying an intertemporal substitution of childbirth for these births. My investigation of the mechanisms involved indicates that women delaying marriage drove this relationship. Overall, the findings indicate that the CSLs have significantly affected the fertility timing of women in Taiwan.
Yichen Shen & Haruko Noguchi. (2021). The Effect of Coverage of Smoking-Cessation Aids on Tobacco Use Outcomes: Evidence from Canada. Health Economics.
Abstract
In clinical trials, smoking-cessation aids (SCAs) have proven to be effective at improving the odds of smoking cessation. Because of the effectiveness of SCAs in these settings, many countries have adopted the coverage of SCAs to reduce tobacco use. However, the effect of such coverage on tobacco use is ambiguous. On one hand, the coverage may have the intended effect and reduce tobacco use. On the other hand, the coverage may cause beneficiaries to participate in tobacco use more as the drug coverage protects beneficiaries from future costs associated with tobacco use. To understand the effect of SCA coverage, we examine it using 2008–2012 Canadian Tobacco Use Monitoring Survey and a difference-in-differences approach. We find that SCA coverage increases cigarette and cigarillo use. Moreover, the effect of SCA coverage on tobacco use is stronger in men and in those with at least a college education. Our results point to the unintended consequences of the coverage of SCAs on tobacco use.
Yichen Shen, Rong Fu, & Haruko Noguchi. (2021). COVID-19's Lockdown and Crime Victimization: The State of Emergency Under the Abe Administration. Asian Economic Policy Review.
Abstract
COVID-19 has led many governments to impose lockdowns in efforts to reduce the spread of the virus. One of the many consequences of the lockdown is a reduction in crime. We apply a difference-in-differences approach to the 2018–2020 Crime Statistics to investigate the effect of the 2020 lockdown on crime victimization in Japan. We find that the 2020 lockdown leads to 12.7% and 20.9% declines in violent and property crime victimization rates per 100,000 people, respectively. Moreover, we observe that premeditated crimes, such as breaking-and-entering and sexual assault, decline more than non-premeditated crimes, such as homicide. We also explore the heterogeneous effects of the lockdown by age groups. We observe that there is a significant decline in sexual assault victimization for those between the ages of 0 and 29, and there are significant declines in overall violent and property crime victimizations and their subtypes for those between ages of 30 and 59. Finally, we show that there is an improvement in suicide rates, which suggests that better mental health is the mechanism partially mediating the relationship between lockdown and crime victimization.
Rong Fu, Yichen Shen, & Haruko Noguchi. (2020). The Best of Both Worlds? The Economic Effects of a Hybrid Fee‐for‐Service and Prospective Payment Reimbursement System. Health Economics.
Abstract
Countries seeking to move away from a purely fee-for-service (FFS) system may consider a hybrid approach whereby only some procedures are paid by FFS while others are paid prospectively. Yet little evidence exists whether such a hybrid payment system contains overall costs without adverse influences on health outcomes. In 2003, Japan experienced a reform from FFS to a hybrid payment system in which only some inpatient procedures were paid prospectively. We exploit this reform to test how such a hybrid system affects overall costs and health outcomes. Briefly, we find that healthcare providers responded opportunistically to the reform, moving some procedures out of the bundled inpatient setting to FFS services, leading to no reduction in cost. There was some evidence of a moderate deterioration in health outcomes, in terms of a decline in the probability of symptoms being cured at discharge. In sum, our results suggest that in some cases, a hybrid payment system can be non-superior to either FFS or prospective payment system.
Google Sites
Report abuse