COVID-19 and Health Outcomes, Spring 2021

The Covid-19 pandemic brought the dual crises of disease burden and the impact of containment policies designed to mitigate it, both of which generate meaningful economic adversities. Yet, there is little evidence on the potential costs of these policies in a low-income country where online substitutes for in-person transactions and social safety-nets are scarce. Given adverse gender norms, women may be especially vulnerable in such settings. Bau, Khanna, Low, Shah, Sharmin, and Voena conduct a large phone survey and combine it with India's unusually geographically variant containment policies, allowing us to estimate the relationship of the pandemic and containment policies with economic outcomes, food security, and female mental health in a lower-income country of 1.4 billion people. The pandemic resulted in drastic income losses and increases in food insecurity. Greater prevalence of containment policies is associated with increased food insecurity, particularly for women, and reduced female mental health and sense of safety. Mental health and food impacts were exacerbated for women who had daughters or lived in female-headed households, who may be more vulnerable. Bau, Khanna, Low, Shah, Sharmin, and Voena provide new evidence on the effects of lockdown policies in a country with limited social safety nets and present some of the first estimates of the Covid-19 pandemic's effect on mental health outside of high-income countries.

Estimates of willingness to get vaccinated for Covid-19 range from about 50% to 60% and are low even for some groups facing high risk of Covid-19 infection, hospitalization, and mortality. These rates are concerning given that models of herd immunity require much higher rates of vaccine take-up. In this work, Chang, Jacobson, Shah, Pramanik, and Shah are partnering with Contra Costa Health Services (CCHS), the department of health in Contra Costa County, CA, to test ways to increase Covid-19 vaccine take-up in a racially and ethnically diverse Medicaid managed care population. The researchers hypothesize that small financial incentives and other low-cost behavioral nudges, such as default appointments and race-concordant provider messages, can be used to increase vaccine take-up.

Although the value of vaccines may seem obvious, government action and investment in vaccines have not been commensurate with the enormous scale of benefits, with many countries not likely to achieve widespread immunization until the end of 2022.