Unintended health benefits of adopting preventive behaviors during a virus outbreak

This study investigates whether changes in risk perception play a critical role in improving of preventive behaviors and health outcomes by examining the 2009 H1N1 influenza (or swine flu) pandemic in Korea. We employ a difference-in-differences estimation strategy by comparing the differential effects of the H1N1 outbreak on the confirmed cases of diseases which can be prevented by preventive behaviors (e.g., intestinal infections) and the cases of diseases which cannot (e.g., injuries). Using unique administrative data from South Korea's National Health Insurance Service (NHIS), we find that the exogenous increase in health risk reduced the incidence of intestinal infections compared to the injuries during the H1N1 influenza outbreak. The reduction was the most substantial among children under five years of age, with a 25.4% decline in cases of intestinal infections relative to injuries. Our findings are robust across various alternative specifications. We provide suggestive evidence that active adoption of preventive behaviors is one of the channels underlying the unexpected decrease in diarrhea cases. The effects, however, faded away shortly after the end of the pandemic and did not last in the long run.