Current projects

(Click each title for project description)

Early health investments and human capital formation: the long-term effects of school doctors in Sweden

With Martin Karlsson and Therese Nilsson. Draft available upon request.

It is well established that events in utero and infancy can have important consequences for later life outcomes, but less is known about the impact of events occurring between early childhood and adulthood. This paper investigates long-run health and socioeconomic effects of the introduction of universal health services in Swedish primary schools starting in 1944. Adoption of the reform was not immediate across all school districts, creating variation over space and time. We combine population-based administrative data with novel data on reform adoption at the school district level to identify the causal effect of access to school health services on health and socioeconomic outcomes using a difference in differences design. We also explore school records for a sub-sample of individuals encompassing information on school grades and sickness absences in primary school. Our results suggest few statistically significant, economically meaningful effects of school health services on health and socioeconomic outcomes in either the short- or long-run.

Children’s books and the early internalisation of gender norms

Draft available upon request.

When they have children, women tend to make labour market decisions that result in substantial and persistent losses in earnings. In this pilot study, I experimentally investigate the role of children’s books in the early internalisation of norms regarding gender, family, and careers. I recruited 81 children and 39 of their parents from a preschool in California, and experimentally varied the book to which children were exposed. The treatment book contains a strong positive message about females and careers, whereas the control book contains no message on this topic. As a measure of internalised norms, I measured implicit and explicit biases immediately after the book reading and collected information about parents’ implicit and explicit biases through an online survey. I can thus correlate the biases of parents and their children. Participating children exhibit some explicit but little implicit biases, and results of the pilot study suggest that exposure to the treatment book may be associated with a reduction in these biases. Implicit biases are, on average, significantly greater among the parents than the children.

Endowments at Birth and Parental Investments in Children: The Role of Cultural Institutions

With Matthew Collins and Patrick Wing McHale. Data analysis in progress.

Working papers

What Do Demographics Have To Do With It? An Oaxaca-Blinder Decomposition of Changes over Time in Inequalities in Alcohol, Narcotics and Tobacco-Related Ill Health in Sweden

With Gawain Heckley and Ulf-G Gerdtham, link to Working Paper

The purpose of this study was to document historical trends and socioeconomic inequalities in ill health outcomes related to alcohol consumption, narcotics use and tobacco smoking over the seventeen years prior to the implementation of the Swedish government’s first strategy for alcohol, narcotics, doping and tobacco (ANDT) in 2011. We also sought to explain the changes over time in terms of changes in the population distribution of selected demographic and socioeconomic characteristics. Our two key research questions, for each of alcohol, narcotics and smoking were: 1) How have trends in a) consumption, inpatient care and deaths, and b) income-related inequalities therein developed over time? 2) To what extent can demographic (gender, age, civil status, foreign background), socioeconomic (parental education, own education) and social characteristics (social isolation, proportion of welfare recipients in the municipality) explain the trends in a) levels of consumption, inpatient care and deaths, and b) income-related inequalities therein? For consumption, we investigated the prevalence of heavy drinking and smoking; data on narcotics use were not available. We used International Classification of Diseases (ICD) codes to identify inpatient care and deaths related to alcohol, narcotics and smoking. In our main analyses we used income as a measure of socioeconomic rank. We performed sensitivity analyses to investigate: i) the use of education as an alternative socioeconomic rank, ii) differences between measures of relative and absolute inequality, and iii) sex-differences in the trends over time. We document increasing pro-poor socioeconomic-related inequalities in all of our outcomes except heavy drinking (which was concentrated among higher income individuals, and did not change significantly) during the study period. This reflects an increasing concentration of smoking, and inpatient care and deaths related to alcohol, narcotics and smoking among low income individuals. We are able to explain some of the change over time by demographic and socioeconomic changes (i.e changes in the distribution of our sample by age, foreign background and educational attainment). However, our findings suggest that most of the change observed was due to external factors, such as changing norms and behaviours, and policy or macroeconomic conditions affecting certain groups more than others. In order to achieve the goal of equality in health, ANDT as a policy area must address the increasing concentration of alcohol-, narcotics- and smoking-related outcomes among the poorest and least educated in our society.

Publications

Put a bet on it: Can self-funded commitment contracts curb fitness procrastination?

With Ulf Gerdtham, Linnea Wickström Östervall and Erik Wengström. Journal of Health Economics (2024).

Education, immigration and rising mental health inequality in Sweden

With Anna Linder, Ulf-G Gerdtham, Sara Fritzell and Gawain Heckley, Social Science and Medicine (2020).

Prognostic value of lymphocyte-monocyte ratio at diagnosis in Hodgkin lymphoma: a meta-analysis

With Shing Fung Lee and Ting Ying Ng. BMC cancer (2019).

Life tables for global surveillance of cancer survival (the CONCORD programme): data sources and methods.

With Finnian Bannon, Audrey Bonaventure, Laura M Woods, Rhea Harewood, Helena Carreira, Michel P Coleman, and Claudia Allemani. BMC cancer (2017).

Worldwide comparison of survival from childhood leukaemia for 1995–2009, by subtype, age, and sex (CONCORD-2): a population-based study of individual data for 89 828 children from 198 registries in 53 countries.

With Audrey Bonaventure, Rhea Harewood, Charles A Stiller, Gemma Gatta, Jaqueline Clavel, Daniela C Stefan, Helena Carreira, Rafael Marcos-Gragera, Rafael Peris-Bonet, et al. The Lancet Haematology (2017).

Population-based cancer survival in the United States: data, quality control, and statistical methods

With Claudia Allemani, Rhea Harewood, Christopher J Johnson, Helena Carreira, Audrey Bonaventure, Kevin Ward, Hannah K Weir and Michel P Coleman. Cancer (2017).

Global surveillance of cancer survival 1995–2009: analysis of individual data for 25 676 887 patients from 279 population-based registries in 67 countries (CONCORD-2)

With Claudia Allemani, Hannah K Weir, Helena Carreira, Rhea Harewood, Xiao-Si Wang, Finnian Bannon, Jane V Ahn, Chistopher J Johnson, Audrey Bonaventure, et al. The Lancet (2015).

Multivariable flexible modelling for estimating complete, smoothed life tables for sub-national populations

With Bernard Rachet, Camille Maringe, Laura M Woods, Libby Ellis and Claudia Allemani. BMC Public Health (2015).

Cancer incidence, mortality, and survival in Eastern Libya: updated report from the Benghazi Cancer Registry

With Mufid El Mistiri, Massimiliano Salati, Luigi Marcheselli, Adel Attia, Salah Habil, Faraj Alhomri, Claudia Allemani and Massimo Federico. Annals of epidemiology (2015).

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