ABSTRACT We investigated the causal effects of a college education on smoking, drinking alcohol, sleeping, and site‐specific cancer‐screening behaviors in Japan. To adjust for endogeneity, we leveraged a unique instrument—demographic distortion caused by a behavior based on a superstition. A superstition held by some Japanese people caused a demographic shift in 1967 that led to an increase in college educational attainment among a certain cohort. Using a recursive bivariate probit approach, we found that having a college education reduced smoking and increased some types of cancer‐screening behaviors. Additionally, we found that the causal relationship may be mediated by an improvement in economic and social resources.
ABSTRACT Primary healthcare systems worldwide face a shortage of General Practitioners and Nurses. One response by the English Health System to combat this shortage is to expand the role of non‐traditional roles in primary care, often shifting away tasks from Nurses. Non‐traditional practitioners, though less taxing on budgets, tend to have less formal training than Doctors and Nurses, which may affect quality of care. Using data from 614,115 respondents to a survey of primary care patients in England between 2018 and 2022, we assess the extent to which non‐traditional practitioners meet patients' needs in primary care appointments. Patients who see a non‐traditional provider have a 12.6 percentage points lower probability that their care needs were met, relative to those seeing a Nurse. Findings are consistent across linear, probit and instrumented recursive bivariate probit models, and concentrated amongst patients aged 35–54.
ABSTRACT This paper investigates how rising women's education and exposure to economic and social globalization jointly shape the Double Burden of Malnutrition (DBM), defined as the coexistence of maternal overweight and child stunting within the same household. Drawing on Demographic and Health Surveys (DHS) spanning 1992–2017 across 38 low‐ and middle‐income countries, we first apply a sub‐national (DHS region) bivariate statistical decomposition framework that teases apart two forces: “structure effects”, which capture changes in how household characteristics relate to DBM while holding their distribution fixed, and “composition effects”, which isolate how shifts in the distribution of household characteristics affect DBM while holding their association with DBM constant. In a second‐stage analysis, structure effects show that as social globalization deepens, the protective role of women's education against DBM is attenuated and becomes positively associated with DBM, especially in more urbanized regions. Composition effects further reveal that where economic globalization is already advanced, gains in women's education are associated with higher DBM prevalence. Taken together, this empirical evidence suggests that women's education alone may be insufficient to counteract the nutritional risks linked to globalization, underscoring the need for complementary institutional, regulatory, and dietary interventions.
