IDEAS home Printed from https://ideas.repec.org/p/sef/csefwp/271.html
   My bibliography  Save this paper

Spillover Effects in Healthcare Programs: Evidence on Social Norms and Information Sharing

Author

Abstract

Although cervical cancer is considered one of the most preventable types of cancer, mortality rates in many developing countries are extremely high. This paper exploits the randomized research design of a large welfare program - PROGRESA - to study the size and determinants of spillover effects in cervical cancer screening in rural Mexico. I find significant evidence of increased demand for Papanicolaou cervical cancer screening among women ineligible for the transfer, yet no evidence of similar externalities in non-gender specific tests, such as blood pressure and blood sugar checks. Different pieces of evidence from the randomized evaluation sample and the nationwide rollout are consistent with the hypothesis that the PROGRESA program has weakened the social norm related to husbands' opposition to screening of their wives by male doctors. I find no support for the hypothesis that the spillover effect is driven by higher levels of health information.

Suggested Citation

  • Ciro Avitabile, 2011. "Spillover Effects in Healthcare Programs: Evidence on Social Norms and Information Sharing," CSEF Working Papers 271, Centre for Studies in Economics and Finance (CSEF), University of Naples, Italy, revised 14 Mar 2011.
    • Handle: RePEc:sef:csefwp:271
    as

    Download full text from publisher

    File URL: http://www.csef.it/WP/wp271.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Raquel Fernández & Alessandra Fogli, 2006. "Fertility: The Role of Culture and Family Experience," Journal of the European Economic Association, MIT Press, vol. 4(2-3), pages 552-561, 04-05.
    2. Rafael Lalive & M. Alejandra Cattaneo, 2009. "Social Interactions and Schooling Decisions," The Review of Economics and Statistics, MIT Press, vol. 91(3), pages 457-477, August.
    3. Glenn Ellison & Drew Fudenberg, 1995. "Word-of-Mouth Communication and Social Learning," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 110(1), pages 93-125.
    4. Angelucci, Manuela & De Giorgi, Giacomo & Rangel, Marcos A. & Rasul, Imran, 2010. "Family networks and school enrolment: Evidence from a randomized social experiment," Journal of Public Economics, Elsevier, vol. 94(3-4), pages 197-221, April.
    5. Tomas J. Philipson & William H. Dow & Xavier Sala-i-Martin, 1999. "Longevity Complementarities under Competing Risks," American Economic Review, American Economic Association, vol. 89(5), pages 1358-1371, December.
    6. Munshi, Kaivan & Myaux, Jacques, 2006. "Social norms and the fertility transition," Journal of Development Economics, Elsevier, vol. 80(1), pages 1-38, June.
    7. Oriana Bandiera & Imran Rasul, 2006. "Social Networks and Technology Adoption in Northern Mozambique," Economic Journal, Royal Economic Society, vol. 116(514), pages 869-902, October.
    8. Orazio Attanasio & Valerie Lechene, 2002. "Tests of Income Pooling in Household Decisions," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 5(4), pages 720-748, October.
    9. Rafael Di Tella & Sebastian Galiant & Ernesto Schargrodsky, 2007. "The Formation of Beliefs: Evidence from the Allocation of Land Titles to Squatters," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 122(1), pages 209-241.
    10. Manuela Angelucci & Giacomo De Giorgi, 2009. "Indirect Effects of an Aid Program: How Do Cash Transfers Affect Ineligibles' Consumption?," American Economic Review, American Economic Association, vol. 99(1), pages 486-508, March.
    11. Enrico Moretti, 2011. "Social Learning and Peer Effects in Consumption: Evidence from Movie Sales," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 78(1), pages 356-393.
    12. Richard Blundell & Frank Windmeijer, 2000. "Identifying demand for health resources using waiting times information," Health Economics, John Wiley & Sons, Ltd., vol. 9(6), pages 465-474, September.
    13. Pascaline Dupas, 2011. "Do Teenagers Respond to HIV Risk Information? Evidence from a Field Experiment in Kenya," American Economic Journal: Applied Economics, American Economic Association, vol. 3(1), pages 1-34, January.
    14. Douglas Almond & Lena Edlund & Kevin Milligan, 2009. "O Sister, Where Art Thou? The Role of Son Preference and Sex Choice: Evidence from Immigrants to Canada," NBER Working Papers 15391, National Bureau of Economic Research, Inc.
    15. Luke, Nancy & Munshi, Kaivan, 2007. "Social affiliation and the demand for health services: Caste and child health in South India," Journal of Development Economics, Elsevier, vol. 83(2), pages 256-279, July.
    16. Edward Miguel & Michael Kremer, 2004. "Worms: Identifying Impacts on Education and Health in the Presence of Treatment Externalities," Econometrica, Econometric Society, vol. 72(1), pages 159-217, January.
    17. Manuela Angelucci & Giacomo de Giorgi & Imran Rasul & Marcos A. Rangel, 2010. "Insurance and Investment within Family Networks," Working Papers id:2649, eSocialSciences.
    18. Paul Schultz, T., 2004. "School subsidies for the poor: evaluating the Mexican Progresa poverty program," Journal of Development Economics, Elsevier, vol. 74(1), pages 199-250, June.
    19. Hongbin Cai & Yuyu Chen & Hanming Fang, 2009. "Observational Learning: Evidence from a Randomized Natural Field Experiment," American Economic Review, American Economic Association, vol. 99(3), pages 864-882, June.
    20. Gravelle, H. S. E., 1990. "Rationing trials by waiting: Welfare implications," International Review of Law and Economics, Elsevier, vol. 10(3), pages 255-270, December.
    21. Michihiro Kandori, 1992. "Social Norms and Community Enforcement," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 59(1), pages 63-80.
    22. Lindsay, Cotton M & Feigenbaum, Bernard, 1984. "Rationing by Waiting Lists," American Economic Review, American Economic Association, vol. 74(3), pages 404-417, June.
    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. M. Angelucci & V. Di Maro, 2016. "Programme evaluation and spillover effects," Journal of Development Effectiveness, Taylor & Francis Journals, vol. 8(1), pages 22-43, March.
    2. Zenou, Yves & List, John & Momeni, Fatemeh, 2019. "Are Estimates of Early Education Programs Too Pessimistic? Evidence from a Large-Scale Field Experiment that Causally Measures," CEPR Discussion Papers 13725, C.E.P.R. Discussion Papers.
    3. List, John A. & Momeni, Fatemeh & Zenou, Yves, 2020. "The Social Side of Early Human Capital Formation: Using a Field Experiment to Estimate the Causal Impact of Neighborhoods," IZA Discussion Papers 13966, Institute of Labor Economics (IZA).
    4. Diana Contreras Suarez & Pushkar Maitra, 2021. "Health spillover effects of a conditional cash transfer program," Journal of Population Economics, Springer;European Society for Population Economics, vol. 34(3), pages 893-928, July.
    5. Independent Evaluation Group, 2014. "Social Safety Nets and Gender : Learning from Impact Evaluations and World Bank Projects," World Bank Publications - Books, The World Bank Group, number 21365.
    6. Olivia D'Aoust & Olivier Sterck & Philip Verwimp, 2013. "Buying Peace: The Mirage of Demobilizing Rebels," Working Papers ECARES ECARES 2013-22, ULB -- Universite Libre de Bruxelles.
    7. Bobonis, Gustavo J. & Castro, Roberto & Morales, Juan S., 2015. "Conditional Cash Transfers for Women and Spousal Violence: Evidence of the Long-Term Relationship from the Oportunidades Program in Rural Mexico," IDB Publications (Working Papers) 7267, Inter-American Development Bank.
    8. List, John A. & Momeni, Fatemeh & Zenou, Yves, 2019. "Are Estimates of Early Education Programs Too Pessimistic? Evidence from a Large-Scale Field Experiment that Causally Measures Neighbor Effects," Working Paper Series 1293, Research Institute of Industrial Economics.

    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. Avitabile, Ciro, 2021. "Spillovers and Social Interaction Effects in the Demand for Preventive Healthcare: Evidence from the PROGRESA program," Journal of Health Economics, Elsevier, vol. 79(C).
    2. Bandiera, Oriana & Gulesci, Selim & Rasul, Imran & Burgess, Robin, 2009. "Community networks and poverty reduction programmes: evidence from Bangladesh," LSE Research Online Documents on Economics 58054, London School of Economics and Political Science, LSE Library.
    3. Matteo Bobba & Jérémie Gignoux, 2014. "Neighborhood effects and take-up of transfers in integrated social policies: Evidence from Progresa," PSE Working Papers halshs-00646590, HAL.
    4. Matteo Bobba & Jérémie Gignoux, 2011. "Policy-induced Social Interactions and Schooling Decisions," PSE Working Papers halshs-00962478, HAL.
    5. Matteo Bobba & Jérémie Gignoux, 2019. "Neighborhood Effects in Integrated Social Policies," The World Bank Economic Review, World Bank, vol. 33(1), pages 116-139.
    6. Manuela Angelucci & Silvia Prina & Heather Royer & Anya Samek, 2015. "When Incentives Backfire: Spillover Effects in Food Choice," NBER Working Papers 21481, National Bureau of Economic Research, Inc.
    7. Jacobus de Hoop & Jed Friedman & Eeshani Kandpal & Furio C. Rosati, 2019. "Child Schooling and Child Work in the Presence of a Partial Education Subsidy," Journal of Human Resources, University of Wisconsin Press, vol. 54(2), pages 503-531.
    8. Bonan, Jacopo & Battiston, Pietro & Bleck, Jaimie & LeMay-Boucher, Philippe & Pareglio, Stefano & Sarr, Bassirou & Tavoni, Massimo, 2021. "Social interaction and technology adoption: Experimental evidence from improved cookstoves in Mali," World Development, Elsevier, vol. 144(C).
    9. Lucila Berniell & Dolores de la Mata & Nieves Valdés, 2013. "Spillovers Of Health Education At School On Parents' Physical Activity," Health Economics, John Wiley & Sons, Ltd., vol. 22(9), pages 1004-1020, September.
    10. Angelucci, Manuela & De Giorgi, Giacomo & Rangel, Marcos A. & Rasul, Imran, 2010. "Family networks and school enrolment: Evidence from a randomized social experiment," Journal of Public Economics, Elsevier, vol. 94(3-4), pages 197-221, April.
    11. Michael Christian Lehman, 2014. "Long-Run Effects Of Conditional Cash Transfers," Anais do XLI Encontro Nacional de Economia [Proceedings of the 41st Brazilian Economics Meeting] 223, ANPEC - Associação Nacional dos Centros de Pós-Graduação em Economia [Brazilian Association of Graduate Programs in Economics].
    12. Gordon B. Dahl & Katrine V. L?ken & Magne Mogstad, 2014. "Peer Effects in Program Participation," American Economic Review, American Economic Association, vol. 104(7), pages 2049-2074, July.
    13. Marcel Fafchamps & Ana Vaz & Pedro C. Vicente, 2020. "Voting and Peer Effects: Experimental Evidence from Mozambique," Economic Development and Cultural Change, University of Chicago Press, vol. 68(2), pages 567-605.
    14. Rafael P. Ribas, 2020. "Liquidity constraints, spillovers, and entrepreneurship: evidence from a cash transfer program," Small Business Economics, Springer, vol. 55(4), pages 1131-1158, December.
    15. Angelucci, Manuela & De Giorgi, Giacomo & Rangel, Marcos A. & Rasul, Imran, 2009. "Extended Family Networks in Rural Mexico: A Descriptive Analysis," IZA Discussion Papers 4498, Institute of Labor Economics (IZA).
    16. Grohmann, Antonia & Sakha, Sahra, 2019. "The effect of peer observation on consumption choices: evidence from a lab-in-field experiment," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 51(55), pages 5937-5951.
    17. Das, Tanmoy & Banerjee, Priyodorshi, 2023. "Peer effects on decision making in complex financial situations," Economic Modelling, Elsevier, vol. 127(C).
    18. Fishman, Arthur & Fishman, Ram & Gneezy, Uri, 2019. "A tale of two food stands: Observational learning in the field," Journal of Economic Behavior & Organization, Elsevier, vol. 159(C), pages 101-108.
    19. Baylis, Kathy & Ham, Andres, 2015. "How important is spatial correlation in randomized controlled trials?," 2015 AAEA & WAEA Joint Annual Meeting, July 26-28, San Francisco, California 205586, Agricultural and Applied Economics Association.
    20. Kate Ambler & Diego Aycinena & Dean Yang, 2015. "Channeling Remittances to Education: A Field Experiment among Migrants from El Salvador," American Economic Journal: Applied Economics, American Economic Association, vol. 7(2), pages 207-232, April.

    More about this item

    Keywords

    Cervical cancer; Social norm; Information sharing; Progresa;
    All these keywords.

    JEL classification:

    • D83 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Search; Learning; Information and Knowledge; Communication; Belief; Unawareness
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • J16 - Labor and Demographic Economics - - Demographic Economics - - - Economics of Gender; Non-labor Discrimination

    NEP fields

    This paper has been announced in the following NEP Reports:

    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:sef:csefwp:271. 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: Dr. Maria Carannante (email available below). General contact details of provider: https://edirc.repec.org/data/cssalit.html .

    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.