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. 2017 Jul:54:40-55.
doi: 10.1016/j.jhealeco.2017.03.008. Epub 2017 Mar 31.

Health shocks and their long-lasting impact on health behaviors: Evidence from the 2009 H1N1 pandemic in Mexico

Jorge M Agüero  1 , Trinidad Beleche  2
Affiliations

Health shocks and their long-lasting impact on health behaviors: Evidence from the 2009 H1N1 pandemic in Mexico

Jorge M Agüero et al. J Health Econ. 2017 Jul.

Abstract

Worldwide, the leading causes of death could be avoided with health behaviors that are low-cost but also difficult to adopt. We show that exogenous health shocks could facilitate the adoption of these behaviors and provide long-lasting effects on health outcomes. Specifically, we exploit the spatial and temporal variation of the 2009 H1N1 influenza pandemic in Mexico and show that areas with a higher incidence of H1N1 experienced larger reductions in diarrhea-related cases among young children. These reductions continue even three years after the shock ended. Health improvements and evidence of information seeking via Google searches were consistent with changes in hand washing behaviors. Several robustness checks validate our findings and mechanism.

Keywords: Children; Diarrhea; Hand washing; Health behaviors; Health shocks.

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Figures

Fig. 1
Fig. 1
Geographic Variation of Laboratory Confirmed H1N1 Cases and Diarrhea-related Hospitalizations in Mexico. Panel A. Laboratory Confirmed Swine Flu Cases, 2009. Panel B. Diarrhea-related Hospitalizations, 2006–2008. Sources: Authors’ analysis of hospital discharge data from Mexico’s Ministry of Health (Secretaria de Salud).
Fig. 2
Fig. 2
Confirmed Cases of H1N1 and Diarrhea-related Hospitalizations: by Age Groups. Panel A. Confirmed Cases of H1N1 and Diarrhea-related Hospitalizations, 2009. Panel B. Diarrhea-related Hospitalizations, 2008–2009. Source: Authors’ analysis of data from Mexico’s Ministry of Health (Secretaria de Salud).
Fig. 3
Fig. 3
Changes in Hospitalizations for Children under Five Years of Age. Notes: Mexico has 31 states and the Federal District (Mexico City), each of which is represented by a point on Panel A and Panel B. In Panel A, each point represents the difference in the average number of cases of diarrhea between 2008 and 2009 in each state. In Panel B, each point represents the difference between the average number of cases of diarrhea in 2006–2007 and the average number of confirmed H1N1 cases in 2009 in each Mexican state. Sources: Authors’ analysis of hospital discharge and H1N1 laboratory confirmed data from Mexico’s Ministry of Health (Secretaria de Salud).
Fig. 4
Fig. 4
Google Searches for Hand Sanitizer Information. Panel A. Google Searches for “gel” in 2009. Pane B. Google Searches for “gel” pre- and post-2009. Sources: Authors’ analysis of data on internet searches for the Word “gel” in Mexico from GoogleTrends (https://www.google.com/trends/).
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References

    1. Ånestad G., Nordbø S.A. Virus interference. did rhinoviruses activity hamper the progress of the 2009 influenza a (H1N1) pandemic in Norway? Med. Hypotheses. 2011;77(6):1132–1134. doi: 10.1016/j.mehy.2011.09.021. - DOI - PubMed
    1. Aburto N.J., Pevzner E., Lopez-Ridaura R., Rojas R., Lopez-Gatell H., Lazcano E. Knowledge and adoption of community mitigation efforts in Mexico during the 2009 H1N1 pandemic. Am. J. Prev. Med. 2010;39(5):395–402. doi: 10.1016/j.amepre.2010.07.011. - DOI - PubMed
    1. Ashraf N., Berry K.J., Shapiro J. Can higher prices stimulate product use? evidence from a field experiment in Zambia. Am. Econ. Rev. 2010;100(5):2383–2413. doi: 10.1257/aer.100.5.2383. - DOI
    1. Askitas N., Zimmermann K. Google econometrics and unemployment forecasting. Appl. Econ. Q. 2009;55(2):107–120. doi: 10.3790/aeq.55.2.107. - DOI
    1. Bennett D., Chiang C.F., Malani A. Learning during a crisis: the SARS epidemic in Taiwan. J. Dev. Econ. 2015;112:1–18. doi: 10.1016/j.jdeveco.2014.09.006. - DOI - PMC - PubMed