Arndt R. Reichert

The Causal Impact of Fear of Unemployment on Psychological Health

We analyze the effect of job insecurity on psychological health. We extend the group of people being affected to employees who have insecure jobs to account for a broader measure of the mental health consequences of potential unemployment. Using panel data with staff reductions in the company as an exogenous source of job insecurity, we find that an increase in fear of unemployment substantially decreases the mental health status of employees. Quantile regression results yield particularly strong effects for individuals of already poor mental health.

The Causal Link between Financial Incentives and Weight Loss: An Evidence‐Based Survey of the Literature

Obesity and overweight are linked to diseases that cost society a significant amount of resources. While behavior modification can reduce the problem, instigating such lifestyle changes is an uneasy task. One potential way to reduce the problem is through the use of financial incentives. In this survey, we review the available evidence, properly emphasizing studies that credibly yield meaningful estimates of the effect of financial incentives on weight loss. We find that the scientific literature on the subject has not yet satisfactorily settled whether such a mechanism is effective at eliciting the desired behavioral and health outcomes. We therefore advocate a rigorous large-scale randomized experiment to provide reliable estimates of the effect.

Obesity, Weight Loss, and Employment Prospects – Evidence from a Randomized Trial

This study presents credible estimates for the causal effect of BMI growth on employment among the obese. By exploring random assignment of a weight-loss intervention based on monetary rewards, I provide convincing evidence that weight loss positively affects the employment prospects of obese women but not of obese men. Consistent with this, significant effects of weight loss on proxy variables for labor productivity are found only for obese women.

Weight Loss and Sexual Activity in Adult Obese Individuals: Establishing a Causal Link

Obesity may not only be linked to undesirable health outcomes but also to limitations in sexual life. The present paper aims to assess whether there is a causal relationship between weight loss and sexual activity in adult obese individuals. To address the endogeneity of weight loss that is likely to result in biased estimation results, the analysis is based on data from a randomized field experiment. In this experiment financial weight-loss rewards were offered to a random subgroup of participants and can be used as exogenous source of weight variation in an instrumental variables approach. Estimation results indicate that for obese males loosing weight increases the probability for being involved in a sexual relationship. Conditional on having already lost some weight, a further reduction in obesity also increases the frequency of sexual intercourse.

Small Cash Rewards for Big Losers: Experimental Insights into the Fight Against the Obesity Epidemic

This paper examines the sustainability of weight loss achieved through cash rewards and, for the first time, the potential of monetary incentives to prevent weight cycling. In a three period randomized controlled trial, about 700 obese persons were assigned to two treatment groups, which were promised different cash rewards contingent on the achievement of an individually assigned target weight, and to a control group. Successful participants were subsequently allocated to two treatment groups offered different monetary incentives for maintaining the previously achieved target weight and to a control group. This is the first experiment of this kind that finds sustainable effects of weight loss rewards on the body weight of the obese even 18 months after the rewards were removed. Additional incentives to maintain an achieved body weight improve the sustainability of weight loss only while are in place.

New Evidence on Employment Effects of Informal Care Provision in Europe

OBJECTIVE To estimate how labor force participation is affected when adult children provide informal care to their parents. DATA SOURCE Survey of Health, Ageing and Retirement in Europe from 2004 to 2013. STUDY DESIGN To offset the problem of endogeneity, we exploit the availability of other potential caregivers within the family as predictors of the probability to provide care for a dependent parent. Contrary to most previous studies, the dataset covers the whole working-age population in the majority of European countries. Individuals explicitly had to opt for or against the provision of care to their care-dependent parents, which allows us to more precisely estimate the effect of caregiving on labor force participation. PRINCIPAL FINDINGS Results reveal a negative causal effect that indicates that informal care provision reduces labor force participation by 14.0 percentage points (95 percent CI: -0.307, 0.026). Point estimates suggest that the effect is larger for men; however, this gender difference is not significantly different from zero at conventional levels. CONCLUSIONS Results apply to individuals whose consideration in long-term care policy is highly relevant, that is, children whose willingness to provide informal care to their parents is altered by available alternatives of family caregivers.

Nursing home prices and quality of care — Evidence from administrative data

There is widespread concern about the quality of care in nursing homes. On the basis of administrative data of a large health insurance fund, we investigate whether nursing home prices are associated with relevant quality of care indicators at the resident level. Our results indicate negative associations between price and both inappropriate and psychotropic medication. In contrast, we do not find any relationship between the price and impairments of physical health.

The Effect of a Bonus Program for Preventive Health Behavior on Health Expenditures

This paper contributes to the analysis of policy measures that attempt to reduce health care expenditures of insurers. We examine the impact of a cash bonus program for preventive health behavior of a German health insurer on prevention effort and health care expenditures using a unique administrative dataset that covers all insurants of the health insurer between 2003 and 2008. We find that the program has been successful in both increasing individual prevention effort and achieving net savings every year since its implementation in 2004. However, while the estimated effect on health care expenditures is statistically significant in the first year, the effects for the second, third, and fourth years turn insignificant. In the fifth year, results for net savings are sensitive in terms of statistical significance when accounting for dynamic selection into the treatment.

Habit formation, obesity, and cash rewards

This paper examines weight loss and the formation of healthy habits through cash rewards in the context of a multi-phase randomized controlled trial involving 700 obese individuals. We find effects of monetary incentives for weight loss of up to EUR 300 on body weight during all experimental phases, including a period of a year and a half following the exposure to the financial rewards. We also find effects on healthy behavior during this follow-up phase. After the initial incentive period, we additionally provided participants who had lost a substantial amount of weight with monetary rewards of up to EUR 500. These had only short-term effects on body weight and healthy behavior. We argue that our findings are best explained by monetarily incentivized participants having formed healthy habits by the time the experiment ended and that only the speed of the transition to the new (health) equilibrium was affected by the additional rewards. Contrary to the pessimistic perspective presented in earlier empirical research on habit formation, our results suggest that a simple program relying on weight loss rewards can result in long-term health behavioral change.

Biting Back at Malaria: Assessing Health‐Service Providers' Compliance with Treatment Guidelines

Non-compliance with established medical treatment guidelines can have dire consequences for public health and economic well-being. Based on the Demographic and Health Surveys, we examine malaria-treatment practices of various health-care providers in sub-Saharan Africa, where more than 90% of malaria-induced deaths occur. We estimate each providers likelihood (i) to comply with guidelines to administer (effective) antimalarial drugs and (ii) to relieve children of fever—a symptom of malaria—after having had a fever episode within the previous two weeks. Our results indicate that, relative to self-medication, seeking treatment at most providers is positively associated with taking an antimalarial drug and negatively associated with using only ineffective chloroquine. Non-traditional healers are also associated with fever relief.