Spend as you were told: Evidence from labeled COVID-19 stimulus payments in South Korea.

We test the income fungibility assumption from standard economic theory by analyzing spending responses to South Korea's labeled COVID-19 stimulus payments. We exploit unique policy rules for identification: (1) recipients cannot use payments outside their province of residence, and (2) they can only use payments at establishments in pre-specified sectors. Using data on card transactions in Seoul, we find that households do not consider stimulus payments fungible. Compared to Seoul residents' benchmark spending responses to cash income gains by sector, the stimulus payments disproportionately increased Seoul residents' spending in the allowed sector compared to the non-allowed sector. The payments did not increase non-Seoul residents' card spending. Our results imply that labeled stimulus payments with usage restrictions can boost household consumption spending in targeted sectors or locations during economic recessions.

Health insurance and subjective well-being: Evidence from two healthcare reforms in the United States.

We study the role of access to health insurance coverage as a determinant of individuals' subjective well-being (SWB) by analyzing large-scale healthcare reforms in the United States. Using data from the Behavioral Risk Factor Surveillance System and Panel Study of Income Dynamics, we find that the 2006 Massachusetts reform and 2014 Affordable Care Act Medicaid expansion improved the overall life satisfaction of Massachusetts residents and low-income adults in Medicaid expansion states, respectively. The results are robust to various sensitivity and falsification tests. Our findings imply that access to health insurance plays an important role in improving SWB. Without considering psychological benefits, the actual benefits of health insurance may be underemphasized.

Associations of the COVID-19 pandemic with older individuals' healthcare utilization and self-reported health status: a longitudinal analysis from Singapore.

BACKGROUND: The COVID-19 pandemic has challenged the capacity of healthcare systems around the world and can potentially compromise healthcare utilization and health outcomes among non-COVID-19 patients. OBJECTIVES: To examine the associations of the COVID-19 pandemic with healthcare utilization, out-of-pocket medical costs, and perceived health among middle-aged and older individuals in Singapore. METHOD: Utilizing data collected from a monthly panel survey, a difference-in-differences approach was used to characterize monthly changes of healthcare use and spending and estimate the probability of being diagnosed with a chronic condition and self-reported health status before and during the COVID-19 outbreak in 2020. SUBJECTS: Data were analyzed from 7569 nationally representative individuals from 2019 January and 2020 December. MEASURES: Healthcare utilization and healthcare spending by medical service categories as well as self-reported health status. RESULTS: Between January and April 2020 (the first peak period of COVID-19 in Singapore), doctor visits decreased by 30%, and out-of-pocket medical spending decreased by 23%, mostly driven by reductions in inpatient and outpatient care. As a result, the probability of any diagnosis of chronic conditions decreased by 19% in April 2020. The decreased healthcare utilization and spending recovered after lifting the national lockdown in June, 2020 and remained similar to the pre-pandemic level through the rest of 2020. CONCLUSIONS: Middle-aged and older Singaporeans' healthcare utilization and the diagnosis of chronic conditions substantially decreased during the first peak period of the COVID-19 outbreak. Further studies to track the longer-term health effect of the pandemic among non-COVID-19 patients are warranted.

Short-term impact of COVID-19 on consumption spending and its underlying mechanisms: Evidence from Singapore.

We examine the short-term impact of COVID-19 on consumption spending and its underlying mechanisms using individual-level monthly panel data from Singapore. Although Singapore's case fatality rate was one of the lowest in the world in the early stage of the pandemic (0.05%), we find that the COVID-19 pandemic reduced household consumption spending by almost one quarter at its peak, with a larger response from households with above-median wealth. We show that the reduction in consumption spending is associated with the nationwide lockdown policy, heightened economic uncertainty and reduced income. In addition, we find a substantial increase in monthly savings among households without income losses, suggesting a substantial rebound in consumption spending after the lifting of the lockdown. The results from June 2020 confirm this conjecture, as we find that consumption spending rebounded by about 10 percentage points in that month.

Incidence de la COVID­19 à court terme sur les dépenses de consommation et leurs mécanismes sous­jacents : l'exemple de Singapour. À l'aide de données de panel mensuelles recueillies au niveau individuel, nous analysons l'impact de la COVID­19 à court terme sur les dépenses de consommation et leurs mécanismes sous­jacents à Singapour. Bien que le taux de létalité dans le pays ait été l'un des plus faibles au monde au début de la pandémie (0,05 %), nous avons observé une diminution de la consommation des ménages de près de 25 % lors du pic épidémique avec une réaction plus importante des foyers à revenus supérieurs à la médiane. Nous montrons que la baisse des dépenses de consommation est corrélée à la politique de confinement du pays, au contexte économique de plus en plus incertain et à la baisse des revenus. Nous constatons également que la baisse des revenus ne constitue vraisemblablement pas le facteur moteur dans la diminution globale de la consommation. En outre, nous observons une augmentation substantielle de l'épargne mensuelle des foyers n'ayant pas subi de perte de revenus, laissant entrevoir un net rebond des dépenses dès la levée du confinement. Les données de juin 2020 confirment cette hypothèse puisque les dépenses de consommation ont augmenté d'environ 10 % au cours de ce même mois.

Economic impact of targeted government responses to COVID-19: Evidence from the large-scale clusters in Seoul.

We estimate the economic impact of South Korea's targeted responses to the large-scale COVID-19 clusters in a highly concentrated business area (Guro) and a highly concentrated entertainment area (Itaewon) in Seoul, respectively. We find that foot traffic and retail sales decreased only within a 300 m radius and recovered to their pre-outbreak level after four weeks in the case of the Guro cluster. The reductions appear to be driven by temporary business closures rather than by citizens' risk avoidance behavior. However, the adverse economic impacts measured by foot traffic and retail sales of another outbreak of the COVID-19 cluster in Itaewon were persistent. Our results imply that the effects of less intense but more targeted COVID-19 interventions, such as pinpointed, temporary closures of businesses, can differ by underlying geographical characteristics.

The effects of income on health: Evidence from lottery wins in Singapore.

We estimate the causal effects of household income on self-reported health status by exploiting random variations in the amount of lottery prizes won. We find that a S$10,000 (US$7,245) increase in income via lottery wins improves individuals' health by a standard deviation of 0.18. As possible mechanisms, we find that lottery wins increase household consumption spending and improve overall life satisfaction, but do not change healthcare spending, labor supply, and risky health behavior. Previous studies, which focused on the health effects of lottery prizes in Western European countries with strong social safety nets, do not find positive effects other than those on mental health. By contrast, the current study contributes to the literature by providing new evidence of the positive health effect of income via lottery wins in a country without strong social safety nets.

Does a delayed school start time cause students to exercise less? Evidence from South Korea.

A delayed school start time (DSST), achieved by removing zero period, could change students' other time use during school as well as other forms of human capital accumulation. Using difference-in-differences, we find evidence that a DSST in South Korea reduced the time students spent in gym class without worsening students' health status. Combined with previous studies that provided evidence that DSSTs increased students' test scores, our results imply that a DSST can increase students' academic achievement without reducing other forms of human capital accumulation, although schools might change students' other time use.

The Great Recession and Workers' Health Benefits.

During a recession, cost-sharing of employer-sponsored health benefits could increase to reduce labor costs in the U.S. Using a variation in the severity of recession shocks across industries, I find evidence that the enrollment rate of high deductible health plans (HDHPs) among workers covered by employer-sponsored health benefits increased more among firms in industries that experienced severe recession shocks. As potential mechanisms, I study employer-side and worker-side mechanisms. I find that employers changed health benefit offerings to force or incentivize workers to enroll in HDHPs. But I find little evidence of an increase in workers' demand for HDHPs due to a reduction in income. These results suggest that the HDHP enrollment rate increased during the Great Recession, as employers tried to save costs of offering health benefits.

Association of diabetes diagnosis with dietary changes and weight reduction.

BACKGROUND: Lifestyle modifications are associated with better outcomes for patients with diabetes. Patients' awareness of having diabetes may promote lifestyle changes, but there is limited evidence to support this assertion. This study examined whether a report of physician-diagnosed diabetes is associated with dietary changes and efforts to lose weight. METHODS: Cross-sectional comparison of individuals with and without diabetes or prediabetes diagnosis, matched on glycosylated hemoglobin (HbA1c) level, socio-demographic characteristics, and health status using propensity-score matching analysis. Non-pregnant US adult participants (aged 20 and older with an HbA1c level between 5.7% and 7.5%) in the 1999-2014 National Health and Nutrition Examination Survey were included (N = 10,781). RESULTS: Compared with matched controls who did not report having diabetes or prediabetes (N = 1,769), persons with a diagnosis of diabetes or prediabetes (N = 1,769) reported less sugar consumption (14.9 grams [95% CI: 8.9 to 21.0]); less carbohydrate consumption (11.6 grams [95% CI: 1.7 to 21.5]); higher rates of trying to lose weight (12.3 percentage points [95% CI: 5.3 to 19.2]); and a greater one-year weight reduction (4.8 ounces [95% CI: 3.3 to 6.4]). CONCLUSIONS: Awareness of a diagnosis of diabetes or prediabetes from a health profession is associated with the uptake of recommended life-style modifications.

Maternal breastfeeding and children's cognitive development.

Do children with lower test scores benefit more from breastfeeding than those with higher scores? In this paper, I examine the distributional effects of maternal breastfeeding on the cognitive test scores of 11,544 children who were born in 2000 and 2001 in the United Kingdom using a semiparametric quantile regression model. I find evidence that maternal breastfeeding has larger positive impacts on children with lower test scores. Effects for children below the 20th percentile are about 2-2.5 times greater than those for children above the 80th percentile. I also find that these distributional effects are larger when the duration of breastfeeding is extended. One policy implication is that a public policy aims at promoting breastfeeding might narrow a disparity in children's cognition.