Portrait of Dr Olena Nizalova

Dr Olena Nizalova

Senior Lecturer in Economics
Senior Research Fellow in Health Economics

About

Dr Olena Nizalova is a Senior Lecturer in Economics in the School of Economics, and a joint Senior Research Fellow in Health Economics in the Centre for Health Services Studies (CHSS) and the Personal Social Services Research Unit (PSSRU) within the School of Social Policy, Sociology, and Social Research (SSPSSR).

She joined the University of Kent in 2013, having completed a tenure as an Associate Professor at the Kyiv School of Economics in Ukraine, where she worked from 2005.

She has an MSc in Business Management from the Ukrainian State Maritime Technical University, MA in Economic Theory from the EERC MA Program in Economics at the National University 'Kyiv Mohyla Academy' Ukraine, and a PhD in Economics from Michigan State University (USA). Her dissertation title was 'Three Essays in Labour Economics and Economics of Aging'.

Olena is a member of the School of Economics' Microeconomics Research Group and the SSPSSR’s Welfare State Research Cluster.

Research interests

Olena uses econometric methods and utility maximisation framework to study how people make choices with regards to their health, work and families in ageing societies and post-Soviet countries in order to contribute to the development of sustainable ways of our comfortable life on Earth.

Her current research projects include:

  1. Study of the risk factors which contribute to an increased use of social care in the future.
  2. Interdependency between formal and informal elderly care.
  3. Effect of TB epidemic in Ukraine on productivity of individuals and firms.
  4. RISKIT-CJS evaluation of a multi-component intervention to reduce substance use and risk-behaviour in adolescents engaged with the criminal justice system.

Teaching

Supervision

Current students

  • Yannis Galanakis (Economics)
  • Lucas Adeoye (Economics)
  • Boniface Oyugi (SSPSSR)
  • Maria Vasiakina  (visiting, University of Insubria, Italy) 

Professional

  • Director, Q-Step
  • Director, GLO VirtYS 
  • American Economic Association
  • International Health Economics Association
  • Global Labor Organization

Publications

Article

  • Nizalova, O. (2019). Net versus Gross Measure of Monetary Transfers in Intergenerational Exchange Studies. [Online]. Available at: http://dx.doi.org/10.13140/RG.2.2.36347.67361.
    This paper investigates whether the choice of the net versus gross measure of monetary transfers from adult children to their elderly parents can explain the differences in the estimates of the wage effect on money transfers found in earlier studies. It carefully documents the transfer pattern and points to the limitations of the OLS specification in the analysis of net transfers. A three-part model is offered as a better alternative for the analysis of net transfers. This model consists of a multinomial probit and two OLS equations for negative and positive net transfers. The results from estimating this model uncover the following empirical regularities. First, wages of adult children play an important role in the determination of the transfer status: higher wages are associated with a lower likelihood of adult children being net recipients and higher likelihood of them being net givers. Second, there is a significant positive effect of wages on the amount of transfers given to elderly parents among the net givers while the wage effect among the net recipients is negative but not statistically different from zero. Finally, it has been found that certain characteristics have similar effect on both probability of being a net recipient and probability of being a net giver. These features provide a useful guideline for future theoretical research. One of the possible theoretical models that possesses such features is outlined in this paper.
  • Norton, E., Nizalova, O. and Murtazashvili, I. (2018). Does past unemployment experience explain the transition happiness gap?. Journal of Comparative Economics [Online] 46:1104-1121. Available at: https://dx.doi.org/10.1016/j.jce.2018.04.004.
    The profound economic and political changes of the 1990s had detrimental social effects in many domains of life in post-socialist countries, including diminishing life expectancy and growing unhappiness. Despite economic improvements in the second decade of transition, research has documented that happiness lagged behind. We test whether past unemployment experience can explain this “transition happiness gap in the context of Ukraine”, a country with a painful delayed transition from planned to market economy. We analyze unique longitudinal data for the period 2003–2012. Current unemployment substantially reduces subjective wellbeing, and the effect is roughly 50% larger for men than for women. The effect of past unemployment is significant, but small in magnitude compared to the effect of current unemployment. However, it does correspond to around 8% of the ‘’transition happiness gap” found by Guriev and Melnikov (2017), suggesting that past unemployment experience can be considered as a partial explanation.
  • Voßemer, J., Gebel, M., Nizalova, O. and Nikolaieva, O. (2018). The effect of an early-career involuntary job loss on later life health in Europe. Advances in Life Course Research [Online] 35:69-76. Available at: https://doi.org/10.1016/j.alcr.2018.01.001.
    Recent years have witnessed an increase in interest towards the long-term health consequences of early-career job loss and youth unemployment. Relying on detailed retrospective data from the third wave (2008/09) of the Survey of Health, Ageing and Retirement in Europe (SHARE) this paper investigates whether an involuntary job loss in the first 10 years after labour market entry has lasting negative effects on health more than 30 years later. The results show that an early-career involuntary job loss due to a layoff or plant closure increases the probability of fair or poor self-rated health in late life by about 6 percentage points. Moreover, examining the mechanisms behind this relationship, the analysis reveals that the subsequent unemployment risks and employment instability only explain a small share of the total effect. In line with previous studies, these findings highlight the importance of early career experiences for workers’ later life health.
  • Nizalova, O. (2017). Motherhood wage penalty may affect pronatalist policies. IZA Worldof Labor [Online] 359. Available at: https://wol.iza.org/articles/motherhood-wage-penalty-may-affect-pronatalist-policies.
    The motherhood wage penalty denotes the difference in
    wages between mothers and women without children
    that is not explained by differences in human capital
    characteristics and labor market experience. As part of the
    gender pay gap, the motherhood wage penalty can represent
    a significant cost to being female and having children. If
    ignored, it may undermine policy initiatives aiming to
    increase fertility rates in post-socialist countries, such as
    the costly “baby bonus,” which is a government payment to
    new parents to assist with the costs of childrearing
  • Yang, W., Forder, J. and Nizalova, O. (2016). Measuring the productivity of residential long-term care in England: methods for quality adjustment and regional comparison. European Journal of Health Economics [Online] 18:635-647. Available at: http://dx.doi.org/10.1007/s10198-016-0816-z.
    Productivity trend information is valuable in developing policy and for understanding changes in the ‘value for money’ of the care system. In this paper, we consider approaches to measuring productivity of adult social care (ASC), and particularly care home services. Productivity growth in the public sector is traditionally measured by comparing change in total output to change in total inputs, but has not accounted for changes in service quality and need. In this study, we propose a method to estimate ‘quality adjusted’ output based on indicators of the Adult Social Care Outcomes Toolkit (ASCOT), using data collected in the annual adult social care survey (ASCS). When combined with expenditure and activity data for 2010 to 2012, we found that this approach was feasible to implement with current data and that it altered the productivity results compared with non-adjusted productivity metrics. Overall, quality-adjusted productivity grew in most regions between 2010 and 2011 and remained unchanged for most regions from 2011 to 2012.
  • Nizalova, O. and Murtazashvili, I. (2016). Exogenous treatment and endogenous factors: vanishing of omitted variable bias on the interaction term. Journal of Econometric Methods [Online] 5:71-77. Available at: https://doi.org/10.1515/jem-2013-0012.
    Whether interested in the differential impact of a particular factor in various institutional settings or in the heterogeneous effect of policy or random experiment, the empirical researcher confronts a problem if the factor of interest is correlated with an omitted variable. This paper presents the circumstances under which it is possible to arrive at a consistent estimate of the mentioned effect. We find that if the source of heterogeneity and omitted variable are jointly independent of policy or treatment, then the OLS estimate on the interaction term between the treatment and endogenous factor turns out to be consistent.
  • Nizalova, O., Sliusarenko, T. and Shpak, S. (2016). The Motherhood Wage Penalty in Times of Transition. Journal of Comparative Economics [Online]. Available at: https://doi.org/10.1016/j.jce.2015.10.009.
    Depopulation trend in Ukraine caused to a large extent by the lowest low fertility rates raises serious concerns about long-term economic growth and the country’s future in general. In this paper we investigate the existence and the extent of the motherhood wage penalty as a potential impediment to having (more) children in a unique institutional environment. This environment is characterized by: de jure family supportive labor laws but de facto no legal enforcement of these laws; publicly subsidized childcare; and low cultural support for maternal employment, combined with extensive involvement of grand-parents. Relying on the data from the Ukrainian Longitudinal Monitoring Survey over the period from 1997 to 2007, we find that the overall motherhood wage penalty in Ukraine is much lower than in countries with similar de jure family policies and cultural norms. It constitutes approximately 19%, controlling for individual unobserved heterogeneity, a number of human capital characteristics, actual time in the labor force, and selection into employment. We also find that the motherhood wage penalty differs by education, age at birth of first child, and marital status.
  • Nizalova, O. (2012). The Wage Elasticity of Informal Care Supply: Evidence from the Health and Retirement Study. Southern Economic Journal [Online] 79:350-366. Available at: http://dx.doi.org/10.4284/0038-4038-2010.133.
    This article focuses on the wage elasticity of informal care supply to elderly parents employing an instrumental variable approach to account for the fact that the wage rate is likely to be correlated with omitted variables. Using the 1998 wave of the 1998), the wage elasticity of informal care supply is estimated to be negative and larger in magnitude than found previously. The lower bound of this elasticity is estimated to be ?1.8 for males and ?3.6 for females. Additional findings suggest that this wage elasticity differs by the type of care provided to elderly parents and that it is larger in magnitude among individuals with siblings and those with independently living parents. Overall the reductions in the informal care constitute about 18% of the labor supply response for men and about 56% of the labor supply response for women, which are not compensated by monetary transfers.
  • Winkler, J., Thornsbury, S., Artavia, M., Chmielewski, F., Kirschke, D., Lee, S., Liszewska, M., Loveridge, S., Tan, P., Zhong, S., Andresen, J., Black, J., Kurlus, R., Nizalov, D., Olynk, N., Ustrnul, Z., Zavalloni, C., Bisanz, J., Bujdosó, G., Fusina, L., Henniges, Y., Hilsendegen, P., Lar, K., Malarzewski, L., Moeller, T., Nizalova, O., Murmylo, R., Niedzwiedz, T., Prawiranata, H., Rothwel, N., van Ravensway, J., von Witzke, H. and Woods, M. (2010). A Conceptual Framework for Multi-Regional Climate Change Assessments for International Market Systems with Long-Term Investments. A conceptual framework for multi-regional climate change assessments for international market systems with long-term investments [Online] 103:445-470. Available at: http://dx.doi.org/10.1007/s10584-009-9781-1.
    A conceptual framework for climate change assessments of international market systems that involve long-term investments is proposed. The framework is a hybrid of dynamic and static modeling. Dynamic modeling is used for those system components for which temporally continuous modeling is possible, while fixed time slices are used for other system components where it can be assumed that underlying assumptions are held constant within the time slices but allowed to vary between slices. An important component of the framework is the assessment of the “metauncertainty” arising from the structural uncertainties of a linked sequence of climate, production, trade and decision-making models. The impetus for proposing the framework is the paucity of industry-wide assessments for market systems with multiple production regions and long-term capital investments that are vulnerable to climate variations and change, especially climate extremes. The proposed framework is pragmatic, eschewing the ideal for the tractable. Even so, numerous implementation challenges are expected, which are illustrated using an example industry. The conceptual framework is offered as a starting point for further discussions of strategies and approaches for climate change impact, vulnerability and adaptation assessments for international market systems.
  • Nizalova, O. and Vyshnya, M. (2010). Evaluation of the impact of the Mother and Infant Health Project in Ukraine. Health Economics [Online] 19:107-125. Available at: http://dx.doi.org/10.1002/hec.1609.
    This paper exploits a unique opportunity to evaluate the impact of the quality change in the labor and delivery services brought about by the Mother and Infant Health Project in Ukraine. Employing program evaluation methods, we find that the administrative units participating in the Project have exhibited greater improvements in both maternal and infant health compared to the control ones. Among the infant health characteristics, the MIHP impact is most pronounced for infant mortality resulting from deviations in perinatal period. As for the maternal health, the MIHP is the most effective at combating anemia, blood circulation and urinary-genital system complications, and late toxicosis. The analysis suggests that the effects are due to early attendance of antenatal clinics, lower share of C-sections, and greater share of normal deliveries. Preliminary cost-effectiveness analysis shows enormous benefit per dollar spent on the project: the cost to benefit ratio is one to 97 taking into account both maternal and infant lives saved as well as cost savings due to the changes in labor and delivery practices.
  • Nizalova, O., Nizalov, D. and Smal, V. (2007). Economically Distressed Areas in Ukraine: Methods and Examples of Delimitation. Regional Studies:159-169.
  • Neumark, D. and Nizalova, O. (2007). Minimum Wage Effect in the Longer Run. Journal of Human Resources [Online] 42:435-452. Available at: http://www.dx.doi.org/10.3368/jhr.XLII.2.435.
    Exposure to minimum wages at young ages could lead to adverse longer-run effects via decreased labor market experience and tenure, and diminished education and training, while beneficial longer-run effects could arise if minimum wages increase skill acquisition. Evidence suggests that as individuals reach their late 20s, they earn less the longer they were exposed to a higher minimum wage at younger ages, and the adverse longer-run effects are stronger for blacks. If there are such longer-run effects of minimum wages, they are likely more significant than the contemporaneous effects on youths that are the focus of research and policy debate.

Conference or workshop item

  • Gadsby, E., Eida, T., Marchand, C., Hendrie, N., Vass, R. and Nizalova, O. (2018). Working differently for improved primary care for young people in a difficult financial climate.
    Purpose: To think collectively and creatively about working in different ways in order to improve our response to multiple overlapping issues that lead directly and indirectly to poor health and wellbeing in young people.

    Context: Difficult economic conditions for many people in Europe have been created by government measures to reduce public expenditure. Large cuts to social security, a lack of earnings growth, minimal or no job security, and high housing and living costs are leading to people becoming locked in a cycle of poverty and neglect in an era of rising inequality. In efforts to survive in a time of austerity, many local councils in the UK have made cuts to children and young people’s services that have taken away some of the ‘lifeline’ support for vulnerable children and families, as well as some of the educational and recreational opportunities for young people. Prevention services such as preventive substance misuse, teenage pregnancy services and youth offending teams have also been reduced in many areas. This summer, analysis of the Millennium Cohort Study – a multi-disciplinary research project following the lives of around 19,000 children born in the UK in 2000-01 – found that a quarter of girls and 9% of boys were depressed at age 14. A recent Children’s Society survey of 11,000 14 year olds found that 22% of girls and nearly one in 10 boys had self-harmed in a year.

    GPs in the UK often talk about their feeling of helplessness when faced with increasing numbers of patients presenting with poor health and wellbeing caused by adverse life circumstances. Many of these issues are not medical, but they fill up the country’s surgeries nonetheless. Some GPs have coined a phrase to describe the condition of these patients: ‘shit-life syndrome’. It describes a situation where someone has so many things not working out for them that even an attempt to change one thing is often wiped out by the remaining factors causing them harm. Some areas with large numbers of patients in such situations have seen anti-depressant prescribing increase significantly.

    State of the art: In this workshop, we will briefly introduce the problem, with the help of a short video focused on a seaside town in England, and encourage participants to think about the nature of the situation. We will then describe three very different projects that CHSS are currently working on, and identify relevant learning and key challenges emerging from them. The group will then have time to think collectively about working in different ways in order to contribute to a better future for young people. There will be opportunities for small and whole group discussion and feedback, and questions to the CHSS team.
  • Gadsby, E., Eida, T., Marchand, C., Hendrie, N., Vass, R. and Nizalova, O. (2018). Working differently for improved primary care for young people in a difficult financial climate. In: European Forum for Primary Care 2018.
    In an environment of growing relative poverty, rising inequalities, high housing and living costs, increases in in-work poverty and cuts to social security, education, training and young people's services, GPs in the UK are often faced with patients who present with ‘low mood’ caused by adverse life circumstances. Many GPs have dubbed this ‘Shit-Life Syndrome’. This presentation considers the potential of three different projects being delivered or evaluated by the Centre for Health Service Studies to build understanding of the complex and dynamic ways in which these issues are interconnected. These projects include: ‘RISKIT’ – a ‘multi-component’ approach to addressing alcohol and substance use and risk-taking behaviour among young offenders; ‘Go Golborne’ – a ‘place-based’ approach to improving child health by reducing child obesity; and ‘EXCEPT’ – policy initiatives to help young people in Europe to overcome labour market insecurities and related risks. Together they present opportunities to reject reductionism in our approaches to dealing with complexity.
  • Nizalova, O. (2014). Performance of Health Care Systems: Does Structure of Government Spending Matter?. In: European Mortality Workshop.
  • Nizalova, O., Forder, J. and Gousia, K. (2014). Body Mass, Physical Activity and Future Care Needs. In: International Long-Term Care Policy Network Conference 2014. Available at: http://www.slideshare.net/olenanizalova/bmi-future-care20140901.
    Previous literature shows that Body Mass Index (obesity status) is a strong predictor of the
    disability and functional limitations. Relying on the data from the English Longitudinal Survey of
    Ageing over the period from 2002 to 2011, we find that obesity status is also a significant risk
    factor in determining future informal care needs but not formal care use, even after controlling for
    ADLs and IADLS and for specific existing health conditions, including diabetes, high blood pressure,
    and CVD. Obese elderly are 1.7-1.8 times more likely to use informal care and privately paid care,
    but not formal care, in two-year’s time. Sensitivity analysis on a restricted sample shows that this
    result is not driven by prediabetes. We also find that physical activity is associated with a
    significantly lower likelihood of using any mode of care in the future, with the strongest effect for
    formal care use. Moreover, the effect of obesity on informal care use is larger for females, but the
    protective effect of physical activity is stronger for males.
  • Nizalova, O. (2014). Relative Cost Effectiveness of Informal Care, Social Care and Paid Help Services in Preventing/Postponing Care/Nursing Home Admissions. In: International Long-Term Care Policy Network Conference 2014. Available at: http://www.ilpnetwork.net/index.php/accepted-abstracts.
  • Nizalova, O. (2014). The Wage Elasticity of Informal Care Supply: Do Long-Term Care Policies Matter?. In: 10th World Congress “Health Economics in the Age of Longevity”.
  • Nizalova, O. (2014). Inequality in Workplace (Dis)amenities Over the Course of Transition. In: 2nd Annual Congress. Available at: http://www.kse.org.ua/download.php?downloadid=346.
  • Nizalova, O. (2013). Long-run Effects of Severe Economic Recessions: Drastic Changes in Working Hours and Male BMI Trajectories. In: IHEA 9th World Congress on Health Economics. Available at: http://ihea2013.abstractsubmit.org/presentations/10266/.
    The recent economic downturn has inspired researchers to revisit earlier literature [started by Ruhm (2000)] documenting that mortality decreases during economic recessions. Ruhm (2005) demonstrates that during the hard times people smoke less and lose weight. Moreover, these changes in behavior disproportionately occur among heavy smokers and severely obese individuals. At the same time, those who were completely physically inactive become more likely to exercise.
    Applying the conclusions from this literature to the collapse of the Soviet Union implies that the severe economic downturn (of about 40%) that happened over the course of 5-6 years should have led to a tremendous improvement in health outcomes. Yet, since the beginning of transition period Ukraine, Russia and other post-Soviet countries have also experienced dramatic health deterioration. Males in those countries suffered the most health decline with Ukrainian male life expectancy at birth being the lowest among European countries (62.2 years in 2011). So, perhaps a modest economic downturn is good for one’s health, but too much of it can lead to deadly outcomes.
    Ukraine has the fastest rate of depopulation in Europe. Premature mortality of Ukrainian prime-age males is one of the major contributors to this pattern. The leading cause of death and disability is cardio-vascular disease (67% of all deaths in 2009), which is closely related to hypertension, obesity, and tobacco use. A recent health survey shows that hypertension prevalence among males is 30 percent and almost 50 percent of them are unaware of having this condition, 12 percent of males are obese and 50 percent are overweight. At the same time more than 60 percent of them are daily smokers.
    This paper’s goal is to investigate to what extent labor market fluctuations—both through individual experience and local conditions—are responsible for changes in obesity prevalence and related health behaviors. We focus our attention on three questions. The first two use data aggregated to the regional level. First, do sizeable changes in working hours change BMI trajectories. Second, can these changes in BMI trajectories be explained by changes in physical exercise related to more or less time availability, or by changes in tobacco and alcohol consumption due to more or less stressful lifestyle. Finally, we study whether an individual’s history of labor market shocks during the 1990s (a time of considerable economic downturn) affects their individual BMI-age trajectory.
    We use growth curve approach to model the trajectory of BMI by age. These models can help control for selection by allowing the differences in the initial levels of BMI (intercept) and in slopes of the BMI-age trajectories to vary with individual future working hours: those who significantly increased working hours, those who significantly decreased working hours, and those who preserved same number of working hours. To address the issue of endogeneity, we use local labor market conditions as instruments for changes in individual working hours and the history of local labor market conditions as an instrument for the history of individual labor market shocks.
  • Ganna, V., Nizalova, O. and Nizalov, D. (2013). Social Assistance System Modernization and Participation of the Poor. In: Global Development Network Annual Conference. Available at: http://gdn.int/admin/uploads/editor/files/2013Conf_Papers/OlenaNizalova_Paper.pdf.
    This paper evaluates the impact of the recent Social Assistance System Modernization Project on the
    three outcomes – probability of application, probability of getting any assistance, and probability of
    participation in more than two social assistance programs. Allowing for heterogeneous effect of the
    Project measures on poor and non-poor families, we find that in general the re-engineering of the
    system considerably improves targeting. For example, the purchase of new computers and
    modernization of computer networks improves targeting of the system by decreasing both the
    application and participation rate among the non-poor and increasing among the poor. Single
    window application procedure has positive impact on the participation of both groups of population,
    although the impact on the poor is twice larger in magnitude. Renovation of premises and purchase
    of new office equipment leads to higher application and participation rate across all population
    groups.
  • Nizalova, O. (2010). Evaluation of the Social Assistance System Modernization Project in Ukraine. In: GIZ Conference of Systemic Policy Evaluation.
  • Nizalova, O. and Vyshnya, M. (2009). Evaluation of the Mother and Infant Health Project in Ukraine. In: IHEA 7th World Congress on Health Economics. Available at: http://ihea2009.abstractbook.org/presentation/113/.
    This paper exploits a unique opportunity to evaluate the impact of improvement in the quality of prenatal care and labor and delivery services on maternal and infant mortality and morbidity. Since basic medical care has been universally available in Ukraine, implementation of the Mother and Infant Health Project allows addressing quality rather than quantity effect of medical care. Employing program evaluation methods we find that the administrative units (rayons) participating in the Project have exhibited greater improvements in both maternal and infant health compared to the control rayons. Among the infant health characteristics, the MIHP impact is most pronounced for stillbirths, as well as infant mortality and morbidity resulted from deviations in perinatal period and congenital anomalies. As for the maternal health, the MIHP is most effective at combating such complications related blood circulation, veins, and urinary-genital systems, as well as late toxicosis and anemia. The analysis suggests that the effects are due to early attendance of antenatal clinics, lower share of C-sections, and greater share of normal deliveries. Preliminary cost-effectiveness analysis shows enormous benefit per dollar spent on the project: the cost to benefit ratio is one to 85 taking into account both maternal and infant lives saved as well as cost savings due to changes in labor and delivery practices.
  • Nizalova, O. (2007). Effect of Wages on Informal Care Supply and Labor Supply: Do Long Term Care Policies Matter?. In: IZA Long Term Care Workshop. Available at: http://www.iza.org/conference_files/LTC2007/nizalova_o1949.pdf.
    This paper analyzes the two sets of policies aimed at sustaining old-age support systems in
    European countries. One set of policies aims at increasing labor supply of individuals around
    the retirement age, the other strives at promoting provision of informal care for the elderly
    by family members. Accounting for the countries’ policies on long-term care provision, it has
    been found that the presence of universal long-term care coverage leads to larger negative
    wage e?ect on informal care provision by both males and females. General taxation as a
    means of ?nancing formal long-term care system has virtually no e?ect on the wage response
    in informal caregiving, but has signi?cant positive e?ect on the wage elasticity of male labor
    supply. With respect to policies that target informal long-term care, direct payments for
    caregiving have signi?cant positive e?ect on the wage elasticity of both informal care supply
    and labor supply of males, while having no e?ect on those of females. Availability of family
    paid leaves signi?cantly increases only the wage elasticity of female labor supply.
  • Nizalova, O. (2005). The Wage Elasticity of Informal Care Supply. In: 80th Annual Meeting of the Western Economic International Association.
  • Nizalova, O. (2000). Economic and Social Consequences of Maternity Protection: a cross country analysis. In: The Second Annual Global Development Conference. Beyond Economics: Multidisciplinary Approaches to Development.
    This study is devoted to the investigation of the social and economic
    consequences of maternity protection all over the world. Its proponents often
    state that maternity protection helps to improve the health of children and
    eliminate gender discrimination in the labor market. Moreover, maternity leave
    entitlements are designed so that they reduce to some extent the cost of children
    for women, influencing in such a way fertility rate. Maternity leave laws have
    similar design in more than 100 countries. The findings of this study suggest that
    the relationship between maternity leave duration and variables under
    consideration (fertility rate, infant mortality rate, and female-male labor market
    differentials) is significantly different across country groupings. This raises doubts
    as to the practicability of imposing similar policies without embodying regional
    and cultural differences in their structure.

Confidential report

  • Merritt, R., Pellatt-Higgins, T., Nizalova, O., Hashem, F. and Rees, T. (2016). Evaluation of the British Lung Foundation’s Integrated Breathe Easy Voluntary Group Network Findings from the Outcome, Impact and Economic Evaluation. [Online]. Canterbury: University of Kent. Available at: https://www.blf.org.uk/sites/default/files/IntegratedBreatheEasy-081216a.pdf.

Monograph

  • Saloniki, E., Nizalova, O., Malisauskaite, G. and Forder, J. (2019). The Impact of Formal Care on Informal Care for People over 75 in England. PSSRU.
    In this study, we examine the relationship between formal care provision and informal care receipt from within and outside the household for people over 75 years old using data from the British Household Panel Survey between 1991 and 2009. To address potential concerns about endogeneity of formal care we use a set of instrumental variables including a novel care eligibility variable. We find a negative and statistically significant effect of formal care on informal care from within the household, suggesting a substantial degree of substitutability between these two modes of care. With regards to informal care provided from outside the household, although the effect is still negative, the degree of substitutability is substantially smaller and mostly not statistically significant. These findings support current discussions and policies towards the implementation of an integrated care system, providing grounds for estimates of savings in the cost of informal care enabled by spending on formal care.
  • Gousia, K., Nizalova, O., Malisauskaite, G. and Forder, J. (2019). Heterogeneity in the Effect of Obesity on Future Long-Term Care Use in England. PSSRU.
    Although there is some recent evidence around the effects of obesity on health care utilisation and costs, not much is known about the relationship between obesity and long-term care utilisation (Public Health England, 2013). Few studies from the USA find that obesity increases the risk of nursing home admissions and use of personal care assistance (Elkins et al. 2006, Ziza et al. 2002, Resnik et al. 2005, Yang and Zhang 2014). Nizalova, Gousia and Forder (2017) show that obesity leads to higher use of informal care but find no effect on other types of long-term care. In this study we explore whether the effect on various types of care differs depending on the degree of obesity among older people in England and whether the findings are sensitive to the incorporation of information on long-term care use prior to death. We find that in addition to the obesity at the level of BMI between 25 and 45 representing a risk for future use of informal care, (super) obesity at the level of BMI at 45 and greater represents a significant risk for all types of care use, including social care and nursing home/residential care.
  • Nizalova, O. and Norton, E. (2019). Long-Term Effects of Severe Economic Recessions on Male BMI Trajectories and Health Behaviors. n/a.
    With periodic recessions and rising costs of health care, it is important to know how severe economic recessions can affect health outcomes. This study’s goal is to establish a causal relationship between job loss and health across the life cycle. We use a unique data set from Ukraine to examine the long-term effects from past labor market shocksdefined as job separations due to business closures, reorganizations, bankruptcies, or privatizationon BMI, smoking, alcohol consumption, and physical activity. This study contributes to the literature on the health consequences of job loss by identifying the effects from exogenous job separations, modeling these effects across the life cycle, and examining concurrent health-compromising and health-promoting behaviors. Applying growth-curve models, we show that past exogenous labor market shocks increase average BMI at young ages and alter the BMI-age trajectory’s shape. Moreover, we found that effects from job separations on health operate through health-compromising behaviors.
  • Bojke, C., Castelli, A. and Nizalova, O. (2018). Every Death Counts: Investigating the Role of “avoidable” and “unavoidable” Deaths to Compare Hospital Quality. The Case of Circulatory Diseases in England. Centre for Health Economics, University of York.
    Since the 19th century, standardised mortality rates have frequently been used as an indicator of quality for the purposes of rating hospital quality. Despite being a measurable and clearly meaningful metric, there has been a sustained opposition to this practice. Lilford and Pronovost, for example, describes them as ‘a bad idea that won’t go away’, arguing that there is simply too much noise to avoid spurious conclusions. In response to these objections, we explore the economic and econometric issues of using avoidable deaths as signals of hospital quality. We illustrate this with an econometric estimation of mortality of inpatients with circulatory diseases treated in hospitals in England. Using data for 2003/04 to 2008/09 period from the Hospital Episode Statistics (HES), we obtain Empirical Bayesian Estimates of hospital specific effects on the probability of in-hospital deaths by exploiting the panel data nature of the HES dataset and using a random effects specification and adjusting for case-mix, improvements over time and other ‘noise’. We find statistically significant differences between hospitals. It is not clear however that this is a valid reason for ignoring exploration of variations in death rates in conditions that are considered ‘non-amenable’.
  • Nizalova, O., Gousia, K. and Forder, J. (2018). Body Mass, Physical Activity and Future Long-Term Care Use. The Quality and Outcomes of Person-centred Care Policy Research Unit.
    Obesity and physical activity rates are known to be strong predictors of disability and functional limitations, and in turn use of health care. In this study we aim to explore whether obesity and physical activity are also significant risk factors for future long-term care need (both informal and formal care). We use regression analysis of data from the English Longitudinal Study of Ageing (ELSA) between 2002 to 2011 to addres this aim. Selection issues are tackled using the rich set of control variables in ELSA; exploiting the longitudinal structure of the data; and accounting for loss to follow-up (including death). Control factors include: impairment (ADLs) and specific existing health conditions – notably diabetes, high blood pressure, and CVD. We find that obese older people are 25% more likely to be in receipt of informal or privately paid care in two year’s time, but this does not hold for formal care. People who are physically active are 38% less likely to be using any care two years later, with the strongest effect for formal care use. Sensitivity analysis suggests that the results are not driven by either prediabetes, or a link between obesity and subjective health and depression, or unobserved factors.
  • Nizalova, O., Shapoval, N. and Nikolaieva, O. (2017). Current Population Health Needs and Their Regional Distribution in Ukraine Working Paper 2. Centre for Health Services Studies, Unviersity of Kent and Kyiv Economics Institute, Kyiv School of Economics.
  • Rokicka, M., Strandh, M., Högberg, B., Nizalova, O., Gousia, K., Middleton, T., Bertolini, S., Bolzoni, M., Ghislieri, C., Goglio, V., Martino, S., Meo, A., Moiso, V., Musumeci, R., Ricucci, R., Torrioni, P., Unt, M., Täht, K., Hofäcker, D., Neumman-Schmidt, I. and Braun, S. (2017). Medium-Term Socio-Economic Consequences of Insecure Labour Market Positions. EXCEPT Working Paper No.12. Available at: http://www.except-project.eu/files/filemanager/files/WP12_Medium_term_socio_economic_consequences_V2.pdf.
  • Athanasiades, C., Figou, L., Flouli, A., Gebel, M., Gousia, K., Bjorn, H., Kostouli, M., Nizalova, O., Shapoval, N., Sourvinou, M., Strandh, M., Taht, K., Unt, M., Vossemer, J. and Xanthopoulou, D. (2016). Report on the Institutional Setting and Policies on the Well-Being and Health of Youth in Insecure Labour Market Positions in EU-28 and Ukraine. EXCEPT Working Paper No.7. Available at: http://www.except-project.eu/files/filemanager/files/WP7_Report_on_the_impact_of_the_institutional_setting_and_policies_on_the_well-being_and_health.pdf.
  • Baronowska-Rataj, A., Gebel, M., Gousia, K., Nikolaieva, O., Malgorzata, K., Nizalova, O., Norton, E., Rokicka, M., Stasiowski, J., Strandh, M. and Voßemer, J. (2016). Interdependencies Between Labour Market Insecurity and Well-Being: Evidence from Panel Data. EXCEPT Working Paper No.8. Available at: http://www.except-project.eu/files/filemanager/files/WP8_Interdependencies_between_labour_market_insecurity_and_well-being.pdf.
  • Castelli, A. and Nizalova, O. (2011). Avoidable Mortality: What It Means And How It Is Measured. University of York. Available at: http://www.york.ac.uk/media/che/documents/papers/researchpapers/CHERP63_avoidable_mortality_what_it_means_and_how_it_is_measured.pdf.
    We explore in this research paper the concept of avoidable mortality and how the way it is measured
    has evolved over time. Starting from an earlier review by Nolte and McKee (2004), we review the
    empirical studies which have been produced since then. Finally we appraise the empirical
    applications of the most recent literature. The concept of “avoidable mortality” refers, broadly
    speaking, to all those deaths that, given current medical knowledge and technology, could be avoided
    by the healthcare system through either prevention and/or treatment. It originates from the pioneering
    work by Rutstein, Berenberg et al. (1976) which introduced the notion of „unnecessary untimely
    deaths? as a new way to measuring the quality of medical care.
    The most recent empirical literature shows that the notion of avoidable mortality continues to be used
    to establish the extent to which people are dying from amenable conditions within and/or across
    countries and over time, and whether socio-economic status and ethnicity are related to mortality from
    amenable conditions. Most studies use data taken from national death registries, with only two which
    link the concept of avoidable mortality to routinely collected administrative data of healthcare
    provision, such as hospitals. A number of criticisms are raised, with probably the most remarkable
    being the lack of association found between avoidable mortality and healthcare inputs. No study has
    actually attempted to use the concept of avoidable mortality within the original aim envisaged by
    Rutstein, i.e. as a quality indicator of healthcare provision.

    We recommend for future work in this area to focus on investigating the link between the provision of
    healthcare and the concept of avoidable mortality, with a particular emphasis on using routinely
    collected administrative data, such as hospital discharge data.
  • Nizalova, O. (2007). Effect of Wages on Informal Care And Labor Supply: Do Long-Term Care Policies Matter?. Kyiv Economics Institute.
    This paper analyzes the two sets of policies aimed at sustaining old-age support systems in European countries. One set of policies aims at increasing labor supply of individuals around the retirement age, the other strives at promoting provision of informal care for the elderly by family members. Accounting for the countries’ policies on long-term care provision, it has been found that the presence of universal long-term care coverage leads to larger negative wage effect on informal care provision by both males and females. General taxation as a means of financing formal long-term care system has virtually no effect on the wage response in informal caregiving, but has significant positive effect on the wage elasticity of male labor supply. With respect to policies that target informal long-term care, direct payments for caregiving have significant positive effect on the wage elasticity of both informal care supply and labor supply of males, while having no effect on those of females. Availability of family paid leaves significantly increases only the wage elasticity of female labor supply.

Research report (external)

  • Nizalova, O., Nizalov, D. and Vakhitova, H. (2010). Social Assistance System Modernization Project Impact Evaluation: Final Report. Ministry of Labor of Ukraine and World Bank.
  • Nizalova, O., Nizalov, D. and Vakhitova, H. (2009). Social Assistance System Modernization Project Impact Evaluation: Interim Report. Ministry of Labor of Ukraine and World Bank.
  • Nizalova, O., Gnezdilova, O., Nizalov, D. and Vakhitov, V. (2006). Industrial Restructuring and Enterprise Development in the City, Region of Kharkiv, Ukraine. [Online]. OECD: Local Economic and Employment Development Program. Available at: http://www.oecd.org/cfe/leed/37068503.pdf.
    Report of an international seminar held in Kharkiv in December 2005 within the framework of a joint initiative by the OECD and the European Commission on Improving the Conditions for Enterprise Development and the Investment Climate for Domestic and International Investors in Ukraine
  • Nizalova, O., Nizalov, D. and Vakhitov, V. (2006). Regional Economy and Tourism Development in the Republic of Crimea, Ukraine. OECD: Local Economic and Employment Development Program.
  • Nizalova, O., Thornsbury, S. and Nizalov, D. (2005). World Markets for Tart Cherries: Ukraine. Michigan State University: Department of Agricultural Economics.

Thesis

  • Mališauskaite, G. (2018). East Versus West: Did Communist Regimes Matter in the Long-Run? Essays on the Comparative Economics of the Former Eastern Bloc Countries.

Forthcoming

  • Gousia, K., Baranowska-Rataj, A., Middleton, T. and Nizalova, O. (2020). The impact of unemployment and non-standard forms of employment on the housing autonomy of young adults. Work, Employment and Society.
    Young people are facing challenges in transitioning to housing autonomy because of changes in labour market conditions in recent years. This article explores the effects of youth unemployment and non-standard employment on the likelihood of leaving the parental home. We adopt a dynamic modelling approach, and use data from a large longitudinal British survey covering the years 2009-2014. We find that unemployment and part-time work, but not the duration of the contract, have a negative effect on the likelihood of obtaining housing autonomy. We also find that past as well as anticipated unemployment have significant negative effects, which suggests that the decision about whether to move out depends on the individual’s longer-term labour market trajectory. The analysis also reveals gender differences in part-time work, but not in unemployment once we take into account unobserved time-invariant heterogeneity.
  • Gousia, K., Baranowska-Rataj, A., Middleton, T. and Nizalova, O. (2019). The impact of unemployment and non-standard employment forms on the housing autonomy of young adults. Work, Employment and Society.
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