IDEAS home Printed from https://ideas.repec.org/a/eee/jhecon/v44y2015icp195-211.html
   My bibliography  Save this article

The indirect impact of antiretroviral therapy: Mortality risk, mental health, and HIV-negative labor supply

Author

Listed:
  • Baranov, Victoria
  • Bennett, Daniel
  • Kohler, Hans-Peter

Abstract

To reduce the burden of the HIV/AIDS epidemic, international donors recently began providing free antiretroviral therapy (ART) in parts of Sub-Saharan Africa. ART dramatically prolongs life and reduces infectiousness for people with HIV. This paper shows that ART availability increases work time for HIV-negative people without caretaker obligations, who do not directly benefit from the medicine. A difference-in-difference design compares people living near and far from ART, before and after treatment becomes available. Next we explore the possible reasons for this pattern. Although we cannot pinpoint the mechanism, we find that ART availability substantially reduces subjective mortality risk and improves mental health. These results show an undocumented economic consequence of the HIV/AIDS epidemic and an important externality of medical innovation. They also provide the first evidence of a link between the disease environment and mental health.

Suggested Citation

  • Baranov, Victoria & Bennett, Daniel & Kohler, Hans-Peter, 2015. "The indirect impact of antiretroviral therapy: Mortality risk, mental health, and HIV-negative labor supply," Journal of Health Economics, Elsevier, vol. 44(C), pages 195-211.
  • Handle: RePEc:eee:jhecon:v:44:y:2015:i:c:p:195-211
    DOI: 10.1016/j.jhealeco.2015.07.008
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0167629615000831
    Download Restriction: Full text for ScienceDirect subscribers only

    File URL: https://libkey.io/10.1016/j.jhealeco.2015.07.008?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 look for a different version below or search for a different version of it.

    Other versions of this item:

    References listed on IDEAS

    as
    1. Adeline Delavande & Xavier Giné & David McKenzie, 2011. "Eliciting probabilistic expectations with visual aids in developing countries: how sensitive are answers to variations in elicitation design?," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 26(3), pages 479-497, April.
    2. Benedicte Apouey & Andrew E. Clark, 2015. "Winning Big but Feeling no Better? The Effect of Lottery Prizes on Physical and Mental Health," Health Economics, John Wiley & Sons, Ltd., vol. 24(5), pages 516-538, May.
    3. Okeke, Edward N. & Wagner, Glenn J., 2013. "AIDS treatment and mental health: Evidence from Uganda," Social Science & Medicine, Elsevier, vol. 92(C), pages 27-34.
    4. Jane G Fortson, 2011. "Mortality Risk and Human Capital Investment: The Impact of HIV/AIDS in Sub-Saharan Africa," The Review of Economics and Statistics, MIT Press, vol. 93(1), pages 1-15, February.
    5. Bernard Fortin & Nicolas Jacquemet & Bruce Shearer, 2010. "Labour Supply, Work Effort and Contract Choice: Theory and Evidence on Physicians," CIRANO Working Papers 2010s-40, CIRANO.
    6. repec:wly:soecon:v:80:1:y:2013:p:26-49 is not listed on IDEAS
    7. Joseph G. Altonji & Todd E. Elder & Christopher R. Taber, 2005. "Selection on Observed and Unobserved Variables: Assessing the Effectiveness of Catholic Schools," Journal of Political Economy, University of Chicago Press, vol. 113(1), pages 151-184, February.
    8. Vivian H. Hamilton & Philip Merrigan & Éric Dufresne, 1997. "Down and out: estimating the relationship between mental health and unemployment," Health Economics, John Wiley & Sons, Ltd., vol. 6(4), pages 397-406, July.
    9. Daron Acemoglu & Simon Johnson, 2007. "Disease and Development: The Effect of Life Expectancy on Economic Growth," Journal of Political Economy, University of Chicago Press, vol. 115(6), pages 925-985, December.
    10. Lakdawalla, Darius & Malani, Anup & Reif, Julian, 2017. "The insurance value of medical innovation," Journal of Public Economics, Elsevier, vol. 145(C), pages 94-102.
    11. Matteo Cervellati & Uwe Sunde, 2013. "Life Expectancy, Schooling, and Lifetime Labor Supply: Theory and Evidence Revisited," Econometrica, Econometric Society, vol. 81(5), pages 2055-2086, September.
    12. Philipson Tomas J & Jena Anupam B, 2006. "Who Benefits from New Medical Technologies? Estimates of Consumer and Producer Surpluses for HIV/AIDS Drugs," Forum for Health Economics & Policy, De Gruyter, vol. 9(2), pages 1-33, January.
    13. Victoria Baranov & Hans-Peter Kohler, 2018. "The Impact of AIDS Treatment on Savings and Human Capital Investment in Malawi," American Economic Journal: Applied Economics, American Economic Association, vol. 10(1), pages 266-306, January.
    14. Achyuta Adhvaryu & James Fenske & Anant Nyshadham, 2019. "Early Life Circumstance and Adult Mental Health," Journal of Political Economy, University of Chicago Press, vol. 127(4), pages 1516-1549.
    15. Jane G. Fortson, "undated". "Mortality Risk and Human Capital Investment: The Impact of HIV/AIDS in Sub-Saharan Africa," Mathematica Policy Research Reports 4fed8158611247e99f2fc838e, Mathematica Policy Research.
    16. Dhaval Dave & R. Inas Rashad & Jasmina Spasojevic, 2008. "The Effects of Retirement on Physical and Mental Health Outcomes," Southern Economic Journal, John Wiley & Sons, vol. 75(2), pages 497-523, October.
    17. Harsha Thirumurthy & Joshua Graff Zivin & Markus Goldstein, 2008. "The Economic Impact of AIDS Treatment: Labor Supply in Western Kenya," Journal of Human Resources, University of Wisconsin Press, vol. 43(3), pages 511-552.
    18. Sarah Baird & Jacobus de Hoop & Berk Özler, 2013. "Income Shocks and Adolescent Mental Health," Journal of Human Resources, University of Wisconsin Press, vol. 48(2), pages 370-403.
    19. Behrman, Jere R. & Foster, Andrew D. & Rosenzweig, Mark R., 1997. "The dynamics of agricultural production and the calorie-income relationship: Evidence from Pakistan," Journal of Econometrics, Elsevier, vol. 77(1), pages 187-207, March.
    20. Alwyn Young, 2005. "The Gift of the Dying: The Tragedy of AIDS and the Welfare of Future African Generations," The Quarterly Journal of Economics, Oxford University Press, vol. 120(2), pages 423-466.
    21. Seema Jayachandran & Adriana Lleras-Muney, 2009. "Life Expectancy and Human Capital Investments: Evidence from Maternal Mortality Declines," The Quarterly Journal of Economics, Oxford University Press, vol. 124(1), pages 349-397.
    22. Susan Watkins & Eliya Msiyaphazi Zulu & Hans-Peter Kohler & Jere Behrman, 2003. "Introduction to "Research on Demographic Aspects of HIV/AIDS in Rural Africa"," Demographic Research Special Collections, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 1(1), pages 1-30.
    23. Benedicte Apouey & Andrew E. Clark, 2015. "Winning Big but Feeling no Better? The Effect of Lottery Prizes on Physical and Mental Health," Health Economics, John Wiley & Sons, Ltd., vol. 24(5), pages 516-538, May.
    24. Thirumurthy Harsha & Pop-Eleches Cristian & Habyarimana James P. & Goldstein Markus & Graff Zivin Joshua, 2012. "Behavioral Responses of Patients in AIDS Treatment Programs: Sexual Behavior in Kenya," Forum for Health Economics & Policy, De Gruyter, vol. 15(2), pages 1-31, January.
    25. Susan L. Ettner & Richard G. Frank & Ronald C. Kessler, 1997. "The Impact of Psychiatric Disorders on Labor Market Outcomes," ILR Review, Cornell University, ILR School, vol. 51(1), pages 64-81, October.
    26. Thomas, Duncan & Witoelar, Firman & Frankenberg, Elizabeth & Sikoki, Bondan & Strauss, John & Sumantri, Cecep & Suriastini, Wayan, 2012. "Cutting the costs of attrition: Results from the Indonesia Family Life Survey," Journal of Development Economics, Elsevier, vol. 98(1), pages 108-123.
    27. Yoram Ben-Porath, 1967. "The Production of Human Capital and the Life Cycle of Earnings," Journal of Political Economy, University of Chicago Press, vol. 75, pages 352-352.
    28. David E. Bloom & David Canning & Bryan Graham, 2003. "Longevity and Life‐cycle Savings," Scandinavian Journal of Economics, Wiley Blackwell, vol. 105(3), pages 319-338, September.
    29. Baird, Sarah & Gong, Erick & McIntosh, Craig & Özler, Berk, 2014. "The heterogeneous effects of HIV testing," Journal of Health Economics, Elsevier, vol. 37(C), pages 98-112.
    30. Moshe Hazan, 2009. "Longevity and Lifetime Labor Supply: Evidence and Implications," Econometrica, Econometric Society, vol. 77(6), pages 1829-1863, November.
    31. Benedicte Apouey & Andrew E. Clark, 2015. "Winning Big but Feeling no Better? The Effect of Lottery Prizes on Physical and Mental Health," Health Economics, John Wiley & Sons, Ltd., vol. 24(5), pages 516-538, May.
    32. 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.
    33. de Walque, Damien & Kazianga, Harounan & Over, Mead, 2010. "Antiretroviral therapy awareness and risky sexual behaviors : evidence from Mozambique," Policy Research Working Paper Series 5486, The World Bank.
    34. Hoyt Bleakley, 2007. "Disease and Development: Evidence from Hookworm Eradication in the American South," The Quarterly Journal of Economics, Oxford University Press, vol. 122(1), pages 73-117.
    35. Marinescu, Ioana, 2014. "HIV, wages, and the skill premium," Journal of Health Economics, Elsevier, vol. 37(C), pages 181-197.
    36. Susan L. Ettner & Richard G. Frank & Ronald C. Kessler, 1997. "The Impact of Psychiatric Disorders on Labor Market Outcomes," NBER Working Papers 5989, National Bureau of Economic Research, Inc.
    37. Tefft, Nathan, 2011. "Insights on unemployment, unemployment insurance, and mental health," Journal of Health Economics, Elsevier, vol. 30(2), pages 258-264, March.
    38. Berndt, Ernst R. & Finkelstein, Stan N. & Greenberg, Paul E. & Howland, Robert H. & Keith, Alison & Rush, A. John & Russell, James & Keller, Martin B., 1998. "Workplace performance effects from chronic depression and its treatment," Journal of Health Economics, Elsevier, vol. 17(5), pages 511-535, October.
    39. Erick Gong, 2015. "HIV Testing and Risky Sexual Behaviour," Economic Journal, Royal Economic Society, vol. 125(582), pages 32-60, February.
    40. Friedman, Willa Helterline, 2018. "Antiretroviral drug access and behavior change," Journal of Development Economics, Elsevier, vol. 135(C), pages 392-411.
    41. repec:mpr:mprres:6928 is not listed on IDEAS
    42. Wilson, Nicholas L. & Xiong, Wentao & Mattson, Christine L., 2014. "Is sex like driving? HIV prevention and risk compensation," Journal of Development Economics, Elsevier, vol. 106(C), pages 78-91.
    43. Mark R. Montgomery, 2000. "Perceiving Mortality Decline," Population and Development Review, The Population Council, Inc., vol. 26(4), pages 795-819, December.
    44. Delavande, Adeline & Giné, Xavier & McKenzie, David, 2011. "Measuring subjective expectations in developing countries: A critical review and new evidence," Journal of Development Economics, Elsevier, vol. 94(2), pages 151-163, March.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Margaret Frye & Sophia Chae, 2017. "Physical attractiveness and women’s HIV risk in rural Malawi," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 37(10), pages 251-294.
    2. Angelucci, Manuela & Bennett, Daniel, 2021. "The Economic Impact of Depression Treatment in India," IZA Discussion Papers 14393, Institute of Labor Economics (IZA).
    3. Tompsett, Anna, 2020. "The Lazarus drug: the impact of antiretroviral therapy on economic growth," Journal of Development Economics, Elsevier, vol. 143(C).
    4. Takahashi, Ryo, 2021. "How to stimulate environmentally friendly consumption: Evidence from a nationwide social experiment in Japan to promote eco-friendly coffee," Ecological Economics, Elsevier, vol. 186(C).
    5. Lucas, Adrienne M. & Chidothe, Margaret & Wilson, Nicholas L., 2019. "Effects of adult health interventions at scale on children’s schooling: Evidence from antiretroviral therapy in Zambia," Economics of Education Review, Elsevier, vol. 72(C), pages 107-120.
    6. Murray, Tim, 2019. "Defined benefit pensions and homeownership in the post-Great Recession era," MPRA Paper 92601, University Library of Munich, Germany.
    7. Wilson, Nicholas, 2021. "Why is ageing associated with lower adoption of new technologies? Evidence from voluntary medical male circumcision and a structural model," The Journal of the Economics of Ageing, Elsevier, vol. 19(C).
    8. Adrienne M. Lucas & Nicholas L. Wilson, 2018. "Can At-Scale Drug Provision Improve the Health of the Targeted in Sub-Saharan Africa?," American Journal of Health Economics, MIT Press, vol. 4(3), pages 358-382, Summer.
    9. Friedman, Willa Helterline, 2018. "Antiretroviral drug access and behavior change," Journal of Development Economics, Elsevier, vol. 135(C), pages 392-411.
    10. Victoria Baranov & Hans-Peter Kohler, 2018. "The Impact of AIDS Treatment on Savings and Human Capital Investment in Malawi," American Economic Journal: Applied Economics, American Economic Association, vol. 10(1), pages 266-306, January.
    11. Mriduchhanda Chattopadhyay & Toshi H. Arimura & Hajime Katayama & Mari Sakudo & Hide-Fumi Yokoo, 2019. "Subjective Probabilistic Expectations, Indoor Air Pollution, and Health: Evidence from cooking fuel use patterns in India," RIEEM Discussion Paper Series 1910, Research Institute for Environmental Economics and Management, Waseda University.
    12. Chicoine, Luke & Lyons, Emily & Sahue, Alexia, 2020. "The Impact of HIV/AIDS on Human Capital Investment in Sub-Saharan Africa: New Evidence," MPRA Paper 100561, University Library of Munich, Germany.
    13. Takahashi, R. & Todo, Y., 2018. "When do consumers stand up for the environment? Evidence from a large-scale social experiment to promote environmentally friendly coffee," 2018 Conference, July 28-August 2, 2018, Vancouver, British Columbia 277507, International Association of Agricultural Economists.
    14. Terris-Prestholt, Fern & Windmeijer, Frank, 2016. "How to sell a condom? The impact of demand creation tools on male and female condom sales in resource limited settings," Journal of Health Economics, Elsevier, vol. 48(C), pages 107-120.
    15. Antoine Marsaudon & Josselin Thuilliez, 2016. "Does democracy reduce the HIV epidemic? Evidence from Kenya," Université Paris1 Panthéon-Sorbonne (Post-Print and Working Papers) halshs-01400833, HAL.
    16. Chattopadhyay, Mriduchhanda & Arimura, Toshi H. & Katayama, Hajime & Sakudo, Mari & Yokoo, Hide-Fumi, 2020. "Subjective Probabilistic Expectations, Household Air Pollution, and Health: Evidence from cooking fuel use patterns in India," Discussion Papers 2020-05, Graduate School of Economics, Hitotsubashi University.
    17. Aleksandra Jakubowski & Katherine Snyman & Dalsone Kwarisiima & Norton Sang & Rachel Burger & Laura Balzer & Tamara Clark & Gabriel Chamie & Starley Shade & Craig Cohen & Elizabeth Bukusi & Edwin Char, 2018. "High CD4 counts associated with better economic outcomes for HIV-positive adults and their HIV-negative household members in the SEARCH Trial," PLOS ONE, Public Library of Science, vol. 13(6), pages 1-18, June.
    18. Bryan McCannon & Zachary Rodriguez, 2016. "A Lasting Effect of the HIV/AIDS Pandemic: Orphans and Pro-Social Behavior," Working Papers 16-10, Department of Economics, West Virginia University.
    19. Tirivayi, Nyasha & Groot, Wim, 2018. "Does integrating AIDS treatment with food assistance affect labor supply? Evidence from Zambia," Economics & Human Biology, Elsevier, vol. 28(C), pages 79-91.
    20. Wilson, Nicholas, 2016. "Antiretroviral therapy and demand for HIV testing: Evidence from Zambia," Economics & Human Biology, Elsevier, vol. 21(C), pages 221-240.
    21. Ryo Takahashi, 2019. "How to stimulate environmentally friendly consumption: Evidence from a nationwide social experiment to promote eco-friendly coffee," Working Papers 1917, Waseda University, Faculty of Political Science and Economics.
    22. Collin Payne & Hans-Peter Kohler, 2017. "The population-level impact of public-sector antiretroviral therapy rollout on adult mortality in rural Malawi," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 36(37), pages 1081-1108.

    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. Nuarpear Lekfuangfu, 2016. "Mortality Risk and Human Capital Investment: The Legacy of Landmines in Cambodia," PIER Discussion Papers 35., Puey Ungphakorn Institute for Economic Research, revised Jul 2016.
    2. Bloom, David E. & Kuhn, Michael & Prettner, Klaus, 2018. "Health and Economic Growth," IZA Discussion Papers 11939, Institute of Labor Economics (IZA).
    3. Emily Oster & Ira Shoulson & E. Ray Dorsey, 2013. "Limited Life Expectancy, Human Capital and Health Investments," American Economic Review, American Economic Association, vol. 103(5), pages 1977-2002, August.
    4. Thornton, Rebecca L., 2012. "HIV testing, subjective beliefs and economic behavior," Journal of Development Economics, Elsevier, vol. 99(2), pages 300-313.
    5. David E. Bloom & Michael Kuhn & Klaus Prettner, 2020. "Modern Infectious Diseases: Macroeconomic Impacts and Policy Responses," NBER Working Papers 27757, National Bureau of Economic Research, Inc.
    6. Friedman, Willa Helterline, 2018. "Antiretroviral drug access and behavior change," Journal of Development Economics, Elsevier, vol. 135(C), pages 392-411.
    7. Victoria Baranov & Hans-Peter Kohler, 2018. "The Impact of AIDS Treatment on Savings and Human Capital Investment in Malawi," American Economic Journal: Applied Economics, American Economic Association, vol. 10(1), pages 266-306, January.
    8. Titus J. Galama & Hans van Kippersluis, 2015. "A Theory of Education and Health," CINCH Working Paper Series 1503, Universitaet Duisburg-Essen, Competent in Competition and Health, revised Mar 2015.
    9. Weil, David N., 2014. "Health and Economic Growth," Handbook of Economic Growth, in: Philippe Aghion & Steven Durlauf (ed.), Handbook of Economic Growth, edition 1, volume 2, chapter 3, pages 623-682, Elsevier.
    10. Mohammad Mainul Hoque & Elizabeth M. King & Claudio E. Montenegro & Peter F. Orazem, 2019. "Revisiting the relationship between longevity and lifetime education: global evidence from 919 surveys," Journal of Population Economics, Springer;European Society for Population Economics, vol. 32(2), pages 551-589, April.
    11. Johanna Catherine Maclean & Douglas A. Webber & Michael T. French & Susan L. Ettner, 2015. "The Health Consequences of Adverse Labor Market Events: Evidence from Panel Data," Industrial Relations: A Journal of Economy and Society, Wiley Blackwell, vol. 54(3), pages 478-498, July.
    12. Hoque, Mohammad Mainul & King, Elizabeth M. & Montenegro, Claudio E. & Orazem, Peter F., 2020. "Life Expectancy at Birth and Lifetime Education and Earnings," ISU General Staff Papers 202009010700001121, Iowa State University, Department of Economics.
    13. Holger Strulik & Katharina Werner, 2016. "50 is the new 30—long-run trends of schooling and retirement explained by human aging," Journal of Economic Growth, Springer, vol. 21(2), pages 165-187, June.
    14. Strulik, Holger & Werner, Katharina, 2014. "Elite education, mass education, and the transition to modern growth," Center for European, Governance and Economic Development Research Discussion Papers 205, University of Goettingen, Department of Economics.
    15. Casper Worm Hansen & Holger Strulik, 2017. "Life expectancy and education: evidence from the cardiovascular revolution," Journal of Economic Growth, Springer, vol. 22(4), pages 421-450, December.
    16. Belgi Turan, 2020. "Life expectancy and economic development: Evidence from microdata," Review of Development Economics, Wiley Blackwell, vol. 24(3), pages 949-972, August.
    17. Bloom, David E. & Kuhn, Michael & Prettner, Klaus, 2017. "Africa'S Prospects For Enjoying A Demographic Dividend," Journal of Demographic Economics, Cambridge University Press, vol. 83(1), pages 63-76, March.
    18. Geppert, Christian, 2015. "On the Distributional Implications of Demographic Change," VfS Annual Conference 2015 (Muenster): Economic Development - Theory and Policy 113070, Verein für Socialpolitik / German Economic Association.
    19. Owen O'Donnell & Eddy Van Doorslaer & Tom Van Ourti, 2013. "Health and Inequality," Tinbergen Institute Discussion Papers 13-170/V, Tinbergen Institute.

    More about this item

    Keywords

    HIV/AIDS; Mental health; Labor supply; Mortality risk;
    All these keywords.

    JEL classification:

    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J22 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Time Allocation and Labor Supply

    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:jhecon:v:44:y:2015:i:c:p:195-211. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: . General contact details of provider: http://www.elsevier.com/locate/inca/505560 .

    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/505560 .

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

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.