We exploit changes in child benefits in Canada to study the impact of family income on child and family well-being. Using variation in child benefits across province, time, and family type, we study ...outcomes spanning test scores, mental health, physical health, and deprivation measures. The findings suggest that child benefit programs had significant positive effects on test scores, maternal health, and mental health, among other measures. We find strong and interesting differences in the effects of benefits by child sex: benefits have stronger effects on educational outcomes and physical health for boys, and on mental health outcomes for girls.
We set out to explore how precarious workers, particularly those employed in the gig economy, balance financial uncertainty, health risks, and mental well-being. We surveyed and interviewed ...precarious workers in France during the COVID-19 crisis, in March and April 2020. We oversampled gig economy workers, in particular in driving and food delivery occupations (hereafter drivers and bikers), residing in metropolitan areas. These workers cannot rely on stable incomes and are excluded from the labor protections offered to employees, features which have been exacerbated by the crisis. We analyzed outcomes for precarious workers during the mandatory lockdown in France as an extreme case to better understand how financial precarity relates to health risks and mental well-being. Our analysis revealed that 3 weeks into the lockdown, 56% of our overall sample had stopped working and respondents had experienced a 28% income drop on average. Gig economy drivers reported a significant 20 percentage point larger income decrease than other workers in our sample. Bikers were significantly more likely to have continued working outside the home during the lockdown. Yet our quantitative analysis also revealed that stress and anxiety levels were not higher for these groups and that bikers in fact reported significantly lower stress levels during the lockdown. While this positive association between being a biker and mental health may be interpreted in different ways, our qualitative data led to a nuanced understanding of the effect of gig work on mental well-being in this population group.
The relationship between socioeconomic status (SES) and health is one of the most robust and well documented findings in social science. Anne Case et al. (2002) look at children in order to find the ...origins of the gradient, since the health of children may be assumed to have relatively little impact on their own socioeconomic status. They show that the well-known cross-sectional relationship between SES and health exists in childhood and is more pronounced among older than among younger children. This study confirms the results of Case et al. using a sample of Canadian children, despite the existence of universal health insurance coverage for doctor and hospital services in Canada. It finds that the gradient steepens in cross section, and that this result is robust to controls for cohort effects. However, little evidence is found that long-term effects of health shocks on future health are different for high-SES and low-SES children, even though in the short run, low-SES children suffer greater health losses than high-SES children after the arrival of a health shock. Instead, evidence is provided which suggests that the cross-sectional relationship between health, family income (or maternal education), and age arises primarily because low-income children are more likely to be subject to health shocks.
Industrial countries typically provide income transfers to families with young children. Traditionally, these family benefit programs were motivated by distributional concerns--families with children ...faced higher expenditure needs than other families, and a concern for horizontal equity led to transfers. Throughout the 1990s, however, many countries introduced benefits aimed at improving labor market incentives for mothers with young children. In the United States, the Earned Income Tax Credit (EITC) has played this role, but similar programs exist in Europe, Canada, and elsewhere. Much effort has been expended on evaluating the labor market impact of child benefits. However, less work has examined the impact of these programs on broader outcomes such as the mental and physical health of both the children and the parents, outcomes that follow from the traditional equity motivation for child benefits. In this paper, we review and extend some recent results studying the expansion of family benefits in Canada. In particular, we exploit a change that occurred in the province of Manitoba to highlight the effects of child benefits on both labor supply and family outcomes.
We use administrative data on a sample of births between 1978 and 1985 to investigate the short-, medium-, and long-term consequences of poor infant health. Our findings offer several advances to the ...existing literature on the effects of early infant health on subsequent health, education, and labor force attachment. First, we use a large sample of both siblings and twins, second, we use a variety of measures of infant health, and finally, we track children through their schooling years and into the labor force. Our findings suggest that poor infant health predicts both mortality within one year, and mortality up to age 17. We also find that infant health is a strong predictor of educational and labor force outcomes. In particular, infant health is found to predict both high school completion and welfare takeup and length.
Survey reports of the incidence of chronic conditions are considered by many researchers to be more objective, and thus preferable, measures of unobserved health status than self-assessed measures of ...global well being. In this paper we evaluate this hypothesis by attempting to validate these "objective, self-reported" measures of health. Our analysis makes use of a unique data set that matches a variety of self-reports of health with respondents' medical records. We find that these measures are subject to considerable response error resulting in large attenuation biases when they are used as explanatory variables.
In 1998, the Canadian government introduced a new child tax credit. The innovation in the program was its integration with social assistance (welfare). Some provinces agreed to subtract the new ...federally-paid benefits from provincially-paid social assistance, partially lowering the welfare wall. Other provinces did not integrate benefits, providing a quasi-experimental framework for estimation. We find large changes in social assistance take-up and employment in provinces that provided the labour market incentives to do so. In our sample, the integration of benefits can account for between 19 and 27% of the decline in social assistance receipt between 1997 and 2000.
Childhood disabilities entail a range of immediate and long-term economic costs that have important implications for the well-being of the child, the family, and society but that are difficult to ...measure. In an extensive research review, Mark Stabile and Sara Allin examine evidence about three kinds of costs—direct, out-of-pocket costs incurred as a result of the child s disability; indirect costs incurred by the family as it decides how best to cope with the disability; and long-term costs associated with the child's future economic performance. Not surprisingly, the evidence points to high direct costs for families with children with disabilities, though estimates vary considerably within these families. Out-of-pocket expenditures, particularly those for medical costs, for example, are higher among families with children with a special health care need. An important indirect cost for these families involves decisions about employment. Stabile and Allin examine several studies that, taken together, show that having a child with disabilities increases the likelihood that the mother (and less often the father) will either curtail hours of work or stop working altogether. Researchers also find that having a child with disabilities can affect a mother s own health and put substantial strains on the parents' relationship. In the longer term, disabilities also compromise a child's schooling and capacity to get and keep gainful employment as an adult, according to the studies Stabile and Allin review. Negative effects on future well-being appear to be much greater, on average, for children with mental health problems than for those with physical disabilities. Stabile and Allin calculate that the direct costs to families, indirect costs through reduced family labor supply, direct costs to disabled children as they age into the labor force, and the costs of safety net programs for children with disabilities average $ 30,500 a year per family with a disabled child. They note that the cost estimates on which they base their calculation vary widely depending on the methodology, jurisdiction, and data used. Because their calculations do not include all costs, notably medical costs covered through health insurance, they represent a lower bound. On that basis, Stabile and Allin argue that many expensive interventions to prevent and reduce childhood disability might well be justified by a cost-benefit calculation.
This paper explores the changing role of government involvement in health care financing policy outside the United States. It provides a review of the economics literature in this area to elucidate ...the implications of recent policy changes on efficiency, costs, and quality. Our review reveals that there has been some convergence in policies adopted across countries to improve financing incentives and encourage efficient use of health services. In the case of risk pooling, all countries with competing pools experience similar difficulties with selection and are adopting more sophisticated forms of risk adjustment. In the case of hospital competition, the key drivers of success appear to be what is competed on and measurable, rather than whether the system is public or private. In the case of both the success of performance-related pay for providers and issues resulting from wait times, evidence differs within and across jurisdictions. However, the evidence does suggest that some governments have effectively reduced wait times when they have chosen explicitly to focus on achieving this goal. Many countries are exploring new ways of generating revenues for health care to enable them to cope with significant cost growth, but there is little evidence to suggest that collection mechanisms alone are effective in managing the cost or quality of care.
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