CHEMP working papers

CHEMP WP # 4
E. Aleksandrova, V. Bagranova, C. Gerry
The Effect Of Health Shocks On Labour Market Outcomes In Russia
Economics/EC. WP BRP. Higher School of Economics, 2020

This paper provides evidence for the effects of health shocks measured by any negative change in self-assessed health (SAH) status on employment, personal income, and wages in the Russian population. We employ the average treatment effect on the treated (ATET) estimator combined with propensity score and nearest neighbour matching and data from Russian Longitudinal Monitoring Survey-HSE (RLMS-HSE) for 2000–2018. We find that adverse health shocks are associated with a reduction in the probability of remaining employed by 2%, and losses of income and wages of 17% and 11%, respectively. For men, the consequences of health shocks are more drastic. Severe health shocks that are measured as a drop in SAH by two or more levels are associated with greater losses: respondents aged 30–45 years old lose approximately 60% of their monthly income for severe shocks, and those aged 46–72 lose 35–45% of their wages and 9–10% in the probability of remaining employed.

CHEMP WP # 3
Sheiman I., Gerry C.
The Health Workforce of the Russian Federation in the Context of the International Trends
Public and Social policy/EC. WP BRP. Высшая школа экономики, 2016

Having one of the highest physician-population ratios in the world, Russia – paradoxically – also faces shortages of physicians. This paper explores the reasons for this paradox through examining the structural characteristics of the Russian health workforce and its development. In comparing Russia with mainstream European countries and in particular the ‘new” EU countries we argue that the shortage of physicians is determined mostly by the prevailing model of health workforce development with its enduring emphasis on quantitative rather than structural indicators. First, the traditional perception of physicians as inexpensive health resources determines the long-term growth of their jobs – irrespective of the new opportunities for substitution and other structural innovations. Second, there is a persistent distortion in the composition of physician supply, of which the most important is the very low share and narrow remit of primary health care providers in comparison to European standards. Third, the international trends in the division of labor between physicians, medical nurses and allied health personnel are not followed in Russia with the result of an inevitable overburden of physicians, the reproduction of a large supply of physicians, while also the paradoxical shortage. Fourth, the system of professional development of physicians does not match international standards. Although with a substantial delay, Russia has now started transition to a workforce model focused on structural characteristics of human resources and so, in the final part of the paper, these new initiatives of the Government are critically assessed.

CHEMP WP # 2
Rykov Y., Meylakhs P., Sinyavskaya Y.
Network Structure of an AIDS-denialist Online Community: Identifying Core Members and the Risk Group
Sociology. SOC. Высшая школа экономики, 2016. No. 71.

Background: With the rapid growth of online social network sites (SNS), the issue of health-related online communities and its social and behavioral implications have become increasingly important for public health and healthcare. Unfortunately, online communities often become vehicles for promotion of pernicious misinformation, for example, alleged harm of vaccination or that HIV-virus is a myth (AIDS-denialism). This study seeks to explore the social structure and participants' behavior of the AIDS-denialists online community to identify and estimate the those who potentially are most susceptible to AIDS-denialists arguments  - “the risk group” in terms of becoming AIDS-denialists. Methods: Social network analysis was used for examining the most numerous AIDS-denialist community in the most popular Russian SNA “VKontakte”, which numbered 13000 – 15 000 members during the various stage of analysis. Qualitative content analysis was also used for collecting relevant for this study members’ attributes, such as HIV status and the extent of belief in AIDS-denialists arguments. Two datasets were collected to analyze friendship relations between community members and their communication relations. Results: Using social network analysis combined with content analysis we have identified the core of online community - cohesive and dedicated AIDS-denialists, and the risk group, which is not equal in composition to all peripheral members appeared in the online group. The risk group is the circle of users who engage with core members through online communication and may be more susceptible the AIDS-denialist propaganda. Analysis allowed to significantly reduce the target audience for possible intervention campaign and simultaneously increase the accuracy of user selection into the risk group (1369 users from the risk group is more than 10 times less than whole online group population counting over 15,000 users). Thus, online information interventions should be aimed at this risk group audience in the first place to prevent their adoption of AIDS-denialism beliefs, further spread of AIDS-denialism, and pernicious health consequences associated with being an HIV-positive AIDS-denialist. Conclusion: More research on influence of AIDS-denialism on HIV-positive online group members is needed. Of particular interest are longitudinal or case control studies that could detect the size of effect of AIDS-denialist propaganda that is communicated from hard-core denialists to the risk group, different factors associated with higher or lower susceptibility to AIDS-denialist views, and real health behavior change that occurs with becoming an AIDS-dentalist