Het aantal personen met een tatoeage stijgt. Tatoeages zijn echter nog altijd controversieel en kunnen gevolgen hebben voor iemands arbeidsmarktuitkomsten. In deze studie onderzoeken wij de karakteristieken van diegenen die kiezen voor het plaatsen van een tatoeage en de mogelijke gevolgen van deze keuze voor onder andere hun arbeidsparticipatie en inkomen.

Placing a tattoo is a choice with potentially significant and long-lasting social and economic consequences. In this study we look at the factors determining the decision to place a tattoo and combine this with several outcomes, such as income and employment status, living together with a partner, (perceived) health and substance use. The analyses are based on unique panel data of a representative sample of Dutch individuals. The tattooed population differs significantly from the non-tattooed population on a wide range of characteristics. The first part of our analysis describes the number, timing, location, size and visibility of tattoos. In the second part we use fixed effects and instrumental variables analysis to explore the effect of tattoos on the above mentioned outcome measures. Our analyses suggest less favorable outcomes for people with (very visible) tattoos, though especially in the case of the labor market, the relationships are relatively weak.

This paper provides new field evidence on the role of probability numeracy in health insurance purchase. Our regression results, based on rich survey panel data, indicate that the expenditure on two out of three measures of health insurance first rises with probability numeracy and then falls again. This non-monotonic relationship suggests that probability numeracy affects health insurance decisions through several channels. In the third case—the obligatory Dutch basic health insurance—we find that high levels of probability numeracy coincide with a lower deductible choice. We discuss possible explanations for the patterns we find, including status quo bias and ambiguity aversion, and the related policy implications.

We study the effect of perceptions in comparison with more objective measures of risk on individuals’ decisions to decline or accept risk reducing interventions such as flu shots, mammograms, and aspirin for the prevention of heart disease. In particular, we elicit individuals’ subjective probabilities of risk, with and without the interventions, and compare these perceptions to individually predicted risk based on epidemiological models. Respondents, especially women, appear to be aware of some of the qualitative relationships between risk factors and probabilities. However, on average they have very poor perceptions of the absolute probability levels as reported in the epidemiological literature. Perceptions of the level of risk are less accurate if a respondent is female and has poor numeracy skills. We find that perceived probabilities significantly affect the subsequent take-up rate of flu shots, mammograms, and aspirin, even after controlling for individually predicted risk using epidemiological models.

We analyze weight and fat percentage measurements of respondents in an online general population panel in the Netherlands, collected using wireless scales, with an average frequency of 1.6 measurements per week. First, we document the existence of a weekly cycle; body mass is lowest on Fridays and highest on Mondays, showing significant (p<0.01) differences of, on average, 0.2 kilogram in weight, 0.06 in BMI value, and 0.03 in fat percentage. Second, we find that in the general population fat-based measures of obesity point at a three times larger prevalence of obesity (53%) than BMI-based measures (17%). Third, we find that feedback that includes a recommended weight range increases the temporal variation in individual body mass by almost ten percent (sd for weight increases from 1.13 to 1.22; sd for BMI increases from 0.37 to 0.41; sd for fat percentage increases from 0.55 to 0.61.

OBJECTIVES:To compare healthcare costs and mortality rates of Dutch patients with a conventional (CON) general practitioner (GP) and patients with a GP who has additionally completed training in complementary and alternative medicine (CAM).DESIGN:Comparative economic evaluation.SETTING:Database from the Dutch insurance company Agis.PARTICIPANTS:1,521,773 patients (98.8%) from a CON practice and 18,862 patients (1.2%) from a CAM practice.MAIN OUTCOME MEASURES:Annual information on five types of healthcare costs for the years 2006-2011: care by GP, hospital care, pharmaceutical care, paramedic care and care covered by supplementary insurance. Healthcare costs in the last year of life. Mortality rates.RESULTS:The mean annual compulsory and supplementary healthcare costs of CON patients are respectively €1821 (95% CI 1813 to 1828) and €75.3 (95% CI 75.1 to 75.5). Compulsory healthcare costs of CAM patients are €225 (95% CI 169 to 281; p<0.001; 12.4%) lower and result mainly from lower hospital care costs (€165; 95% CI 118 to 212; p<0.001) and lower pharmaceutical care costs (€58; 95% CI 41 to 75; p<0.001), especially in the age categories 25-49 and 50-74 years. The costs in the last year of life of patients with CAM, GPs are €1161 (95% CI -138 to 2461; p<0.1) lower. This difference is entirely due to lower hospital costs (€1250; 95% CI 19 to 2481; p<0.05). The mean annual supplementary costs of CAM patients are €33 (95% CI 30 to 37; p<0.001; 44%) higher. CAM patients do not have lower or higher mortality rates than CON patients.CONCLUSIONS:Dutch patients whose GP additionally completed training in CAM on average have €192 (10.1%) lower annual total compulsory and supplementary healthcare costs and do not live longer or shorter than CON patients.

Studies have found evidence that seemingly irrelevant details of an income component such as its label have an effect on how it is used. Using a data set with more than one million employee-month observations, we investigate the role of functional form assumptions and time aggregation in the analysis of these effects. In most cases we find evidence that marginal propensities to save differ across income components. Our analysis reveals a large degree of heterogeneity in savings behavior within the year.

We analyze child mortality in Vietnam focusing on gender aspects. Contrary to several other countries in the region, mortality rates for boys are substantially larger than for girls. The mortality rate of boys appears to be more sensitive to parents’ education levels than the mortality rate of girls. A high education level of the father is particularly protective for boys. The rural–urban mortality difference in the raw data, which is particularly large for boys, can be fully explained by differences in observable characteristics of urban and rural households.

Resit exams–extra opportunities to do an exam in the same academic year–are widely prevalent in European higher education, but uncommon in the US. I present a simple theoretical model to compare rational student behavior in the case of only one exam opportunity versus the case of two exam opportunities. Numerical examples for a wide range of plausible parameter values show that a second exam opportunity increases the ultimate passing probability only slightly, but strongly reduces the average total student effort.

We study individuals' decisions to decline or accept preventive health care interventions such as flu shots and mammograms. In particular, we analyze the role of perceptions of the effectiveness of the intervention, by eliciting individuals' subjective probabilities of sickness and survival, with and without the interventions. Respondents appear to be aware of some of the qualitative relationships between risk factors and probabilities. However, on average they have very poor perceptions of the absolute probability levels as reported in the epidemiological literature. Perceptions are less accurate if a respondent is female and has no college degree. Perceived probabilities significantly affect the subsequent take-up rate of flu shots and mammograms.

Each week, the Dutch Postcode Lottery (PCL) randomly selects a postal code, and distributes cash and a new BMW to lottery participants in that code. We study the effects of these shocks on lottery winners and their neighbors. Consistent with the life-cycle hypothesis, the effects on winners' consumption are largely confined to cars and other durables. Consistent with the theory of in-kind transfers, the vast majority of BMW winners liquidate their BMWs. We do, however, detect substantial social effects of lottery winnings: PCL nonparticipants who live next door to winners have significantly higher levels of car consumption than other nonparticipants.

Health economists have largely ignored complementary and alternative medicine (CAM) as an area of research, although both clinical experiences and several empirical studies suggest cost-effectiveness of CAM. The objective of this paper is to explore the cost-effectiveness of CAM compared to conventional medicine. A data set from a Dutch health insurer was used containing quarterly information on healthcare costs (care by general practitioner (GP), hospital care, pharmaceutical care, and paramedic care), dates of birth and death, gender and 6-digit postcode of all approximately 150,000 insurees, for the years 2006-2009. Data from 1913 conventional GPs were compared to data from 79 GPs with additional CAM training in acupuncture (25), homeopathy (28) and anthroposophic medicine (26). Patients whose GP has additional CAM training have 0 to 30 percent lower healthcare costs and mortality rates, depending on age groups and type of CAM. The lower costs result from fewer hospital stays and fewer prescription drugs. Since the differences are obtained while controlling for confounders including neighborhood specific fixed effects at a highly detailed level, the lower costs and longer lives are unlikely to be related to differences in socio-economic status. Possible explanations include selection (e.g. people with a low taste for medical interventions might be more likely to choose CAM) and better practices (e.g. less overtreatment, more focus on preventive and curative health promotion) by GPs with knowledge of complementary medicine. More controlled studies (replication studies, research based on more comprehensive data, cost-effectiveness studies on CAM for specific diagnostic categories) are indicated.

This paper analyzes the decision making process of adult children to provide informal care to their parents. First, we develop a structural model to explain the amount of time that only children (without siblings) spend on providing care, taking into account opportunity costs in terms of time and money. The model is estimated using two datasets from 12 European countries and reveals the preferences of adult children for consumption, leisure and informal care. Although we assume that differences in behavior between children with and without siblings are due to dissimilar constraints only, by using only children we do not have to make assumptions about interactions between siblings in the structural model. In the presence of siblings, their choices also play a role in the caregiving decision. A central question is whether siblings make cooperative or noncooperative decisions. The second part of this paper aims to establish whether interactions between siblings are cooperative or noncooperative, by comparing predicted cooperative and noncooperative outcomes with observed outcomes. We use the structural parameter estimates from the first part of the paper and model the noncooperative outcomes using a Quantal Response Equilibrium. The results suggest that the nature of the interactions between siblings has a strong effect on the division of informal care between siblings. For almost three quarters of the families the noncooperative model has a better fit than the cooperative model. When the noncooperative families can be pushed into their cooperative outcome, their parents would on average receive 50% more informal care per week from their children, but this would reduce full-time labor supply by 5.7%-points and increase part-time labor supply by 6.7%.