Effects of organized screening programs on breast cancer screening, incidence, and mortality in Europe.

We link data on regional Organized Screening Programs (OSPs) throughout Europe with survey data and population-based cancer registries to estimate effects of OSPs on breast cancer screening (mammography), incidence, and mortality. Identification is from regional variation in the existence and timing of OSPs, and in their age-eligibility criteria. We estimate that OSPs, on average, increase mammography by 25 percentage points, increase breast cancer incidence by 16% five years after the OSPs implementation, and reduce breast cancer mortality by about 10% ten years after.

Trust and COVID-19 vaccine hesitancy.

This article uses novel data collected on a weekly basis covering more than 35,000 individuals in the EU to analyze the relationship between trust in various dimensions and COVID-19 vaccine hesitancy. We found that trust in science is negatively correlated, while trust in social media and the use of social media as the main source of information are positively associated with vaccine hesitancy. High trust in social media is found among adults aged 65+, financially distressed and unemployed individuals, and hesitancy is largely explained by conspiracy beliefs among them. Finally, we found that the temporary suspension of the AstraZeneca vaccine in March 2021 significantly increased vaccine hesitancy and especially among people with low trust in science, living in rural areas, females, and financially distressed. Our findings suggest that trust is a key determinant of vaccine hesitancy and that pro-vaccine campaigns could be successfully targeted toward groups at high risk of hesitancy.

Loneliness among older adults in Europe: The relative importance of early and later life conditions.

The aim of this paper is to study the association between childhood circumstances and loneliness in older adults in Europe. Based on rich information collected by the Survey on Health, Ageing, and Retirement in Europe (SHARE) on childhood characteristics and individual characteristics at age 50+, the study is able to control for personality traits, socioeconomic and demographic factors, social support and health in later life, and country-specific characteristics. The analyses show strong correlations between life circumstances in childhood and feeling lonely in older age; these correlations remain significant after adjusting for covariates. While ill health is the main factor correlated with loneliness at 50+, as expected, the analysis of the relative importance of the determinants reveals that personality traits account for more than 10% of the explained variance and that life circumstances during childhood account for 7%. Social support at older ages is the second highest category of factors, accounting for 27%-with, interestingly, support at home and social network characteristics contributing about 10% each, engaging in activities and computer skills accounting for 7% of the explained variance. Demographic and socioeconomic factors account for 6% and country-level characteristics contribute 5%. This paper points out the relevance of early life interventions to tackling loneliness in older age, and it shows that early interventions and interventions aiming at increasing social support in later life need to be adapted to all personality types. Thus, the role of childhood circumstances and the mechanisms explaining the association between loneliness in childhood and loneliness in later life deserve more attention in future research.

The development of nations conditions the disease space.

Using the economic complexity methodology on data for disease prevalence in 195 countries during the period of 1990-2016, we propose two new metrics for quantifying the disease space of countries. With these metrics, we analyze the geography of diseases and empirically investigate the effect of economic development on the health complexity of countries. We show that a higher income per capita increases the complexity of countries' diseases. We also show that complex diseases tend to be non-ubiquitous diseases that are prevalent in disease-diversified (complex) countries, while non-complex diseases tend to be non-ubiquitous diseases that are prevalent in non-diversified (non-complex) countries. Furthermore, we build a disease-level index that links a disease to the average level of GDP per capita of the countries in which the disease is prevalent. With this index, we highlight the link between economic development and the complexity of diseases and illustrate how increases in income per capita are associated with more complex diseases.

The Impact of the Eligibility Threshold of a French Means-Tested Health Insurance Programme on Doctor Visits: A Regression Discontinuity Analysis.

This paper assesses the impact of eligibility for a free means-tested complementary health insurance plan, called Couverture Maladie Universelle Complémentaire (CMUC), on doctor visits. We use information on the selection rule to qualify for the plan to identify the effect of eligibility and adopt a regression discontinuity approach. Our sample consists of low-income individuals enrolled in the Health Insurance Fund and recipients of social benefits from the Family Allowance Fund of an urban area in Northern France. Our findings do not show significant impacts of the CMUC threshold on the number of doctor visits within the full sample. Among the subsample of adults under 30 years old, however, eligible individuals are more likely to see a specialist and have, on average, significantly more specialist visits than non-eligible individuals. This specific impact of the CMUC cut-off point among young adults may be explained by the fact that young adults are less likely to be covered by a complementary health insurance plan when they are not recipients of the CMUC plan. © 2017 The Authors. Health Economics Published by John Wiley & Sons, Ltd.