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Demonstration effects in preventive care


  • Ritesh Banerjee
  • Ethan Cohen-Cole
  • Giulio Zanella


Using a unique dataset composed of female employees at a large medical organization, this paper explores the role of social interactions among female co-workers and neighbors in the decision to obtain breast cancer screening exams. In our theoretical framework, the experience of other women is salient because it alters the tolerance for ambiguity about their own vulnerability, via a comparative ignorance effect. We find that the social multiplier ranges from 2 to 3: the equilibrium effect of an exogenous shock that impacts the probability of performing a mammogram is two to three times the shock itself. We perform a number of checks: among other things, these reveal (in agreement with the model and our intuition) that such a social effect is stronger for women whose job (according to the O*NET dictionary of occupations) offers more opportunities for social interaction, and weaker for individuals directly involved in health care, such as doctors and nurses.

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  • Ritesh Banerjee & Ethan Cohen-Cole & Giulio Zanella, 2007. "Demonstration effects in preventive care," Risk and Policy Analysis Unit Working Paper QAU07-7, Federal Reserve Bank of Boston.
  • Handle: RePEc:fip:fedbqu:qau07-7

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    References listed on IDEAS

    1. Brock, William A. & Durlauf, Steven N., 2001. "Interactions-based models," Handbook of Econometrics,in: J.J. Heckman & E.E. Leamer (ed.), Handbook of Econometrics, edition 1, volume 5, chapter 54, pages 3297-3380 Elsevier.
    2. Acton, Jan Paul, 1975. "Nonmonetary Factors in the Demand for Medical Services: Some Empirical Evidence," Journal of Political Economy, University of Chicago Press, vol. 83(3), pages 595-614, June.
    3. William A. Brock & Steven N. Durlauf, 2001. "Discrete Choice with Social Interactions," Review of Economic Studies, Oxford University Press, vol. 68(2), pages 235-260.
    4. Craig R. Fox & Amos Tversky, 1995. "Ambiguity Aversion and Comparative Ignorance," The Quarterly Journal of Economics, Oxford University Press, vol. 110(3), pages 585-603.
    5. Deri, Catherine, 2005. "Social networks and health service utilization," Journal of Health Economics, Elsevier, vol. 24(6), pages 1076-1107, November.
    6. Burke & Heiland, 2007. "Social Dynamics Of Obesity," Economic Inquiry, Western Economic Association International, vol. 45(3), pages 571-591, July.
    7. Grossman, Michael, 2000. "The human capital model," Handbook of Health Economics,in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 7, pages 347-408 Elsevier.
    8. Aizer, Anna & Currie, Janet, 2004. "Networks or neighborhoods? Correlations in the use of publicly-funded maternity care in California," Journal of Public Economics, Elsevier, vol. 88(12), pages 2573-2585, December.
    9. Muurinen, Jaana-Marja, 1982. "Demand for health: A generalised Grossman model," Journal of Health Economics, Elsevier, vol. 1(1), pages 5-28, May.
    10. Charles F. Manski, 1993. "Identification of Endogenous Social Effects: The Reflection Problem," Review of Economic Studies, Oxford University Press, vol. 60(3), pages 531-542.
    11. Epstein, Larry G & Wang, Tan, 1994. "Intertemporal Asset Pricing Under Knightian Uncertainty," Econometrica, Econometric Society, vol. 62(2), pages 283-322, March.
    12. Bloom, Joan R. & Spiegel, David, 1984. "The relationship of two dimensions of social support to the psychological well-being and social functioning of women with advanced breast cancer," Social Science & Medicine, Elsevier, vol. 19(8), pages 831-837, January.
    13. Lairson, David R. & Chan, Wenyaw & Newmark, Georgina R., 2005. "Determinants of the demand for breast cancer screening among women veterans in the United States," Social Science & Medicine, Elsevier, vol. 61(7), pages 1608-1617, October.
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