The role of new media on teen sexual behaviors and fertility outcomes—the case of 16 and Pregnant

This article investigates the 2009 premiere of 16 and Pregnant as a shock to teen information sets and potential influence on sexual activity and fertility. The program, chronicling teen pregnancy and providing educational links on sex/contraception, began a continuing stream of teen pregnancy reality shows. My conceptual framework considers how such programs alter the expected (dis)utility or perceived risk of becoming pregnant. I test for differential effects across ages, state‐sex education requirements, and viewership levels in a quasi‐difference‐in‐difference framework that controls for confounding effects of coincident contraception policy changes, the economy, and downward trends in teen fertility. The results indicate that while fertility declined across all adolescents in the postperiod, there are stronger effects among young teens in states without sex education mandates and higher viewership. Supporting evidence from the National Survey of Family Growth shows increased hormonal contraception use in the postperiod for young relative to older teens.     

Early Effects of the Affordable Care Act on Health Care Access,Risky Health Behaviors,and Self-Assessed Health

The goal of the Affordable Care Act (ACA) was to achieve nearly universal health insurance coverage through a combination of mandates, subsidies, marketplaces, and Medicaid expansions, most of which took effect in 2014. We use data from the Behavioral Risk Factor Surveillance System to examine the impacts of the ACA on health care access, risky health behaviors, and self-assessed health after two years. We estimate difference-in-difference-in-differences models that exploit variation in treatment intensity from state participation in the Medicaid expansion and pre-ACA uninsured rates. Results suggest that the ACA led to sizeable improvements in access to health care in both Medicaid expansion and nonexpansion states, with the gains being larger in expansion states along some dimensions. However, we do not find clear effects on risky behaviors or self-assessed health.     

论我国生育保险制度的完善

人口生育是一国劳动力生产的唯一途径,对一个国家的长远发展有深刻而重大的意义。在计划生育基本国策贯彻执行的基础上,我国的人口数量基本符合经济社会发展需要。然而,现阶段为了实现人口优生优育,我国需要完善现行生育保险制度,把游离在生育保险政策之外的育龄妇女纳入生育保险覆盖范围,使其孕育行为处于医疗“干预”下,在保障男女劳动力合理流动、妇女权益得到保障的基础上,实现我国人口优生优育,为培育高素质人才打下坚实基础。     

Health insurance generosity and conditional coverage: Evidence from medicaid managed care in Kentucky

This article estimates the impact of the introduction of Medicaid managed care (MMC) on the formal Medicaid participation of children. We employ a quasi‐experimental approach exploiting the location‐specific timing of MMC implementation in Kentucky. Using data from the March Current Population Survey from 1995 to 2003, our findings suggest that the introduction of MMC increases the likelihood of being uninsured and decreases formal Medicaid participation. This finding is consistent with an increase in “conditional coverage,” waiting until medical care is needed to sign up or re‐enroll in Medicaid. These effects are concentrated among low‐income children and absent for high‐income children. We find no evidence of “crowd‐in,” substituting private coverage for Medicaid. These results are robust to multiple placebo tests and imply the potential for less formal participation (i.e., more conditional coverage) among the Affordable Care Act‐Medicaid expansion population (which is likely to be primarily covered under MMC) than is typically predicted.     

Poverty: Insurance Theory and the Medically Uninsured

The federal/state Medicaid program is designed to provide health insurance for the nation's poorest, yet between 15 and 20 percent of the population continue to have no health insurance. Classic utility-based insurance theory is examined to see if it well explains why some do and some do not purchase health insurance at the state level or if a host of other non-economic factors are needed. This pooled, cross-sectional time-series analysis shows that the state characteristics most strongly associated with the prevalence of a lack of health insurance is the percent of persons whose income falls below the poverty line, the percent of the state's population that is female and the percent of the population with only a high school education. This analysis suggests that the starting point for policies aimed at limiting the number of insured should be limiting poverty and perhaps recognizing the gender/education influence in designing state eligibility requirements.     

Prenatal Smoking Cessation and Infant Health: Evidence from Sibling Births

This article uses a large data set of sibling births to examine when mothers must quit smoking in pregnancy to deliver healthy babies. It applies sibling fixed effects models to provide robust evidence that smoking cessation in the first trimester has a negligible effect on infant health, but cessation as late as second trimester or smoking throughout pregnancy is associated with substantially lower birth weights and higher risks of delivering low birth weight babies. In particular, about two thirds of the total detrimental smoking impact on birth outcomes occurs in the second trimester. Therefore, reallocating resources on prenatal smoking cessation towards the first trimester can lead to a significant efficiency gain. This study also shows when the timing information of prenatal smoking cessation is improperly used, it will introduce a new nontrivial downward bias in estimating the causality between the conventionally used group measure “prenatal smoker” and infant health.     

Trends in elderly health by cohort: Evidence from China

China has the world's largest number of older persons and is undergoing rapid demographic and economic transitions. Using longitudinal data from seven waves of the China Health and Nutrition Survey (CHNS) spanning 1991–2009, this study examines trends by birth cohort for persons born during 1912–54 on several dimensions of elderly health—chronic diseases, physical function limitations, and excess weight. A fixed effects specification was used to distinguish trends in health, physical function, and weight common to all adult age groups and differential trends in these measures according to the person's birth year. The empirical results show that while there was a decline in physical function limitations over time, persons born in later years were more likely to experience a stroke and physical function limitations at older ages than were persons born earlier. A similar pattern occurred for stroke, but not for the other heath indicators. These findings are robust after accounting for sample attrition. The secular changes in health and function could have occurred for several reasons. Among the underlying mechanisms the data allow us to analyze, improved access to medical care and expanded health insurance coverage only had minor effects on observed changes in health and physical function.     

Timing is Everything: The Impact of School Lunch Length on Children's Body Weight

The large number of overweight children in the United States has prompted school administrators and policy makers to identify practices in schools that contribute to unhealthy weight outcomes for children and develop strategies to prevent further increases. Advocates for school nutrition reform have suggested that it is important for children to have an adequate amount of time to eat meals in school in order to maintain a healthy weight. This article examines whether the length of time children are given to eat lunch in school has an impact on their weight. I find evidence that an increase in lunch length reduces the probability a child is overweight, and this finding is robust across various econometric specifications, including a two‐sample instrumental variable model and difference‐in‐differences model that account for the potential endogeneity of lunch length.     

The impact of E‐Verify mandates on labor market outcomes

A number of states have adopted laws that require employers to use the federal government's E‐Verify program to check workers' eligibility to work legally in the United States. Using data from the Current Population Survey, this study examines whether such laws affect labor market outcomes among Mexican immigrants who are likely to be unauthorized. We find evidence that E‐Verify mandates reduce average hourly earnings among likely unauthorized male Mexican immigrants while increasing labor force participation among likely unauthorized female Mexican immigrants. Furthermore, the mandates appear to lead to better labor market outcomes among workers likely to compete with unauthorized immigrants. Employment rises among male Mexican immigrants who are naturalized citizens in states that adopt E‐Verify mandates, and earnings rise among U.S.‐born Hispanic men. There is no evidence of significant effects among U.S.‐born non‐Hispanic whites.     

The Effect of Social Security Contributions on Coverage and Wages: A Gender Perspective Using a Natural Experiment from Colombia

This article investigates, from a gender and marital status perspective, the effects of pension and health care contributions on the employment and wages of workers covered by social security regulations. To do this, I use as a natural experiment a reform implemented in Colombia during the mid‐1990. In particular I employ a differences‐in‐differences estimation based on an endogenous switching‐regression model that accounts for self‐selection into coverage. My results indicate that, for females, a 10% increase in contributions reduces the relative wages of covered workers by 7.2%. On the other hand, for males, the reform increases the relative wages of covered workers by 7.1%. Among females, the effect is predominantly present in single women. Among men, divorced and widowed workers are the only group not to experience an effect on earnings. For most family groups, the social security reform has no significant effect on coverage.     

Do Health Insurers Possess Market Power?

During the 2009–2010 health care reform debates, many policy makers presumed that a lack of competition in the U.S. health insurance industry had resulted in greater levels of uninsurance. However, such a presumption has no basis in current research. This study, with a panel data set of the 50 states and the District of Columbia over the years 2001–2007, examines how health‐insurer market concentration at the state level influences the percentage of the population with either individually purchased or employer‐sponsored private health insurance. Two‐stage least squares estimates are derived using a lagged measure of health‐insurer concentration as an instrument. Results suggest that health insurers exercise market power on the seller side of the health insurance marketplace, but the restriction of output is limited to the individually purchased insurance market segment.     

Income Disparity among Persons with Disabilities,Assessed by Education and Sex: Accentuated Gender Difference Found in Metro Manila,the Philippines

How do persons with disabilities (PWDs) earn a living? This paper presents an investigation of the economic activities of PWDs in the Philippines, where, among developing countries, disability‐related legislation is relatively progressive. In 2008, a field survey was conducted in cooperation with Disability People's Organizations using a tailor‐made questionnaire in Metro Manila. The explanatory variables of income of PWDs were examined using Mincer regression. The conclusions are as follows. (1) There is remarkable income disparity among PWDs, differing with education and sex. (2) After controlling for PWDs' characteristics, it was found that female PWDs are likely to earn less than male PWDs. Such a significant income gap between men and women among PWDs is remarkable in the Philippines, where gender difference in income is generally small. This finding suggests that female PWDs are doubly disadvantaged in earning income.     

Factors Influencing the use of Preventive Medical Care in Malaysia: Evidence from National Health and Morbidity Survey Data

An increase in the prevalence of modifiable health risk factors, such as diabetes, hypertension and hypercholesterolemia, has become a serious public health issue in developed and developing countries. It is the main contributing factor to the rise in non‐communicable diseases (NCD). The use of preventive medical care remains the best method to prevent NCD. The objective of the present study is to examine the factors affecting the decisions of people to use preventive medical care (e.g. blood glucose tests, blood cholesterol tests and blood pressure test). An ordered logit model is estimated based on a nationally representative sample. The present study finds that income, age, education, ethnicity, employment status, health insurance and smoking are significantly associated with the use of preventive medical care. As a measure towards increasing the prevalence of the preventive medical care usage, the government should pay special attention to low income earners, the young and the elderly, the less‐educated, the ethnic minorities, employed individuals, individuals whose medical expenses are not paid by insurance carriers, as well as smokers.     

生育保险中两性权益的探讨

生育保险是社会保险体系中唯一强调性别特征的险种。我国生育保险政策内容主要体现对女性的关怀和权益的维护,如果从男女平等的角度出发,生育保险忽视男性的权利和责任。文章主要描述了国内外生育保险现状,并以对比法分析国内外生育保险中的两性权益。探讨生育保险的权益是否能满足两性的需求,并借鉴国外生育保险的各项法律法规,取其精华,促进我国生育保险的发展和我国生育保险制度的完善。促进两性权益的平等,为创建和谐社会奠定基础。     

The effect of health insurance reform: Evidence from China

This paper estimates the impact of a health insurance reform on health outcomes in urban China. Using the China Health and Nutrition Survey¹ we find that this reform increases the rate of health insurance coverage significantly among workers in Non-State Owned Enterprises. The double difference (DD) estimations show that the reform also leads to better health outcomes: workers are less likely to get sick and more likely to use preventive care. Using an instrumental variable (IV) approach to look at the causal effect of health insurance, we find those with health insurance use more preventive care but do not report significantly better health outcomes, an increase in health care utilisation, or an increase in out-of-pocket medical expenditure.     

Does health insurance decrease health expenditure risk in developing countries? The case of China

This article studies the impact of health insurance on individual out‐of‐pocket health expenditures in China. Using China Health and Nutrition Survey data between 1991 and 2006, we apply two‐part and sample selection models to address issues caused by censored data and selection on unobservables. We find that, although the probability of accessing health care increases with the availability of health insurance, the level of out‐of‐pocket health expenditure decreases. Our results from a selection model with instrumental variables suggest that having health insurance reduces the expected out‐of‐pocket health expenditure of an individual by 29.42% unconditionally. Meanwhile, conditional on being subjected to positive health expenditure, health insurance helps reduce out‐of‐pocket spending by 44.38%. This beneficial effect of health insurance weakens over time, which may be attributable to increases in the coinsurance rates of health insurances in China.     

Social insurance with Chinese characteristics: The role of communist party in private firms

This paper studies the inter-correlation among the Communist Party of China (CPC), unionization, and social insurance in a sample of Chinese private firms. We find that both Party branch and unionization are positively associated with insurance coverage. We further present evidence that Party branch and unionization are complements in association with better coverage of social insurance. When the Party–union complementarity is taken into account, Party branch alone is no longer positively associated with social insurance, while the correlation between unionization and insurance declines significantly. Our results suggest that the role of the CPC is overlooked in the literature on labor relations in China.     

Maternal Depression and the Production of Infant Health

Depression is most prevalent among women of childbearing age and among low-income women, and the medical literature shows it to have adverse effects on infant health. Yet maternal depression has been overlooked in economic studies of infant health production. This research incorporates maternal depressive symptoms into a standard infant health production model and estimates both structural and reduced-form birth weight equations using samples of non-Hispanic white and black women from the National Maternal and Infant Health Survey. A byproduct of this research is an empirical investigation into factors associated with maternal depressive symptoms. All results show that depressive symptoms have a negative effect on birth weight and that they may operate through several channels such as smoking and prenatal care.