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

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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
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    1. 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.
    2. 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.
    3. 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.
    4. 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.
    5. 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.
    6. 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.
    7. 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.
    8. 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.
    9. 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.
    10. 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.
    11. 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.
    12. 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.
    13. Manuela Angelucci & Giacomo de Giorgi & Imran Rasul & Marcos A. Rangel, 2010. "Insurance and Investment within Family Networks," Working Papers id:2649, eSocialSciences.
    14. 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.
    15. 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.
    16. Lindsay, Cotton M & Feigenbaum, Bernard, 1984. "Rationing by Waiting Lists," American Economic Review, American Economic Association, vol. 74(3), pages 404-417, June.
    17. 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.
    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. 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.
    20. Munshi, Kaivan & Myaux, Jacques, 2006. "Social norms and the fertility transition," Journal of Development Economics, Elsevier, vol. 80(1), pages 1-38, June.
    21. 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.
    22. Michihiro Kandori, 1992. "Social Norms and Community Enforcement," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 59(1), pages 63-80.
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    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.

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    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

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