Aline Bütikofer

Long-Term Consequences of Access to Well-Child Visits

A growing literature documents the positive long-term effects of policy-induced improvements in early-life health and nutrition. However, there is still scarce evidence on early-life health programs targeting a large share of the population and the role of such programs in increasing intergenerational mobility. This paper uses the rollout of mother and child health care centers in Norway, which commenced in the 1930s, to study the long-term consequences of increasing access to well-child visits. These well-child visits included a physical examination and the provision of information about adequate infant nutrition. Our results indicate that access to mother and child health care centers had a positive effect on education and earnings: access in the first year of life increased the completed years of schooling by 0.15 years and earnings by two percent. The effects were stronger for children from a low socioeconomic background. In addition, we find that individuals suffer from fewer health risks at age 40 and positive effects on adult height, which support the fact that better nutrition within the first year of life is the likely mechanism behind our findings. While there is increasing knowledge on the benefits of various types of early childhood programs, the costs are often neglected, making it hard to compare different programs. We add to this by showing that investments in mother and child health care centers pass a simple cost-benefit analysis.

Disease Control and Inequality Reduction: Evidence from a Tuberculosis Testing and Vaccination Campaign

This paper examines the economic impact of a tuberculosis control program launched in Norway in 1948. In the 1940s, Norway had one of the highest tuberculosis infection rates in Europe, affecting about 85 percent of the inhabitants. To lower the disease burden, the Norwegian government launched a large-scale tuberculosis testing and vaccination campaign that substantially reduced tuberculosis infection rates among children. We find that cohorts in school during and after the campaign in municipalities with high tuberculosis prevalence gained more in terms of education, earnings, longevity, and height following this public health intervention. Furthermore, the gains from the disease control program are not limited to the initially treated cohorts but also affect their children. The results also suggest that individuals from a low socioeconomic background benefited more from the intervention and we present new evidence that a narrowing of the gap in childhood health can lead to a reduction in socioeconomic inequalities in adulthood.

Missing work is a pain: the effect of Cox-2 inhibitors on sickness absence and disability pension receipt

How does medical innovation affect labor supply? We analyze how the availability of Cox-2 inhibitors, pharmaceuticals used for treating pain and inflammation, affected the sickness absence and disability pension receipt of individuals with joint pain. We exploit the market entry of the Cox-2 inhibitor Vioxx and its sudden market withdrawal as exogenous sources of variation in drug use. Using Norwegian administrative data, we find Vioxx’s entry decreased quarterly sickness absence days among individuals with joint pain by 7–12 percent. The withdrawal increased sickness days by 12–16 percent and increased the quarterly probability of receiving disability benefits by 6–15 percent.

Semiparametric Base-Independent Equivalence Scales and the Cost of Children in Switzerland

SummaryHow much additional income does a couple with two children need to be equally well-off as a childless couple? This question is important for public policy decisions on social benefits or child allowances. Since equivalence scales express the change in the cost required to attain a certain welfare level when the household size and composition varies, they answer this question. This paper provides semi-parametric estimates of consumption-based equivalence scales by applying the extended partially linear model to the Swiss Household Budget Survey 2000–2005. The results permit welfare comparisons across households and provide an indirect measure of the cost of children.

Traffic Accidents in Switzerland: How Hazardous are "High Risk" Groups? An Analysis Based on Police Protocols

SummaryOn January 1, 2005, Switzerland reduced the legal level of blood-alcohol concentration while driving from 0.8‰ to 0.5‰. This happend on basis of the assumption that more restrictive per mil levels increase road safety. The benefit of lower blood-alcohol levels, however, depends on whether drinking drivers indeed pose a risk for themselves and other road users. Analyses using official data of all 84,437 two-car crashes during 2001–2005 indeed show a higher relative risk of drinking to sober drivers. And, we also find evidence that prejudices against drivers with an Eastern European citizenship, contrary to recent newspaper articles, are groundless.