Publications

Life expectancy inequalities in Hungary over 25 years: The role of avoidable deaths (Bíró, Hajdu, Kertesi, Prinz 2021)

Population Studies, DOI: 10.1080/00324728.2021.1877332 Using mortality registers and administrative data on income and population, we develop new evidence on the magnitude of life expectancy inequality in Hungary and the scope for health policy in mitigating this. We document considerable inequalities in life expectancy at age 45 across settlement-level income groups, and show that these inequalities have increased between 1991–96 and 2011–16 for both men and women. We show that avoidable deaths play a large role in life expectancy inequality. Income-related inequalities in health behaviours, access to care, and healthcare use are all closely linked to the inequality in life expectancy.

The long-term impact of restricted access to abortion on children’s socioeconomic outcomes (Hajdu, Hajdu 2021)

Plos One, DOI: 10.1371/journal.pone.0248638 We examine the long-term consequences of restricted access to abortion following a change in the Hungarian abortion law in 1974. Due to a change that restricted access to legal abortions, the number of induced abortions decreased from 169,650 to 102,022 between 1973 and 1974, whereas the number of live births increased from 156,224 to 186,288. We analyze the effects on the adult outcomes of the affected cohort of newborns (educational attainment, labor market participation, teen fertility). We use matched large-scale, individual-level administrative datasets of the Hungarian Central Statistical Office (population census 2011; live birth register), and we...

Temperature, climate change, and human conception rates: evidence from Hungary (Hajdu, Hajdu 2021)

Journal of Population Economics, DOI: 10.1007/s00148-020-00814-1 In this paper, we examine the relationship between temperature and human conception rates and project the impacts of climate change by the mid-twenty-first century. Using complete administrative data on 6.8 million pregnancies between 1980 and 2015 in Hungary, we show that exposure to hot temperatures reduces the conception rate in the first few weeks following exposure, but a partial rebound is observed after that. We project that with absent adaptation, climate change will increase seasonal differences in conception rates and annual conception rates will decline. A change in the number of induced abortions and spontaneous...

Post-conception heat exposure increases clinically unobserved pregnancy losses (Hajdu, Hajdu 2021)

Scientific Reports, DOI: 10.1038/s41598-021-81496-x Evidence of the relationship between temperature during pregnancy and human embryo mortality is limited. Most importantly, the literature lacks causal estimations and studies on early pregnancy losses. Here, we estimate the impact of early pregnancy temperature exposure on the clinically unobserved pregnancy loss rate. We use administrative data of clinically observed pregnancies from more than three decades for Hungary. We apply an empirical approach that allows us to infer the impact of temperature on the clinically unobserved pregnancy loss rate from the estimated effects on the clinically observed conception rate. The results show that exposure to hot...

Regional differences in diabetes across Europe – regression and causal forest analyses (Elek, Bíró 2020)

Economics & Human Biology, DOI: 10.1016/j.ehb.2020.100948 We examine regional differences in diabetes within Europe, and relate them to variations in socio-economic conditions, comorbidities, health behaviour and diabetes management. We use the SHARE (Survey of Health, Ageing and Retirement in Europe) data of 15 European countries and 28,454 individuals, who participated both in the 4th and 7th (year 2011 and 2017) waves of the survey. First, we estimate multivariate regressions, where the outcome variables are diabetes prevalence, diabetes incidence, and weight loss due to diet as an indicator of management. Second, we study the heterogeneous impact of demographic, socio-economic, health and lifestyle...

Job loss, disability insurance and health expenditure (Bíró, Elek 2020)

Labour Economics, DOI: 10.1016/j.labeco.2020.101856 We analyse the causal effect of job loss on disability insurance enrolment on a five-year horizon and the implications on health expenditure. Using administrative panel data from Hungary, we follow individuals displaced due to a mass lay-off and compare their labour force status to non-laid-off individuals with similar employment and health history. According to our estimates, being laid off increases the transition probability to disability 1.5-fold (or by 1.4% points) in four years, and half of the excess transitions occur within the first year. The four-year mortality rate increases 1.7-fold (or by 0.4% point). Total outpatient, inpatient...

Transition shocks during adulthood and health a few decades later in post-socialist Central and Eastern Europe (Bíró, Branyiczki 2020)

BMC Public Health, DOI: 10.1186/s12889-020-08839-7 Background Health of the population of post-socialist Central and Eastern European (CEE) countries lags behind the European Union average. Our aim in this paper is to analyse the link between transition shocks and health two-three decades later. Methods We use retrospective data from the Survey of Health, Ageing and Retirement in Europe. We estimate the implications of stressful periods, financial hardships and job loss occurring around the transition (1987–1993) on subjective and objective measures of health in 2017. We compare these implications across groups of CEE countries and with the health implications of similar difficulties reported...

Caesarean delivery and the use of antidepressants (Bíró, Elek 2020)

European Journal of Public Health, DOI: 10.1093/eurpub/ckaa047 Background The high ratio of caesarean sections (C-sections) is a major public health issue in the developed world; but its implications on maternal mental health are not well understood. Methods We use individual-level administrative panel data from Hungary between 2010 and 2016 to analyze the relationship between caesarean delivery and antidepressant consumption, an objective indicator of mental health. We focus on low-risk deliveries of mothers without subsequent birth in 3 years, and include around 135 000 observations. Results After controlling for medical and socio-economic variables, antidepressant use before delivery is associated with an elevated...

Healthcare spending inequality: Evidence from Hungarian administrative data (Bíró, Prinz 2020)

Health Policy, DOI: 10.1016/j.healthpol.2020.01.006 Using administrative data on a random 50% of the Hungarian population, including individual-level information on incomes, healthcare spending, and mortality for the 2003–2011 period, we develop new evidence on the distribution of healthcare spending and mortality in Hungary by income and geography. By linking detailed administrative data on employment, income, and geographic location with measures of healthcare spending and mortality we are able to provide a more complete picture than the existing literature which has relied on survey data. We compute mean spending and 5-year and 8-year mortality measures by geography and income quantiles, and also present...