Research

Publications

Information and Behavioral Responses during a Pandemic: Evidence from Delays in Covid-19 Death Reports. Journal of Development Economics, 2021. (joint with Emilio Gutierrez and Tiago Tavares) 

Increasing Retirement Savings through Access Points and Persuasive Messages: Evidence from Mexico. Journal of Human Resources, 2021. (joint with Mariano Bosch) 

Shocks to Hospital Occupancy and Mortality: Evidence from the 2009 H1N1 Pandemic. Management Science, 2021. (joint with Emilio Gutierrez)

Illegal Drug Market Responses to State Recreational Cannabis Laws. Addiction, 2021. (joint with Angelica Meinhofer)

Local Water Quality, Diarrheal Disease, and the Unintended Consequences of Soda Taxes. World Bank Economic Review, 2021. (joint with Emilio Gutierrez)

The Effect of a Cash Transfer Program for the Elderly in Mexico City on Co-Residing Children’s School Enrollment. World Bank Economic Review, 2017. (joint with Emilio Gutierrez and Laura Juarez)

Working papers

Trade-Offs Between Access and Quality in Healthcare: Evidence from Retail Clinics in Mexico - R&R, Journal of Public Economics 

Abstract: In settings with inefficient public provision, innovations in private-market healthcare delivery may be welfare-improving by increasing access, but may be sacrificing on quality. I study the expansion of retail clinics at private pharmacies in Mexico. I find that entry leads to large declines in public-sector emergency room visits and a small but significant reduction in public clinic visits for relatively mild respiratory infections. I also find a significant increase in public clinic visits for chronic conditions and a slight decline in emergency room visits, consistent with better disease management. However, I estimate a strong association between retail clinics and a shift toward stronger antibiotics in private-market sales. Hence, although retail clinics improve access to healthcare, they may be overselling their patients.  

Electoral Repercussions of a Pandemic: Evidence from the 2009 H1N1 Outbreak 

(joint with Emilio Gutierrez and Jaakko Meriläinen) - conditionally accepted, Journal of Politics 

Abstract: In the aftermath of a large negative shock, such as an epidemic, retrospective voters evaluate the policy-makers' response and either punish or reward them in elections. A prominent concern during the on-going coronavirus pandemic has been whether politicians who are worried about re-election have incentives to impose stringent mitigation measures that may carry high economic costs.  On the other hand, voters might also react to the shock itself, no matter what the government does. To understand the effect of epidemic outbreaks on voting, we revisit the 2009 H1N1 outbreak in Mexico. Leveraging detailed administrative data and a difference-in-differences approach, we document a strong, negative relationship between the magnitude of the local epidemic outbreak and the governing party vote share in the 2009 congressional election. Although the average effect is small, the magnitudes may be decisive in close elections. The electoral punishment depended on the magnitude of the peak of the epidemic curve but not on its timing, and it occurred independently of the remedial actions taken by the government. Furthermore, we find persistent effects in the 2012 election. Our results indicate that voters are aware of epidemics, responding to them at the ballot box. The findings indirectly suggest that mitigation policies may be politically valuable even if they are costly for the economy.

Previous working papers

Delays in Death Reports and their Implications for Tracking the Evolution of COVID-19 

(joint with Emilio Gutierrez and Tiago Tavares; Covid Economics Working Paper)  

Abstract: Understanding the determinants and implications of delays in reporting COVID-19 deaths is important for managing the epidemic. Contrasting England and Mexico, we document that reporting delays in Mexico are larger on average, exhibit higher geographic heterogeneity, and are more responsive to the total number of occurred deaths in a given location-date. We then estimate simple SIR models for each country to illustrate the implications of not accounting for reporting delays. Our results highlight the fact that low and middle-income countries are likely to face additional challenges during the pandemic due to lower quality of real-time information.  

Over-the-Counter Access Regulations: Evidence from an Antibiotics Law in Mexico

Abstract: Regulations restricting over-the-counter (OTC) access to drugs are important policy tools for mitigating self-medication and encouraging doctor visits. However, they may have unintended consequences when access to affordable healthcare is lacking. This paper estimates the effect of a law restricting OTC sales of antibiotics in Mexico on public hospital admission rates. I find a temporary but significant decline of around 40% in admission rates due to infections. This effect is driven by viral infections, adult patients, and patients from higher education municipalities. OTC regulations may inadvertently increase the socioeconomic health gradient unless accompanied by policies that expand affordable healthcare.