Session Recap: Health Behaviors
November 8, 2014 07:00 PM
By Belem Lamas, University of Southern California
On Friday November 7 at the 2014 Fall Research Conference, three papers were presented under the topic of Health Behaviors. The first presentation by Jason Fletcher, Causal Spousal Health Spillover Effects and Implications for Program Evaluation, focused on causal spillover effects of health behavior choices between spouses. This was done by leveraging experimental data which consists of two randomized substance abuse intervention with information on spousal substance use at baseline and post-treatment: Lung Health Study and COMBINE alcohol study.
The research focuses on reduced form effects on spouses and the peer effect. It concluded that spillovers exist in treatments targeting substance abuse. Treatments including therapy reduce smoking by 12 percent and heavy drinking by 14 percent among baseline user spouses. Some of the determinants of spillover importance in cost-effectiveness analysis included the following: prevalence of condition/behavior in spousal/peer sample; different cost effectiveness rankings for subjects and spouses; and magnitude of cost and treatment effect differentials
The second paper, Does Access to Contraception Affect Timing of Abortions, presented by Inna Cintina, focused on changes in access of contraception in the state of Oregon brought by the mandates for health insurance plans to cover contraception, relaxation of prescription requirement for emergency contraception (EC). Cintina claimed some of the main determinants of timing are: financial and time constraints, accessibility of reproductive service, and individual characteristics. Timing is very important in that it affects abortion costs (10 weeks=$470 and 20 weeks= $1,500).
The study found that the increased availability of contraception yields a small but statistically significant reduction in the time a pregnancy is terminated. The effects are concentrated among women residing in the counties with the per capita income below the state’s average. In addition, the change is likely to be driven by the contraception coverage mandates rather than changes in the EC access.
The last presentation, The Effects of Contractive and Young Adult Dependent Mandates on Coverage, Care and General and Reproductive Health Outcomes, presented by Jennifer Trudeau, was motivated by the two key mandates benefitting young adults: Young Adult Dependent Mandate (YADM), which extends coverage on family insurance plans through age 26, and the Contraception Coverage Mandate (CM), which requires insurance to cover all FDA approved contraceptive methods with no cost sharing.
Using an alternative data resource, Behavioral Risk Factor Surveillance Survey, the researched found no significant effects of the YADC mandate on coverage and no effect for the contraceptive method. The study concluded that, individually the YADM appears to reduce the birth rate. Although the effect appears to be driven by CM, the estimated YADM effect is non trivial and the joint effect positive. Abortion rate decreases with increased access to contraception only.
Joanna N. Lahey, from Texas A&M and NBER, discussed the three presentations and the indirect effects of policy intervention. She concluded by suggesting that as we think about our own work, one should not focus solely on direct effects but on: Who else is impacted? What else is impacted? and What other programs interact to change the impact?