Supplemental Nutrition Assistance Program (SNAP) makes an exception to its rules, which allows elderly and/or disabled individuals, their spouses, as well as homeless beneficiaries, to buy hot prepared food from restaurants if they live in a state that participates in the Restaurant Meals Program (RMP). Using the staggered countywide adoption timeline in California, coupled with a stacked difference-in-differences empirical strategy, I examine the intent-to-treat (ITT) nutritional effects of RMP on the elderly population. Overall, I find no evidence that obesity rates for the elderly are any different in counties with RMP versus those without RMP. I can statistically rule out moderate effects. Additional evidence from some of the early-adopting counties suggests that RMP is associated with a reduction in food insecurity among the elderly.

Using data envelopment analysis, we examine the efficiency of Canada's universal health care system by considering a set of labour (physicians) and capital (beds) inputs, which produce a level of care (measured in terms of health quality and quantity) in a given region. Data from 2013–2015 were collected from the Canadian Institute for Health Information regarding inputs and from the Canadian Community Health Survey and Statistics Canada regarding our output variables, health utility (quality) and life expectancy (quantity). We posit that variation in efficiency scores across Canada is the result of regional heterogeneity regarding socioeconomic and demographic disparities. Regressing efficiency scores on such covariates suggests that regional unemployment and an older population are quite impactful and associated with less efficient health care production. Moreover, regional variation indicates the Atlantic provinces (Newfoundland, Prince Edward Island, Nova Scotia, New Brunswick) are quite inefficient, have poorer economic prospects, and tend to have an older population than the rest of Canada. Oaxaca-Blinder decompositions suggest that the latter two factors explain about one-third of this efficiency gap. Based on our two-stage semi-parametric analysis, we recommend Canada adjust their transfer payments to reflect these disparities, thereby potentially reducing inequality in regional efficiency.

Fertility control strategies became widespread in rural Spain through the twentieth century: a significant number of parents decided to reduce their marital fertility once the advantages of control strategies became widely known. This paper explores the impact of those practices on children through a comparative study of the heights and occupations of grandparents, parents, and children. We analyze more than 1,200 individuals from three different generations born between 1835 and 1959 in 14 rural Spanish villages, studying whether the advantages associated with fertility control were maintained over time favoring a better family status or whether they were diluted in the next generation. The largest increases in height were among children whose parents controlled their fertility by stopping having children before the mother's 36th birthday. However, it does not seem that this increase in biological well-being was accompanied by major episodes of upward social mobility.

Studies of health care expenditure often exclude explanatory variables measuring wealth, despite the intuitive importance and policy relevance. We use the Household, Income and Labour Dynamics in Australia Survey to assess impacts of income and wealth on health expenditure. We investigate four different dependent variables related to health expenditure and use three main methodological approaches. These approaches include a first difference model and introduction of a lagged dependent variable into a cross-sectional context. The key findings include that wealth tends to be more important than income in identifying variation in health expenditure. This applies for health variables which are not directly linked to means testing, such as spending on health practitioners and for being unable to afford required medical treatment. In contrast, the paper includes no evidence of different impacts of income and wealth on spending on medicines, prescriptions or pharmaceuticals. The results motivate two novel policy innovations. One is the introduction of an asset test for determining rebate eligibility for private health insurance. The second is greater focus on asset testing, rather than income tests, for a wide range of general welfare payments that can be used for health expenditure. Australia's world-leading use of means testing can provide a test case for many countries.

It is well-known that marital status is an important predictor for life expectancy. However, non-married individuals are often misclassified as singles which ignores the heterogeneity within the group. This paper shows the importance of distinguishing between types of singles, and in particular whether they are cohabiting, when predicting life expectancies. We use unique and detailed longitudinal register data to track marital status throughout the individual's lifetime. We find that all types of singles consistently benefit from living with a spouse, i.e., after divorce, becoming widower or being never married. This result holds for both men and women. For certain types of cohabiting singles we reject significant differences in life expectancy compared to married individuals. Finally, we use a case study to show that, like married individuals, all types of singles that cohabit also serve as informal caregivers and have the potential to limit the end-of-life long-term care expenditure levels.

In this article, I share insights from the conversations I have enjoyed with my father GC Harcourt on gender, social justice, and economic policy in the last years of his long and fruitful life. Our conversations reflected our overlapping but at times divergent responses to the disruptions caused by environmental, climate, health, economic, and political crises. The article reflects on our conversations around population, alternatives, the pervasiveness of racism in Australia, and the recurring questions of how to bring about change and how to continue despite political disappointments. The article teases out in a gentle way how my perspective, as a feminist political ecologist, diverged from GC Harcourt’s views, and what our conversations together suggest as important challenges to overcome as we confront the current crises of modern capitalism.

Disability-free life expectancy had been rising continuously in the United States until 2010, suggesting working longer as a solution for those financially unprepared for retirement. However, recent developments suggest improvements in working life expectancy have stalled, especially for minorities and those with less education. This paper uses data from the National Vital Statistics System, the American Community Survey, and the National Health Interview Survey to assess how recent trends, up to 2018, in institutionalization, physical impediments to work, and mortality have affected working life expectancy for men and women age 50, by race and education.

This article addresses three main issues: the relationship between commute time and sickness absence, the heterogeneity of the commuting–absenteeism effect between rural migrants and urban citizens, and the effect of China’s Hukou system on the commuting–absenteeism effect. It applies a unique set of employer–employee matched data in China and a zero-inflated negative binomial model. We find clear evidence that a longer commuting time contributes to an increase in sickness absence. The heterogeneity of the commuting–absenteeism effect can also be confirmed: longer commuting leads to higher absence rates for urban citizens but not for rural migrants. Furthermore, we explore the effect of commuting on a set of health-related outcomes. The estimations demonstrate that commuting time has a significant impact on health-related outcomes for both migrants and urban citizens, but unequal access to housing provision and to social health insurance in the Hukou system may mean that rural migrants resort to more informal medical services and thus lack access to the official sickness certificate required to seek legal sickness absence. We recommend accelerated reform of the Hukou system to encourage rural workers to seek appropriate and timely medical services, thereby reducing public health risks.

While other research has shown that higher paid truck and bus drivers are safer, this is the first study showing why higher paid drivers are safer. We estimate the labour supply curve for long-haul truck drivers in the United States, applying two-stage least squares regression to a national survey of truck drivers. We start with the standard model of the labour supply curve and then develop two novel extensions of it, incorporating pay level and pay method, and testing the target earnings hypothesis. We distinguish between long-haul and short-haul jobs driving commercial motor vehicles. Truck and bus drivers choose between long-distance jobs requiring very long hours of work away from home and short-distance jobs generally requiring fewer hours. The labour supply curve exhibits a classic backward bending shape, reflecting drivers’ preference to work until they reach target earnings. Above target earnings, at a ‘safe rate’ for truck drivers, they trade labour for leisure, working fewer hours, leading to greater highway safety. Drivers work fewer hours at a higher pay rate and likely have less fatigue. Pay rates also have implications for driver health because worker health deteriorates as working time exceeds 40 hours.

Human civilisation faces a series of existential threats from the combination of five global and human-engineered challenges, namely climate change, resource depletion, environmental degradation, overpopulation and rising social inequality. These challenges are arguably being manifested in both an increased likelihood and magnified impact of catastrophes like forest fires, prolonged droughts, pandemics and social dislocation/upheaval. This article argues that in understanding and addressing these challenges, important lessons can be drawn from what has repeatedly caused organisational failures. It applies the ‘Ten Pathways to Disaster’ model to a series of disasters/catastrophic events and then argues this model is salient to understanding inadequate responses to the five threats to civilisation. The article argues that because these challenges interact in mutually reinforcing ways, it is critical to address them simultaneously not in isolation.

The decision in the early 1990s to cut back on the building of public housing intensified the already dire shortage of affordable housing and increased the marginalisation of the sector. To be eligible for public housing, new entrants usually have to be in ‘greatest need’. This study argues that the shift in the eligibility criteria for accessing public housing means that public housing estates increasingly reflect what Loïc Wacquant calls ‘advanced urban marginality’. The article assesses whether the features of advanced urban marginality that are identified by Wacquant capture and can be usefully used to analyse the shifts and contemporary characteristics of public housing. The article draws on existing data and in-depth interviews with 33 older (aged more than 65 years) public housing tenants in Sydney, Australia, to analyse the residualisation of public housing using the features of advanced marginality identified by Wacquant – ‘wage labour as a vector of social instability and life insecurity’, ‘functional disconnection from macroeconomic trends’, ‘territorial fixation and stigmatisation’, ‘spatial alienation and the dissolution of place’, ‘loss of hinterland’ and ‘social fragmentation and symbolic splintering’. The study concludes that although Wacquant’s analysis is useful and captures much of what has occurred in public housing estates in Sydney, in many instances, public housing remains a source of pride for its tenants and provides them with the basis for a good life.

The Economy for the Common Good movement proposes an alternative economic model, which promises to offset many of the detrimental effects of the contemporary labour market. Yet, despite its increasing economic and social relevance in Europe, there is little research on Economy for the Common Good firms and the quality of the jobs they offer their employees. We thus, first, introduce the ideas of this movement and then present findings on workplace characteristics and the well-being of workers. Our results are based on our own survey of Economy for the Common Good employees from 2018 and on the sixth wave of the European Working Conditions Survey. Our analyses offer mixed support for the claims of the Economy for the Common Good – while Economy for the Common Good workers can be found in high-quality work settings, their absenteeism and presenteeism, as well as indicators of control, time pressure, direct participation and financial participation do not differ from other workers when controlled in a propensity score matching approach. Based on our findings and feedback from Economy for the Common Good representatives, we conclude that the introduction of Eonomy for the Common Good ideas might be too recent to see any positive effects, but also that Economy for the Common Good companies should place more focus on their employees’ well-being.

How has public healthcare spending prepared countries for tackling the COVID-19 pandemic? Arguably, spending is the primary policy tool of governments for providing effective health. We argue that the effectiveness of spending for reducing COVID deaths is conditional on the existence of healthcare equity and lower political corruption because the health sector is particularly susceptible to political spending. Our results, obtained using ordinary least squares and two-stage least squares estimations, suggest that higher spending targeted at reducing inequitable access to health has reduced COVID deaths. Consistent with the findings of others, our results indirectly suggest that health spending is necessary, but not sufficient unless accompanied by good governance and equitable access. Equitable health systems ease the effects of COVID presumably because they allow states to reach and treat people more effectively. Spending aimed at increasing health system capacity by increasing access thus seems a sound strategy for fighting the spread of disease, ultimately benefiting us all.

We quantify the importance of idiosyncratic health risk in a calibrated general equilibrium model of Social Security. We construct an overlapping generations model with rational-expectations households, idiosyncratic labor income and health risk, profit-maximizing firms, incomplete insurance markets, and a government that provides pensions and health insurance. We calibrate this model to the US economy and perform two computational experiments: $\left (i\right)$ cutting Social Security’s payroll tax, and $\left (ii\right)$ modifying Social Security’s benefit-earnings rule. Our findings suggest that health risk amplifies the welfare implications of both experiments: downsizing Social Security always leads to higher overall welfare, but the welfare gain is larger when we account for health risk, and increasing the progressivity of Social Security’s benefit-earnings rule has a larger positive effect on welfare in the presence of health risk. We also find that allowing households additional tools to self-insure against health risk weakens the precautionary motive, so our experiments have similar welfare implications both with and without health risk.

This study evaluates the impact of the Global Alliance for Vaccines and Immunization (GAVI) on children's health outcomes in developing countries. Using a difference-in-differences identification strategy, we find that GAVI has reduced neonatal, infant and under-five mortality rates. The impact of GAVI on children's health outcomes is larger in countries with lower per capita income. Our findings underscore the relevance of health interventions in improving children's health outcomes in developing economies.

State Medical Aid is a public health insurance program that allows undocumented immigrants with low financial resources to access health care services for free. However, the low take-up rate of this program might threaten its efficiency. The purpose of this study is therefore to provide the determinants of such a low take-up rate. To this end, we rely on the Premier Pas survey. This is an original representative sample of undocumented immigrants attending places of assistance to vulnerable populations in France. Determinants of State Medical Aid take-up are analyzed through probit and Cox modeling. The results show that only 51% of those who are eligible for the State Medical Aid program are actually covered, and this proportion is higher among women than among men. The length of stay in France is the most important determinant of take-up. It is worth noting that State Medical Aid take-up is not associated with chronic diseases or functional limitations and is negatively associated with poor mental health. There is, therefore, mixed evidence of health selection into the program. Informational barriers and vulnerabilities experienced by undocumented immigrants are likely to explain this low take-up.

Climate change and weather shocks have multi-faceted impacts on food systems with important implications for economic policy. Combining a longitudinal household survey with high-resolution climate data, we demonstrate that both climate and weather shocks increase food insecurity; cash assistance and participation in Ethiopia’s Productive Safety Net Programme have reduced food insecurity; but food assistance has been ineffective. Importantly, households with savings, and those that stored their harvest to sell at higher prices rather than for home use, suffered less from food insecurity, yet both strategies are harder for the poorest and most food insecure households to adopt. Our paper provides micro-founded evidence needed to design policies that both improve agricultural yields in the context of a changing climate and target households’ abilities to cope with shocks that put upwards pressure on food prices.

This paper assesses inequality in longevity across education and gender groups in 23 OECD countries around 2011. Data on mortality rates by age, gender, educational attainment, and, for 17 countries, cause of death were collected from national sources, with similar treatment applied to all countries in order to derive comparable measures of longevity at age 25 and 65 by gender and education. These estimates show that, on average, the gap in life expectancy between high and low-educated people is 7.6 years for men and 4.8 years for women at age 25 years, and 3.6 years for men and 2.6 years for women at age 65. At the age of 25, the gap in life expectancy between high and low-educated people varies between 4.1 years (in Canada) and 13.9 years (in Hungary) for men, and between 2.5 years (in Italy) and 8.3 years (in Latvia) for women; in the United States, the gap is 10.0 years for men and 7.0 years for women. Cardiovascular diseases are the first cause of death for all gender and education groups after age 65 years, and the first cause of mortality inequality between the high and low-education elderly.

The debate about extending working lives in response to population ageing often overlooks the lack of employment opportunity for older adults with disabilities. Without work, their living standards depend heavily on government transfers. This study contributes to the literature on health inequalities by analysing the sources of income and poverty outcomes for people aged 50 to 64 in two liberal democratic countries yet with contrasting disability benefit contexts – Canada and the United Kingdom. This choice of countries offers the opportunity to assess whether the design of benefit systems has led the most disadvantaged groups to fare differently between countries. Overall, disabled older persons without work faced a markedly higher risk of poverty in Canada than in the UK. Public transfers played a much greater role in the UK, accounting for two-thirds of household income among low-educated groups, compared with one-third in Canada. The average benefit amount received was similar in both countries, but the coverage of disabled people was much lower in Canada than in the UK, leading to a high poverty risk among disabled people out of work. Our findings highlight the importance of income support systems in preventing the widening of the poverty-disability gap at older ages.

This article analyses the evolution of nutritional inequality in Spain among cohorts born between 1840 and 1964. With male height data (N = 358,253), the secular trend of biological well-being and intergenerational anthropometric inequalities are studied based on the coefficient of variation, height percentiles and socioeconomic categories (students, literate non-students and illiterate). The results reveal that the nutritional inequalities were very large in the mid-19th century. Anthropometric inequalities diminished among those born between 1880 and 1919 and increased again, although only moderately, from the cohorts of the 1920s. From the 1930s there was a cycle of sustained increase in height. Despite nutritional improvement, the data suggest that nutritional inequalities increased during the Franco regime, affecting the low-income population segments particularly.