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Quasi-Experimental Evidence on the Effects of Health Information on Preventive Behaviour in Europe†
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The authors are grateful to Andrew Jones, Hendrik Jürges, Owen O'Donnell, Nicola Persico and Richard Cookson for useful comments. We also thank all participants at HEDG seminar held in York (October 2014) and all participants at Italian Health Economics Annual Meeting held in Trento (October 2013), the participants at Centre of health Economics Research (COHERE) seminar held in Odense (December 2013), the participants at the 6. Jahrestagung der Deutschen Gesellschaft für Gesundheitsökonomie held in Munich (March 2014), the participants at the Augsburg Workshop on the Economics of Health Behaviors and Prevention (November 2013), and the participants at the PhD Seminar on Health Economics and Policy in Grindelwald (January 2014) for helpful comments and suggestions. We thank Maryna Ivets, Ieva Scriubaite and Jan Thom for proofreading the paper. All remaining errors are our own.
Abstract
We investigate the effect of information on preventive decisions in a quasi-experimental setting arising from the implementation of local breast cancer screening programmes in Europe. To identify the causal effect of invitation on preventive uptake, we link administrative public data on regional screening policies to individual data from the Survey of Health Ageing and Retirement in Europe (SHARE) and exploit regional variation in the availability of screening policies and in age eligibility criteria. We find home invitation increases mammography uptakes by around 24%. Significant effects are found when at least 50% of the population is reached by the invitation letter. The stock of health information and the ability to process the information received seem to play a significant role, as the effects of invitation are higher among low educated and lower among cognitively impaired women.