Olivier Chanel

Faculty ,  CNRS

Public economics
Chanel
Status
Research professor
Research domain(s)
Econometrics, Environmental economics, Health economics
Thesis
1993, École des hautes études en sciences sociales
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Contact
olivier.chanel[at]univ-amu.fr
+33(0)4 13 55 25 35
Address

AMU - AMSE
5-9 Boulevard Maurice Bourdet, CS 50498
​13205 Marseille Cedex 1

Abstract To the best of our knowledge, this study provides the first broad-scale, nation-wide analysis of a set of long-term morbidity effects of air pollution and assessment of their economic impacts in France. We used the Health Risk Assessment method and the latest concentration-response functions, both from the World Health Organization (WHO). The economic analysis - a comprehensive cost of illness approach - includes direct health and non-health care costs, indirect and intangible costs. Beyond its impact on mortality, the study shows that lowering PM2.5 levels over time in France would produce substantial health and well-being benefits by reducing the onset of several diseases. Documented here as attributable to long-term exposure to anthropogenic PM2.5 on average in a given year are 20 % of new cases of respiratory diseases in children and 7–11 % of new cases of respiratory, cardiovascular or metabolic diseases in adults. We also show that reducing PM2.5 concentrations to WHO’s air-quality guideline (AQG) levels would reduce morbidity attributable to this anthropogenic pollution by up to 75 %. Finally, if average PM2.5 levels were reduced to their anthropogenic thresholds, annual benefits to health and well-being for the diseases studied would total €201812.88 billion. Given these findings, complying with WHO AQG would reduce mortality and morbidity attributable to air pollution in France and help achieve the objective of WHO’s Global Action Plan for the Prevention and Control of Noncommunicable Diseases, namely a one-third reduction in the risk of dying from a chronic disease by 2030.
Keywords Economic assessment, Health risk assessment, Long term impacts, Morbidity, PM25, Air pollution
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Abstract Recurring statistical issues such as censoring, non-random selection and heteroskedasticity often impact the analysis of observational data from natural and human processes. We investigate the potential advantages of models based on quantile regression (QR) for addressing these issues, with a particular focus on non-market valuation data. First, we provide analytical arguments showing how QR can tackle these issues. Second, we show by means of a Monte Carlo experiment how censored QR (CQR)-based methods perform compared to standard models with selection both accounted for and not accounted for in the modeling. Incidentally, we propose an alternative to the standard estimation procedure for the CQR model with selection, which divides computation time by about 100. Third, we apply these four models to a French contingent valuation survey on flood risk. Our findings suggest that selection-censored models are useful for simultaneously tackling issues often present in observational and human data. In addition, the CQR models give a better picture of the heterogeneity of the coefficients, but the computational complexity of the CQR-selection model does not seem to be offset by better performance.
Keywords Selection model censored quantile regression Monte Carlo experiment nonmarket valuation flood
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Abstract This paper tests experimentally how preferences for redistribution of members of the general public depend on how money is earned. An experiment was designed to form of “microparticipatory-democracy”where redistribution from winners to losers is decided through a sequential strategy-proof majority voting procedure. Based on five distributive justice theories, we elicit people’s preferences for redistribution when their earnings come from four factors: effort, social circumstances, brute luck, and option luck. In the aggregate, our results show that a relative majority of people agree with Dworkin’s cut, namely, to compensate for social circumstances and brute luck but not effort and option luck. Participants with bad outcomes are more likely to engage in a self-serving vote, but on average, the dominant concern in voting remains people’s fairness view. The knowledge of the distribution of earnings and petition for equality of opportunity make participants vote more in favor of redistribution.
Keywords Experiment, Responsibility, Equality of opportunity, Micro participatory-democracy, Social justice
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Abstract What this study adds: This study provides evidence of the health burden and economic losses attributable to heat and cold in Central and South American countries, covering various climates and populations. Most of the mortality burden for Central and South American countries is caused by cold compared to heat. The results showed geographical and climatic variations, indicating a significantly higher impact of nonoptimal temperatures in countries of the Southern Cone and locations with temperate climates. These findings offer direct evidence to guide policymakers in developing public health policies for mitigation and adaptation to the region's health effects and economic impacts of nonoptimal temperatures.
Keywords Mortality burden, Economic loss, Time series, Distributed lag nonlinear models, Multicountry, Central and South America, Nonoptimal temperatures
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Abstract Air pollution is currently accountable for 40,000 deaths every year in France. The main objective of this study was to characterize the evolution of urban air pollution and its impact on mortality, by comparing two air pollution exposure periods, 2008–2010 and 2017–2019, within the Toulouse area. We also aimed to estimate the presumed health benefits had tracer pollutant concentrations reached the level indicated by the updated 2021 World Health Organization (WHO) guidelines over the 2017–2019 period. The breakdown of this health impact, according to level of social deprivation, was also assessed along with an exploration of the associated economic impacts. Several quantitative health impact studies (EQIS) were conducted by modeling population exposure to PM2.5 and NO2 within the region covered by the second Toulouse Air Protection Plan (PPA). The French European Deprivation Index (F-EDI) was used as a fine-scale indicator of social deprivation, and economic impacts were estimated by assigning a monetary value to the prevention of one death linked to air pollution. Across the area of study, average annual concentration levels decreased from 17.2 μg/m3 to 10.3 μg/m3 for PM2.5, and from 21.7 μg/m3 to 18.1 μg/m3 for NO2 between 2009 and 2019. The proportion of all causes of mortality attributable to air pollution (95% confidence interval [95% CI]) thus dropped from 15.7% [5.8; 23.8] to 7.2% [2.6; 11.2] for PM2.5 between 2009 and 2019, and it decreased from 2.7% [0.9; 4.2] to 1.9% [0.7; 2.9] for NO2 over the same period. Despite this improvement, concentrations of tracer pollutants remained above WHO 2021 guidelines, and there were still 440 annual deaths attributable to overexposure to PM2.5, which could have been avoided had these values been reached in 2019. Regarding social deprivation, a low but increasing gradient of exposure to air pollution was observed between the least and most deprived population quintiles. This led to an even greater mortality gradient attributable to air pollution between these same quintiles, and this worsened between 2009 and 2019. The annual economic gains that could have potentially been achieved, had the WHO 2021 guidelines been met, are estimated at 2,772 million euros2018 in 2009 and 1,423 million euros2018 in 2019.
Keywords Social deprivation, Cost-benefit analysis, Mortality, Air pollution, Pollution de l&#039, air, Mortalité, Privation sociale, Analyse coût-bénéfice
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Abstract Objectives: We propose a general framework for estimating long-term health and economic effects that takes into account four time-related aspects.We apply it to a reduction in exposure to air pollution in the Canton of Geneva. Study design: Methodological developments on the evaluation of long-term economic and health benefits, with an empirical illustration. Methods: We propose a unified frameworkdthe comprehensive impact assessment (CIA)dto assess the long-term effects of morbidity and mortality in health and economic terms. This framework takes full account of four time-related issues: cessation lag, policy/technical implementation timeframe, discounting and time horizon. We compare its results with those obtained from standard quantitative health impact assessment (QHIA) in an empirical illustration involving air pollution reduction in the canton of Geneva. Results: We find that by neglecting time issues, the QHIA estimates greater health and economic benefits than the CIA. The overestimation is about 50% under reasonable assumptions and increases ceteris paribus with the magnitude of the cessation lag and the discount factor. It decreases both with the time horizon and with the implementation timeframe. Conclusion: A proper evaluation of long-term health and economic effects is an important issue when they are to be used in cost-benefit analyses, particularly for mortality, which often represents the largest fraction. We recommend using the CIA to calculate more accurate values.
Keywords Long-term health effects, Switzerland, Economic assessment, Air pollution, Comprehensive impact assessment, Quantitative health impact assessment
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Abstract This paper investigates how affective forecasting errors (A.F.E.s), the difference between anticipated emotion and the emotion actually experienced, may induce changes in preferences on time, risk and occupation after combat. Building on psychological theories incorporating the role of emotion in decision-making, we designed a before-and-after-mission survey for Danish soldiers deployed to Afghanistan in 2011. Our hypothesis of an effect from A.F.E.s is tested by controlling for other mechanisms that may also change preferences: immediate emotion, trauma effect – proxied by post-traumatic stress disorder (P.T.S.D.) – and changes in wealth and risk perception. At the aggregate level, results show stable preferences before and after mission. We find positive A.F.E.s for all three emotions studied (fear, anxiety and excitement), with anticipated emotions stronger than those actually experienced. We provide evidence that positive A.F.E.s regarding fear significantly increase risk tolerance and impatience, while positive A.F.E.s regarding excitement strengthen the will to stay in the military. Trauma has no impact on these preferences.
Keywords Risk preferences, Time preferences, Affective forecasting errors, PTSD, Afghanistan, Combat
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Abstract Introduction: We estimated the health and economic impacts of chronic exposure to air pollution for the Swiss part of the Greater Geneva area from 2016 to 2018. Materials and methods: We extracted from fine-scale modelled concentration maps for two pollutant indicators, particulate matter PM 2.5 and nitrogen dioxide. Then, we performed a quantitative health impact assessment of the health burden attributable to anthropogenic-origin air pollution, and estimated the benefits of compliance with the federal Ordinance on Air Pollution Control (OAPC) limit values. Finally, we computed the economic impacts of these health effects. Results: Exposure to fine particles of anthropogenic origin was responsible for 7.5% of annual mortality (280 deaths or 5,900 life years lost), for 14 lung cancers and for 68 strokes annually in the Canton of Geneva. Compliance with the OAPC limit value of 10 µg/m 3 as an annual average would reduce annual mortality by 1.5% (62 deaths avoided or 1,300 life years gained). Exposure to anthropogenic-origin NO 2 was associated with 5.3% of annual deaths (approximately 200 deaths per year). The estimated total negative economic impacts of anthropogenic-origin fine particles were at least CHF 2017 1.3 billion per year, whereas compliance with the OAPC limit values would result in annual economic benefits of at least CHF 2017 290 million. Conclusion: We confirmed that air quality remains a health issue on which stakeholder mobilisation is vital. Action plans should tackle emissions from freight and personal mobility, heating, industry and agriculture, while seeking to improve knowledge on health risks from air pollution exposure.
Keywords Switzerland, Economic assessment, Morbidity, Mortality, Quantitative health impact assessment
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Abstract Revealed and stated preference techniques are widely used to assess willingness to pay (WTP) for non-market goods as input to public and private decision-making. However, individuals first have to satisfy subsistence needs through market good consumption, which affects their ability to pay. We provide a methodological framework and derive a simple ex post adjustment factor to account for this effect. We quantify its impacts on the WTP for non-market goods and the ranking of projects theoretically, numerically and empirically. This confirms that non-adjusted WTP tends to be plutocratic: the views of the richest – whatever they are – are more likely to impact decision-making, potentially leading to ranking reversal between projects. We also suggest that the subsistence needs-based adjustment factor we propose has a role to play in value transfer procedures. The overall goal is a better representation of the entire population’s preferences with regard to non-market goods.
Keywords Subsistence needs, Adjustment factor, Non-market valuation, Value transfer, Population’s preferences
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Abstract Background Reducing the mortality burden associated with urban air pollution constitutes a public health priority, and evidence of unequal exposure and susceptibility across population subgroups is growing. Many European countries have implemented low emission zones (LEZs) in densely populated city centers. Although LEZs decrease air pollution exposure and health impacts, evidence is lacking on their impact across neighborhoods and socio-economic groups. Objectives The aim of this study was to evaluate the most equitable approach to implementing the second phase of the LEZ in Paris, France. We also present a literature review of the studies evaluating the benefits associated with LEZs in Europe. Methods A health impact assessment (HIA) was conducted to quantify changes in air pollution exposure and expected health benefits by socioeconomic group and neighborhood related to four hypothetical scenarios for the second phase of the LEZ based on French Deprivation Index scores. The study focused on NO 2 and PM 2.5 as air pollutants and evaluated the impact of the LEZ on the inequitable burden of childhood asthma and all-cause premature adult mortality. We also conducted an economic evaluation associated with the LEZ benefits on prevented deaths and asthma cases. Results The scenario with the largest LEZ perimeter and the most stringent vehicle standards prevented the highest number of cases and produced the most equitable distribution of health benefits, especially childhood asthma. It is expected that 810 deaths and 3200 cases of asthma could be prevented from the LEZ extension in this scenario. These results were distributed heterogeneously across three socioeconomic (SES) groups, most noticeably with asthma cases as 230, 180, and 210 cases were avoided per 100,000 inhabitants in high, medium, and low SES groups, respectively. We found substantial economic benefits associated with LEZ, with estimates ranging from €0.76 billion to €2.36 billion for prevented deaths. The benefits associated with asthma reduction ranged from €2.3 million to €8.3 million. Discussion Conducting HIAs with a focus on equity will further inform policy makers of the impact of LEZ models on air pollution, health, and environmental justice. Developing these systematic methods and applying them to future LEZs and other air pollution policies will increase their effectiveness to reduce the burden of ambient air pollution on society and the environment.
Keywords Environmental justice, Health equity, Air pollution policy, Air pollution, Traffic-related air pollution, Low emission zones
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Abstract We provide an estimate of the environmental impact of the recruitment system in the economics profession, known as the “international job market for economists”. Each year, most graduating PhDs seeking jobs in academia, government, or companies participate in this job market. The market follows a standardized process, where candidates are pre-screened in a short interview which takes place at an annual meeting in Europe or in the United States. Most interviews are arranged via a non-profit online platform, econjobmarket.org, which kindly agreed to share its anonymized data with us. Using this dataset, we estimate the individual environmental impact of 1057 candidates and one hundred recruitment committees who attended the EEA and AEA meetings in December 2019 and January 2020. We calculate that this pre-screening system generated the equivalent of about 4800 tons of avoidable CO2-eq and a comprehensive economic cost over €4.4 million. We contrast this overall assessment against three counterfactual scenarios: an alternative in-person system, a hybrid system (where videoconference is used for some candidates) and a fully online system (as it happened in 2020–21 due to the COVID-19 pandemic). Overall, the study can offer useful information to shape future recruitment standards in a more sustainable way.
Keywords Comprehensive economic cost, Environmental impact, Carbon footprint, International job market, Job market for economists
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Abstract In September 2021, the World Health Organization decided to implement stronger air quality guidelines for protecting health, based on the last decade of research. Ambient air pollution (AAP) was already the first environmental risk to health in terms of number of premature deaths, and this decision suggests that the risk was seriously underestimated. This chapter covers the relationship between AAP and health from an economic perspective. The first part presents the major regulated air pollutants and their related health effects, the way population exposure is measured, and the individual vulnerability and susceptibility to AAP-related effects. Then, the main approaches that estimate the relationships between health effects and air pollutants are covered: pure observational and interventional/quasi-experimental studies. Up-to-date reviews of the most robust relationships, and of the main findings of interventional/causal inference methods, are detailed. Next, impact assessments studies are tackled and some recent global assessments of health impacts due to AAP are presented. Once calculated, the health impacts can be expressed in monetary terms to enter the decision-making process. The relevant approaches for valuing market and nonmarket health impacts – market prices, revealed and stated preferences – are critically outlined, and their adequation with the AAP context examined. Finally, the economic health-related impacts of AAP are presented and discussed, with specific sections devoted to the necessity of an interdisciplinary approach and inequity-related issues at national and international levels. This chapter concludes with a widening of the perspective that tackles interactions between AAP on the one hand and climate change and indoor pollution on the other hand.
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Abstract Each year, the international job market for economists involves more than 1,000 candidates and several hundred recruiters from around the world meeting for short pre-screening interviews at annual congresses in Europe and the United States. Alberto Prati, Olivier Chanel and Morgan Raux argue that it’s time to reassess this unsustainable system and estimate the carbon footprint of alternatives.
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Abstract Cet article propose une approche intégrant le temps de latence dans le processus d’évaluation de la mortalité de long terme et dans sa valorisation économique, suite à un choc transitoire. Il l’applique aux conséquences des restrictions d’activité en lien avec la Covid‑19 au printemps 2020 sur la pollution de l’air ambiant en France. Ces conséquences sont évaluées en termes d’années de vie gagnées (AVG) ainsi qu’en termes monétaires pour deux indicateurs de pollution de l’air. Cette approche est comparée à une estimation standard par différence. Elle conduit à des résultats inférieurs d’un facteur 3.7 à 5.5 pour les AVG et, du fait de l’influence additionnelle de l’actualisation, à une valorisation économique inférieure d’un facteur 4.7 à 6.9. Ces résultats indiquent qu’une évaluation adaptée des bénéfices sanitaires de long terme, puis leur traduction en termes monétaires, est essentielle pour comparer les conséquences à long terme de politiques ou de chocs exogènes transitoires.
Keywords Economic valuation, Air pollution, Activity restrictions, Long‑term mortality, COVID‑19, Restrictions d’activité, Pollution de l’air, Évaluation économique, Mortalité de long terme, COVID‑19
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Abstract Redistributive justice is based on the premise that it is unfair for people to be better or worse off relative to others simply because of their fortune or misfortune. It assumes equal opportunities arising from four factors: social circumstances, effort, option luck and brute luck. This paper seeks to investigate how differences in perceived brute luck influence individual preferences for redistribution in favour of two public policies: “health intervention” and “environmental actions”. These policies are viewed somewhat differently: the environment is considered a pure “public good” and health, more as a “private good” with a strong public good element. Consequently, potential self-serving biases inherent in the preferences for redistributive policies are expected to differ, more likely favouring health than the environment. The perceived degree of brute luck may capture such a difference—those perceiving themselves as luckiest should be less amenable to redistribution in favour of health than the unluckiest. Data from the three waves (2000, 2006 and 2008) of a French population survey are used to examine this self-serving bias. A Generalised Ordered Logit (GOL) model is found to be statistically more relevant compared to other logistic regression models (multinomial and ordered). We find that a perceived low degree of brute luck is significantly associated with a decreased preference of redistributive environmental policies but the reverse is true for redistributive health policies, i.e., association with an increased preference. Assuming that all inequalities due to differing luck are unjust, this empirical validation gives redistributive justice grounds for equalisation policies regarding health.
Keywords Health humanities, Economics
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Abstract Introduction: Developing countries face major challenges in implementing universal health coverage (UHC): a widespread informal sector, general discontent with rising economic insecurity and inequality and the rollback of state and public welfare. Under such conditions, estimating the demand for a health insurance scheme (HIS) on voluntary basis can be of interest to accelerate the progress of UHC-oriented reforms. However, a major challenge that needs to be addressed in such context is related to protest attitudes that may reflect, inter alia, a null valuation of the expected utility or unexpressed demand. Methods: We propose to tackle this by applying a contingent valuation survey to a non-healthcare-covered Tunisian sample vis-à-vis joining and paying for a formal HIS. Our design pays particular attention to identifying the nature of the willingness-to-pay (WTP) values obtained, distinguishing genuine null values from protest values. To correct for potential selection issues arising from protest answers, we estimate an ordered-Probit-selection model and compare it with the standard Tobit and Heckman sample selection models. Results: Our results support the presence of self-selection and, by predicting protesters' WTP, allow the “true” sample mean WTP to be computed. This appears to be about 14% higher than the elicited mean WTP. Conclusion: The WTP of the poorest non-covered respondents represents about one and a half times the current contributions of the poorest formal sector enrolees, suggesting that voluntary participation in the formal HIS is feasible.
Keywords Protest answers, Self-selection, Universal health coverage, Willingness-to-pay, Contingent valuation
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Abstract Le changement climatique, la perte de la biodiversité et l’altération globale de l’environnement détériorent la santé des populations. Plus particulièrement, l’augmentation des périodes marquées par des températures élevées et leur persistance pourraient constituer un risque majeur pour une large part de la population et limiter drastiquement l’activité humaine. Pourtant, les vagues de chaleur sont sous-représentées dans les analyses des événements météorologiques extrêmes, en particulier dans les évaluations économiques. Ce manque d’études, associé à la faible perception par la population du risque lié à la chaleur, limite la mise en place de mesures d’adaptation, alors que les effets des canicules sont en grande partie évitables. Cet article présente l’évolution de l’impact économique global des effets sanitaires des vagues de chaleur observées en France entre 1974 et 2020.
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Abstract Despite unprecedented progress in developing COVID-19 vaccines, global vaccination levels needed to reach herd immunity remain a distant target, while new variants keep emerging. Obtaining near universal vaccine uptake relies on understanding and addressing vaccine resistance. Simple questions about vaccine acceptance however ignore that the vaccines being offered vary across countries and even population subgroups, and differ in terms of efficacy and side effects. By using advanced discrete choice models estimated on stated choice data collected in 18 countries/territories across six continents, we show a substantial influence of vaccine characteristics. Uptake increases if more efficacious vaccines (95% vs 60%) are offered (mean across study areas = 3.9%, range of 0.6%–8.1%) or if vaccines offer at least 12 months of protection (mean across study areas = 2.4%, range of 0.2%–5.8%), while an increase in severe side effects (from 0.001% to 0.01%) leads to reduced uptake (mean = −1.3%, range of −0.2% to −3.9%). Additionally, a large share of individuals (mean = 55.2%, range of 28%–75.8%) would delay vaccination by 3 months to obtain a more efficacious (95% vs 60%) vaccine, where this increases further if the low efficacy vaccine has a higher risk (0.01% instead of 0.001%) of severe side effects (mean = 65.9%, range of 41.4%–86.5%). Our work highlights that careful consideration of which vaccines to offer can be beneficial. In support of this, we provide an interactive tool to predict uptake in a country as a function of the vaccines being deployed, and also depending on the levels of infectiousness and severity of circulating variants of COVID-19.
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Abstract Scarcity of data on the health impacts and associated economic costs of heat waves may limit the will to invest in adaptation measures. We assessed the economic impact associated with mortality, morbidity, and loss of well-being during heat waves in France between 2015 and 2019. Methods Health indicators monitored by the French national heat wave plan were used to estimate excess visits to emergency rooms and outpatient clinics and hospitalizations for heat-related causes. Total excess mortality and years of life loss were considered, as well as the size of the population that experienced restricted activity. A cost-of-illness and willingness-to-pay approach was used to account for associated costs. Results Between 2015 and 2019, the economic impact of selected health effects of heat waves amounts to €25.5 billion, mainly in mortality (€23.2 billion), minor restricted activity days (€2.3 billion), and morbidity (€0.031 billion). Conclusion A better understanding of the economic impacts of climate change on health is required to support concrete adaptation actions and to alert decision-makers to the urgency of the situation.
Keywords Climate change, Economic assessment, Mortality, Heat-related illness, Extreme heat
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Abstract Bien que les canicules soient les événements climatiques extrêmes les plus importants en termes de mortalité, leurs impacts sont rarement considérés sous un angle économique. Cette méconnaissance, couplée à une perception du risque qui demeure faible, s'avère un frein à l'action en matière d'adaptation. Nous proposons une évaluation monétaire des impacts sanitaires des canicules en France métropolitaine entre 2015 et 2020. Méthode - Les indicateurs sanitaires suivis dans le cadre du Plan national canicule ont été utilisés pour appréhender les coûts des passages aux urgences et consultations SOS Médecins pour une sélection de causes liées à la chaleur. La mortalité en excès et la perte d'espérance de vie ont également été valorisées économique ment, ainsi que la perte de bien-être due aux restrictions d'activité. Une approche fondée sur le coût total de la maladie (coût direct, indirects et intangibles) et le consentement à payer a été utilisée. Résultats - Entre 2015 et 2020, les impacts sanitaires étudiés représentent au total, selon la méthode choisie, autour de 22 ou de 37 milliards €. La mortalité en excès est majoritaire (16 milliards € lorsqu'exprimée en années de vie perdues, ou 30 milliards € lorsqu'exprimée à partir des décès en excès) et la restriction d'activité est évaluée à environ 6 milliards €. Conclusions - Cette étude permet de mieux objectiver l'impact économique de ces événements climatiques extrêmes. Dans un contexte où les évolutions climatiques annoncent un accroissement des températures et des phénomènes de vagues de chaleur, pouvant conduire à une aggravation des impacts, ces résultats obtenus soulignent encore l'importance et l'urgence de mesures d'action permettant de renforcer l'adaptation aux canicules.
Keywords Mortality, Health impacts of health, Economic assessment, Climate change, Heatwave, Canicule, Mortalité, Impacts sanitaires de la chaleur, Évaluation économique, Changement climatique
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Abstract We propose a structural econometric model that incorporates altruism towards other household members into the willingness to pay for a public good. The model distinguishes preferences for public good improvements for oneself from preferences for improvements for other household members. We test for three different types of altruism - ‘pure self-interest’, ‘pure altruism’ and ‘public-good-focused non-pure altruism’. Using French contingent valuation data regarding air quality improvements, we find positive and significant degrees of concern for children under the age of 18, which are explained by determinants related to health and subjective air quality assessment. All other forms of pure or air-quality-focused altruism within the family are insignificant, including for children over 18, siblings, spouses, and parents. This result suggests that benefit estimates that do not consider altruism could undervalue improvements in air quality in France.
Keywords Willingness to pay, Contingent valuation, Field experiment, Familial altruism, Air pollution
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Abstract Cet article propose une discussion méthodologique à partir d’une évaluation économique des impacts sur la mortalité de l’exposition chronique aux particules fines en France continentale. Il prend comme point de départ l’évaluation quantitative d’impact sanitaire (EQIS), réalisée par Santé publique France en 2016, de 5 scénarios de réduction des concentrations par deux méthodes de mesure de la mortalité (nombre de décès prématurés évités et nombre total d’années de vie gagnées). Après une justification des valeurs monétaires utilisées – 3 millions € pour la valeur d’évitement d’un décès et 80 000 € pour celle d’une année de vie gagnée – nous les appliquons aux données sanitaires, et obtenons des résultats comparables aux études contemporaines. En particulier, dans un scénario sans pollution anthropique, l’EQIS de 2016 estime à 48 283 les décès prématurés évités, que nous évaluons à 144,85 milliards €2008. Nous questionnons ensuite les méthodes et pratiques, en commençant par identifier les sources de divergence avec la précédente étude française menée en 1998-99, dont l’évaluation était 5 fois moindre en dépit d’émissions particulaires plus élevées. Puis, nous discutons le choix des valeurs monétaires et les conditions d’utilisation de ces résultats dans la décision publique. Au final, nous apportons un argument supplémentaire sur la nécessité de réduire l’exposition des populations à la pollution de l’air ambiant en France.
Keywords Value of a prevented fatality, Mortality, Economic valuation, Air pollution, Valeur d&#039, évitement d&#039, un décès, Pollution atmosphérique, Évaluation économique, Mortalité
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Abstract Les effets sur la santé dits de long terme pose des difficultés particulières dans les évaluations économiques. En effet, puisque ces effets sont dues à une exposition cumulée à des facteurs de risque, il faut s'attendre à des délais entre la date de mise en oeuvre d'une politique de réduction de ces facteurs de risque et le moment où la totalité des bénéfices sanitaires espérés seront obtenus. Nous développons une méthodologie qui permet d'estimer ces délais et l'évolution des bénéfices obtenus. Nous appliquons cette méthodologie au cas d'une politique de réduction de la pollution de l'air. Le résultat principal est que la prise en compte de ces délais conduit à diviser par un facteur 1,6 à 2,5 les bénéfices. Il apparaît aussi que le taux d'actualisation a un effet qui dépend de la méthode de valorisation monétaire des effets sanitaires.
Keywords Air pollution, Long term mortality, Cost-benefit analysis, Discounting, Life expectancy, Analyse coût-bénéfice, Effet de long terme, Pollution de l&#039, air, Actualisation, Espérance de vie, Coûts sanitaires, Mortalité
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Abstract Stated preference surveys are usually carried out in one session, without any follow-up interview after respondents have had the opportunity to experience the public goods or policies they were asked to value. Consequently, a stated preference survey needs to be designed so as to provide respondents with all the relevant information, and to help them process this information so they can perform the valuation exercise properly. In this paper, we study experimentally an elicitation procedure in which respondents are provided with a sequence of different types of information (social cues and objective information) that allows them to sequentially revise their willingness-to-pay (WTP) values. Our experiment was carried out in large groups using an electronic voting system which allows us to construct social cues in real time. To analyse the data, we developed an anchoring-type structural model that allows us to estimate the direct effect (at the current round) and the indirect effect (on subsequent rounds) of information. Our results shed new light on the interacted effect of social cues and objective information: social cues have little or no direct effect on WTP values but they have a strong indirect effect on how respondents process scientific information. Social cues have the most noticeable effect on respondents who initially report a WTP below the group average but only after receiving additional objective information about the valuation task. We suggest that the construction and the provision of social cues should be added to the list of tools and controls for stated preference methods.
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Abstract The elicitation format is a crucial aspect of Contingent Valuation (CV) surveys and can impact their reliability. This paper contributes to the extensive debate on WTP (Willingness To Pay) elicitation formats by assessing whether the Circular Payment Card (CPC) can reduce anchoring on respondents' previous answers under multiple elicitation questions. This new format uses a visual pie-chart representation without start or end points: respondents spin the circular card in any direction until they find the section that best matches their WTP. We used a CV survey based on two ways of reducing risks associated with flooding, each randomly presented first to half of the respondents, to test the absolute performance of CPC. We presented a second survey on two social insurance schemes for subjects currently uninsured to respondents randomly split into three subgroups. Each group's WTP was elicited using one of three formats: Open-Ended (OE), standard Payment Card (PC) and the new CPC. The two insurance schemes were always proposed in the same order, and we assessed the relative performance of CPC by comparing anchoring across respondents. Our results provide evidence that CPC is likely to reduce anchoring in multiple elicitation questions and that respondents may rely on different heuristic decisions when giving WTP in the OE and in the two PC formats.
Keywords Flood, Social insurance, Circular payment card, Payment card, Elicitation format, Willingness to pay
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Abstract Les analyses coûts-bénéfices constituent un moyen pour le décideur public comme privé de rationaliser ses choix. Le processus semble transparent et le traitement des préférences égalitaire, puisque les préférences de chaque individu sont prises en compte de façon similaire lors de l’agrégation. Toutefois, en présence de composantes non marchandes évaluées sur la base des préférences de la population, les individus sont limités dans l’expression de leurs préférences, à la fois par leur revenu et par leur besoin de subsistance. Nous étudions les conséquences de ces contraintes sur la révélation des préférences et sur l’évaluation monétaire des biens non marchands. Nous trouvons qu’elles amènent à favoriser implicitement les préférences des individus à revenu élevé. Se pose alors la question de la correction des évaluations monétaires lors du traitement des préférences individuelles.
Keywords Economics, Health policy, Environmental policy, Consumer preference, Environment and public health
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Abstract Ce document évalue monétairement les impacts de l’exposition chronique aux particules fines sur la mortalité calculés par Santé publique France (Pascal et al., 2016a, 2016b) en France continentale. Il reprend les 5 scénarios de réduction retenus et les deux méthodes de mesure de la mortalité : en nombre de décès prématurés évités et en nombre total d’années de vie gagnées. Les calculs sont effectués pour la France continentale entière, et pour chacune des 12 nouvelles régions. Ils apportent un argument supplémentaire sur la nécessité de réduire l’exposition des populations à la pollution de l’air ambiant en France. Une synthèse est disponible dans Chanel (2017).
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Abstract Dans le secteur des transports, les émissions de gaz à effet de serre (GES) et de polluants atmosphériques locaux (PAL) sont analysées de manière indépendante non seulement lors de la fixation des normes d’émissions, mais également dans l’analyse économique. Puisqu’elles ont la même origine (le pétrole), nous proposons d’étudier les conséquences de leur traitement joint sur le choix d’une politique de transport. Dans un premier temps, nous mettons en évidence les relations existant entre les impacts sanitaires et socio-économiques associés à ces deux sources de pollution, et rappelons les modalités de leur évaluation monétaire. Nous établissons ensuite que la politique de transport à privilégier, lorsque les GES et les PAL sont pris en compte conjointement avec leurs incertitudes et irréversibilités respectives, favorise la diminution du transport privé motorisé. Nous discutons enfin les implications pratiques de ce résultat en matière de choix sociétaux.
Keywords Économie, Politique environnementale, Pollution atmosphérique, Changement climatique
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Abstract Background: The choice of elicitation format is a crucial but tricky aspect of stated preferences surveys. It affects not only the quantity and quality of the information collected on respondents’ willingness to pay (WTP) but also the potential errors/biases that prevent their true WTP from being observed. Objectives: We propose a new elicitation mechanism, the circular payment card (CPC), and show that it helps overcome the drawbacks of the standard payment card (PC) format. It uses a visual pie chart representation without start or end points: respondents spin the circular card in any direction until they find the section that best matches their true WTP. Methods: We performed a contingent valuation survey regarding a mandatory health insurance scheme in Tunisia, a middle-income country. Respondents were randomly allocated into one of three subgroups and their WTP was elicited using one of three formats: open-ended (OE), standard PC and the new CPC. We compared the elicited WTP. Results: We found significant differences in unconditional and conditional analyses. Our empirical results consistently indicated that the OE and standard PC formats led to significantly lower WTP than the CPC format. Conclusion: Overall, our results are encouraging and suggest CPC could be an effective alternative format to elicit ‘true’ WTP.
Keywords Contingent Valuation Survey, Payment card, Elicitation Method, Dichotomous Choice, Contingent valuation, Contingent Valuation Survey
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Abstract BRCA1/2 carriers have a higher risk of developing breast and ovarian cancer at a younger age. Preimplantation genetic diagnosis (PGD) and prenatal diagnosis (PND) are two of the few options available to avoid transmitting the mutation. To inform the bioethics debate about authorization, a contingent valuation survey elicited preferences regarding access to PGD and PND from a sample of 460 unaffected by cancer BRCA1/2 carriers (GENEPSO cohort). We find that the respondents can be classified into three groups: one opposed to PGD/PND (28.3%), one strongly in favour of PGD/PND (45.8%), and one in an intermediate position (25.9%). We look for the determinants of these preferences, especially of the willingness to pay for PGD/PND. Overall, we find that BRCA1/2 carriers support access to PGD/PND, which has implications for recommendations to decision-makers.
Keywords Economie quantitative
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Abstract This paper analyses how French general practitioners? (GPs) labour supply would respond to changes in their fee per consultation, seeking to determine whether there is a backward-bending curve.?Because French GPs? fees only evolve very slowly and are generally fixed by the National Health Insurance Fund, fee variability is not sufficient to observe changes in labour supply.?Therefore, we designed a contingent valuation survey randomly presenting GPs with three hypothetical fee increases.?Empirical evidence from 1,400 GPs supports the hypothesis of a negative slope in their labour supply curve.?This suggests that increasing fees is not an effective policy to increase the supply of medical services. JEL Codes: C21, I12, J22, J4.
Keywords Economie quantitative
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Abstract Abstract Public decision-makers commonly use health impact assessments (HIA) to quantify the impacts of various regulation policies. However, standard HIAs do not consider that chronic diseases (CDs) can be both caused and exacerbated by a common factor, and generally focus on exacerbations. As an illustration, exposure to near road traffic-related pollution (NRTP) may affect the onset of CDs, and general ambient or urban background air pollution (BP) may exacerbate these CDs. We propose a comprehensive HIA that explicitly accounts for both the acute effects and the long-term effects, making it possible to compute the overall burden of disease attributable to air pollution. A case study applies the two HIA methods to two CDs—asthma in children and coronary heart disease (CHD) in adults over 65—for ten European cities, totaling 1.89 million 0–17-year-old children and 1.85 million adults aged 65 and over. We compare the current health effects with those that might, hypothetically, be obtained if exposure to NRTP was equally low for those living close to busy roads as it is for those living farther away, and if annual mean concentrations of both PM10 and NO2—taken as markers of general urban air pollution—were no higher than 20 μg/m3. Returning an assessment of € 0.55 million (95 % CI 0–0.95), the HIA based on acute effects alone accounts for only about 6.2 % of the annual hospitalization burden computed with the comprehensive method [€ 8.81 million (95 % CI 3–14.4)], and for about 0.15 % of the overall economic burden of air pollution-related CDs [€ 370 million (95 % CI 106–592)]. Morbidity effects thus impact the health system more directly and strongly than previously believed. These findings may clarify the full extent of benefits from any public health or environmental policy involving CDs due to and exacerbated by a common factor.
Keywords Local traffic-related exposure, Health effects, Europe, Economic assessment, Air pollution
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Abstract Le changement climatique et la montée du niveau de la mer associée peuvent avoir des conséquences lourdes pour les écosystèmes côtiers et les sociétés qui y sont installées (Hinkel & Klein, 2003). En 2008, Poumadère et al. avaient constaté encore peu d’intérêt pour ce sujet en France, mais des évènements comme Xyntia (2010) ou la COP21 ont comme conséquence de soulever plus d’interrogations. Notre présentation porte sur une étude menée par Ruchi Mudaliar sur la perception du changement climatique par les habitants de Marseille et Nice. Cette étude est conçue comme une étude culturelle comparative avec le travail de Mudaliar (2012) en Inde. Les questions traitées sont : Est-ce que le changement climatique est une préoccupation pour les habitants de ces deux villes de la côté française méditerranéenne ? Si oui, est-ce qu’ils pensent qu’ils peuvent y faire face, s’y adapter, et comment ? L’outil de recueil de données a été la version française et adaptée de l’échelle de perception du changement climatique par Rishi et Mudaliar (2009). Il s’agit d’une échelle de type Likert, qui mesure les aspects cognitifs, affectifs et motivationnels de la perception du changement climatique. Cette échelle a été, dans la version française, complétée par des items issus d’enquêtes économiques et géographiques. La méthode d’analyse a été entre autres corrélationnelle afin de connaitre les liens entre les différentes variables et permettre des calculs de régression. Cette recherché a bénéficié du soutien d’OT Med-Fernand Braudel-IFER et du réseau ECCOREV.
Keywords Adaptation, Submersion marine, Perception du changement climatique, Marseille, Bien-être côtier, Nice
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Abstract This is the first book combining research on the Global Environment, Catastrophic Risks and Economic Theory and Policy. Modern economic theory originated in the middle of the twentieth century when industrial expansion coupled with population growth led to a voracious use of natural resources and global environmental concerns. It is uncontested that, for the first time in recorded history, humans dominate the planet, changing the planet's atmosphere, its bodies of water, and the complex web of species that makes life on earth. This radical change in circumstances led to rethinking of the foundations of human organization and, in particular, the industrial economy and the economic theory behind it. This book brings together new approaches on multiple levels: environmental sustainability requires rethinking in terms of economic theory and policy as well as the considerations of catastrophic risk and extremal events. Leading experts address questions of economic governance, risk management, policy decision making and distribution across time and space.
Keywords Emotion, Catastrophic risk
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Abstract L'évaluation des impacts sanitaires et économiques de la pollution atmosphérique constitue un enjeu majeur pour la population et pour les décideurs. Impliqués de longue date dans ce domaine, nous ne pouvons que nous féliciter de la parution de l'article de Rafenberg et al. (2015). II contribue en effet à la prise en compte de la morbidité chronique dans l'évaluation économique des effets de la pollution atmosphérique, une voie que le projet Aphekom avait également exploré par d'autres approches. Il nous a pourtant semblé nécessaire de clarifier un certain nombre de points relatifs à cette publication. Nous commencerons par évoquer les questions de méthodes. Nous aborderons ensuite la présentation et l'interprétation de certaines études discutées dans Rafenberg et al. (2015), car la présence d'erreurs relativise la portée de certains points de la discussion de cet article.
Keywords Economie quantitative
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Abstract In this paper, we propose a behavioral approach to determine the extent to which the consumer/citizen distinction affects interpretations of monetary values in stated preferences methods. We perform a field experiment dealing with air pollution, where some (randomly selected) subjects are given the opportunity to behave politically by signing a petition for environmental protection prior to stating their private preferences in a standard contingent valuation exercise. We show that signing has the potential to influence respondents' willingness to pay values. Results indicate that even market-like situations are not immune to citizen behavior.
Keywords Willingness to pay, Field experiment, Contingent valuation, Consumer, Commitment, Citizen, Air pollution
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Abstract Since the 1970s, legislation has led to progress in tackling several air pollutants. We quantify the annual monetary benefits resulting from reductions in mortality from the year 2000 onwards following the implementation of three European Commission regulations to reduce the sulphur content in liquid fuels for vehicles. We first compute premature deaths attributable to these implementations for 20 European cities in the Aphekom project by using a two-stage health impact assessment method. We then justify our choice to only consider mortality effects as short-term effects. We rely on European studies when selecting the central value of a life-year estimate (€2005 86 600) used to compute the monetary benefits for each of the cities. We also conduct an independent sensitivity analysis as well as an integrated uncertainty analysis that simultaneously accounts for uncertainties concerning epidemiology and economic valuation. Results: The implementation of these regulations is estimated to have postponed 2212 (95% confidence interval: 772–3663) deaths per year attributable to reductions in sulphur dioxide for the 20 European cities, from the year 2000 onwards. We obtained annual mortality benefits related to the implementation of the European regulation on sulphur dioxide of €2005 191.6 million (95% confidence interval: €2005 66.9–€2005 317.2). Conclusion: Our approach is conservative in restricting to mortality effects and to short-term benefits only, thus only providing the lower-bound estimate. Our findings underline the health and monetary benefits to be obtained from implementing effective European policies on air pollution and ensuring compliance with them over time.
Keywords Economie quantitative
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Abstract We extend the individual dynamic model of lifetime resource allocation to assess the monetary value given to the increase in survival probabilities for every member of a household induced by improved air quality. We interpret this monetary value as VPF (value of a prevented fatality), which can also be expressed as a flow of discounted VOLY (value of life years) lost, and account for potential altruism towards other household members. We use a French air pollution contingent valuation survey that provides a description of the life-length reduction implied by a change in air pollution exposure. By privatising the public commodity air pollution, we succeed in ruling out any form of altruism (towards others living today and towards future generations) except altruism towards one's family. We estimate a mean VOLY of € 2001 140,000, a 30% premium for VOLY in perfect health w.r.t. average expected health status, and a mean VPF of € 2001 1.45 million for the respondent, all context-specific. In addition, we find an inverted U-shaped relationship between his/her age and VOLY/VPF, and significant benevolence only towards children under 18.
Keywords Economie quantitative
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Abstract Recent epidemiological research suggests that near road traffic-related pollution may cause chronic disease, as well as exacerbate related pathologies, implying that the entire “chronic disease progression” should be attributed to air pollution, no matter what the proximate cause was. We estimated the burden of childhood asthma attributable to air pollution in 10 European cities by calculating the number of cases of 1) asthma caused by near road traffic-related pollution, and 2) acute asthma events related to urban air pollution levels. We then expanded our approach to include coronary heart diseases in adults.Derivation of attributable cases required combining concentration-response function (CRF) between exposures and the respective health outcome of interest (obtained from published literature), an estimate of the distribution of selected exposures in the target population, and information about the frequency of the assessed morbidities.Exposure to roads with high vehicle traffic, a proxy for near road traffic-related pollution, accounted for 14% of all asthma cases. When a causal relationship between near road traffic-related pollution and asthma is assumed, 15% of all episodes of asthma symptoms were attributable to air pollution. Without this assumption, only 2% of asthma symptoms were attributable to air pollution. Similar patterns were found for coronary heart diseases in older adults.Pollutants along busy roads are responsible for a large and preventable share of chronic disease and related acute exacerbation in European urban areas.
Keywords Economie quantitative
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Abstract An analysis of the hourly SO2 pollution patterns with time can be a useful tool for policy makers and stakeholders in developing more effective local policies in relation to air quality as it facilitates a deeper understanding of concentrations and potential source apportionment. A detailed analysis of hourly inter-annual, seasonal and weekday-specific SO2 concentration patterns using data obtained from 6 cities involved in the Aphekom project was conducted. This type of analysis has been done for other pollutants but less so for SO2, and not in a systematic fashion for a number of European cities. Individual diurnal SO2 profiles and working weekday versus weekend specific 24-hr plots were generated using hourly SO2 measurements from a roadside and an urban background monitoring sites for 1993, 2001 and 2009 for each of the 6 European cities (Athens, Barcelona, Brussels, London, Paris, and Vienna). This facilitated the assessment of city specific patterns and comparison of changes with time. SO2 concentrations varied throughout the day and tended to be lower on the weekends. A general decreasing trend for SO2 levels with time was observable at all stations. This study provides a useful European perspective on patterns of exposure. For the 6 EU cities examined, road traffic, heating, and shipping in port cities appeared to be important sources of SO2 emissions, and hence the driving components widely reflected in the diurnal profiles with lower levels on the weekend likely due to lower traffic volume and industry related emissions. Although ambient SO2 concentrations have fallen over the assessed study period at all measurement sites, the daily patterns remained relatively unchanged.
Keywords Weekend, Weekday, Vs
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Abstract no abstract
Keywords Ozone, Particulate matter, PUBLIC HEALTH, Air pollution
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Abstract [fr] La valorisation économique d’une diminution du risque de mortalité recourt de plus en plus fréquemment aux techniques d’évaluation contingente. Celles‑ci consistent à interroger un échantillon d’individus sur leur «consentement à payer » (CAP) pour réduire ce risque à partir de scénarios hypothétiques. Les CAP dépendent toutefois de nombreux facteurs et notamment de la nature du risque sous‑jacent et du scénario proposé pour le réduire. Cet article s’intéresse à la diminution du risque de mortalité associé à une exposition à la pollution atmosphérique et teste l’effet d’une modification du contexte d’évaluation hypothétique à travers trois scénarios : un nouveau médicament, un déménagement et de nouvelles réglementations. Pour analyser les CAP déclarés dans les différents scénarios, nous définissons un cadre d’analyse unifié, théorique puis économétrique, qui prend en compte les préférences des participants pour le présent, ainsi que celles des autres membres du ménage. Deux résultats en découlent. Les taux d’actualisation implicites estimés, spécifiques à chacun des scénarios hypothétiques, se révèlent significativement différents. De l’ordre de 7 % pour le scénario «déménagement » , ils sont respectivement de 24 % et 26 % pour les scénarios «médicament » et «réglementation » . Il en résulte des «valeurs d’évitement d’un décès » (VED) moyennes très différentes entre le scénario «déménagement » (801 000) d’une part, et les scénarios «médicament » (299 000) et «réglementation » (252 000) d’autre part. [en] The economic value placed on a reduction in the risk of mortality relies more and more frequently on contingent assessment techniques. These consist in questioning a sample of individuals on their “ willingness to pay” (WTP) in order to reduce this risk, on the basis of hypothetical scenarios. These WTP nevertheless depend on many factors, especially the nature of the underlying risk and the scenario proposed to reduce it. This article deals with reducing the risk of mortality associated with exposure to atmospheric pollution and tests the effect of a change in the hypothetical context of assessment through three scenarios : a new drug, a house move and new regulations. To analyse the “ willingness to pay” stated in the different scenarios, we define a unified, theoretical then econometric framework of analysis, taking into account the preferences of the participants at present, and also those of other household members. There are two main results. The estimated implicit updating rates, specific to each hypothetical scenario, were seen to differ significantly. They were about 7% for the “ move” scenario and 24% and 26% for the “ drugs” and “ regulations” scenarios respectively. Results showed that the average “ values set for avoiding death” differed greatly between the “ move” scenario (801,000) on the one hand, and the “ drugs” (299,000) and “ regulations” (252,000) scenarios on the other hand.
Keywords Economie quantitative
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Abstract no abstract
Keywords Public Health Practice, Quality Control, Risk Assessment, Urban Health, World Health Organization, Humans, Health Impact Assessment, Europe, Epidemiological Monitoring, Environmental Monitoring, Environmental Exposure, Air pollution, Air Pollutants
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Abstract Global environmental phenomena like climate change, major extinction events or flutype pandemics can have catastrophic consequences. By properly assessing the outcomes involved – especially those concerning human life – economic theory of choice under uncertainty is expected to help people take the best decision. However, the widely used expected utility theory values life in terms of the low probability of death someone would be willing to accept in order to receive extra payment. Common sense and experimental evidence refute this way of valuing life, and here we provide experimental evidence of people's unwillingness to accept a low probability of death, contrary to expected utility predictions. This work uses new axioms of choice defined by Chichilnisky (2000), especially an axiom that allows extreme responses to extreme events, and the choice criterion that they imply. The implied decision criteria are a combination of expected utility with extreme responses, and seem more consistent with observations.
Keywords Value of prevented fatality, Experiment, Expected Utility, Decision under risk, Catastrophic risk
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Abstract The objective of this paper is to outline the determinants of municipal land zoning in favor of agricultural and natural land conservation through a parsimonious allocation of land to urban development. We first rely on an abundant theoretical and empirical literature, especially on Solé-Ollé and Viladecans-Marsal (2012) and on a purposely designed field study of municipalities in Southern France to propose a theoretical model better suited to the French framework. The model is then econometrically tested, to account for possible selection bias. This empirical validation highlights the role of agricultural characteristics and the unexpected effect of electoral competition.
Keywords Political economy, Econometrics and qualitative approaches, Urban sprawl, Local land use policy
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Abstract Vaccination campaigns to prevent the spread of epidemics are successful only if the targeted populations subscribe to the recommendations of health authorities. However, because compulsory vaccination is hardly conceivable in modern democracies, governments need to convince their populations through efficient and persuasive information campaigns. In the context of the swine-origin A (H1N1) 2009 pandemic, we use an interactive study among the general public in the South of France, with 175 participants, to explore what type of information can induce change in vaccination intentions at both aggregate and individual levels.We find that individual attitudes to vaccination are based on rational appraisal of the situation, and that it is information of a purely scientific nature that has the only significant positive effect on intention to vaccinate.
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Abstract Vaccination campaigns to prevent the spread of epidemics are successful only if the targeted populations subscribe to the recommendations of health authorities. However, because compulsory vaccination is hardly conceivable in modern democracies, governments need to convince their populations through efficient and persuasive information campaigns. In the context of the swine-origin A (H1N1) 2009 pandemic, we use an interactive study among the general public in the South of France, with 175 participants, to explore what type of information can induce change in vaccination intentions at both aggregate and individual levels. We find that individual attitudes to vaccination are based on rational appraisal of the situation, and that it is information of a purely scientific nature that has the only significant positive effect on intention to vaccinate.
Keywords Information, Vaccination, Influenza A H1N1, Attitudes, Interactive, Experiment, France, Experience, Grippe A
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Abstract Transport generates many externalities, some related to atmospheric pollution. In this paper, we focus on two: greenhouse gases, and local pollution. In the search for optimal transport policies, these two externalities have usually been analysed separately. Here, we study them jointly, in a sequential decision-making model. Our model allows for the irreversibility of the policies undertaken, as well as the possibility of a progressive reduction of uncertainties with the arrival of information. We find that when both sources of externalities are analysed jointly, structural measures enabling private transport requirements to be reduced are identified as being more advantageous economically than technological measures to reduce emissions of pollutants. We illustrate the usefulness of a joint analysis of externalities with two examples: tax measures on cars and housing policy.
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Abstract À la fin des années 1980, l’intoxication saturnine a émergé en France non plusseulement sous forme de cas isolés d’intoxication aiguë, mais comme uneforme pernicieuse d’atteinte chronique, souvent cliniquement latente, quidevait faire l’objet d’une préoccupation spécifique de la part des autorités sanitaires.En effet, lié à un toxique largement répandu dans l’environnement, aux effetscliniques difficilement décelables et à un détriment sanitaire prolongé très audelàde la soustraction à l’exposition, le saturnisme infantile présente dessingularités à prendre en compte dans toute démarche visant à en réduire lafréquence et les effets.Les sources de plomb sont multiples (peintures anciennes, effluents industriels,eau…), et leur accessibilité variable, d’où une grande diversité des processusd’exposition et d’intoxication du jeune enfant et du très jeune enfant. Ceux-cisont particulièrement sensibles aux effets neurotoxiques du fait de leur organismeen développement.De plus, les ressources thérapeutiques disponibles ne prétendent pas à la guérisonmais à l’évitement des formes les plus aiguës.Enfin, et ce n’est pas la moindre caractéristique, le saturnisme infantile estapparu – en raison des facteurs de risque mis en évidence – comme une pathologieatteignant de manière quasi exclusive les groupes sociaux les plus pauvreset se cumulant aux autres facteurs d’inégalités sociales de santé, et plus généralementde logement, d’accès aux droits et d’éducation.L’ensemble de ces particularités fait que le dépistage de l’intoxication saturninedu jeune enfant relève d’une démarche active des acteurs médicosociaux,et qui doit nécessairement être associée à une action coordonnée sur les sourcestoxiques en cause et à la suppression de l’exposition des enfants(...)
Keywords Intoxication saturnine, Neurotoxique, Plomb, Plombémie
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Keywords Industrie de la carte à puce, Alliances, Acquisitions
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Keywords Banks and banking technological innovations, Smart card technology, Moneo electronic purse, France
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Abstract Abstract This paper concerns the difficulty of taking long-term effects on health into account in an economic valuation. Indeed, public decision makers should incorporate the cessation lag between implementation of an abatement policy and achievement of all of the expected mortality-related benefits for any projects involving health impacts. This paper shows how this time lag problem can be handled by proposing two approaches - either in terms of deaths avoided or of life years saved - within a dynamic perspective. The main findings are that long-term health benefits calculated by standard methods and widely applied to adverse health effects should be corrected downwards when incorporated into an economic analysis. The magnitude of correction depends on the discount rate, on technical choices dealing with epidemiology and on the method chosen to assess mortality benefits.
Keywords Air pollution, Health effect, Lattency effect
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Abstract Cet article propose une méthode d'évaluation monétaire des politiques de prévntion dont les bénéfices sanitaires s'étalent dans le temps. La méthodologie proposée prend en compte l'effet de latence entre la mise en place de la politique et l'obtention de l'ensemble des bénéfices sanitaires relatifs à la mortalité. Ces bénéfices sont évalués en termes d'années de vie gagnées et de décès prématurés évités pour deux programmes de prévention : une réduction de la pollution de l'air et une politique de prévention routière. Les principaux enseignements sont que la comparaison relative des bénéfices des deux politiques s'avère très sensible aux choix de la technique de monétarisation et du taux d'actualisation.
Keywords Politique de prévention, Pollution de l&#039, air, Prévention routière, Analyse coûst-bénéfices, Effet de latence, Monétarisation de la mortalité
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Abstract L'évaluation de politiques de prévention sanitaire par le recours à des Consentements A Payer (CAP) issus d'enquêtes auprès de la population est de plus en plus fréquent. Lorsque ces politiques revêtent une dimension collective, les CAP déclarés par les individus peuvent refléter une composante altruiste, ce qui rend problématique le calcul économique. A partir d'une enquête d'évaluation contingente portant sur deux politiques de prévention de la Fièvre Q, l'une collective et l'autre individuelle, nous mobilisons le cadre théorique de l'utilité espérée pour déterminer le caractère altruiste (ou non) des individus, que nous expliquons ensuite par certaines de leurs caractéristiques socio-économiques. Le principal résultat est que 66% des répondants incluent une composante altruiste lors de la révélation du CAP pour le programme collectif. Elle représente 3,6 euro en moyenne, soit environ 25% du CAP considéré.
Keywords Altruisme
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Abstract Air pollution contributes to mortality and morbidity. We estimated the impact of outdoor (total) and traffic-related air pollution on public health in Austria, France, and Switzerland. Attributable cases of morbidity and mortality were estimated. Methods: Epidemiology-based exposure-response functions for a 10 μg/m3 increase in particulate matter (PM10) were used to quantify the effects of air pollution. Cases attributable to air pollution were estimated for mortality (adults ≥30 years), respiratory and cardiovascular hospital admissions (all ages), incidence of chronic ronchitis (adults ≥25 years), bronchitis episodes in children (>15 years), restricted activity days (adults ≥20 years), and asthma attacks in adults and children. Population exposure (PM10) was modelled for each km2. The traffic-related fraction was estimated based on PM10 emission inventories. Findings: Air pollution caused 6% of total mortality or more than 40 000 attributable cases per year. About half of all mortality caused by air pollution was attributed to motorised traffic, accounting also for: more than 25 000 new cases of chronic bronchitis (adults); more than 290 000 episodes of bronchitis (children); more than 0·5 million asthma attacks; and more than 16 million person-days of restricted activities. Interpretation: This assessment estimates the public-health impacts of current patterns of air pollution. Although individual health risks of air pollution are relatively small, the public-health consequences are considerable. Traffic-related air pollution remains a key target for public-health action in Europe. Our results, which have also been used for economic valuation, should guide decisions on the assessment of environmental health-policy options.
Keywords Air pollution, Health impact
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Abstract Background: Air pollution contributes to mortality and morbidity. We estimated the impact of outdoor (total) and traffic-related air pollution on public health in Austria, France, and Switzerland. Attributable cases of morbidity and mortality were estimated. Methods: Epidemiology-based exposure-response functions for a 10 μg/m3 increase in particulate matter (PM10) were used to quantify the effects of air pollution. Cases attributable to air pollution were estimated for mortality (adults \textgreater30 years), respiratory and cardiovascular hospital admissions (all ages), incidence of chronic bronchitis (adults \textgreater25 years), bronchitis episodes in children (\textless15 years), restricted activity days (adults \textgreater20 years), and asthma attacks in adults and children. Population exposure (PM10) was modelled for each km2. The traffic-related fraction was estimated based on PM10 emission inventories. Findings: Air pollution caused 6% of total mortality or more than 40 000 attributable cases per year. About half of all mortality caused by air pollution was attributed to motorised traffic, accounting also for: more than 25 000 new cases of chronic bronchitis (adults); more than 290 000 episodes of bronchitis (children); more than 0·5 million asthma attacks; and more than 16 million person-days of restricted activities. Interpretation: This assessment estimates the public-health impacts of current patterns of air pollution. Although individual health risks of air pollution are relatively small, the public-health consequences are considerable. Traffic-related air pollution remains a key target for public-health action in Europe. Our results, which have also been used for economic valuation, should guide decisions on the assessment of environmental health-policy options.
Keywords Economie quantitative
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Abstract Efficacité de la dépense publique en matière de santé Cohérence des instruments de régulation La recherche confiée au GREQAM par le Commissariat Général du Plan, « Efficacité de la dépense publique en matière de santé : cohérence des instruments de régulation », se présente sous la forme de deux études, l’une théorique et l’autre empirique. La partie théorique est composée de trois analyses séparées. Les deux premières ont été suscitées par les réformes institutionnelles de 1996 :l’une s’intéresse aux mécanismes d’enveloppe globale instaurés par lesdites «ordonnances Juppé » pour maîtriser les dépenses du secteur hospitalier privé ; l’autre étudie un aspect de la décentralisation régionale du budget santé (passage d el’OQN aux OQR). La troisième étude questionne une pratique de régulation plus ancienne, mais constante, des dépenses du secteur hospitalier public. La partie empirique est entièrement consacrée à l’analyse du PMSI-privé. Elle est composée de trois études :l’une, institutionnelle, présente le système de tarification des cliniques ; es deux suivantes sont centrées sur l’exploitation de la base PMSI-privé. Par rapport au projet initial, cette analyse empirique a pris une importance accrue afin de tirer le meilleur parti d’une opportunité rare : la mise à disposition par les Fédérations professionnelles de l’hospitalisation privée de la base de données nationale dont elles disposent. Pa n souci d’efficacité, chaque volet de cette recherche a été placé sous la responsabilité d’un directeur de recherche,quia assuré de bout en bout la maîtrise d’œuvre. Néanmoins, tous les membres du GREQAM, mobilisés par cette recherche,ont participé à l’ensemble des travaux.
Keywords Économétrie de la santé, Dépenses publiques depuis 1980, Formation Enseignants
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Abstract Le plomb est un métal exploité depuis des millénaires, mais son usage s'estaccentué avec la révolution industrielle. L'exposition de populations travaillantdans les industries utilisant le plomb a révélé les effets délétères de ce métal surdifférentes fonctions biologiques. L'introduction du plomb dans certaines peinturesen tant que pigment, puis dans l'essence après la découverte de ses propriétésantidétonantes, a eu pour conséquence une diffusion encore plus large dansl'environnement. Cette pollution, touchant l'ensemble de la planète, conduit às'interroger maintenant sur les conséquences en termes de santé publique d'uneexposition permanente au cours de la vie à des doses faibles ou moyennes. Lesenfants sont une population particulièrement vulnérable puisque les effets du plombsont importants sur le cerveau en développement, mais ces effets toxiquespourraient également se manifester à d'autres périodes de la vie.L'analyse des études épidémiologiques effectuées dans les populationsprofessionnellement exposées au plomb ou en population générale et des travauxexpérimentaux in vivo et in vitro, permet de répertorier les différents effets duplomb sur l'organisme. Chez les enfants, les études longitudinales et transversalesmettent en évidence que des niveaux croissants d'exposition au plomb sont corrélésà une réduction des scores de développement intellectuel et psychique exprimésnotamment par le QI.Des stratégies de dépistage chez les enfants ont été développées à large échelle auxEtats-Unis sous l'impulsion des Centers for disease control sur la base de plusieursfacteurs de risque, principalement l'habitat dégradé, source potentielle depoussières chargées de plomb, et le niveau socio-économique. Une approchedifférente du dépistage doit-elle être envisagée à la lumière des données sur lesrisques liés à une exposition plus faible ? Quel est le nombre d'enfants affectés enFrance par une baisse de QI, selon l'existence ou non d'un seuil d'exposition ?Quelles sont les principales sources d'apport en plomb selon le site géographique,pour le nourrisson, l'enfant et l'adulte ? Quels sont les bénéfices attendus d'uneréduction globale de l'exposition au plomb de la population générale et ceux de labaisse de l'exposition chez les enfants de moins de 6 ans vivant dans un habitatdégradé ? Quels sont les coûts d'une politique visant principalement le risquehydrique, et ceux résultant des mesures de réhabilitation d'urgence ou d'éradicationcomplète du plomb dans l'ensemble des logements ?...
Keywords Contamination des sols, Fonctions cognitives, Habitat contaminé, Intoxication par le plomb, Pollution atmosphérique, Pollution de l&#039, eau, Saturnisme
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Abstract Recurring statistical issues such as censoring, selection and heteroskedasticity often impact the analysis of observational data. We investigate the potential advantages of models based on quantile regression (QR) for addressing these issues, with a particular focus on willingness to pay-type data. We gather analytical arguments showing how QR can tackle these issues. We show by means of a Monte Carlo experiment how censored QR (CQR)-based methods perform compared to standard models. We empirically contrast four models on flood risk data. Our findings confirm that selection-censored models based on QR are useful for simultaneously tackling issues often present in observational data.
Keywords Censored Quantile Regression, Contingent valuation, Flood, Monte Carlo Experiment, Quantile regression, Selection Model, Willingness to pay
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Abstract Revealed and stated preference techniques are widely used to assess willingness to pay (WTP) for non-market goods as input to public and private decision-making. However, individuals first have to satisfy subsistence needs through market good consumption, which affects their ability to pay. We provide a methodological framework and derive a simple ex post adjustment factor to account for this effect. We quantify its impacts on the WTP for non-market goods and the ranking of projects theoretically, numerically and empirically. This confirms that non-adjusted WTP tends to be plutocratic: the views of the richest-whatever they are-are more likely to impact decision-making, potentially leading to ranking reversal between projects. We also suggest that the subsistence needs-based adjustment factor we propose has a role to play in value transfer procedures. The overall goal is a better representation of the entire population's preferences with regard to non-market goods.
Keywords Non-market valuation, Value transfer, Population&#039, s preferences, Adjustment factor, Subsistence needs
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Abstract Cet article propose une discussion méthodologique à partir d’une évaluation économique des impacts sur la mortalité de l’exposition chronique aux particules fines en France continentale. Il prend comme point de départ l’évaluation quantitative d’impact sanitaire (EQIS), réalisée par Santé publique France en 2016, de 5 scénarios de réduction des concentrations par deux méthodes de mesure de la mortalité (nombre de décès prématurés évités et nombre total d’années de vie gagnées). Après une justification des valeurs monétaires utilisées – 3 millions € pour la valeur d’évitement d’un décès et 80 000 € pour celle d’une année de vie gagnée – nous les appliquons aux données sanitaires, et obtenons des résultats comparables aux études contemporaines. En particulier, dans un scénario sans pollution anthropique, l’EQIS de 2016 estime à 48 283 les décès prématurés évités, que nous évaluons à 144,85 milliards €2008. Nous questionnons ensuite les méthodes et pratiques : les sources de divergence avec la précédente étude française menée en 1998-99, le choix des valeurs monétaires et les conditions d’utilisation de ces résultats dans la décision publique. Au final, nous apportons un argument supplémentaire sur la nécessité de réduire l’exposition des populations à la pollution de l’air ambiant en France.
Keywords Évaluation économique, Mortalité, Valeur d’évitement d’un décès, Pollution atmosphérique
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Abstract In their attempts to implement universal health coverage (UHC), different developing countries encounter different types of obstacles. In Tunisia, major challenges include a widespread informal sector and protestors’ general discontent with rising economic insecurity and inequality, the rollback of the state and public welfare. We apply a contingent valuation survey to a non-healthcare-covered Tunisian sample vis-à-vis joining and paying for a health insurance scheme. We pay attention to the nature of the willingness- to-pay (WTP) values obtained, distinguishing genuine null from protest values. The latter may reflect not only protesters’ beliefs regarding the survey, but also their lack of trust in government’s commitment to ensuring the provision of quality healthcare. We use alternative econometric modeling strategies to account and correct for selection issues arising from protest answers. Our results support the presence of self- selection and, by predicting protesters’ WTP, allow the “true” sample mean WTP to be computed. This appears to be about 14% higher than the elicited mean WTP. The WTP of the poorest non-covered respondents represents about one and a half times the current contributions of the poorest formal sector enrollees, suggesting that voluntary affiliation to the formal health insurance scheme could be a step towards achieving UHC. Overall, we highlight the importance of taking into account protest positions for the evaluation of progress towards UHC.
Keywords Willingness-to-pay, Self-selection, Protest attitude, Contingent valuation, Universal health coverage
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