IDEAS home Printed from https://ideas.repec.org/a/eee/pubeco/v208y2022ics0047272722000287.html
   My bibliography  Save this article

The effect of emergency financial assistance on healthcare use

Author

Listed:
  • Downes, Henry
  • Phillips, David C.
  • Sullivan, James X.

Abstract

Does providing financial assistance to people who have just experienced an income shock affect their healthcare use? To address this question, we examine healthcare outcomes in a setting where people at risk of homelessness due to an income shock were offered or denied referral to financial assistance quasi-randomly. Among callers who have been screened as eligible for assistance at Chicago’s Homelessness Prevention Call Center (HPCC), some are denied assistance because the availability of funding varies. Conditional on some observable characteristics, funding availability is as-good-as-randomly assigned to callers. We link callers to healthcare utilization records and observe their inpatient hospital stays and emergency department visits. We find that referral to financial assistance has little effect on overall healthcare use–we can reject increases in total utilization greater than 7% of the base rate and decreases of more than 4%. This null effect can be explained, in part, by the fact that the income shock does not significantly change overall healthcare use among those not receiving assistance, suggesting that these individuals can insure health and healthcare demand against these shocks in other ways.

Suggested Citation

  • Downes, Henry & Phillips, David C. & Sullivan, James X., 2022. "The effect of emergency financial assistance on healthcare use," Journal of Public Economics, Elsevier, vol. 208(C).
  • Handle: RePEc:eee:pubeco:v:208:y:2022:i:c:s0047272722000287
    DOI: 10.1016/j.jpubeco.2022.104626
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0047272722000287
    Download Restriction: Full text for ScienceDirect subscribers only

    File URL: https://libkey.io/10.1016/j.jpubeco.2022.104626?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Leslie, Emily & Wilson, Riley, 2020. "Sheltering in place and domestic violence: Evidence from calls for service during COVID-19," Journal of Public Economics, Elsevier, vol. 189(C).
    2. Parente Paulo M.D.C. & Santos Silva João M.C., 2016. "Quantile Regression with Clustered Data," Journal of Econometric Methods, De Gruyter, vol. 5(1), pages 1-15, January.
    3. Cicala, Steve, 2021. "The incidence of extreme economic stress: Evidence from utility disconnections," Journal of Public Economics, Elsevier, vol. 200(C).
    4. Gardner, Jonathan & Oswald, Andrew J., 2007. "Money and mental wellbeing: A longitudinal study of medium-sized lottery wins," Journal of Health Economics, Elsevier, vol. 26(1), pages 49-60, January.
    5. Ludwig, Jens & Duncan, Greg J. & Katz, Lawrence F. & Kessler, Ronald & Kling, Jeffrey R. & Gennetian, Lisa A. & Sanbonmatsu, Lisa, 2012. "Neighborhood Effects on the Long-Term Well-Being of Low-Income Adults," Scholarly Articles 11870359, Harvard University Department of Economics.
    6. Keith Kranker, 2018. "dtalink: Faster probabilistic record linking and deduplication methods in Stata for large data files," 2018 Stata Conference 31, Stata Users Group.
    7. David Card & Gordon B. Dahl, 2011. "Family Violence and Football: The Effect of Unexpected Emotional Cues on Violent Behavior," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 126(1), pages 103-143.
    8. Alberto Abadie & Matthew M. Chingos & Martin R. West, 2018. "Endogenous Stratification in Randomized Experiments," The Review of Economics and Statistics, MIT Press, vol. 100(4), pages 567-580, October.
    9. Lindsey Rose Bullinger & Jillian B. Carr & Analisa Packham, 2020. "COVID-19 and Crime: Effects of Stay-at-Home Orders on Domestic Violence," NBER Working Papers 27667, National Bureau of Economic Research, Inc.
    10. Christopher J. Ruhm, 2000. "Are Recessions Good for Your Health?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 115(2), pages 617-650.
    11. Daniel Sullivan & Till von Wachter, 2009. "Job Displacement and Mortality: An Analysis Using Administrative Data," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 124(3), pages 1265-1306.
    12. Bruce D. Meyer & Angela Wyse & Alexa Grunwaldt & Carla Medalia & Derek Wu, 2021. "Learning about Homelessness Using Linked Survey and Administrative Data," NBER Working Papers 28861, National Bureau of Economic Research, Inc.
    13. Bernstein, Shai & Diamond, Rebecca & McQuade, Timothy James & Pousada, Beatriz, 2018. "The Contribution of High-Skilled Immigrants to Innovation in the United States," Research Papers 3748, Stanford University, Graduate School of Business.
    14. Barrow, S.M. & Herman, D.B. & Córdova, P. & Struening, E.L., 1999. "Mortality among homeless shelter residents in New York City," American Journal of Public Health, American Public Health Association, vol. 89(4), pages 529-534.
    15. Peter Ganong & Damon Jones & Pascal J. Noel & Fiona E. Greig & Diana Farrell & Chris Wheat, 2020. "Wealth, Race, and Consumption Smoothing of Typical Income Shocks," NBER Working Papers 27552, National Bureau of Economic Research, Inc.
    16. Bharel, M. & Lin, W.-C. & Zhang, J. & O'Connell, E. & Taube, R. & Clark, R.E., 2013. "Health care utilization patterns of homeless individuals in Boston: Preparing for Medicaid expansion under the Affordable Care Act," American Journal of Public Health, American Public Health Association, vol. 103(S2), pages 311-317.
    17. Jillian B. Carr & Analisa Packham, 2021. "SNAP Schedules and Domestic Violence," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 40(2), pages 412-452, March.
    18. Christopher J. Ruhm, 2018. "Deaths of Despair or Drug Problems?," NBER Working Papers 24188, National Bureau of Economic Research, Inc.
    19. Palmer, Caroline & Phillips, David C. & Sullivan, James X., 2019. "Does emergency financial assistance reduce crime?," Journal of Public Economics, Elsevier, vol. 169(C), pages 34-51.
    20. David Cesarini & Erik Lindqvist & Robert Östling & Björn Wallace, 2016. "Wealth, Health, and Child Development: Evidence from Administrative Data on Swedish Lottery Players," The Quarterly Journal of Economics, Oxford University Press, vol. 131(2), pages 687-738.
    21. Kushel, M.B. & Perry, S. & Bangsberg, D. & Clark, R. & Moss, A.R., 2002. "Emergency department use among the homeless and marginally housed: Results from a community-based study," American Journal of Public Health, American Public Health Association, vol. 92(5), pages 778-784.
    22. Brian A. Jacob & Jens Ludwig, 2012. "The Effects of Housing Assistance on Labor Supply: Evidence from a Voucher Lottery," American Economic Review, American Economic Association, vol. 102(1), pages 272-304, February.
    23. Rebecca Diamond & Tim McQuade & Franklin Qian, 2019. "The Effects of Rent Control Expansion on Tenants, Landlords, and Inequality: Evidence from San Francisco," American Economic Review, American Economic Association, vol. 109(9), pages 3365-3394, September.
    24. Stephen E. Snyder & William N. Evans, 2006. "The Effect of Income on Mortality: Evidence from the Social Security Notch," The Review of Economics and Statistics, MIT Press, vol. 88(3), pages 482-495, August.
    25. Daniel Gubits & Marybeth Shinn & Michelle Wood & Scott R. Brown & Samuel R. Dastrup & Stephen H. Bell, 2018. "What Interventions Work Best for Families Who Experience Homelessness? Impact Estimates from the Family Options Study," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 37(4), pages 835-866, September.
    26. David C. Phillips, 2020. "Measuring Housing Stability With Consumer Reference Data," Demography, Springer;Population Association of America (PAA), vol. 57(4), pages 1323-1344, August.
    27. Evans, William N. & Moore, Timothy J., 2011. "The short-term mortality consequences of income receipt," Journal of Public Economics, Elsevier, vol. 95(11), pages 1410-1424.
    28. Gruber, Jonathan, 1997. "The Consumption Smoothing Benefits of Unemployment Insurance," American Economic Review, American Economic Association, vol. 87(1), pages 192-205, March.
    29. Burgard, Sarah A. & Seefeldt, Kristin S. & Zelner, Sarah, 2012. "Housing instability and health: Findings from the Michigan recession and recovery study," Social Science & Medicine, Elsevier, vol. 75(12), pages 2215-2224.
    30. Craig Garthwaite & John A. Graves & Tal Gross & Zeynal Karaca & Victoria R. Marone & Matthew J. Notowidigdo, 2019. "All Medicaid Expansions Are Not Created Equal: The Geography and Targeting of the Affordable Care Act," NBER Working Papers 26289, National Bureau of Economic Research, Inc.
    31. Chambers, C. & Chiu, S. & Katic, M. & Kiss, A. & Redelmeier, D.A. & Levinson, W. & Hwang, S.W., 2013. "High utilizers of emergency health services in a population-based cohort of homeless adults," American Journal of Public Health, American Public Health Association, vol. 103(S2), pages 302-310.
    32. Brian A. Jacob & Max Kapustin & Jens Ludwig, 2015. "The Impact of Housing Assistance on Child Outcomes: Evidence from a Randomized Housing Lottery," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 130(1), pages 465-506.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. William N. Evans & David C. Phillips & Krista Ruffini, 2021. "Policies To Reduce And Prevent Homelessness: What We Know And Gaps In The Research," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 40(3), pages 914-963, June.
    2. McInerney, Melissa & Mellor, Jennifer M. & Nicholas, Lauren Hersch, 2013. "Recession depression: Mental health effects of the 2008 stock market crash," Journal of Health Economics, Elsevier, vol. 32(6), pages 1090-1104.
    3. Hannes Schwandt, 2018. "Wealth Shocks and Health Outcomes: Evidence from Stock Market Fluctuations," American Economic Journal: Applied Economics, American Economic Association, vol. 10(4), pages 349-377, October.
    4. William N. Evans & David C. Philips & Krista J. Ruffini, 2019. "Reducing and Preventing Homelessness: A Review of the Evidence and Charting a Research Agenda," NBER Working Papers 26232, National Bureau of Economic Research, Inc.
    5. Adriana Lleras‐Muney, 2022. "Education and income gradients in longevity: The role of policy," Canadian Journal of Economics/Revue canadienne d'économique, John Wiley & Sons, vol. 55(1), pages 5-37, February.
    6. Owen O'Donnell & Eddy Van Doorslaer & Tom Van Ourti, 2013. "Health and Inequality," Tinbergen Institute Discussion Papers 13-170/V, Tinbergen Institute.
    7. Oscar Erixson, 2017. "Health responses to a wealth shock: evidence from a Swedish tax reform," Journal of Population Economics, Springer;European Society for Population Economics, vol. 30(4), pages 1281-1336, October.
    8. Elira Kuka, 2020. "Quantifying the Benefits of Social Insurance: Unemployment Insurance and Health," The Review of Economics and Statistics, MIT Press, vol. 102(3), pages 490-505, July.
    9. Clémentine Garrouste & Mathilde Godard, 2016. "The lasting health impact of leaving school in a bad economy : Britons in the 1970s recession," Post-Print hal-01408637, HAL.
    10. Carlson, Kyle, 2015. "Fear itself: The effects of distressing economic news on birth outcomes," Journal of Health Economics, Elsevier, vol. 41(C), pages 117-132.
    11. Winnie van Dijk & Robert Collinson & John Eric Humphries & Nicholas Mader & Davin Reed & Daniel Tannenbaum, 2022. "Eviction and Poverty in American Cities," Working Papers 2022-24, Human Capital and Economic Opportunity Working Group.
    12. Jérôme Adda & Yarine Fawaz, 2020. "The Health Toll of Import Competition," The Economic Journal, Royal Economic Society, vol. 130(630), pages 1501-1540.
    13. Munford, Luke A. & Fichera, Eleonora & Sutton, Matt, 2020. "Is owning your home good for your health? Evidence from exogenous variations in subsidies in England," Economics & Human Biology, Elsevier, vol. 39(C).
    14. Andersson, Elvira & Lundborg, Petter & Vikström, Johan, 2015. "Income receipt and mortality — Evidence from Swedish public sector employees," Journal of Public Economics, Elsevier, vol. 131(C), pages 21-32.
    15. Matteo Picchio & Sigrid Suetens & Jan C. van Ours, 2018. "Labour Supply Effects of Winning a Lottery," Economic Journal, Royal Economic Society, vol. 128(611), pages 1700-1729, June.
    16. Sarah A. Burgard & Jennifer A. Ailshire & Lucie Kalousova, 2013. "The Great Recession and Health," The ANNALS of the American Academy of Political and Social Science, , vol. 650(1), pages 194-213, November.
    17. Alexander Ahammer & Dominik Grübl & Rudolf Winter-Ebmer, 2020. "The health externalities of downsizing," Economics working papers 2020-26, Department of Economics, Johannes Kepler University Linz, Austria.
    18. Dorn, Florian & Lange, Berit & Braml, Martin & Gstrein, David & Nyirenda, John L.Z. & Vanella, Patrizio & Winter, Joachim & Fuest, Clemens & Krause, Gérard, 2023. "The challenge of estimating the direct and indirect effects of COVID-19 interventions – Toward an integrated economic and epidemiological approach," Economics & Human Biology, Elsevier, vol. 49(C).
    19. Gathmann, Christina & Huttunen, Kristiina & Jernström, Laura & Sääksvuori, Lauri & Stitzing, Robin, 2020. "In Sickness and in Health: Job Displacement and Health Spillovers in Couples," IZA Discussion Papers 13329, Institute of Labor Economics (IZA).
    20. Broughel, James & Viscusi, Kip, 2017. "Death by Regulation: How Regulations Can Increase Mortality Risk," Working Papers 06864, George Mason University, Mercatus Center.

    More about this item

    Keywords

    Homelessness prevention; Healthcare use; Social insurance;
    All these keywords.

    JEL classification:

    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs
    • H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Government: Health, Education, and Welfare
    • R21 - Urban, Rural, Regional, Real Estate, and Transportation Economics - - Household Analysis - - - Housing Demand
    • R28 - Urban, Rural, Regional, Real Estate, and Transportation Economics - - Household Analysis - - - Government Policy

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:pubeco:v:208:y:2022:i:c:s0047272722000287. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/inca/505578 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.