google scholar research topics in economics

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500+ Google Scholar Research Topics

Google Scholar is a powerful search engine designed to help researchers find scholarly articles, books, and other academic resources. It’s a fantastic tool for exploring new research topics and staying up-to-date with the latest developments in your field.

In this article, we’ll be exploring a wide range of research topics that you can explore using Google Scholar. Whether you’re a student, an academic, or a curious mind looking to expand your knowledge, you’ll find something of interest here.

We’ll cover topics from various fields, including science, technology, engineering, mathematics, social sciences, and humanities. We’ll also discuss how to use Google Scholar effectively to find relevant research and explore new ideas.

Google Scholar Research Topics

Google Scholar Research Topics ideas are as follows:

The impact of artificial intelligence on the job market
Climate change mitigation strategies for small island states
Analysis of social media and its effects on mental health
The role of education in reducing income inequality
Investigating the potential use of gene editing for disease prevention
The impact of globalization on cultural diversity
A critical analysis of corporate social responsibility practices in multinational corporations
Understanding the mechanisms of drug resistance in cancer cells
Exploring the effectiveness of mindfulness-based interventions for stress reduction
Investigating the relationship between physical activity and cognitive function in aging adults.
Investigating the effects of music therapy on mental health disorders
Examining the relationship between childhood trauma and adult mental health outcomes
A critical analysis of police brutality and the use of excessive force
The role of renewable energy in mitigating climate change
Understanding the mechanism of action of novel drugs for treating Alzheimer’s disease
Investigating the impact of cultural diversity on team performance in multinational corporations
The use of virtual reality in pain management
The impact of COVID-19 on mental health outcomes and healthcare systems
Examining the use of big data in predicting and preventing disease outbreaks
Investigating the relationship between diet and mental health outcomes
A critical analysis of the use of surveillance technology in public spaces
The role of social support in promoting mental health resilience
Investigating the relationship between air pollution and respiratory disease
A comparative analysis of different approaches to conflict resolution
The use of gene therapy for treating genetic disorders
The impact of microplastics on marine ecosystems
The role of early childhood education in reducing the achievement gap
Examining the effects of mindfulness meditation on emotional regulation
Investigating the relationship between sleep and mental health outcomes
A critical analysis of the ethics of artificial intelligence
The use of stem cells in regenerative medicine
The impact of climate change on food security
Examining the effects of exercise on mental health outcomes in adolescents
Investigating the role of social media in political polarization
A comparative analysis of different healthcare systems around the world
The use of virtual reality in treating phobias
The impact of gentrification on urban communities
The role of nutrition in preventing chronic diseases
Investigating the relationship between personality traits and job satisfaction
A critical analysis of the impact of social media on body image
The use of nanotechnology in drug delivery
The impact of technology on social relationships
Examining the effectiveness of cognitive-behavioral therapy for treating anxiety disorders
Investigating the relationship between cultural values and mental health outcomes
The role of public policy in reducing income inequality
The use of precision medicine in cancer treatment
The impact of social inequality on health outcomes
Examining the effects of social isolation on mental health outcomes in older adults
Investigating the role of the microbiome in human health
A critical analysis of the use of performance-enhancing drugs in sports
The use of biotechnology in food production
The impact of gentrification on affordable housing availability
Examining the effects of early childhood trauma on brain development
Investigating the relationship between gender and mental health outcomes
The role of the arts in promoting mental health and well-being
The use of artificial intelligence in healthcare diagnostics
The impact of social media on political participation
Examining the effects of meditation on immune function
Investigating the relationship between income and health outcomes
A critical analysis of the use of social media in promoting mental health literacy.
Investigating the impact of artificial light at night on wildlife behavior
The role of nutrition in brain development and cognitive function
Examining the effects of mindfulness interventions on workplace productivity
Investigating the impact of climate change on mental health outcomes
A critical analysis of the use of facial recognition technology in law enforcement
The use of genetic engineering for crop improvement
The impact of media on body dissatisfaction and eating disorders
Examining the effects of physical exercise on brain function in older adults
Investigating the relationship between cultural identity and mental health outcomes
The use of personalized medicine for treating rare diseases
The impact of air pollution on cognitive function
A critical analysis of the use of surveillance capitalism in data collection
Investigating the relationship between music and mental health outcomes
The role of nature exposure in promoting mental health and well-being
Examining the effects of cognitive training on brain plasticity
Investigating the impact of climate change on infectious disease transmission
The use of robotics in healthcare delivery
The impact of social media on romantic relationships
A critical analysis of the use of autonomous weapons in military conflicts
Investigating the relationship between spirituality and mental health outcomes
The role of nutrition in preventing chronic inflammation
Examining the effects of meditation on stress and anxiety in college students
Investigating the impact of climate change on water availability and quality
The use of artificial intelligence in finance and investment
The impact of social media on self-esteem and body image in adolescents
A critical analysis of the use of autonomous vehicles in transportation
Investigating the relationship between sleep disorders and mental health outcomes
The role of traditional medicine in improving healthcare access in developing countries
Examining the effects of mindfulness-based interventions on addiction recovery
Investigating the impact of climate change on biodiversity loss
The use of gene editing for treating inherited diseases
The impact of social media on political polarization and civic engagement
A critical analysis of the use of facial recognition technology in public spaces
Investigating the relationship between socioeconomic status and mental health outcomes
The role of community-based interventions in promoting mental health in marginalized populations
Examining the effects of physical exercise on academic achievement in children
Investigating the impact of climate change on mental health outcomes in vulnerable populations
The use of artificial intelligence in customer service and sales
The impact of social media on romantic relationships and intimacy
A critical analysis of the use of predictive policing algorithms in law enforcement
Investigating the relationship between spirituality and aging well-being
The role of dietary supplements in improving immune function
Examining the effects of sleep on athletic performance
Investigating the impact of climate change on human migration patterns
The use of 3D printing in medicine and healthcare
The impact of social media on political participation and civic knowledge
A critical analysis of the use of facial recognition technology in workplace monitoring
Investigating the relationship between cultural competence and mental health outcomes
The role of community gardens in promoting mental health and well-being
Examining the effects of outdoor adventure programs on adolescent mental health.
The use of virtual reality in treating phobias and anxiety disorders
Investigating the impact of climate change on mental health outcomes in indigenous communities in the Arctic region
The role of family therapy in improving mental health outcomes in children with attention deficit hyperactivity disorder (ADHD)
Investigating the relationship between childhood trauma and mental health outcomes in adulthood
The role of yoga therapy in improving mental health outcomes in individuals with anxiety disorders
Examining the effects of mindfulness-based interventions on stress and burnout in healthcare professionals
Investigating the impact of climate change on mental health outcomes in low-income communities
The use of virtual reality in treating social anxiety disorder in adolescents
The impact of social media on the mental health outcomes of individuals with autism spectrum disorder (ASD)
A critical analysis of the use of predictive analytics in healthcare fraud detection
Investigating the relationship between sleep and mental health outcomes in individuals with bipolar disorder
The role of animal-assisted therapy in promoting mental health and well-being in individuals with intellectual disabilities
Examining the effects of expressive arts therapy on self-esteem and resilience in individuals with depression
Investigating the impact of climate change on mental health outcomes in refugees and asylum seekers
The use of artificial intelligence in predicting and preventing post-traumatic stress disorder (PTSD) in military personnel
The impact of social media on the mental health outcomes of individuals with obsessive-compulsive personality disorder (OCPD)
A critical analysis of the use of facial recognition technology in law enforcement and criminal justice systems
Investigating the relationship between physical activity and mental health outcomes in individuals with schizophrenia
The role of play therapy in promoting mental health and well-being in children with attention deficit hyperactivity disorder (ADHD)
Examining the effects of music therapy on anxiety and depression in individuals with chronic pain
Investigating the impact of climate change on mental health outcomes in urban communities
The use of virtual reality in treating phobias in adults
The impact of social media on the mental health outcomes of individuals with borderline personality disorder (BPD)
A critical analysis of the use of predictive analytics in disaster response and emergency management
Investigating the relationship between sleep and mental health outcomes in individuals with post-traumatic stress disorder (PTSD)
The role of art therapy in improving mental health outcomes in individuals with schizophrenia
Examining the effects of dance/movement therapy on anxiety and depression in individuals with anxiety disorders
Investigating the impact of climate change on mental health outcomes in coastal fishing communities
The use of artificial intelligence in predicting and preventing relapse in individuals with substance use disorders
The impact of social media on the mental health outcomes of individuals with postpartum depression
A critical analysis of the use of facial recognition technology in public safety and security
Investigating the relationship between physical activity and mental health outcomes in individuals with eating disorders
The role of occupational therapy in promoting mental health and well-being in individuals with spinal cord injuries
Examining the effects of art therapy on anxiety and depression in individuals with chronic illnesses
Investigating the impact of climate change on mental health outcomes in rural fishing communities
The use of virtual reality in treating depression in older adults
The impact of social media on the mental health outcomes of individuals with hoarding disorder
A critical analysis of the use of predictive analytics in financial fraud detection
Investigating the relationship between sleep and mental health outcomes in individuals with multiple sclerosis
The role of drama therapy in improving mental health outcomes in individuals with personality disorders
Examining the effects of mindfulness-based interventions on self-compassion and self-criticism in individuals with eating disorders
Investigating the impact of climate change on mental health outcomes in urban heat island effects
Investigating the impact of climate change on mental health outcomes in rural farming communities
The use of virtual reality in treating obsessive-compulsive disorder (OCD) in adults
The impact of social media on the mental health outcomes of individuals with borderline personality disorder
A critical analysis of the use of facial recognition technology in online privacy and security
Investigating the relationship between physical activity and mental health outcomes in individuals with multiple sclerosis
The role of music therapy in improving mental health outcomes in veterans with post-traumatic stress disorder (PTSD)
Examining the effects of cognitive-behavioral therapy on anxiety and depression in individuals with chronic pain
Investigating the impact of climate change on mental health outcomes in small island developing states (SIDS)
The use of artificial intelligence in predicting and preventing suicide risk in adolescents
The impact of social media on the mental health outcomes of individuals with obsessive-compulsive disorder (OCD)
A critical analysis of the use of predictive analytics in election forecasting
Investigating the relationship between sleep and mental health outcomes in individuals with diabetes
The role of group therapy in improving mental health outcomes in individuals with substance use disorders
Examining the effects of horticultural therapy on stress and anxiety in individuals with depression
Investigating the impact of climate change on mental health outcomes in nomadic communities
The use of virtual reality in treating body dysmorphic disorder (BDD) in adolescents
The impact of social media on the mental health outcomes of individuals with schizophrenia
A critical analysis of the use of facial recognition technology in education and student privacy
Investigating the relationship between physical activity and mental health outcomes in individuals with chronic obstructive pulmonary disease (COPD)
The role of art therapy in improving mental health outcomes in individuals with eating disorders
Examining the effects of mindfulness-based interventions on depression and anxiety in individuals with postpartum depression
Investigating the impact of climate change on mental health outcomes in coastal tourism communities
The use of artificial intelligence in predicting and preventing depression relapse in individuals with major depressive disorder (MDD)
The impact of social media on the mental health outcomes of individuals with social anxiety disorder (SAD)
A critical analysis of the use of predictive analytics in cybersecurity
Investigating the relationship between sleep and mental health outcomes in individuals with anxiety disorders
The role of occupational therapy in promoting mental health and well-being in individuals with Parkinson’s disease
Examining the effects of dance/movement therapy on self-esteem and body image in individuals with eating disorders
Investigating the impact of climate change on mental health outcomes in indigenous communities in the South Pacific
The use of virtual reality in treating panic disorder in adults
The impact of social media on the mental health outcomes of individuals with bipolar disorder
A critical analysis of the use of facial recognition technology in border security and immigration policies
Investigating the relationship between physical activity and mental health outcomes in individuals with chronic pain
The role of peer support in mental health recovery for individuals with eating disorders
Examining the effects of art therapy on self-esteem and body image in individuals with chronic illnesses
Investigating the impact of climate change on mental health outcomes in urban development and infrastructure projects
The use of artificial intelligence in predicting and preventing workplace violence
The impact of social media on the mental health outcomes of individuals with body dysmorphic disorder (BDD)
The use of virtual reality in treating post-traumatic stress disorder in military veterans
The role of mindfulness-based interventions in improving cognitive function in older adults
The impact of social media on body image and self-esteem in adolescent girls
Investigating the relationship between physical activity and mental health outcomes in individuals with Parkinson’s disease
The role of family-based interventions in improving mental health outcomes in refugees
Examining the effects of animal-assisted therapy on stress and anxiety in college students
The use of artificial intelligence in detecting and predicting mental health disorders in children and adolescents
The impact of social media on interpersonal communication and social skills development in young adults
A critical analysis of the use of predictive analytics in the criminal justice system
Investigating the relationship between sleep and mental health outcomes in individuals with chronic obstructive pulmonary disease (COPD)
The role of group therapy in improving mental health outcomes in individuals with borderline personality disorder
Examining the effects of music therapy on anxiety and depression in individuals with Alzheimer’s disease
Investigating the impact of climate change on mental health outcomes in indigenous communities in the Amazon region
The use of virtual reality in treating anxiety and stress in healthcare professionals
The impact of social media on the self-perception of physical appearance and body satisfaction in men
A critical analysis of the use of facial recognition technology in the workplace
Investigating the relationship between physical activity and mental health outcomes in individuals with heart disease
The role of art therapy in improving mental health outcomes in individuals with traumatic brain injury
Examining the effects of mindfulness-based interventions on stress and anxiety in individuals with irritable bowel syndrome (IBS)
Investigating the impact of climate change on mental health outcomes in urban slum communities
The use of artificial intelligence in predicting and preventing mental health crises in college students
The role of occupational therapy in promoting mental health and well-being in individuals with intellectual disabilities
Examining the effects of dance/movement therapy on depression and anxiety in individuals with fibromyalgia
Investigating the impact of climate change on mental health outcomes in Pacific island communities
The impact of social media on the mental health outcomes of individuals with eating disorders
A critical analysis of the use of facial recognition technology in border control and migration management
Investigating the relationship between physical activity and mental health outcomes in individuals with rheumatoid arthritis
The role of peer support in mental health recovery for individuals with bipolar disorder
Examining the effects of art therapy on depression and anxiety in individuals with cancer
Investigating the impact of climate change on mental health outcomes in refugee camps
The use of artificial intelligence in predicting and preventing workplace burnout
The impact of social media on the mental health outcomes of individuals with substance use disorders
A critical analysis of the use of predictive analytics in housing and real estate markets
Investigating the relationship between sleep and mental health outcomes in individuals with chronic kidney disease
Investigating the impact of climate change on mental health outcomes in indigenous populations
The role of exercise in managing symptoms of depression and anxiety during pregnancy
The impact of social media on academic achievement and performance in college students
A critical analysis of the use of predictive analytics in healthcare decision-making
Investigating the relationship between diet and mental health outcomes in individuals with eating disorders
The use of cognitive behavioral therapy in treating insomnia and sleep disorders
The impact of climate change on mental health outcomes in urban communities
The role of art therapy in improving mental health outcomes in individuals with autism spectrum disorder
Examining the effects of physical exercise on immune function and health outcomes in older adults
Investigating the impact of social media on mental health outcomes in individuals with disabilities
A critical analysis of the use of facial recognition technology in border control and immigration
The use of mindfulness-based interventions in treating substance use disorders
The impact of climate change on mental health outcomes in disaster-affected communities
Investigating the relationship between socioeconomic status and mental health outcomes in children and adolescents
The role of occupational therapy in promoting successful aging and quality of life
Examining the effects of music therapy on pain and anxiety in cancer patients
Investigating the impact of climate change on mental health outcomes in rural communities
The use of artificial intelligence in predicting and preventing suicide risk
The impact of social media on body dissatisfaction and disordered eating behaviors in young adults
A critical analysis of the use of predictive analytics in public policy decision-making
The role of family-based interventions in promoting mental health and well-being in children and adolescents
Examining the effects of mindfulness-based interventions on pain management in chronic pain patients
The use of telepsychiatry in improving access to mental health care in underserved areas
The impact of social media on body image and self-esteem in men and boys
A critical analysis of the use of facial recognition technology in public protests and demonstrations
Investigating the relationship between sleep and mental health outcomes in college students
The role of dance/movement therapy in improving mental health outcomes in individuals with PTSD
Examining the effects of physical exercise on depression and anxiety in individuals with chronic pain
The use of virtual reality in pain management for burn patients
The impact of social media on mental health outcomes in individuals with chronic pain
A critical analysis of the use of predictive analytics in employment decision-making
Investigating the relationship between physical activity and mental health outcomes in individuals with diabetes
The role of peer support in mental health recovery for individuals with schizophrenia
Examining the effects of art therapy on anxiety and depression in older adults
Investigating the impact of climate change on mental health outcomes in agricultural communities
The use of artificial intelligence in diagnosing and treating mental health disorders in emergency departments
The impact of social media on romantic relationships and satisfaction
A critical analysis of the use of facial recognition technology in education and schools
Investigating the relationship between sleep and mental health outcomes in older adults
The role of occupational therapy in promoting mental health and well-being in the workplace
Examining the effects of mindfulness-based interventions on anxiety and depression
The use of virtual reality in education and training
Examining the effects of job stress on mental health outcomes in healthcare workers
Investigating the relationship between social media use and sleep quality in adolescents
The role of nutritional supplements in preventing age-related cognitive decline
The impact of climate change on crop yields and food security in developing countries
Investigating the relationship between childhood trauma and addiction
The use of telemedicine in improving healthcare access and outcomes in rural areas
Examining the effects of physical exercise on mental health outcomes in individuals with schizophrenia
Investigating the impact of climate change on mental health outcomes in refugees
The role of mindfulness-based interventions in addiction recovery
The use of artificial intelligence in predicting and preventing falls in older adults
The impact of social media on political polarization and echo chambers
A critical analysis of the use of facial recognition technology in public transportation
Investigating the relationship between sleep disorders and mental health outcomes in children
The role of animal-assisted therapy in improving mental health outcomes
Examining the effects of cognitive training on executive function in older adults
Investigating the impact of climate change on mental health outcomes in coastal communities
The use of virtual reality in pain management and rehabilitation
The impact of social media on interpersonal relationships and communication
A critical analysis of the use of predictive analytics in financial decision-making
Investigating the relationship between chronic pain and mental health outcomes in adults
The role of peer support in mental health recovery for veterans
Examining the effects of music therapy on anxiety and depression in individuals with autism
Investigating the impact of climate change on mental health outcomes in Arctic populations
The use of artificial intelligence in early detection and prevention of heart disease
The impact of social media on self-disclosure and privacy
A critical analysis of the use of facial recognition technology in retail marketing
Investigating the relationship between physical activity and mental health outcomes in pregnant women
The role of community-based interventions in promoting healthy aging and well-being
Examining the effects of mindfulness-based interventions on emotional regulation in individuals with borderline personality disorder
Investigating the impact of climate change on mental health outcomes in low-income populations
The use of telemedicine in improving mental health access and outcomes in prisons
The impact of social media on adolescent substance use and addiction
A critical analysis of the use of predictive analytics in criminal justice decision-making
Investigating the relationship between social support and mental health outcomes in individuals with HIV/AIDS
The role of creative arts therapies in improving mental health outcomes in children and adolescents
Examining the effects of physical exercise on cognitive function in individuals with Parkinson’s disease
The use of artificial intelligence in diagnosing and treating mental health disorders in primary care
The impact of social media on mental health outcomes in individuals with chronic illnesses
A critical analysis of the use of facial recognition technology in workplace surveillance
Investigating the relationship between sleep and mental health outcomes in shift workers
The role of occupational therapy in mental health recovery
Examining the effects of mindfulness-based interventions on cognitive function in individuals with traumatic brain injury
Investigating the impact of parental divorce on children’s mental health
The role of artificial intelligence in healthcare diagnosis and treatment
Examining the effects of workaholism on employee well-being and productivity
Investigating the impact of climate change on coastal erosion
A critical analysis of the use of biometric data in online security
The use of genetic testing in personalized nutrition and fitness plans
The impact of technology on romantic relationships and communication
Examining the effects of mindfulness interventions on chronic pain management
Investigating the relationship between trauma and addiction recovery
The use of wearable technology in improving sports performance and injury prevention
The impact of climate change on urban heat islands
A critical analysis of the use of blockchain technology in healthcare
Investigating the relationship between exercise and depression in older adults
The role of natural disasters in mental health outcomes
Examining the effects of cognitive behavioral therapy on anxiety and depression in adolescents
Investigating the impact of climate change on food security
The use of virtual reality in mental health treatment
The impact of social media on mental health outcomes in LGBTQ+ populations
A critical analysis of the use of facial recognition technology in education
Investigating the relationship between diet and mental health outcomes in children and adolescents
The role of music therapy in improving mental health outcomes in cancer patients
Examining the effects of physical exercise on cognitive function in individuals with multiple sclerosis
Investigating the impact of climate change on wildfire frequency and severity
The use of robotics in agriculture and food production
The impact of social media on workplace communication and productivity
A critical analysis of the use of algorithmic decision-making in hiring and recruitment
Investigating the relationship between personality traits and mental health outcomes
The role of peer support in addiction recovery
Examining the effects of mindfulness-based interventions on sleep quality and quantity
Investigating the impact of climate change on air quality and respiratory health
The use of artificial intelligence in predicting and preventing medication errors
The impact of social media on mental health outcomes in older adults
A critical analysis of the use of facial recognition technology in border security
The role of physical activity in preventing chronic diseases
Examining the effects of cognitive training on academic achievement in children
The use of 3D printing in creating prosthetics and assistive devices
The impact of social media on body positivity and self-acceptance
Investigating the relationship between social support and mental health outcomes in college students
The role of community-based interventions in promoting healthy eating habits in children
Examining the effects of mindfulness-based interventions on caregiver burden and stress
Investigating the impact of climate change on water scarcity and conflicts
The use of artificial intelligence in improving mental health diagnosis and treatment
The impact of social media on mental health outcomes in individuals with eating disorders
A critical analysis of the use of facial recognition technology in retail surveillance
Investigating the relationship between social isolation and mental health outcomes in older adults
The role of complementary and alternative medicine in mental health treatment
Examining the effects of physical exercise on executive function in individuals with ADHD.
Investigating the impact of workplace bullying on mental health outcomes in healthcare workers
The use of cognitive behavioral therapy in improving sleep outcomes in individuals with insomnia
Examining the effects of music therapy on social skills and communication in individuals with autism spectrum disorder (ASD)
The role of narrative therapy in improving mental health outcomes in individuals with complex trauma histories
A critical analysis of the use of predictive analytics in credit scoring
Investigating the relationship between sleep and mental health outcomes in individuals with schizophrenia
The role of dance/movement therapy in promoting mental health and well-being in individuals with intellectual disabilities
Examining the effects of cognitive remediation therapy on cognitive functioning in individuals with traumatic brain injuries
The use of artificial intelligence in predicting and preventing workplace accidents
A critical analysis of the use of facial recognition technology in retail environments
The role of drama therapy in promoting mental health and well-being in incarcerated individuals
Examining the effects of art therapy on emotional regulation in individuals with borderline personality disorder (BPD)
Investigating the impact of climate change on mental health outcomes in Indigenous youth
The use of virtual reality in treating post-traumatic stress disorder (PTSD) in veterans
A critical analysis of the use of predictive analytics in social media advertising
The role of horticulture therapy in improving mental health outcomes in individuals with depression
Examining the effects of cognitive behavioral therapy on emotional dysregulation in individuals with borderline personality disorder (BPD)
Investigating the impact of climate change on mental health outcomes in migrant populations
The use of artificial intelligence in predicting and preventing cyberbullying
The impact of social media on the mental health outcomes of individuals with personality disorders
A critical analysis of the use of facial recognition technology in airport security
Investigating the relationship between physical activity and mental health outcomes in individuals with cardiovascular disease
The role of expressive writing therapy in promoting mental health and well-being in individuals with trauma histories
Examining the effects of mindfulness-based interventions on pain management in individuals with chronic pain
Investigating the impact of climate change on mental health outcomes in First Nations communities
The use of virtual reality in treating phobias in individuals with developmental disabilities
The impact of social media on the mental health outcomes of individuals with chronic illnesses
A critical analysis of the use of predictive analytics in criminal justice reform
The role of bibliotherapy in promoting mental health and well-being in individuals with anxiety disorders
Examining the effects of cognitive behavioral therapy on rumination and worry in individuals with generalized anxiety disorder (GAD)
The role of equine-assisted therapy in promoting mental health and well-being in individuals with trauma histories
Examining the effects of cognitive behavioral therapy on anxiety and depression in individuals with chronic pain
Investigating the impact of climate change on mental health outcomes in Indigenous communities
The use of virtual reality in treating phobias in children
The impact of social media on the mental health outcomes of individuals with body-focused repetitive behaviors (BFRBs)
A critical analysis of the use of predictive analytics in public health surveillance
Investigating the relationship between sleep and mental health outcomes in individuals with Huntington’s disease
The role of music therapy in improving mental health outcomes in individuals with autism spectrum disorder (ASD)
Examining the effects of mindfulness-based interventions on self-regulation and emotion regulation in individuals with borderline personality disorder (BPD)
The use of artificial intelligence in predicting and preventing domestic violence
A critical analysis of the use of facial recognition technology in immigration enforcement
The role of art therapy in promoting mental health and well-being in individuals with traumatic brain injuries
Investigating the impact of climate change on mental health outcomes in disaster survivors
The use of virtual reality in treating anxiety and depression in individuals with chronic illnesses
The impact of social media on the mental health outcomes of individuals with gender dysphoria
A critical analysis of the use of predictive analytics in hiring and recruitment processes
Investigating the relationship between sleep and mental health outcomes in individuals with Alzheimer’s disease
The role of play therapy in promoting mental health and well-being in children with trauma histories
Examining the effects of art therapy on self-esteem and body image in individuals with eating disorders
The use of artificial intelligence in predicting and preventing school violence
The impact of social media on the mental health outcomes of individuals with intellectual disabilities
A critical analysis of the use of facial recognition technology in public transportation systems
Investigating the relationship between physical activity and mental health outcomes in individuals with spinal cord injuries
The role of drama therapy in improving mental health outcomes in individuals with substance use disorders
Examining the effects of mindfulness-based interventions on emotional regulation and impulsivity in individuals with attention deficit hyperactivity disorder (ADHD)
Investigating the impact of climate change on mental health outcomes in forest-dependent communities
The use of virtual reality in treating postpartum depression in new mothers
The impact of social media on the mental health outcomes of individuals with gambling disorder
A critical analysis of the use of predictive analytics in sports performance analysis
Investigating the relationship between sleep and mental health outcomes in individuals with fibromyalgia
The role of animal-assisted therapy in promoting mental health and well-being in individuals with post-traumatic stress disorder (PTSD)
The use of cognitive behavioral therapy in treating depression in individuals with chronic pain
The role of art therapy in promoting mental health and well-being in survivors of sexual assault
Examining the effects of music therapy on pain management in individuals with fibromyalgia
A critical analysis of the use of facial recognition technology in border control
Investigating the relationship between sleep and mental health outcomes in individuals with attention deficit hyperactivity disorder (ADHD)
The role of animal-assisted therapy in improving mental health outcomes in individuals with post-traumatic stress disorder (PTSD)
Examining the effects of cognitive behavioral therapy on impulsivity in individuals with borderline personality disorder (BPD)
Investigating the impact of climate change on mental health outcomes in farming communities
The use of virtual reality in treating agoraphobia in individuals with anxiety disorders
The impact of social media on the mental health outcomes of individuals with chronic pain
A critical analysis of the use of predictive analytics in the hiring process
Investigating the relationship between physical activity and mental health outcomes in individuals with cancer
The role of narrative therapy in promoting mental health and well-being in refugees
Examining the effects of art therapy on body image in individuals with eating disorders
Investigating the impact of climate change on mental health outcomes in coastal Indigenous communities
The use of artificial intelligence in predicting and preventing traffic accidents
Investigating the relationship between sleep and mental health outcomes in individuals with chronic fatigue syndrome
The role of dance/movement therapy in promoting mental health and well-being in older adults
Examining the effects of cognitive remediation therapy on social cognition in individuals with schizophrenia
Investigating the impact of climate change on mental health outcomes in Arctic communities
The use of virtual reality in treating acrophobia in individuals with anxiety disorders
The impact of social media on the mental health outcomes of individuals with gambling disorders
A critical analysis of the use of predictive analytics in healthcare resource allocation
Investigating the relationship between physical activity and mental health outcomes in individuals with chronic kidney disease on dialysis
The role of bibliotherapy in promoting mental health and well-being in individuals with postpartum depression
Examining the effects of cognitive behavioral therapy on self-esteem in individuals with social anxiety disorder
Investigating the impact of climate change on mental health outcomes in Pacific Islander communities
The use of animal-assisted therapy in treating anxiety disorders in children and adolescents
A critical analysis of the use of facial recognition technology in public protests
Investigating the relationship between sleep and mental health outcomes in individuals with traumatic brain injuries
The role of drama therapy in promoting mental health and well-being in LGBTQ+ individuals
Examining the effects of mindfulness-based interventions on anxiety and depression in individuals with Parkinson’s disease
Investigating the impact of climate change on mental health outcomes in refugee communities
The use of virtual reality in treating claustrophobia in individuals with anxiety disorders
The impact of childhood trauma on mental health outcomes in adulthood
The use of music therapy in improving cognitive function in individuals with dementia
Examining the effects of cognitive behavioral therapy on depression in individuals with chronic obstructive pulmonary disease (COPD)
Investigating the impact of climate change on mental health outcomes in Indigenous communities in Australia
The role of mindfulness-based interventions in promoting mental health and well-being in college students
A critical analysis of the use of predictive analytics in criminal justice sentencing
Investigating the relationship between sleep and mental health outcomes in individuals with irritable bowel syndrome (IBS)
The use of art therapy in improving self-esteem in individuals with substance use disorders
Examining the effects of animal-assisted therapy on aggression in individuals with autism spectrum disorder (ASD)
The role of cognitive remediation therapy in improving executive functioning in individuals with traumatic brain injuries
A critical analysis of the use of facial recognition technology in the criminal justice system
The use of narrative therapy in promoting resilience in individuals who have experienced trauma
Examining the effects of dance/movement therapy on body image in individuals with body dysmorphic disorder (BDD)
The use of virtual reality in treating fear of flying in individuals with anxiety disorders
A critical analysis of the use of predictive analytics in predicting student performance in higher education
The role of mindfulness-based interventions in promoting mental health and well-being in older adults
Examining the effects of cognitive behavioral therapy on insomnia in individuals with depression
Investigating the impact of climate change on mental health outcomes in Arctic Indigenous communities
The use of animal-assisted therapy in improving social skills in children with autism spectrum disorder (ASD)
The role of art therapy in promoting mental health and well-being in individuals with chronic pain
Examining the effects of cognitive remediation therapy on attention in individuals with attention deficit hyperactivity disorder (ADHD)
The use of virtual reality in treating fear of needles in children with medical conditions
A critical analysis of the use of predictive analytics in predicting criminal behavior
Investigating the relationship between sleep and mental health outcomes in individuals with chronic kidney disease not on dialysis
The role of drama therapy in promoting mental health and well-being in individuals with schizophrenia
Examining the effects of mindfulness-based interventions on pain management in individuals with chronic migraines
Investigating the impact of climate change on mental health outcomes in communities affected by natural disasters

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Muhammad Hassan

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Gender inequality as a barrier to economic growth: a review of the theoretical literature

Open access
Published: 15 January 2021
Volume 19 , pages 581–614, ( 2021 )

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google scholar research topics in economics

Manuel Santos Silva 1 &
Stephan Klasen 1

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In this article, we survey the theoretical literature investigating the role of gender inequality in economic development. The vast majority of theories reviewed argue that gender inequality is a barrier to development, particularly over the long run. Among the many plausible mechanisms through which inequality between men and women affects the aggregate economy, the role of women for fertility decisions and human capital investments is particularly emphasized in the literature. Yet, we believe the body of theories could be expanded in several directions.

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1 Introduction

Theories of long-run economic development have increasingly relied on two central forces: population growth and human capital accumulation. Both forces depend on decisions made primarily within households: population growth is partially determined by households’ fertility choices (e.g., Becker & Barro 1988 ), while human capital accumulation is partially dependent on parental investments in child education and health (e.g., Lucas 1988 ).

In an earlier survey of the literature linking family decisions to economic growth, Grimm ( 2003 ) laments that “[m]ost models ignore the two-sex issue. Parents are modeled as a fictive asexual human being” (p. 154). Footnote 1 Since then, however, economists are increasingly recognizing that gender plays a fundamental role in how households reproduce and care for their children. As a result, many models of economic growth are now populated with men and women. The “fictive asexual human being” is a dying species. In this article, we survey this rich new landscape in theoretical macroeconomics, reviewing, in particular, micro-founded theories where gender inequality affects economic development.

For the purpose of this survey, gender inequality is defined as any exogenously imposed difference between male and female economic agents that, by shaping their behavior, has implications for aggregate economic growth. In practice, gender inequality is typically modeled as differences between men and women in endowments, constraints, or preferences.

Many articles review the literature on gender inequality and economic growth. Footnote 2 Typically, both the theoretical and empirical literature are discussed, but, in almost all cases, the vast empirical literature receives most of the attention. In addition, some of the surveys examine both sides of the two-way relationship between gender inequality and economic growth: gender equality as a cause of economic growth and economic growth as a cause of gender equality. As a result, most surveys end up only scratching the surface of each of these distinct strands of literature.

There is, by now, a large and insightful body of micro-founded theories exploring how gender equality affects economic growth. In our view, these theories merit a separate review. Moreover, they have not received sufficient attention in empirical work, which has largely developed independently (see also Cuberes & Teignier 2014 ). By reviewing the theoretical literature, we hope to motivate empirical researchers in finding new ways of putting these theories to test. In doing so, our work complements several existing surveys. Doepke & Tertilt ( 2016 ) review the theoretical literature that incorporates families in macroeconomic models, without focusing exclusively on models that include gender inequality, as we do. Greenwood, Guner and Vandenbroucke ( 2017 ), in turn, review the theoretical literature from the opposite direction; they study how macroeconomic models can explain changes in family outcomes. Doepke, Tertilt and Voena ( 2012 ) survey the political economy of women’s rights, but without focusing explicitly on their impact on economic development.

To be precise, the scope of this survey consists of micro-founded macroeconomic models where gender inequality (in endowments, constraints, preferences) affects economic growth—either by influencing the economy’s growth rate or shaping the transition paths between multiple income equilibria. As a result, this survey does not cover several upstream fields of partial-equilibrium micro models, where gender inequality affects several intermediate growth-related outcomes, such as labor supply, education, health. Additionally, by focusing on micro-founded macro models, we do not review studies in heterodox macroeconomics, including the feminist economics tradition using structuralist, demand-driven models. For recent overviews of this literature, see Kabeer ( 2016 ) and Seguino ( 2013 , 2020 ). Overall, we find very little dialogue between the neoclassical and feminist heterodox literatures. In this review, we will show that actually these two traditions have several points of contact and reach similar conclusions in many areas, albeit following distinct intellectual routes.

Although the incorporation of gender in macroeconomic models of economic growth is a recent development, the main gendered ingredients of those models are not new. They were developed in at least two strands of literature. First, since the 1960s, “new home economics” has applied the analytical toolbox of rational choice theory to decisions being made within the boundaries of the family (see, e.g., Becker 1960 , 1981 ). Footnote 3 A second literature strand, mostly based on empirical work at the micro level in developing countries, described clear patterns of gender-specific behavior within households that differed across regions of the developing world (see, e.g., Boserup 1970 ). Footnote 4 As we shall see, most of the (micro-founded) macroeconomic models reviewed in this article use several analytical mechanisms from "new home economics”; these mechanisms can typically rationalize several of the gender-specific regularities observed in early studies of developing countries. The growth theorist is then left to explore the aggregate implications for economic development.

The first models we present focus on gender discrimination in (or on access to) the labor market as a distortionary tax on talent. If talent is randomly distributed in the population, men and women are imperfect substitutes in aggregate production, and, as a consequence, gender inequality (as long as determined by non-market processes) will misallocate talent and lower incentives for female human capital formation. These theories do not rely on typical household functions such as reproduction and childrearing. Therefore, in these models, individuals are not organized into households. We review this literature in section 2 .

From there, we proceed to theories where the household is the unit of analysis. In sections 3 and 4 , we cover models that take the household as given and avoid marriage markets or other household formation institutions. This is a world where marriage (or cohabitation) is universal, consensual, and monogamous; families are nuclear, and spouses are matched randomly. The first articles in this tradition model the household as a unitary entity with joint preferences and interests, and with an efficient and centralized decision making process. Footnote 5 These theories posit how men and women specialize into different activities and how parents interact with their children. Section 3 reviews these theories. Over time, the literature has incorporated intra-household dynamics. Now, family members are allowed to have different preferences and interests; they bargain, either cooperatively or not, over family decisions. Now, the theorist recognizes power asymmetries between family members and analyzes how spouses bargain over decisions. Footnote 6 These articles are surveyed in section 4 .

The final set of articles we survey take into account how households are formed. These theories show how gender inequality can influence economic growth and long-run development through marriage market institutions and family formation patterns. Among other topics, this literature has studied ages at first marriage, relative supply of potential partners, monogamy and polygyny, arranged and consensual marriages, and divorce risk. Upon marriage, these models assume different bargaining processes between the spouses, or even unitary households, but they all recognize, in one way or another, that marriage, labor supply, consumption, and investment decisions are interdependent. We review these theories in section 5 .

Table 1 offers a schematic overview of the literature. To improve readability, the table only includes studies that we review in detail, with articles listed in order of appearance in the text. The table also abstracts from models’ extensions and sensitivity checks, and focuses exclusively on the causal pathways leading from gender inequality to economic growth.

The vast majority of theories reviewed argue that gender inequality is a barrier to economic development, particularly over the long run. The focus on long-run supply-side models reflects a recent effort by growth theorists to incorporate two stylized facts of economic development in the last two centuries: (i) a strong positive association between gender equality and income per capita (Fig. 1 ), and (ii) a strong association between the timing of the fertility transition and income per capita (Fig. 2 ). Footnote 7 Models that endogenize a fertility transition are able to generate a transition from a Malthusian regime of stagnation to a modern regime of sustained economic growth, thus replicating the development experience of human societies in the very long run (e.g., Galor 2005a , b ; Guinnane 2011 ). In contrast, demand-driven models in the heterodox and feminist traditions have often argued that gender wage discrimination and gendered sectoral and occupational segregation can be conducive to economic growth in semi-industrialized export-oriented economies. Footnote 8 In these settings—that fit well the experience of East and Southeast Asian economies—gender wage discrimination in female-intensive export industries reduces production costs and boosts exports, profits, and investment (Blecker & Seguino 2002 ; Seguino 2010 ).

Income level and gender equality. Income is the natural log of per capita GDP (PPP-adjusted). The Gender Development Index is the ratio of gender-specific Human Development Indexes: female HDI/male HDI. Data are for the year 2000. Sources: UNDP

Income level and timing of the fertility transition. Income is the natural log of per capita GDP (PPP-adjusted) in 2000. Years since fertility transition are the number of years between 2000 and the onset year of the fertility decline. See Reher ( 2004 ) for details. Sources: UNDP and Reher ( 2004 )

In most long-run, supply-side models reviewed here, irrespectively of the underlying source of gender differences (e.g., biology, socialization, discrimination), the opportunity cost of women’s time in foregone labor market earnings is lower than that of men. This gender gap in the value of time affects economic growth through two main mechanisms. First, when the labor market value of women’s time is relatively low, women will be in charge of childrearing and domestic work in the family. A low value of female time means that children are cheap. Fertility will be high, and economic growth will be low, both because population growth has a direct negative impact on long-run economic performance and because human capital accumulates at a slower pace (through the quantity-quality trade-off). Second, if parents expect relatively low returns to female education, due to women specializing in domestic activities, they will invest relatively less in the education of girls. In the words of Harriet Martineau, one of the first to describe this mechanism, “as women have none of the objects in life for which an enlarged education is considered requisite, the education is not given” (Martineau 1837 , p. 107). In the long run, lower human capital investments (on girls) lead to slower economic development.

Overall, gender inequality can be conceptualized as a source of inefficiency, to the extent that it results in the misallocation of productive factors, such as talent or labor, and as a source of negative externalities, when it leads to higher fertility, skewed sex ratios, or lower human capital accumulation.

We conclude, in section 6 , by examining the limitations of the current literature and pointing ways forward. Among them, we suggest deeper investigations of the role of (endogenous) technological change on gender inequality, as well as greater attention to the role and interests of men in affecting gender inequality and its impact on growth.

2 Gender discrimination and misallocation of talent

Perhaps the single most intuitive argument for why gender discrimination leads to aggregate inefficiency and hampers economic growth concerns the allocation of talent. Assume that talent is randomly distributed in the population. Then, an economy that curbs women’s access to education, market employment, or certain occupations draws talent from a smaller pool than an economy without such restrictions. Gender inequality can thus be viewed as a distortionary tax on talent. Indeed, occupational choice models with heterogeneous talent (as in Roy 1951 ) show that exogenous barriers to women’s participation in the labor market or access to certain occupations reduce aggregate productivity and per capita output (Cuberes & Teignier 2016 , 2017 ; Esteve-Volart 2009 ; Hsieh, Hurst, Jones and Klenow 2019 ).

Hsieh et al. ( 2019 ) represent the US economy with a model where individuals sort into occupations based on innate ability. Footnote 9 Gender and race identity, however, are a source of discrimination, with three forces preventing women and black men from choosing the occupations best fitting their comparative advantage. First, these groups face labor market discrimination, which is modeled as a tax on wages and can vary by occupation. Second, there is discrimination in human capital formation, with the costs of occupation-specific human capital being higher for certain groups. This cost penalty is a composite term encompassing discrimination or quality differentials in private or public inputs into children’s human capital. The third force are group-specific social norms that generate utility premia or penalties across occupations. Footnote 10

Assuming that the distribution of innate ability across race and gender is constant over time, Hsieh et al. ( 2019 ) investigate and quantify how declines in labor market discrimination, barriers to human capital formation, and changing social norms affect aggregate output and productivity in the United States, between 1960 and 2010. Over that period, their general equilibrium model suggests that around 40 percent of growth in per capita GDP and 90 percent of growth in labor force participation can be attributed to reductions in the misallocation of talent across occupations. Declining in barriers to human capital formation account for most of these effects, followed by declining labor market discrimination. Changing social norms, on the other hand, explain only a residual share of aggregate changes.

Two main mechanisms drive these results. First, falling discrimination improves efficiency through a better match between individual ability and occupation. Second, because discrimination is higher in high-skill occupations, when discrimination decreases, high-ability women and black men invest more in human capital and supply more labor to the market. Overall, better allocation of talent, rising labor supply, and faster human capital accumulation raise aggregate growth and productivity.

Other occupational choice models assuming gender inequality in access to the labor market or certain occupations reach similar conclusions. In addition to the mechanisms in Hsieh et al. ( 2019 ), barriers to women’s work in managerial or entrepreneurial occupations reduce average talent in these positions, resulting in aggregate losses in innovation, technology adoption, and productivity (Cuberes & Teignier 2016 , 2017 ; Esteve-Volart 2009 ). The argument can be readily applied to talent misallocation across sectors (Lee 2020 ). In Lee’s model, female workers face discrimination in the non-agricultural sector. As a result, talented women end up sorting into ill-suited agricultural activities. This distortion reduces aggregate productivity in agriculture. Footnote 11

To sum up, when talent is randomly distributed in the population, barriers to women’s education, employment, or occupational choice effectively reduce the pool of talent in the economy. According to these models, dismantling these gendered barriers can have an immediate positive effect on economic growth.

3 Unitary households: parents and children

In this section, we review models built upon unitary households. A unitary household maximizes a joint utility function subject to pooled household resources. Intra-household decision making is assumed away; the household is effectively a black-box. In this class of models, gender inequality stems from a variety of sources. It is rooted in differences in physical strength (Galor & Weil 1996 ; Hiller 2014 ; Kimura & Yasui 2010 ) or health (Bloom et al. 2015 ); it is embedded in social norms (Hiller 2014 ; Lagerlöf 2003 ), labor market discrimination (Cavalcanti & Tavares 2016 ), or son preference (Zhang, Zhang and Li 1999 ). In all these models, gender inequality is a barrier to long-run economic development.

Galor & Weil ( 1996 ) model an economy with three factors of production: capital, physical labor (“brawn”), and mental labor (“brain”). Men and women are equally endowed with brains, but men have more brawn. In economies starting with very low levels of capital per worker, women fully specialize in childrearing because their opportunity cost in terms of foregone market earnings is lower than men’s. Over time, the stock of capital per worker builds up due to exogenous technological progress. The degree of complementarity between capital and mental labor is higher than that between capital and physical labor; as the economy accumulates capital per worker, the returns to brain rise relative to the returns to brawn. As a result, the relative wages of women rise, increasing the opportunity cost of childrearing. This negative substitution effect dominates the positive income effect on the demand for children and fertility falls. Footnote 12 As fertility falls, capital per worker accumulates faster creating a positive feedback loop that generates a fertility transition and kick starts a process of sustained economic growth.

The model has multiple stable equilibria. An economy starting from a low level of capital per worker is caught in a Malthusian poverty trap of high fertility, low income per capita, and low relative wages for women. In contrast, an economy starting from a sufficiently high level of capital per worker will converge to a virtuous equilibrium of low fertility, high income per capita, and high relative wages for women. Through exogenous technological progress, the economy can move from the low to the high equilibrium.

Gender inequality in labor market access or returns to brain can slow down or even prevent the escape from the Malthusian equilibrium. Wage discrimination or barriers to employment would work against the rise of relative female wages and, therefore, slow down the takeoff to modern economic growth.

The Galor and Weil model predicts how female labor supply and fertility evolve in the course of development. First, (married) women start participating in market work and only afterwards does fertility start declining. Historically, however, in the US and Western Europe, the decline in fertility occurred before women’s participation rates in the labor market started their dramatic increase. In addition, these regions experienced a mid-twentieth century baby boom which seems at odds with Galor and Weil’s theory.

Both these stylized facts can be addressed by adding home production to the modeling, as do Kimura & Yasui ( 2010 ). In their article, as capital per worker accumulates, the market wage for brains rises and the economy moves through four stages of development. In the first stage, with a sufficiently low market wage, both husband and wife are fully dedicated to home production and childrearing. The household does not supply labor to the market; fertility is high and constant. In the second stage, as the wage rate increases, men enter the labor market (supplying both brawn and brain), whereas women remain fully engaged in home production and childrearing. But as men partially withdraw from home production, women have to replace them. As a result, their time cost of childrearing goes up. At this stage of development, the negative substitution effect of rising wages on fertility dominates the positive income effect. Fertility starts declining, even though women have not yet entered the labor market. The third stage arrives when men stop working in home production. There is complete specialization of labor by gender; men only do market work, and women only do home production and childrearing. As the market wage rises for men, the positive income effect becomes dominant and fertility increases; this mimics the baby-boom period of the mid-twentieth century. In the fourth and final stage, once sufficient capital is accumulated, women enter the market sector as wage-earners. The negative substitution effect of rising female opportunity costs dominates once again, and fertility declines. The economy moves from a “breadwinner model” to a “dual-earnings model”.

Another important form of gender inequality is discrimination against women in the form of lower wages, holding male and female productivity constant. Cavalcanti & Tavares ( 2016 ) estimate the aggregate effects of wage discrimination using a model-based general equilibrium representation of the US economy. In their model, women are assumed to be more productive in childrearing than men, so they pay the full time cost of this activity. In the labor market, even though men and women are equally productive, women receive only a fraction of the male wage rate—this is the wage discrimination assumption. Wage discrimination works as a tax on female labor supply. Because women work less than they would without discrimination, there is a negative level effect on per capita output. In addition, there is a second negative effect of wage discrimination operating through endogenous fertility. Since lower wages reduce women’s opportunity costs of childrearing, fertility is relatively high, and output per capita is relatively low. The authors calibrate the model to US steady state parameters and estimate large negative output costs of the gender wage gap. Reducing wage discrimination against women by 50 percent would raise per capita income by 35 percent, in the long run.

Human capital accumulation plays no role in Galor & Weil ( 1996 ), Kimura & Yasui ( 2010 ), and Cavalcanti & Tavares ( 2016 ). Each person is exogenously endowed with a unit of brains. The fundamental trade-off in the these models is between the income and substitution effects of rising wages on the demand for children. When Lagerlöf ( 2003 ) adds education investments to a gender-based model, an additional trade-off emerges: that between the quantity and the quality of children.

Lagerlöf ( 2003 ) models gender inequality as a social norm: on average, men have higher human capital than women. Confronted with this fact, parents play a coordination game in which it is optimal for them to reproduce the inequality in the next generation. The reason is that parents expect the future husbands of their daughters to be, on average, relatively more educated than the future wives of their sons. Because, in the model, parents care for the total income of their children’s future households, they respond by investing relatively less in daughters’ human capital. Here, gender inequality does not arise from some intrinsic difference between men and women. It is instead the result of a coordination failure: “[i]f everyone else behaves in a discriminatory manner, it is optimal for the atomistic player to do the same” (Lagerlöf 2003 , p. 404).

With lower human capital, women earn lower wages than men and are therefore solely responsible for the time cost of childrearing. But if, exogenously, the social norm becomes more gender egalitarian over time, the gender gap in parental educational investment decreases. As better educated girls grow up and become mothers, their opportunity costs of childrearing are higher. Parents trade-off the quantity of children by their quality; fertility falls and human capital accumulates. However, rising wages have an offsetting positive income effect on fertility because parents pay a (fixed) “goods cost” per child. The goods cost is proportionally more important in poor societies than in richer ones. As a result, in poor economies, growth takes off slowly because the positive income effect offsets a large chunk of the negative substitution effect. As economies grow richer, the positive income effect vanishes (as a share of total income), and fertility declines faster. That is, growth accelerates over time even if gender equality increases only linearly.

The natural next step is to model how the social norm on gender roles evolves endogenously during the course of development. Hiller ( 2014 ) develops such a model by combining two main ingredients: a gender gap in the endowments of brawn (as in Galor & Weil 1996 ) generates a social norm, which each parental couple takes as given (as in Lagerlöf 2003 ). The social norm evolves endogenously, but slowly; it tracks the gender ratio of labor supply in the market, but with a small elasticity. When the male-female ratio in labor supply decreases, stereotypes adjust and the norm becomes less discriminatory against women.

The model generates a U-shaped relationship between economic development and female labor force participation. Footnote 13 In the preindustrial stage, there is no education and all labor activities are unskilled, i.e., produced with brawn. Because men have a comparative advantage in brawn, they supply more labor to the market than women, who specialize in home production. This gender gap in labor supply creates a social norm that favors boys over girls. Over time, exogenous skill-biased technological progress raises the relative returns to brains, inducing parents to invest in their children’s education. At the beginning, however, because of the social norm, only boys become educated. The economy accumulates human capital and grows, generating a positive income effect that, in isolation, would eventually drive up parental investments in girls’ education. Footnote 14 But endogenous social norms move in the opposite direction. When only boys receive education, the gender gap in returns to market work increases, and women withdraw to home production. As female relative labor supply in the market drops, the social norm becomes more discriminatory against women. As a result, parents want to invest relatively less in their daughters’ education.

In the end, initial conditions determine which of the forces dominates, thereby shaping long-term outcomes. If, initially, the social norm is very discriminatory, its effect is stronger than the income effect; the economy becomes trapped in an equilibrium with high gender inequality and low per capita income. If, on the other hand, social norms are relatively egalitarian to begin with, then the income effect dominates, and the economy converges to an equilibrium with gender equality and high income per capita.

In the models reviewed so far, human capital or brain endowments can be understood as combining both education and health. Bloom et al. ( 2015 ) explicitly distinguish these two dimensions. Health affects labor market earnings because sick people are out of work more often (participation effect) and are less productive per hour of work (productivity effect). Female health is assumed to be worse than male health, implying that women’s effective wages are lower than men’s. As a result, women are solely responsible for childrearing. Footnote 15

The model produces two growth regimes: a Malthusian trap with high fertility and no educational investments; and a regime of sustained growth, declining fertility, and rising educational investments. Once wages reach a certain threshold, the economy goes through a fertility transition and education expansion, taking off from the Malthusian regime to the sustained growth regime.

Female health promotes growth in both regimes, and it affects the timing of the takeoff. The healthier women are, the earlier the economy takes off. The reason is that a healthier woman earns a higher effective wage and, consequently, faces higher opportunity costs of raising children. When female health improves, the rising opportunity costs of children reduce the wage threshold at which educational investments become attractive; the fertility transition and mass education periods occur earlier.

In contrast, improved male health slows down economic growth and delays the fertility transition. When men become healthier, there is only a income effect on the demand for children, without the negative substitution effect (because male childrearing time is already zero). The policy conclusion would be to redistribute health from men to women. However, the policy would impose a static utility cost on the household. Because women’s time allocation to market work is constrained by childrearing responsibilities (whereas men work full-time), the marginal effect of health on household income is larger for men than for women. From the household’s point of view, reducing the gender gap in health produces a trade-off between short-term income maximization and long-term economic development.

In an extension of the model, the authors endogeneize health investments, while keeping the assumption that women pay the full time cost of childrearing. Because women participate less in the labor market (due to childrearing duties), it is optimal for households to invest more in male health. A health gender gap emerges from rational household behavior that takes into account how time-constraints differ by gender; assuming taste-based discrimination against girls or gender-specific preferences is not necessary.

In the models reviewed so far, parents invest in their children’s human capital for purely altruistic reasons. This is captured in the models by assuming that parents derive utility directly from the quantity and quality of children. This is the classical representation of children as durable consumption goods (e.g., Becker 1960 ). In reality, of course, parents may also have egoistic motivations for investing in child quantity and quality. A typical example is that, when parents get old and retire, they receive support from their children. The quantity and quality of children will affect the size of old-age transfers and parents internalize this in their fertility and childcare behavior. According to this view, children are best understood as investment goods.

Zhang et al. ( 1999 ) build an endogenous growth model that incorporates the old-age support mechanism in parental decisions. Another innovative element of their model is that parents can choose the gender of their children. The implicit assumption is that sex selection technologies are freely available to all parents.

At birth, there is a gender gap in human capital endowment, favoring boys over girls. Footnote 16 In adulthood, a child’s human capital depends on the initial endowment and on the parents’ human capital. In addition, the probability that a child survives to adulthood is exogenous and can differ by gender.

Parents receive old-age support from children that survive until adulthood. The more human capital children have, the more old-age support they provide to their parents. Beyond this egoistic motive, parents also enjoy the quantity and the quality of children (altruistic motive). Son preference is modeled by boys having a higher relative weight in the altruistic-component of the parental utility function. In other words, in their enjoyment of children as consumer goods, parents enjoy “consuming” a son more than “consuming” a girl. Parents who prefer sons want more boys than girls. A larger preference for sons, a higher relative survival probability of boys, and a higher human capital endowment of boys positively affect the sex ratio at birth, because, in the parents’ perspective, all these forces increase the marginal utility of boys relative to girls.

Zhang et al. ( 1999 ) show that, if human capital transmission from parents to children is efficient enough, the economy grows endogenously. When boys have a higher human capital endowment than girls, and the survival probability of sons is not smaller than the survival probability of daughters, then only sons provide old-age support. Anticipating this, parents invest more in the human capital of their sons than on the human capital of their daughters. As a result, the gender gap in human capital at birth widens endogenously.

When only boys provide old-age support, an exogenous increase in son preference harms long-run economic growth. The reason is that, when son preference increases, parents enjoy each son relatively more and demand less old-age support from him. Other things equal, parents want to “consume” more sons now and less old-age support later. Because parents want more sons, the sex ratio at birth increases; but because each son provides less old-age support, human capital investments per son decrease (such that the gender gap in human capital narrows). At the aggregate level, the pace of human capital accumulation slows down and, in the long run, economic growth is lower. Thus, an exogenous increase in son preference increases the sex ratio at birth, and reduces human capital accumulation and long-run growth (although it narrows the gender gap in education).

In summary, in growth models with unitary households, gender inequality is closely linked to the division of labor between family members. If women earn relatively less in market activities, they specialize in childrearing and home production, while men specialize in market work. And precisely due to this division of labor, the returns to female educational investments are relatively low. These household behaviors translate into higher fertility and lower human capital and thus pose a barrier to long-run development.

4 Intra-household bargaining: husbands and wives

In this section, we review models populated with non-unitary households, where decisions are the result of bargaining between the spouses. There are two broad types of bargaining processes: non-cooperative, where spouses act independently or interact in a non-cooperative game that often leads to inefficient outcomes (e.g., Doepke & Tertilt 2019 , Heath & Tan 2020 ); and cooperative, where the spouses are assumed to achieve an efficient outcome (e.g., De la Croix & Vander Donckt 2010 ; Diebolt & Perrin 2013 ). As in the previous section, all of these non-unitary models take the household as given, thereby abstracting from marriage markets or other household formation institutions, which will be discussed separately in section 5 . When preferences differ by gender, bargaining between the spouses matters for economic growth. If women care more about child quality than men do and human capital accumulation is the main engine of growth, then empowering women leads to faster economic growth (Prettner & Strulik 2017 ). If, however, men and women have similar preferences but are imperfect substitutes in the production of household public goods, then empowering women has an ambiguous effect on economic growth (Doepke & Tertilt 2019 ).

A separate channel concerns the intergenerational transmission of human capital and woman’s role as the main caregiver of children. If the education of the mother matters more than the education of the father in the production of children’s human capital, then empowering women will be conducive to growth (Agénor 2017 ; Diebolt & Perrin 2013 ), with the returns to education playing a crucial role in the political economy of female empowerment (Doepke & Tertilt 2009 ).

However, different dimensions of gender inequality have different growth impacts along the development process (De la Croix & Vander Donckt 2010 ). Policies that improve gender equality across many dimensions can be particularly effective for economic growth by reaping complementarities and positive externalities (Agénor 2017 ).

The idea that women might have stronger preferences for child-related expenditures than men can be easily incorporated in a Beckerian model of fertility. The necessary assumption is that women place a higher weight on child quality (relative to child quantity) than men do. Prettner & Strulik ( 2017 ) build a unified growth theory model with collective households. Men and women have different preferences, but they achieve efficient cooperation based on (reduced-form) bargaining parameters. The authors study the effect of two types of preferences: (i) women are assumed to have a relative preference for child quality, while men have a relative preference for child quantity; and (ii) parents are assumed to have a relative preference for the education of sons over the education of daughters. In addition, it is assumed that the time cost of childcare borne by men cannot be above that borne by women (but it could be the same).

When women have a relative preference for child quality, increasing female empowerment speeds up the economy’s escape from a Malthusian trap of high fertility, low education, and low income per capita. When female empowerment increases (exogenously), a woman’s relative preference for child quality has a higher impact on household’s decisions. As a consequence, fertility falls, human capital accumulates, and the economy starts growing. The model also predicts that the more preferences for child quality differ between husband and wife, the more effective is female empowerment in raising long-run per capita income, because the sooner the economy escapes the Malthusian trap. This effect is not affected by whether parents have a preference for the education of boys relative to that of girls. If, however, men and women have similar preferences with respect to the quantity and quality of their children, then female empowerment does not affect the timing of the transition to the sustained growth regime.

Strulik ( 2019 ) goes one step further and endogeneizes why men seem to prefer having more children than women. The reason is a different preference for sexual activity: other things equal, men enjoy having sex more than women. Footnote 17 When cheap and effective contraception is not available, a higher male desire for sexual activity explains why men also prefer to have more children than women. In a traditional economy, where no contraception is available, fertility is high, while human capital and economic growth are low. When female bargaining power increases, couples reduce their sexual activity, fertility declines, and human capital accumulates faster. Faster human capital accumulation increases household income and, as a consequence, the demand for contraception goes up. As contraception use increases, fertility declines further. Eventually, the economy undergoes a fertility transition and moves to a modern regime with low fertility, widespread use of contraception, high human capital, and high economic growth. In the modern regime, because contraception is widely used, men’s desire for sex is decoupled from fertility. Both sex and children cost time and money. When the two are decoupled, men prefer to have more sex at the expense of the number of children. There is a reversal in the gender gap in desired fertility. When contraceptives are not available, men desire more children than women; once contraceptives are widely used, men desire fewer children than women. If women are more empowered, the transition from the traditional equilibrium to the modern equilibrium occurs faster.

Both Prettner & Strulik ( 2017 ) and Strulik ( 2019 ) rely on gender-specific preferences. In contrast, Doepke & Tertilt ( 2019 ) are able to explain gender-specific expenditure patterns without having to assume that men and women have different preferences. They set up a non-cooperative model of household decision making and ask whether more female control of household resources leads to higher child expenditures and, thus, to economic development. Footnote 18

In their model, household public goods are produced with two inputs: time and goods. Instead of a single home-produced good (as in most models), there is a continuum of household public goods whose production technologies differ. Some public goods are more time-intensive to produce, while others are more goods-intensive. Each specific public good can only be produced by one spouse—i.e., time and good inputs are not separable. Women face wage discrimination in the labor market, so their opportunity cost of time is lower than men’s. As a result, women specialize in the production of the most time-intensive household public goods (e.g., childrearing activities), while men specialize in the production of goods-intensive household public goods (e.g., housing infrastructure). Notice that, because the household is non-cooperative, there is not only a division of labor between husband and wife, but also a division of decision making, since ultimately each spouse decides how much to provide of his or her public goods.

When household resources are redistributed from men to women (i.e., from the high-wage spouse to the low-wage spouse), women provide more public goods, in relative terms. It is ambiguous, however, whether the total provision of public goods increases with the re-distributive transfer. In a classic model of gender-specific preferences, a wife increases child expenditures and her own private consumption at the expense of the husband’s private consumption. In Doepke & Tertilt ( 2019 ), however, the rise in child expenditures (and time-intensive public goods in general) comes at the expense of male consumption and male-provided public goods.

Parents contribute to the welfare of the next generation in two ways: via human capital investments (time-intensive, typically done by the mother) and bequests of physical capital (goods-intensive, typically done by the father). Transferring resources to women increases human capital, but reduces the stock of physical capital. The effect of such transfers on economic growth depends on whether the aggregate production function is relatively intensive in human capital or in physical capital. If aggregate production is relatively human capital intensive, then transfers to women boost economic growth; if it is relatively intensive in physical capital, then transfers to women may reduce economic growth.

There is an interesting paradox here. On the one hand, transfers to women will be growth-enhancing in economies where production is intensive in human capital. These would be more developed, knowledge intensive, service economies. On the other hand, the positive growth effect of transfers to women increases with the size of the gender wage gap, that is, decreases with female empowerment. But the more advanced, human capital intensive economies are also the ones with more female empowerment (i.e., lower gender wage gaps). In other words, in settings where human capital investments are relatively beneficial, the contribution of female empowerment to human capital accumulation is reduced. Overall, Doepke and Tertilt’s ( 2019 ) model predicts that female empowerment has at best a limited positive effect and at worst a negative effect on economic growth.

Heath & Tan ( 2020 ) argue that, in a non-cooperative household model, income transfers to women may increase female labor supply. Footnote 19 This result may appear counter-intuitive at first, because in collective household models unearned income unambiguously reduces labor supply through a negative income effect. In Heath and Tan’s model, husband and wife derive utility from leisure, consuming private goods, and consuming a household public good. The spouses decide separately on labor supply and monetary contributions to the household public good. Men and women are identical in preferences and behavior, but women have limited control over resources, with a share of their income being captured by the husband. Female control over resources (i.e., autonomy) depends positively on the wife’s relative contribution to household income. Thus, an income transfer to the wife, keeping husband unearned income constant, raises the fraction of her own income that she privately controls. This autonomy effect unambiguously increases women’s labor supply, because the wife can now reap an additional share of her wage bill. Whenever the autonomy effect dominates the (negative) income effect, female labor supply increases. The net effect will be heterogeneous over the wage distribution, but the authors show that aggregate female labor supply is always weakly larger after the income transfer.

Diebolt & Perrin ( 2013 ) assume cooperative bargaining between husband and wife, but do not rely on sex-specific preferences or differences in ability. Men and women are only distinguished by different uses of their time endowments, with females in charge of all childrearing activities. In line with this labor division, the authors further assume that only the mother’s human capital is inherited by the child at birth. On top of the inherited maternal endowment, individuals can accumulate human capital during adulthood, through schooling. The higher the initial human capital endowment, the more effective is the accumulation of human capital via schooling.

A woman’s bargaining power in marriage determines her share in total household consumption and is a function of the relative female human capital of the previous generation. An increase in the human capital of mothers relative to that of fathers has two effects. First, it raises the incentives for human capital accumulation of the next generation, because inherited maternal human capital makes schooling more effective. Second, it raises the bargaining power of the next generation of women and, because women’s consumption share increases, boosts the returns on women’s education. The second effect is not internalized in women’s time allocation decisions; it is an intergenerational externality. Thus, an exogenous increase in women’s bargaining power would promote economic growth by speeding up the accumulation of human capital across overlapping generations.

De la Croix & Vander Donckt ( 2010 ) contribute to the literature by clearly distinguishing between different gender gaps: a gap in the probability of survival, a wage gap, a social and institutional gap, and a gender education gap. The first three are exogenously given, while the fourth is determined within the model.

By assumption, men and women have identical preferences and ability, but women pay the full time cost of childrearing. As in a typical collective household model, bargaining power is partially determined by the spouses’ earnings potential (i.e., their levels of human capital and their wage rates). But there is also a component of bargaining power that is exogenous and captures social norms that discriminate against women—this is the social and institutional gender gap.

Husbands and wives bargain over fertility and human capital investments for their children. A standard Beckerian result emerges: parents invest relatively less in the education of girls, because girls will be more time-constrained than boys and, therefore, the female returns to education are lower in relative terms.

There are at least two regimes in the economy: a corner regime and an interior regime. The corner regime consists of maximum fertility, full gender specialization (no women in the labor market), and large gender gaps in education (no education for girls). Reducing the wage gap or the social and institutional gap does not help the economy escaping this regime. Women are not in labor force, so the wage gap is meaningless. The social and institutional gap will determine women’s share in household consumption, but does not affect fertility and growth. At this stage, the only effective instruments for escaping the corner regime are reducing the gender survival gap or reducing child mortality. Reducing the gender survival gap increases women’s lifespan, which increases their time budget and attracts them to the labor market. Reducing child mortality decreases the time costs of kids, therefore drawing women into the labor market. In both cases, fertility decreases.

In the interior regime, fertility is below the maximum, women’s labor supply is above zero, and both boys and girls receive education. In this regime, with endogenous bargaining power, reducing all gender gaps will boost economic growth. Footnote 20 Thus, depending on the growth regime, some gender gaps affect economic growth, while others do not. Accordingly, the policy-maker should tackle different dimensions of gender inequality at different stages of the development process.

Agénor ( 2017 ) presents a computable general equilibrium that includes many of the elements of gender inequality reviewed so far. An important contribution of the model is to explicitly add the government as an agent whose policies interact with family decisions and, therefore, will impact women’s time allocation. Workers produce a market good and a home good and are organized in collective households. Bargaining power depends on the spouses’ relative human capital levels. By assumption, there is gender discrimination in market wages against women. On top, mothers are exclusively responsible for home production and childrearing, which takes the form of time spent improving children’s health and education. But public investments in education and health also improve these outcomes during childhood. Likewise, public investment in public infrastructure contributes positively to home production. In particular, the ratio of public infrastructure capital stock to private capital stock is a substitute for women’s time in home production. The underlying idea is that improving sanitation, transportation, and other infrastructure reduces time spent in home production. Health status in adulthood depends on health status in childhood, which, in turn, relates positively to mother’s health, her time inputs into childrearing, and government spending. Children’s human capital depends on similar factors, except that mother’s human capital replaces her health as an input. Additionally, women are assumed to derive less utility from current consumption and more utility from children’s health relative to men. Wives are also assumed to live longer than their husbands, which further down-weights female’s emphasis on current consumption. The final gendered assumption is that mother’s time use is biased towards boys. This bias alone creates a gender gap in education and health. As adults, women’s relative lower health and human capital are translated into relative lower bargaining power in household decisions.

Agénor ( 2017 ) calibrates this rich setup for Benin, a low income country, and runs a series of policy experiments on different dimensions of gender inequality: a fall in childrearing costs, a fall in gender pay discrimination, a fall in son bias in mother’s time allocation, and an exogenous increase in female bargaining power. Footnote 21 Interestingly, despite all policies improving gender equality in separate dimensions, not all unambiguously stimulate economic growth. For example, falling childrearing costs raise savings and private investments, which are growth-enhancing, but increase fertility (as children become ‘cheaper’) and reduce maternal time investment per child, thus reducing growth. In contrast, a fall in gender pay discrimination always leads to higher growth, through higher household income that, in turn, boosts savings, tax revenues, and public spending. Higher public spending further contributes to improved health and education of the next generation. Lastly, Agénor ( 2017 ) simulates the effect of a combined policy that improves gender equality in all domains simultaneously. Due to complementarities and positive externalities across dimensions, the combined policy generates more economic growth than the sum of the individual policies. Footnote 22

In the models reviewed so far, men are passive observers of women’s empowerment. Doepke & Tertilt ( 2009 ) set up an interesting political economy model of women’s rights, where men make the decisive choice. Their model is motivated by the fact that, historically, the economic rights of women were expanded before their political rights. Because the granting of economic rights empowers women in the household, and this was done before women were allowed to participate in the political process, the relevant question is why did men willingly share their power with their wives?

Doepke & Tertilt ( 2009 ) answer this question by arguing that men face a fundamental trade-off. On the one hand, husbands would vote for their wives to have no rights whatsoever, because husbands prefer as much intra-household bargaining power as possible. But, on the other hand, fathers would vote for their daughters to have economic rights in their future households. In addition, fathers want their children to marry highly educated spouses, and grandfathers want their grandchildren to be highly educated. By assumption, men and women have different preferences, with women having a relative preference for child quality over quantity. Accordingly, men internalize that, when women become empowered, human capital investments increase, making their children and grandchildren better-off.

Skill-biased (exogenous) technological progress that raises the returns to education over time can shift male incentives along this trade-off. When the returns to education are low, men prefer to make all decisions on their own and deny all rights to women. But once the returns to education are sufficiently high, men voluntarily share their power with women by granting them economic rights. As a result, human capital investments increase and the economy grows faster.

In summary, gender inequality in labor market earnings often implies power asymmetries within the household, with men having more bargaining power than women. If preferences differ by gender and female preferences are more conducive to development, then empowering women is beneficial for growth. When preferences are the same and the bargaining process is non-cooperative, the implications are less clear-cut, and more context-specific. If, in addition, women’s empowerment is curtailed by law (e.g., restrictions on women’s economic rights), then it is important to understand the political economy of women’s rights, in which men are crucial actors.

5 Marriage markets and household formation

Two-sex models of economic growth have largely ignored how households are formed. The marriage market is not explicitly modeled: spouses are matched randomly, marriage is universal and monogamous, and families are nuclear. In reality, however, household formation patterns vary substantially across societies, with some of these differences extending far back in history. For example, Hajnal ( 1965 , 1982 ) described a distinct household formation pattern in preindustrial Northwestern Europe (often referred to as the “European Marriage Pattern”) characterized by: (i) late ages at first marriage for women, (ii) most marriages done under individual consent, and (iii) neolocality (i.e., upon marriage, the bride and the groom leave their parental households to form a new household). In contrast, marriage systems in China and India consisted of: (i) very early female ages at first marriage, (ii) arranged marriages, and (iii) patrilocality (i.e., the bride joins the parental household of the groom).

Economic historians argue that the “European Marriage Pattern” empowered women, encouraging their participation in market activities and reducing fertility levels. While some view this as one of the deep-rooted factors explaining Northwestern Europe’s earlier takeoff to sustained economic growth (e.g., Carmichael, de Pleijt, van Zanden and De Moor 2016 ; De Moor & Van Zanden 2010 ; Hartman 2004 ), others have downplayed the long-run significance of this marriage pattern (e.g., Dennison & Ogilvie 2014 ; Ruggles 2009 ). Despite this lively debate, the topic has been largely ignored by growth theorists. The few exceptions are Voigtländer and Voth ( 2013 ), Edlund and Lagerlöf ( 2006 ), and Tertilt ( 2005 , 2006 ).

After exploring different marriage institutions, we zoom in on contemporary monogamous and consensual marriage and review models where gender inequality affects economic growth through marriage markets that facilitate household formation (Du & Wei 2013 ; Grossbard & Pereira 2015 ; Grossbard-Shechtman 1984 ; Guvenen & Rendall 2015 ). In contrast with the previous two sections, where the household is the starting point of the analysis, the literature on marriage markets and household formation recognizes that marriage, labor supply, and investment decisions are interlinked. The analysis of these interlinkages is sometimes done with unitary households (upon marriage) (Du & Wei 2013 ; Guvenen & Rendall 2015 ), or with non-cooperative models of individual decision-making within households (Grossbard & Pereira 2015 ; Grossbard-Shechtman 1984 ).

Voigtländer and Voth ( 2013 ) argue that the emergence of the “European Marriage Pattern” is a direct consequence of the mid-fourteen century Black Death. They set up a two-sector agricultural economy consisting of physically demanding cereal farming, and less physically demanding pastoral production. The economy is populated by many male and female peasants and by a class of idle, rent-maximizing landlords. Female peasants are heterogeneous with respect to physical strength, but, on average, are assumed to have less brawn relative to male peasants and, thus, have a comparative advantage in the pastoral sector. Both sectors use land as a production input, although the pastoral sector is more land-intensive than cereal production. All land is owned by the landlords, who can rent it out for peasant cereal farming, or use it for large-scale livestock farming, for which they hire female workers. Crucially, women can only work and earn wages in the pastoral sector as long as they are unmarried. Footnote 23 Peasant women decide when to marry and, upon marriage, a peasant couple forms a new household, where husband and wife both work on cereal farming, and have children at a given time frequency. Thus, the only contraceptive method available is delaying marriage. Because women derive utility from consumption and children, they face a trade-off between earned income and marriage.

Initially, the economy rests in a Malthusian regime, where land-labor ratios are relatively low, making the land-intensive pastoral sector unattractive and depressing relative female wages. As a result, women marry early and fertility is high. The initial regime ends in 1348–1350, when the Black Death kills between one third and half of Europe’s population, exogenously generating land abundance and, therefore, raising the relative wages of female labor in pastoral production. Women postpone marriage to reap higher wages, and fertility decreases—moving the economy to a regime of late marriages and low fertility.

In addition to late marital ages and reduced fertility, another important feature of the “European Marriage Pattern” was individual consent for marriage. Edlund and Lagerlöf ( 2006 ) study how rules of consent for marriage influence long-run economic development. In their model, marriages can be formed according to two types of consent rules: individual consent or parental consent. Under individual consent, young people are free to marry whomever they wish, while, under parental consent, their parents are in charge of arranging the marriage. Depending on the prevailing rule, the recipient of the bride-price differs. Under individual consent, a woman receives the bride-price from her husband, whereas, under parental consent, her father receives the bride-price from the father of the groom. Footnote 24 In both situations, the father of the groom owns the labor income of his son and, therefore, pays the bride-price, either directly, under parental consent, or indirectly, under individual consent. Under individual consent, the father needs to transfer resources to his son to nudge him into marrying. Thus, individual consent implies a transfer of resources from the old to the young and from men to women, relative to the rule of parental consent. Redistributing resources from the old to the young boosts long-run economic growth. Because the young have a longer timespan to extract income from their children’s labor, they invest relatively more in the human capital of the next generation. In addition, under individual consent, the reallocation of resources from men to women can have additional positive effects on growth, by increasing women’s bargaining power (see section 4 ), although this channel is not explicitly modeled in Edlund and Lagerlöf ( 2006 ).

Tertilt ( 2005 ) explores the effects of polygyny on long-run development through its impact on savings and fertility. In her model, parental consent applies to women, while individual consent applies to men. There is a competitive marriage market where fathers sell their daughters and men buy their wives. As each man is allowed (and wants) to marry several wives, a positive bride-price emerges in equilibrium. Footnote 25 Upon marriage, the reproductive rights of the bride are transferred from her father to her husband, who makes all fertility decisions on his own and, in turn, owns the reproductive rights of his daughters. From a father’s perspective, daughters are investments goods; they can be sold in the marriage market, at any time. This feature generates additional demand for daughters, which increases overall fertility, and reduces the incentives to save, which decreases the stock of physical capital. Under monogamy, in contrast, the equilibrium bride-price is negative (i.e., a dowry). The reason is that maintaining unmarried daughters is costly for their fathers, so they are better-off paying a (small enough) dowry to their future husbands. In this setting, the economic returns to daughters are lower and, consequently, so is the demand for children. Fertility decreases and savings increase. Thus, moving from polygny to monogamy lowers population growth and raises the capital stock in the long run, which translates into higher output per capita in the steady state.

Instead of enforcing monogamy in a traditionally polygynous setting, an alternative policy is to transfer marriage consent from fathers to daughters. Tertilt ( 2006 ) shows that when individual consent is extended to daughters, such that fathers do not receive the bride-price anymore, the consequences are qualitatively similar to a ban on polygyny. If fathers stop receiving the bride-price, they save more physical capital. In the long run, per capita output is higher when consent is transferred to daughters.

Grossbard-Shechtman ( 1984 ) develops the first non-cooperative model where (monogamous) marriage, home production, and labor supply decisions are interdependent. Footnote 26 Spouses are modeled as separate agents deciding over production and consumption. Marriage becomes an implicit contract for ‘work-in-household’ (WiHo), defined as “an activity that benefits another household member [typically a spouse] who could potentially compensate the individual for these efforts” (Grossbard 2015 , p. 21). Footnote 27 In particular, each spouse decides how much labor to supply to market work and WiHo, and how much labor to demand from the other spouse for WiHo. Through this lens, spousal decisions over the intra-marriage distribution of consumption and WiHo are akin to well-known principal-agent problems faced between firms and workers. In the marriage market equilibrium, a spouse benefiting from WiHo (the principal) must compensate the spouse producing it (the agent) via intra-household transfers (of goods or leisure). Footnote 28 Grossbard-Shechtman ( 1984 ) and Grossbard ( 2015 ) show that, under these conditions, the ratio of men to women (i.e., the sex ratio) in the marriage market is inversely related to female labor supply to the market. The reason is that, as the pool of potential wives shrinks, prospective husbands have to increase compensation for female WiHo. From the potential wife’s point of view, as the equilibrium price for her WiHo increases, market work becomes less attractive. Conversely, when sex ratios are lower, female labor supply outside the home increases. Although the model does not explicit derive growth implications, the relative increase in female labor supply is expected to be beneficial for economic growth, as argued by many of the theories reviewed so far.

In an extension of this framework, Grossbard & Pereira ( 2015 ) analyze how sex ratios affect gendered savings over the marital life-cycle. Assuming that women supply a disproportionate amount of labor for WiHo (due, for example, to traditional gender norms), the authors show that men and women will have very distinct saving trajectories. A higher sex ratio increases savings by single men, who anticipate higher compensation transfers for their wives’ WiHo, whereas it decreases savings by single women, who anticipate receiving those transfers upon marriage. But the pattern flips after marriage: precautionary savings raise among married women, because the possibility of marriage dissolution entails a loss of income from WiHo. The opposite effect happens for married men: marriage dissolution would imply less expenditures in the future. The higher the sex ratio, the higher will be the equilibrium compensation paid by husbands for their wives’ WiHo. Therefore, the sex ratio will positively affect savings among single men and married women, but negatively affect savings among single women and married men. The net effect on the aggregate savings rate and on economic growth will depend on the relative size of these demographic groups.

In a related article, Du & Wei ( 2013 ) propose a model where higher sex ratios worsen marriage markets prospects for young men and their families, who react by increasing savings. Women in turn reduce savings. However, because sex ratios shift the composition of the population in favor of men (high saving type) relative to women (low saving type) and men save additionally to compensate for women’s dis-saving, aggregate savings increase unambiguously with sex ratios.

In Guvenen & Rendall ( 2015 ), female education is, in part, demanded as insurance against divorce risk. The reason is that divorce laws often protect spouses’ future labor market earnings (i.e., returns to human capital), but force them to share their physical assets. Because, in the model, women are more likely to gain custody of their children after divorce, they face higher costs from divorce relative to their husbands. Therefore, the higher the risk of divorce, the more women invest in human capital, as insurance against a future vulnerable economic position. Guvenen & Rendall ( 2015 ) shows that, over time, divorce risk has increased (for example, consensual divorce became replaced by unilateral divorce in most US states in the 1970s). In the aggregate, higher divorce risk boosted female education and female labor supply.

In summary, the rules regulating marriage and household formation carry relevant theoretical consequences for economic development. While the few studies on this topic have focused on age at marriage, consent rules and polygyny, and the interaction between sex ratios, marriage, and labor supply, other features of the marriage market remain largely unexplored (Borella, De Nardi and Yang 2018 ). Growth theorists would benefit from further incorporating theories of household formation in gendered macro models. Footnote 29

6 Conclusion

In this article, we surveyed micro-founded theories linking gender inequality to economic development. This literature offers many plausible mechanisms through which inequality between men and women affects the aggregate economy (see Table 1 ). Yet, we believe the body of theories could be expanded in several directions. We discuss them below and highlight lessons for policy.

The first direction for future research concerns control over fertility. In models where fertility is endogenous, households are always able to achieve their preferred number of children (see Strulik 2019 , for an exception). The implicit assumption is that there is a free and infallible method of fertility control available for all households—a view rejected by most demographers. The gap between desired fertility and achieved fertility can be endogeneized at three levels. First, at the societal level, the diffusion of particular contraceptive methods may be influenced by cultural and religious norms. Second, at the household level, fertility control may be object of non-cooperative bargaining between the spouses, in particular, for contraceptive methods that only women perfectly observe (Ashraf, Field and Lee 2014 ; Doepke & Kindermann 2019 ). More generally, the role of asymmetric information within the household is not yet explored (Walther 2017 ). Third, if parents have preferences over the gender composition of their offspring, fertility is better modeled as a sequential and uncertain process, where household size is likely endogenous to the sex of the last born child (Hazan & Zoabi 2015 ).

A second direction worth exploring concerns gender inequality in a historical perspective. In models with multiple equilibria, an economy’s path is often determined by its initial level of gender equality. Therefore, it would be useful to develop theories explaining why initial conditions varied across societies. In particular, there is a large literature on economic and demographic history documenting how systems of marriage and household formation differed substantially across preindustrial societies (e.g., De Moor & Van Zanden 2010 ; Hajnal 1965 , 1982 ; Hartman 2004 ; Ruggles 2009 ). In our view, more theoretical work is needed to explain both the origins and the consequences of these historical systems.

A third avenue for future research concerns the role of technological change. In several models, technological change is the exogenous force that ultimately erodes gender gaps in education or labor supply (e.g., Bloom et al. 2015 ; Doepke & Tertilt 2009 ; Galor & Weil 1996 ). For that to happen, technological progress is assumed to be skill-biased, thus raising the returns to education—or, in other words, favoring brain over brawn. As such, new technologies make male advantage in physical strength ever more irrelevant, while making female time spent on childrearing and housework ever more expensive. Moreover, recent technological progress increased the efficiency of domestic activities, thereby relaxing women’s time constraints (e.g., Cavalcanti & Tavares 2008 ; Greenwood, Seshadri and Yorukoglu 2005 ). These mechanisms are plausible, but other aspects of technological change need not be equally favorable for women. In many countries, for example, the booming science, technology, and engineering sectors tend to be particularly male-intensive. And Tejani & Milberg ( 2016 ) provide evidence for developing countries that as manufacturing industries become more capital intensive, their female employment share decreases.

Even if current technological progress is assumed to weaken gender gaps, historically, technology may have played exactly the opposite role. If technology today is more complementary to brain, in the past it could have been more complementary to brawn. An example is the plow that, relative to alternative technologies for field preparation (e.g., hoe, digging stick), requires upper body strength, on which men have a comparative advantage over women (Alesina, Giuliano and Nunn 2013 ; Boserup 1970 ). Another, even more striking example, is the invention of agriculture itself—the Neolithic Revolution. The transition from a hunter-gatherer lifestyle to sedentary agriculture involved a relative loss of status for women (Dyble et al. 2015 ; Hansen, Jensen and Skovsgaard 2015 ). One explanation is that property rights on land were captured by men, who had an advantage on physical strength and, consequently, on physical violence. Thus, in the long view of human history, technological change appears to have shifted from being male-biased towards being female-biased. Endogeneizing technological progress and its interaction with gender inequality is a promising avenue for future research.

Fourth, open economy issues are still almost entirely absent. An exception is Rees & Riezman ( 2012 ), who model the effect of globalization on economic growth. Whether global capital flows generate jobs primarily in female or male intensive sectors matters for long-run growth. If globalization creates job opportunities for women, their bargaining power increases and households trade off child quantity by child quality. Fertility falls, human capital accumulates, and long-run per capita output is high. If, on the other hand, globalization creates jobs for men, their intra-household power increases; fertility increases, human capital decreases, and steady-state income per capita is low. The literature would benefit from engaging with open economy demand-driven models of the feminist tradition, such as Blecker & Seguino ( 2002 ), Seguino ( 2010 ). Other fruitful avenues for future research on open economy macro concern gender analysis of global value chains (Barrientos 2019 ), gendered patterns of international migration (Cortes 2015 ; Cortes & Tessada 2011 ), and the diffusion of gender norms through globalization (Beine, Docquier and Schiff 2013 ; Klasen 2020 ; Tuccio & Wahba 2018 ).

A final point concerns the role of men in this literature. In most theoretical models, gender inequality is not the result of an active male project that seeks the domination of women. Instead, inequality emerges as a rational best response to some underlying gender gap in endowments or constraints. Then, as the underlying gap becomes less relevant—for example, due to skill-biased technological change—, men passively relinquish their power (see Doepke & Tertilt 2009 , for an exception). There is never a male backlash against the short-term power loss that necessarily comes with female empowerment. In reality, it is more likely that men actively oppose losing power and resources towards women (Folbre 2020 ; Kabeer 2016 ; Klasen 2020 ). This possibility has not yet been explored in formal models, even though it could threaten the typical virtuous cycle between gender equality and growth. If men are forward-looking, and the short-run losses outweigh the dynamic gains from higher growth, they might ensure that women never get empowered to begin with. Power asymmetries tend to be sticky, because “any group that is able to claim a disproportionate share of the gains from cooperation can develop social institutions to fortify their position” (Folbre 2020 , p. 199). For example, Eswaran & Malhotra ( 2011 ) set up a household decision model where men use domestic violence against their wives as a tool to enhance male bargaining power. Thus, future theories should recognize more often that men have a vested interest on the process of female empowerment.

More generally, policymakers should pay attention to the possibility of a male backlash as an unintended consequence of female empowerment policies (Erten & Keskin 2018 ; Eswaran & Malhotra 2011 ). Likewise, whereas most theories reviewed here link lower fertility to higher economic growth, the relationship is non-monotonic. Fertility levels below the replacement rate will eventually generate aggregate social costs in the form of smaller future workforces, rapidly ageing societies, and increased pressure on welfare systems, to name a few.

Many theories presented in this survey make another important practical point: public policies should recognize that gender gaps in separate dimensions complement and reinforce one another and, therefore, have to be dealt with simultaneously. A naïve policy targeting a single gap in isolation is unlikely to have substantial growth effects in the short run. Typically, inequalities in separate dimensions are not independent from each other (Agénor 2017 ; Bandiera & Does 2013 ; Duflo 2012 ; Kabeer 2016 ). For example, if credit-constrained women face weak property rights, are unable to access certain markets, and have mobility and time constraints, then the marginal return to capital may nevertheless be larger for men. Similarly, the return to male education may well be above the female return if demand for female labor is low or concentrated in sectors with low productivity. In sum, “the fact that women face multiple constraints means that relaxing just one may not improve outcomes” (Duflo 2012 , p. 1076).

Promising policy directions that would benefit from further macroeconomic research are the role of public investments in physical infrastructure and care provision (Agénor 2017 ; Braunstein, Bouhia and Seguino 2020 ), gender-based taxation (Guner, Kaygusuz and Ventura 2012 ; Meier & Rainer 2015 ), and linkages between gender equality and pro-environmental agendas (Matsumoto 2014 ).

See Echevarria & Moe ( 2000 ) for a similar complaint that “theories of economic growth and development have consistently neglected to include gender as a variable” (p. 77).

A non-exhaustive list includes Bandiera & Does ( 2013 ), Braunstein ( 2013 ), Cuberes & Teignier ( 2014 ), Duflo ( 2012 ), Kabeer ( 2016 ), Kabeer & Natali ( 2013 ), Klasen ( 2018 ), Seguino ( 2013 , 2020 ), Sinha et al. ( 2007 ), Stotsky ( 2006 ), World Bank ( 2001 , 2011 ).

For an in-depth history of “new home economics” see Grossbard-Shechtman ( 2001 ) and Grossbard ( 2010 , 2011 ).

For recent empirical reviews see Duflo ( 2012 ) and Doss ( 2013 ).

Although the unitary approach has being rejected on theoretical (e.g., Echevarria & Moe 2000 ; Folbre 1986 ; Knowles 2013 ; Sen 1989 ) and empirical grounds (e.g., Doss 2013 ; Duflo 2003 ; Lundberg et al. 1997 ), these early models are foundational to the subsequent literature. As it turns out, some of the key mechanisms survive in non-unitary theories of the household.

For nice conceptual perspectives on conflict and cooperation in households see Sen ( 1989 ), Grossbard ( 2011 ), and Folbre ( 2020 ).

The relationship depicted in Fig. 1 is robust to using other composite measures of gender equality (e.g., UNDP’s Gender Inequality Index or OECD’s Social Institutions and Gender Index (SIGI) (see Branisa, Klasen and Ziegler 2013 )), and other years besides 2000. In Fig. 2 , the linear prediction explains 56 percent of the cross-country variation in per capita income.

See Seguino ( 2013 , 2020 ) for a review of this literature.

The model allows for sorting on ability (“some people are better teachers”) or sorting on occupation-specific preferences (“others derive more utility from working as a teacher”) (Hsieh et al. 2019 , p. 1441). Here, we restrict our presentation to the case where sorting occurs primarily on ability. The authors find little empirical support for sorting on preferences.

Because the home sector is treated as any other occupation, the model can capture, in a reduced-form fashion, social norms on women’s labor force participation. For example, a social norm on traditional gender roles can be represented as a utility premium obtained by all women working on the home sector.

Note, however, that discrimination against women raises productivity in the non-agricultural sector. The reason is that the few women who end up working outside agriculture are positively selected on talent. Lee ( 2020 ) shows that this countervailing effect is modest and dominated by the loss of productivity in agriculture.

This is not the classic Beckerian quantity-quality trade-off because parents cannot invest in the quality of their children. Instead, the mechanism is built by assumption in the household’s utility function. When women’s wages increase relative to male wages, the substitution effect dominates the income effect.

The hypothesis that female labor force participation and economic development have a U-shaped relationship—known as the feminization-U hypothesis—goes back to Boserup ( 1970 ). See also Goldin ( 1995 ). Recently, Gaddis & Klasen ( 2014 ) find only limited empirical support for the feminization-U.

The model does not consider fertility decisions. Parents derive utility from their children’s human capital (social status utility). When household income increases, parents want to “consume” more social status by investing in their children’s education—this is the positive income effect.

Bloom et al. ( 2015 ) build their main model with unitary households, but show that the key conclusions are robust to a collective representation of the household.

This assumption does not necessarily mean that boys are more talented than girls. It can be also interpreted as a reduced-form way of capturing labor market discrimination against women.

Many empirical studies are in line with this assumption, which is rooted in evolutionary psychology. See Strulik ( 2019 ) for references. There are several other evolutionary arguments for men wanting more children (including with different women). See, among others, Mulder & Rauch ( 2009 ), Penn & Smith ( 2007 ), von Rueden & Jaeggi ( 2016 ). However, for a different view, see Fine ( 2017 ).

They do not model fertility decisions. So there is no quantity-quality trade-off.

In their empirical application, Heath & Tan ( 2020 ) study the Hindu Succession Act, which, through improved female inheritance rights, increased the lifetime unearned income of Indian women. Other policies consistent with the model are, for example, unconditional cash transfers to women.

De la Croix & Vander Donckt ( 2010 ) show this with numerical simulations, because the interior regime becomes analytically intractable.

We focus on gender-related policies in our presentation, but the article simulates additional public policies.

Agénor and Agénor ( 2014 ) develop a similar model, but with unitary households, and Agénor and Canuto ( 2015 ) have a similar model of collective households for Brazil, where adult women can also invest time in human capital formation. Since public infrastructure substitutes for women’s time in home production, more (or better) infrastructure can free up time for female human capital accumulation and, thus, endogenously increase wives’ bargaining power.

Voigtländer and Voth ( 2013 ) justify this assumption arguing that, in England, employment contracts for farm servants working in animal husbandry were conditional on celibacy. However, see Edwards & Ogilvie ( 2018 ) for a critique of this assumption.

The bride-price under individual consent need not be paid explicitly as a lump-sum transfer. It could, instead, be paid to the bride implicitly in the form of higher lifetime consumption.

In Tertilt ( 2005 ), all men are similar (except in age). Widespread polygyny is possible because older men marry younger women and population growth is high. This setup reflects stylized facts for Sub-Saharan Africa. It differs from models that assume male heterogeneity in endowments, where polygyny emerges because a rich male elite owns several wives, while poor men remain single (e.g., Gould, Moav and Simhon 2008 ; Lagerlöf 2005 , 2010 ).

See Grossbard ( 2015 ) for more details and extensions of this model and Grossbard ( 2018 ) for a non-technical overview of the related literature. For an earlier application, see Grossbard ( 1976 ).

The concept of WiHo is closely related but not equivalent to the ‘black-box’ term home production used by much of the literature. It also relates to feminist perspectives on care and social reproduction labor (c.f. Folbre 1994 ).

In the general setup, the model need not lead to a corner solution where only one spouse specializes in WiHo.

For promising approaches, see, among others, Cubeddu and Ríos-Rull ( 2003 ), Goussé, Jacquemet and Robin ( 2017 ), Greenwood, Guner, Kocharkov and Santos ( 2016 ), Guler, Guvenen and Violante ( 2012 ), Walther ( 2017 ), Wong ( 2016 ).

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Acknowledgements

We thank the Editor, Shoshana Grossbard, and three anonymous reviewers for helpful comments. We gratefully acknowledge funding from the Growth and Economic Opportunities for Women (GrOW) initiative, a multi-funder partnership between the UK’s Department for International Development, the Hewlett Foundation and the International Development Research Centre. All views expressed here and remaining errors are our own. Manuel dedicates this article to Stephan Klasen, in loving memory.

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Santos Silva, M., Klasen, S. Gender inequality as a barrier to economic growth: a review of the theoretical literature. Rev Econ Household 19 , 581–614 (2021). https://doi.org/10.1007/s11150-020-09535-6

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Published : 15 January 2021

Issue Date : September 2021

DOI : https://doi.org/10.1007/s11150-020-09535-6

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Published: 25 January 2024

Research trends in contemporary health economics: a scientometric analysis on collective content of specialty journals

Clara C. Zwack ORCID: orcid.org/0000-0002-9866-6470 1 ,
Milad Haghani 2 &
Esther W. de Bekker-Grob 3

Health Economics Review volume 14 , Article number: 6 ( 2024 ) Cite this article

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Introduction

Health economics is a thriving sub-discipline of economics. Applied health economics research is considered essential in the health care sector and is used extensively by public policy makers. For scholars, it is important to understand the history and status of health economics—when it emerged, the rate of research output, trending topics, and its temporal evolution—to ensure clarity and direction when formulating research questions.

Nearly 13,000 articles were analysed, which were found in the collective publications of the ten most specialised health economic journals. We explored this literature using patterns of term co-occurrence and document co-citation.

The research output in this field is growing exponentially. Five main research divisions were identified: (i) macroeconomic evaluation, (ii) microeconomic evaluation, (iii) measurement and valuation of outcomes, (iv) monitoring mechanisms (evaluation), and (v) guidance and appraisal. Document co-citation analysis revealed eighteen major research streams and identified variation in the magnitude of activities in each of the streams. A recent emergence of research activities in health economics was seen in the Medicaid Expansion stream. Established research streams that continue to show high levels of activity include Child Health, Health-related Quality of Life (HRQoL) and Cost-effectiveness. Conversely, Patient Preference, Health Care Expenditure and Economic Evaluation are now past their peak of activity in specialised health economic journals. Analysis also identified several streams that emerged in the past but are no longer active.

Conclusions

Health economics is a growing field, yet there is minimal evidence of creation of new research trends. Over the past 10 years, the average rate of annual increase in internationally collaborated publications is almost double that of domestic collaborations (8.4% vs 4.9%), but most of the top scholarly collaborations remain between six countries only.

Health economics, a discipline of economics that focuses on studying how resources are allocated, utilised, and distributed in the healthcare sector [ 1 ]. Health economists use various economic tools and techniques, such as cost-effectiveness analysis, cost-benefit analysis, econometric modelling, and microeconomic theory, to examine a wide range of healthcare issues [ 2 , 3 ]. The field has experienced rapid evolution, largely due to the decades of work of committed scholars. These scholars have not only built a foundation of knowledge, but also developed and refined a set of methodological tools to guide decision making by health care authorities [ 4 ]. Modern day health systems are constantly challenged by scarcity of resources, which is attributable to an aging population, diseases of prosperity, rapid urbanisation, technological advancement in the medical field and large scale migrations [ 4 ], not to mention the new threat of global pandemics [ 5 , 6 ]. Another contemporary issue is the rising out-of-pocket health spending that continues to threaten the affordability of medical care, even for some of the most advanced OECD countries [ 7 , 8 ]. These challenging and complex environments create strong drivers for the further development of health economics.

In 1963, Kenneth Arrow published “Uncertainty and the welfare economics of medical care” in The American Economic Review [ 9 ]. It became one of the most highly cited articles in health economics and was considered the article that established the field. From here, the term “health economics” increased rapidly in articles published in economics, however, it was not until the early 1980’s that saw the creation of specialised health economics journals.

The unprecedented surge in publications presents researchers with challenges in keeping up with the latest advancements in the field of health economics. Hence, consolidating research and its outcomes has gained even greater importance [ 10 ]. For scholars, it is important to understand the history and status of health economics—when it emerged, the rate of research output, trending topics, and its temporal evolution—to ensure clarity and direction when formulating research questions. The course of health economics has been charted previously [ 11 , 12 ], however, these analyses focus on bibliometric properties of the field. Whilst this is important to report, this paper will extend current knowledge by completing a scientometric analysis of contemporary health economics, using specialised sources and advanced analytical and clustering tools. In health economics, systematic reviews are considered the gold standard for measuring efficacy and effectiveness of a specific topic due to their rigorous nature. However, scientometrics can be utilised to complement systematic reviews to summarise the overall trends observed with a topic [ 10 , 13 ].

The main objectives of our study presented in this paper are to determine the patterns in regional distribution of relevant health economics publications, prominent author networks, the major divisions and research streams of health economics literature, and the variation of activity for each sub-area. This paper also reports on the trending topics and highlights, based on a multitude of objective metrics, the influential references of health economics literature that have shaped the formation of each research stream.

The dataset of references

To retrieve the data for this study, the Web of Science (WoS) Core Collection was accessed and searched in May 2022. A search query was formulated in consultation with an experienced health economist. The ten sources (i.e. scientific peer-reviewed journals) that predominantly publish articles relevant to health economics were included. A list of sources was initially identified if they were listed by the WoS in both categories of “Health Policy & Services” and “Economics”. From this list, the ten sources with the largest volume of content were selected for inclusion in the search. Keywords were not utilised in the search strategy due to the diversity of the terms being used across health economics along with the lack of distinctiveness across other fields (e.g. economics and medicine).

Search strategy

SO = (“Value in Health” OR “Health Economics” OR “Pharmacoeconomics” OR “Pharmacoeconomics Open” OR “International Journal of Health Economics and Management” OR “Journal of Health Economics” OR “Health Economics Review” OR “Applied Health Economics and Health Policy” OR “American Journal of Health Economics” OR “European Journal of Health Economics”).

Upon initial inspection of the 68,000 documents found by the search strategy, Value in Health journal has indexed 54,000 documents as meeting abstracts. These records did not display abstract or reference lists, which are essential for scientometric analysis. Hence, it was determined that for this analysis the inclusion criteria needed to be refined to articles and review articles only. No restrictions were set on other subcategories. The maximum year was set to December 31, 2021, with no restriction on the minimum. Full bibliographic details of the documents were exported from WoS as text files. Details include document title, authors, author affiliations, year of publication, source (journal) title, citation count, document type, abstract, author keywords, keywords plus, funding source, full list of document references and conference information, if relevant.

General findings

The estimated size of the literature, highly cited documents, prominent sources and author affiliations (i.e. country and institution) were analysed using the meta data extracted directly from WoS.

Semantic analysis

Title and abstract, and keyword analyses were conducted using VOSviewer 1.6.15. Keywords provide insight into the temporal shifts in research and scholarly focus. Clusters of terms extracted from the titles and abstracts are formed by the frequency they occur (set to a minimum of 15) in the articles to provide an objective overview of the structure and divisions within this research topic.

Networks of author collaboration

Analyses of author networks were conducted using VOSviewer 1.6.15. Each author is represented by a node and is connected to other authors via links. The number of co-authored documents is indicated by the thickness of the link between the two nodes.

Influential articles analysis

Document co-citation and citation burst analyses was completed using CiteSpace 5.7.R1 [ 14 ]. The concept of document co-citation, a methodology developed by Chen [ 15 ], was used to obtain an indication of the most influential studies within the field of health economics as well as the clusters of thematically similar references. The methodology identifies cohorts of references that are frequently co-cited in the reference lists of health economics papers, on the premise that such references are similar in subjects and represent the knowledge foundation of a certain topic in the field. Document co-citation analysis results in a new set of documents, which include valuable knowledge sources for health economics that are instrumental in the development of this literature but were not captured by the WoS search query.

From document co-citation we can find (i) references with the most local citations (citations from within the literature exclusively relevant to this topic), (ii) references with the strongest citation burst (heightened attention to an individual article within the field, representing a temporal component of the research topic) and, iii) references with the highest centrality (document co-citation across multiple clusters).

Temporal analysis

CiteSpace 5.7.R1 [ 14 ] was used to generate the dynamic visualisation, which shows insight into the emergence and activities of each research stream since 1990. Research streams are named using the titles of the citing articles (of each stream). Nouns and noun phrases are extracted from the titles. These nouns and noun phrases are each allocated a score depending on the frequency of appearance and the coverage of the citing article they are extracted from (coverage of a citing article refers to the number of cited references of the cluster that it cites). Heavier weighting is given to the noun phrases extracted from high coverage articles because they are more instrumental in the development of the cluster. These noun phrases are sorted based on this score and the top ones are used as a guide for the naming of the cluster. This means that labelling is done by the field expert but guided by an algorithmic determination. In the visualisation, parts of the network that have been most active during each year appear more striking, representing co-citation instances during that year. Influential references are identified using the three metrics (local citations, bursts, centrality). However, these metrics are measuring articles that may or may not be about health economics, so we must also look at the citing articles with the highest coverage to determine which articles related to health economics are citing the most references within the specific research stream.

The time period for the analysis was set for 1990–2021 (1-year intervals; look back years = 50 [reference lists published less than 50 years ago]). Each node represents an individual reference. The size of the node is proportional to the number of local citations identified to that reference, and the nodes are connected by links (indicating co-occurrence of co-citation) to create a network of major research streams, all contained within the field of health economics. Each stream has a descriptor based on the contents of the cluster. Furthermore, CiteSpace analysis also provides a timeline view of the evolution of research streams. The references of each stream are visualised and aligned across the timeline based on the year of publication from 1950–2021.

General findings and the history of health economics

The size of the specialised field of health economics is estimated to be 12,977 items, as of December 31, 2021. The first article published in a specialty journal ( Journal of Health Economics ) is ‘Effects of teaching on hospital costs’ in 1983 [ 16 ]. The following decade saw only a small number of documents published before a significant increase in research output was observed around the mid-1990s (Fig. 1 ). Since then, there has been an upwards trend, with post-2005 showing a sharp incline in the number of publications.

Above (L) Total number of articles and review articles in health economics specialty journals; Above (R) All document types versus total number of articles and reviews in health economics specialty journals; Bar graphs (L) Number of documents by journal source for articles and review articles. Bar graphs (R) Number of documents by journal source for all document types

If all document types were included in the field analysis, there would be nearly 70,000 items, with meeting abstracts published in Value in Health contributing to around 80% of documents (Fig. 1 ). Over the past three decades, the number of specialised health economics journals in this field has grown from three to ten, with Health Economics and Value in Health publishing the most literature in 2010–2021 (Fig. 1 ).

The onset of Covid-19 in early 2020 has not dampened publication of health economics articles and reviews, however, surprisingly only 72 published articles directly explore the topics related to the pandemic. Conversely, a large decline in meeting abstracts has occurred over the past 3 years, however, if and how the pandemic has contributed is unclear, as the decline started in 2019 (from 4,500 to 4000 in the years 18–19) and cannot be solely attributed to a reduction in organised conferences.

An overview of the articles specific subject areas was identified using WoS Categories . Unsurprisingly, all records are indexed in the disciplines of Economics and Health Policy Services (12,977 records, 100%). Other categories include Health Care Sciences Services (11,039 records, 85%), Pharmacology Pharmacy (2,992 records, 23%) and Business Finance (156 records, 1%).

Over 26,000 scholars have contributed to health economics research, of which 242 authors have published 15 or more documents related to this field. The top published authors include John Brazier ( n = 78 records), Werner Brouwer ( n = 64), Michael Drummond ( n = 55) and Maarten Postma ( n = 54). The top ranked academic institutions include the League of European Research Universities (7.5% of total publications), Erasmus University Rotterdam (5%), University of London (5%), University of York [UK] (4.5%) and Harvard University (3.5%).

The main body of research output in health economics is exclusive to six countries: USA, England, Netherlands, Canada, Australia, and Germany. More recently however, countries in Eastern Europe, Africa, Southeast Asia and the Middle East have become more prominent researchers in health economics. Over the previous three decades, the top five countries have remained mostly consistent (Fig. 2 ), except for Australia, where scholarly output in this area is growing extensively.

a Top five countries to contribute to health economics research output, by decade; b domestic versus international collaboration

Since 2015, international collaboration has been sharply on the rise (Fig. 2 ). The gap between domestic and international collaborated publications appears to be closing. Currently, domestic publications contribute to 58.6% of the scholarly output compared to 41.4% international publications, however, over the past 10 years, the average rate of annual increase in internationally collaborated publications is almost double that of domestic collaborations (8.4% vs 4.9%). The main six countries in health economics show patterns of strong international collaboration. Together, they have produced approximately one third of the research field (4,000 articles). The strongest links are between the USA and England, USA and Canada, and England and The Netherlands.

Semantic analysis; titles, abstracts and keywords

Five major divisions were identified in the field of health economics (Fig. 3 ). 1) Macro-economics, 2) Micro-economics, 3) Measurement and valuation of outcomes, 4) Monitoring mechanisms and 5) Guidance and appraisal. Division 3, measurements and valuation of outcomes is the most cited, and division 5, Guidance and appraisal has the most recent publications.

Major divisions of health economics. Below (L) divisions of bibliographic coupling; Below (R) average number of citations and average year of publication for each major division. Interactive version of the title and abstract map are available via this link: VOSviewer Online

Bibliographic coupling resulted in similar divisions of health economics research areas. Macro-economics (purple) and micro-economics (green) are the densest divisions, showing extensive overlap of references. Methods for measurement and valuation of patient outcomes, including Discrete Choice Experiments (DCEs), and the EQ-5Dto a lesser extent, are central to both macro- and micro-economics. Table 1 shows the top title and abstract terms of each major division in health economics.

The composition of the field of health economics research is dynamic. Keyword analysis across three decades shows there are common research themes including, cost effectiveness , QALYs and economic evaluation (Fig. 4 ). However, there is a distinct shift to health-related quality of life (HRQoL) in the early millennium, followed by the appearance of DCEs in the most recent decade. Unsurprisingly obesity , a global epidemic of the 21 st century, has also been a topic of focus for scholarly research since 2010.

Top keywords in health economics, by decade

Influential references

This section acknowledges the most influential entities (authors and references) in health economics, aiming to pave the way for further interdisciplinary collaborations and advancements in the domain. These are the most influential entities in a subset of health economics journals. Although the analysis considered a large number of articles (approximately 13,000), it’s important to recognize that there may be other influential entities not represented in this paper.

The top ten globally cited articles have quite distinct topics (Appendix 1 ). The most cited article, according to WoS, is ‘The price of innovation: new estimates of drug development costs’, authored by DiMasie et al. and is published in Journal of Health Economics. The article has received 2,475 citations, and provides data used to estimate the average pre-tax of new drug development [ 17 ].

Influential articles relevant to health economics, ranked by local citation count, are listed in Appendix 2 . The most cited article specific to this research field is ‘Recommendations of the Panel on Cost-effectiveness in Health and Medicine’, published in JAMA in 1996 [ 18 ]. The authors recommended that if researchers follow a standard set of methods in cost-effectiveness analysis, the utility of studies can be much improved. Lastly, the articles that have had the strongest burst of citations since publication are shown in Appendix 3 . This article, published in 2016 and titled ‘Recommendations for Conduct, Methodological Practices, and Reporting of Cost-effectiveness Analyses’ provides major changes to the recommendations made by Weinstein et al. in 1996 [ 19 , 20 ].

A major focus is on identifying temporal patterns of scholarly research in this field and the formation of its various research streams as well as the most influential entities within each stream. Document co-citation analysis revealed eighteen research streams. Figure 5 shows a bird’s-eye view of the field and Table 2 identifies the influential references that have shaped each stream. Two streams related to Economic Evaluation emerged, with slight variations. ‘Overall’ Economic Evaluation is broader and includes guidelines, applications of evaluation, reviews of evaluation studies, and articles reporting on willingness to pay studies. ‘Elements’ of Economic Evaluation includes steps involved in evaluation, criteria for evaluation and is mostly focussed on cost-effectiveness studies. These are both central to the field of health economics and are very active areas of research every year, as reflected in instances of article co-citation (Fig. 6 ). Economic Evaluation is closely related to the activities in Patient Preference and Health-related Quality of Life research (involving measurement tools such as DCEs and EQ-5D, respectively). Figure 7 shows the research streams in time-line format for clear observation of bursts of activity since 1950.

Bird’s-eye view of the major research streams in the field of health economics

State of health economics literature during the last three decades of development. Salient parts of the map specify active areas of research during each year, as reflected in instances of article co-citation. A dynamic visualisation from 1990–2021 is available here https://unisyd-my.sharepoint.com/:v:/g/personal/clara_zwack_sydney_edu_au/EeT-KZTsqdJHuGzL6s-R9ksBzmQ0ln-2jjYJu5Cv7F0usg?e=pkaOqt

Timeline view of the major research streams in health economics

Co-citation also identified variation in the magnitude of activities in each of the streams (Fig. 8 ). A recent emergence of heightened research activities in health economics was only seen in the Medicaid Expansion stream. Medicaid expansion is an United States initiative with the goal to increase insurance coverage among low-income adults. It became effective in January 2014, which aligns with the clusters research activity increasing around 2015. Established research streams that continue to show high levels of activity include Child Health, HRQoL and Economic Evaluation (elements). Conversely, Patient Preference, Health care Expenditure and Economic Evaluation (overall) are now past their peak of activity and are slowing down in specialised health economic journals.

Number of citations (blue) and number of citing articles (green) for each research stream. Note: scale is different for each cluster. Y-axis is Number of articles and X-axis is Number of citations

Three streams show fluctuating patterns of activity: Adverse Selection (a phenomenon where individuals with higher risks or health issues are more likely to seek or retain health insurance coverage compared to individuals with lower risks), Migraine and Rheumatoid Arthritis. Analysis also identified several streams in this field that have transient peaks of activity and are currently not active. These include Influenza Vaccine, Prospect Theory, Coronary Heart Disease, Congestive Heart Failure, Supplied Inducement and Psychotropics. Lastly, HIV Infection had a very transient period of activity in the early 2000’s. It has since been mostly non-existent, aside from a distinct peak in 2010 where 13 citing articles gave a total coverage of around 140. The critical references were studies measuring the cost effectiveness of Darunavir/Ritonavir, a HIV antiviral drug [ 305 , 309 , 311 ].

This scientometric analysis presents an overview of health economics research exclusively from the top journals specific to the field. Evaluation of around 13,000 documents has revealed contemporary patterns of publication, authorship, and research activities. Five major divisions have been identified within the field using objective clustering methods. This includes macro-economics, micro-economics, measurement and valuation of outcomes, monitoring mechanisms (evaluation), and guidance and appraisal. Along with the major divisions, analysis of document co-citation revealed eighteen specific research streams, each showing varying levels of activity.

Interestingly, there are few ‘hot topics’ emerging in health economics. One possible reason for this could be that the pace of research in health economics could be to some degrees determined by the field of economics and advancement within that mother field, which is considered slow-moving in terms of establishment of new trends [ 401 ]. Economists tend to be cautious in recognising emerging areas of research, and instead prefer to use an established knowledge base when supporting their research with previous literature.

In a world where digital transformation is changing the face of every industry, including health care, it is surprising that economic evaluation of digital health innovations has not emerged as a trending research topic. However, there are examples in the literature highlighting the complexities of economic analysis for digital health innovations, which may be stalling the progression of this research area [ 402 , 403 , 404 ]. As the knowledge foundation for these freshly emerging areas develop, subsequent analyses of similar nature may be able to detect them as emerging divisions. This knowledge foundation could currently be scattered and not established. The emergence and progression of such area, however, could be detectable with a time lag once the health economics literature begins to converge on a specific cohort of references as the knowledge base in this area.

A sharp rise in scholarly output in health economics was observed around 2005. This is likely around the time that DCEs and patient preference surveys became trendy in healthcare [ 405 ]. After heightened research activity in this area for a decade (2005–2015), the Patient Preference research stream has now passed its peak in specialised health economic journals. However, this does not necessarily mean that it is no longer trendy. In fact, it is known that DCEs have now been more widely adopted to elicit preferences for health care products and programs across most medical fields [ 164 , 406 ]. Peer-reviewed articles are now likely being published in discipline-specific or broader health journals (e.g., British Medical Journal, Health Service Research Journal), rather than the health economics sources used in this analysis.

The main body of this literature has been produced by six countries in Europe, North America and Australia. Since the inception and rapid growth of health economics in the early 1990s, contribution to scholarly literature from these six countries has mostly been consistent, aligning with reports by Wagstaff and Culyer [ 12 ]. Few non-OECD countries are included in the top contributors to this research field. For example, China, which now surpassed the USA as the largest producer of scientific research in certain disciplines [ 407 ], is not a major contributor to health economics research. However, this may be because China’s primary research foci are technological fields and chemistry, and not social sciences. It is also promising to see recent health economic research output increasing in Low- and Middle-Income Countries. Internationally collaborated research output appears to be moving closer to the domestic output, a promising sign of a connected research field. However, the diversity of health care systems and unique public health issues will likely ensure that domestic research continues to thrive. Applications of new knowledge are often exclusive to a standalone health care system.

It should be noted that the conclusions of this study rely only on a sample of the literature of health economics, by analysing the collective content of ten mainstream health economics journals. While large enough to identify the research trends in the field, as the main motive of the study, the underlying dataset does not necessarily embody the entire literature of health economics. This limitation is simply due to the fact that an attempt for obtaining the entirety of health economics literature seems impossible without jeopardising the dataset with too many false positives. However, it should also be considered that the analytic methodology from which the core findings have been obtained has been chosen such that trends can be identified with minimal sensitivity to missing items in the dataset. The methodology of document co-citation analysis that has produced the core findings of the study is fairly robust to the effects of sampling and potential missing items. This is simply due to the fact that, in this methodology, influential references as well as trends are identified by referring to the reference lists of the articles in the dataset. In other words, the entities of analysis are items listed as the references of the papers in the dataset as opposed to the articles of the dataset itself (as in an article bibliographic coupling analysis for example [ 408 , 409 ]). In a document co-citation approach, the formation of a cluster on topic X does not rely capturing all citing articles that have contributed to the creation of stream/cluster X. If a large enough subset of such citing articles are captured in the data, then stream X as well as its temporal trends will still manifest. This is particularly the case in relation to the major streams (as opposed top smaller/minor clusters) whose sensitivity to the sample is minimal. For that reason, the analyses of this study were limited exclusively to interpreting the major streams only and minor clusters were excluded from an in-depth interpretation. For a typical cluster on a topic such as X, it is possible that papers outside the content of the ten specialty journals (i.e., the current dataset) are also identifiable, in addition to papers related to such topic and disseminated in mainstream specialty journals. But so long as enough of such papers do exist within the content of specialty journals, then the cohort of references co-cited by those papers will still form that stream and topic X along with the temporal patterns of its evolution is still captured by the sample. In summary, the coverage of the underlying data of this study can be improved, but at the same time, we believe that the sensitivity of the main findings to potential missing literature is rather minimal.

The current state of research in health economics has brought valuable insight into healthcare interventions, market dynamics and behavioural factors. Health economics is a growing field, yet there is minimal evidence of creation of new research trends. This doesn’t necessarily indicate that there are no ‘hot topics’ in health economics, but likely that the new research is being disseminated in sources beyond the speciality journals. Over the past 10 years, the average rate of annual increase in internationally collaborated publications is almost double that of domestic collaborations (8.4% vs 4.9%), but most of the top scholarly collaborations remain between six countries only.

Several avenues for future research exist to deepen our understanding and address the evolving challenges in this field. By considering broader societal perspectives, embracing technological advancements, and integrating behavioural insights, health economist researchers can contribute to evidence-based policy-making and drive improvements in healthcare outcomes, efficiency, and equity.

Availability of data and materials

All data is available upon reasonable request to the corresponding author.

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CZ and MH led the conception of the study. CZ and MH developed the review protocol. CZ conducted the literature search. CZ conducted data extraction, with MH’s support in coordination. EWD provided support to refining the results. CZ drafted the manuscript, with MH’s support in the Methods section. All authors provided substantial suggestions and edits for the writing of the paper. All authors approved the submission of this paper.

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Zwack, C.C., Haghani, M. & de Bekker-Grob, E.W. Research trends in contemporary health economics: a scientometric analysis on collective content of specialty journals. Health Econ Rev 14 , 6 (2024). https://doi.org/10.1186/s13561-023-00471-6

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Research trends in contemporary health economics: a scientometric analysis on collective content of specialty journals

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