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," Cahiers de recherche 1034, CIRPEE.
    6. Philip Anglewicz & Hans-Peter Kohler, 2009. "Overestimating HIV infection:," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 20(6), pages 65-96.
    7. repec:wly:soecon:v:80:1:y:2013:p:26-49 is not listed on IDEAS
    8. 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.
    9. 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.
    10. 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.
    11. Lakdawalla, Darius & Malani, Anup & Reif, Julian, 2017. "The insurance value of medical innovation," Journal of Public Economics, Elsevier, vol. 145(C), pages 94-102.
    12. 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.
    13. Harold Alderman & Jere Behrman & Hans-Peter Kohler & John A. Maluccio & Susan Watkins, 2001. "Attrition in Longitudinal Household Survey Data," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 5(4), pages 79-124.
    14. 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.
    15. 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.
    16. 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.
    17. 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.
    18. 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.
    19. 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.
    20. 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.
    21. Jason Fletcher, 2013. "Adolescent Depression and Adult Labor Market Outcomes," Southern Economic Journal, John Wiley & Sons, vol. 80(1), pages 26-49, July.
    22. 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.
    23. Alwyn Young, 2005. "The Gift of the Dying: The Tragedy of AIDS and the Welfare of Future African Generations," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 120(2), pages 423-466.
    24. Seema Jayachandran & Adriana Lleras-Muney, 2009. "Life Expectancy and Human Capital Investments: Evidence from Maternal Mortality Declines," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 124(1), pages 349-397.
    25. 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.
    26. 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(1), pages 1-31, January.
    27. 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.
    28. 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.
    29. 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(4), pages 352-352.
    30. 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.
    31. 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.
    32. 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.
    33. Moshe Hazan, 2009. "Longevity and Lifetime Labor Supply: Evidence and Implications," Econometrica, Econometric Society, vol. 77(6), pages 1829-1863, November.
    34. repec:hal:pseose:halshs-01155641 is not listed on IDEAS
    35. 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.
    36. Hoyt Bleakley, 2007. "Disease and Development: Evidence from Hookworm Eradication in the American South," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 122(1), pages 73-117.
    37. 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.
    38. Marinescu, Ioana, 2014. "HIV, wages, and the skill premium," Journal of Health Economics, Elsevier, vol. 37(C), pages 181-197.
    39. repec:hal:pseose:halshs-00566789 is not listed on IDEAS
    40. 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.
    41. Tefft, Nathan, 2011. "Insights on unemployment, unemployment insurance, and mental health," Journal of Health Economics, Elsevier, vol. 30(2), pages 258-264, March.
    42. 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.
    43. Erick Gong, 2015. "HIV Testing and Risky Sexual Behaviour," Economic Journal, Royal Economic Society, vol. 125(582), pages 32-60, February.
    44. Philip Anglewicz & Jimi Adams & Francis Obare & Hans-Peter Kohler & Susan Watkins, 2009. "The Malawi Diffusion and Ideational Change Project 2004-06," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 20(21), pages 503-540.
    45. Friedman, Willa Helterline, 2018. "Antiretroviral drug access and behavior change," Journal of Development Economics, Elsevier, vol. 135(C), pages 392-411.
    46. repec:mpr:mprres:6928 is not listed on IDEAS
    47. 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.
    48. Mark R. Montgomery, 2000. "Perceiving Mortality Decline," Population and Development Review, The Population Council, Inc., vol. 26(4), pages 795-819, December.
    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. 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.
    2. 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.
    3. Bloom, David E. & Kuhn, Michael & Prettner, Klaus, 2018. "Health and Economic Growth," IZA Discussion Papers 11939, Institute of Labor Economics (IZA).
    4. 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.
    5. 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.
    6. Thornton, Rebecca L., 2012. "HIV testing, subjective beliefs and economic behavior," Journal of Development Economics, Elsevier, vol. 99(2), pages 300-313.
    7. 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.
    8. Lekfuangfu, Warn N., 2022. "Mortality risk, perception, and human capital investments: The legacy of landmines in Cambodia," Labour Economics, Elsevier, vol. 78(C).
    9. David E. Bloom & Michael Kuhn & Klaus Prettner, 2022. "Modern Infectious Diseases: Macroeconomic Impacts and Policy Responses," Journal of Economic Literature, American Economic Association, vol. 60(1), pages 85-131, March.
    10. Friedman, Willa Helterline, 2018. "Antiretroviral drug access and behavior change," Journal of Development Economics, Elsevier, vol. 135(C), pages 392-411.
    11. 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.
    12. 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.
    13. 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.
    14. Hoque,Mohammad Mainul & King,Elizabeth M. & Montenegro,Claudio E. & Orazem,Peter F., 2017. "Longevity and lifetime education : global evidence from 919 surveys," Policy Research Working Paper Series 8175, The World Bank.
    15. Elena Kotyrlo, 2014. "Northern Investment Risks in Human Capital Formation: Russian Experience," ERSA conference papers ersa14p294, European Regional Science Association.
    16. Michael Kuhn & Alexia Prskawetz & Uwe Sunde, 2014. "Health, education, and retirement over the prolonged life cycle: a selective survey of recent research," Vienna Yearbook of Population Research, Vienna Institute of Demography (VID) of the Austrian Academy of Sciences in Vienna, vol. 12(1), pages 1-22.
    17. 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.
    18. Strulik, Holger & Werner, Katharina, 2014. "Elite education, mass education, and the transition to modern growth," University of Göttingen Working Papers in Economics 205, University of Goettingen, Department of Economics.
    19. 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.

    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.

    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. RePEc uses bibliographic data supplied by the respective publishers.