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.     

Economic Freedom and Exercise: Evidence from State Outcomes

Exercise is an important part of a healthy lifestyle and influences a variety of health outcomes. Regions vary in their levels of exercise due to geography, climate, culture, and policy. The extent to which a country's policies are consistent with economic freedom has been found to be positively associated with greater participation in physical activity. We empirically investigate the relationship between economic freedom and exercise across U.S. states. Contrary to the cross-country results, we find that states with higher levels of economic freedom have lower rates of participation in exercise.     

The Wage Elasticity of Informal Care Supply: Evidence from the Health and Retirement Study

This article focuses on the wage elasticity of informal care supply to elderly parents employing an instrumental variable approach to account for the fact that the wage rate is likely to be correlated with omitted variables. Using the 1998 wave of the 1998 ), the wage elasticity of informal care supply is estimated to be negative and larger in magnitude than found previously. The lower bound of this elasticity is estimated to be ?1.8 for males and ?3.6 for females. Additional findings suggest that this wage elasticity differs by the type of care provided to elderly parents and that it is larger in magnitude among individuals with siblings and those with independently living parents. Overall the reductions in the informal care constitute about 18% of the labor supply response for men and about 56% of the labor supply response for women, which are not compensated by monetary transfers.     

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.     

Effect of Stress on Later-Life Health: Evidence from the Vietnam War Draft

This article contributes to the literature examining how stress during the early stages of life impacts later-life health using a novel proxy for stress: risk of military induction during the Vietnam War. The article estimates that an increase in induction risk in young adulthood is associated with higher rates of obesity, endocrine disease, and hypertension later in life. These findings do not appear to be cohort effects; these associations exist only for men who did not serve in the war, not for same-aged women. These results suggest stress experienced during early adulthood can have adverse health consequences later in life.     

The Role of Economic Shocks on Health: Evidence from German Reunification

Sudden economic shocks impact the everyday lives of people from one day to the next. A number of studies have examined the association between economic fluctuations and health; however, no consensus on the nature of this relationship has been established. By exploiting the dramatic economic fluctuations following the German Reunification of 1990, which included a sudden change from a socialist to a capitalist system in East Germany, this study examines the association between broad negative economic shocks and health. The article finds that increases in state unemployment rates are associated with large and statistically significant declines in health outcomes. Estimates are stronger for people who became unemployed shortly after reunification, for low‐income individuals, and for East Germans, a group confronted with larger economic fluctuations. When examining potential mechanisms that could explain the observed health deteriorations, the study finds significant reductions in exercise frequency and increases in economic uncertainty and overall stress.     

Identification of Job Lock and Inefficient Labor Market Mobility

The common practice of linking employment with certain fringe benefits, notably health insurance, has long been thought to impede labor market mobility, thereby producing a phenomenon called job lock. A sizable literature has developed theoretical frameworks for how job lock impacts the labor market and empirically estimated the magnitudes of these effects. However, most empirical studies rely on identification strategies that do not separately identify productivity enhancing from productivity reducing labor market mobility. This article develops a simple theoretical framework showing how prior identification strategies confound both types of mobility and outlines conditions where productivity reducing mobility is of greatest concern.     

The Implicit Costs of Motherhood over the Lifecycle: Cross-Cohort Evidence from Administrative Longitudinal Data

It is well known that the explicit costs of raising a child have grown over the past several decades. Less well understood are the implicit costs of having a child, and how they have changed over time. In this article, we are the first to examine the evolution of the implicit costs of motherhood over the lifecycle and across generations using high quality administrative data. We estimate that the lifetime labor market income gap between mothers and women who never have children (never-mothers) decreases from around $350,000 to $280,000 between women born in the late 1940s and late 1960s. Gaps tend to increase monotonically over the lifecycle, and decrease monotonically between cohorts. Our evidence suggests that changes in the gaps are caused by changing labor force participation rates.     

WIC Participation and Relative Quality of Household Food Purchases: Evidence from FoodAPS

We examine the effect of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) on the quality of household food purchases using the National Household Food Acquisition and Purchase Survey (FoodAPS) and propensity score matching. A healthy purchasing index (HPI) is used to measure nutritional quality of household food purchases. WIC foods explain the improvement in quality of food purchases, not self‐selection of more nutrition‐conscious households into the program. The improvement in purchase quality was driven entirely by WIC participating households who redeemed WIC foods during the interview week. There was no significant difference between WIC participants who did not redeem WIC foods and eligible nonparticipants. In this sample, there is no evidence that lack of access to clinics has adverse effects on participation nor is there evidence that HPI depends on supermarket access. A supervised machine learning process supports our main conclusion on the importance of WIC foods.     

Short‐run marginal medical costs from booze and butts: Evidence from the states

This article uses a panel data set of U.S. states over the 1980 to 2007 period to estimate the demands for medical care, cigarettes, and beer. The estimation process generates own‐price, income, and cross‐price elasticities for all three goods. Implied per capita beer and cigarette consumption elasticities of per capita health care expenditures, suggested by our baseline estimates, are 0.83 and 0.14, respectively. These results are robust to a number of specification tests. Simulations suggest that yearly marginal medical costs amount to approximately $12 per bottle and 27 cents per cigarette in the short run (in 2012 dollars). These results are likely to be driven by the much larger corresponding increases in the consumption of binge drinkers and heavy smokers.

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Food Security and Agricultural Changes in the Course of China＇s Urbanization

China's small farmers face increasing challenges because of land and water resource constraints and the effects of climate change. With the strengthened agricultural stimulus policies, poverty reduction and social protection programs, as well as the expanding international food trade, up to now China has achieved food security through small farm agriculture. During intensive economic restructuring, smallholders still coexist with large‐sized farms and industrialized agricultural businesses, but are in a vulnerable position in market transactions. Oriented to 2050, China's agricultural development and food security policies should work to improve domestic market structure, to further release international trade control and to empower smallholders.     

Health insurance reform and economic growth: Simulation analysis in Japan

This paper evaluates the drastic reforms of Japanese public health insurance initiated in 2006. We employ a computable general equilibrium framework to numerically examine the reforms for an aging Japan in the dynamic context of overlapping generations. Our simulation produced the following results: first, an increase in the co-payment rate, a prominent feature of the 2006 reform, would promote economic growth and welfare by encouraging private saving. Second, the ex-post moral hazard behavior following the increase in co-payment rates, however, reduces economic growth. Third, Japan's trend of increasing the future public health insurance benefits can mainly be explained by its aging population, and increasing the co-payment rate does little to reduce future payments of public health insurance benefits. Fourth, the effect on future economic burdens of reducing medical costs through efficiencies in public health insurance, emphasis on preventive medical care, or technological progress in the medical field is small. Finally, a policy of maintaining public health insurance at a fixed percentage of GDP will require reducing public health insurance benefits, perhaps up to 45% by 2050. Such a policy also reduces economic growth until approximately 2035. Our simulation indicates that the reform does not significantly reduce future public health insurance benefits, but it can enhance economic growth and welfare by encouraging private saving.     

Surface Coal Mining and Human Health: Evidence from West Virginia

This article presents the first panel-data evidence of a human health externality from the air pollution generated by surface coal mining. In West Virginia, a standard deviation increase in a county's exposure to surface coal mining is associated with 9.85 more asthma hospitalizations per 100,000 residents in a given quarter. Interpreted causally, this suggests over $11 million in hospitalization costs over the 6-year study period. The study builds on earlier cross-sectional research by controlling for unobserved county-level heterogeneity, and by defining more accurate measures of exposure. Both methods are shown to reduce the bias associated with earlier estimates of coal mining's effect on health. Young and elderly women demonstrate the largest sensitivities to surface mining. Falsification tests reveal that neither hernias nor bone fractures demonstrate any relationship with surface mining activity.     

Seasonal Migration and Microcredit During Agricultural Lean Seasons: Evidence from Northwest Bangladesh

This paper investigates the interlinkage between microcredit and temporary seasonal migration, an issue which has been given little attention in the standard rural–urban migration literature. Seasonal migration due to agricultural downturns is a common phenomenon in developing countries. Using primary data from a cross‐sectional household survey of the northwest part of Bangladesh, this paper quantifies the factors that influence such migration decisions. Our results suggest that people with prior access to microcredit are more likely to migrate during an agricultural lean season. Furthermore, we find evidence of a negative selection effect between microcredit and seasonal migration, conditional on an individual's village of residence and observed characteristics. Our results have numerous potential policy implications, including the design of typical microcredit schemes for developing countries.     

The Impact of Self‐Perceived Relative Income on Life Satisfaction: Evidence from British Panel Data

This is the first article that uses panel data to investigate the impact of individuals' self‐perceived relative income on life satisfaction. Analyses show that the self‐perceived relative income has a significant impact on life satisfaction, but the impact is asymmetric. The decline in life satisfaction is much more significant due to perceiving a lower relative income in comparison to the rise in life satisfaction because of perceiving a higher relative income. Absolute income is only significantly and positively associated with life satisfaction in the pooled ordinary least squares estimations, but the association is never significantly different from zero when individual fixed effects are controlled. Household savings have a positive but small impact on life satisfaction. Among different financial‐related shocks, people's self‐perceived relative income varies the most due to changes in household net income, total savings, and employment status.     

Health Status and Earnings of Migrant Workers from Rural China

The migration of rural laborers into cities for employment has been one of the main driving forces of China's economic growth over the past three decades. Based on a dataset collected by the Ministry of Agriculture of China from 2003 to 2007, this paper examines the impact of health on the earnings of migrant workers engaging in physically‐intensive work requiring good health. Our findings indicate that a poor health status not only weakens the incentive of rural laborers to participate in the migrant labor force but also significantly reduces their earnings. A migrant worker in poor health only earns 67 percent of what a healthy worker makes. Among all the human capital characteristics and family economic factors, health status is the most influential on earnings for less educated workers. Labor productivity has a greater impact on earnings than the annual number of days that a person works. Ongoing health‐care reforms aimed at the improvement of the health‐care services available to rural laborers are urged to help reduce poverty in rural China.     

Parental Education and Child Health: Evidence from China*

This paper examines the effect of parental, household and community character‐istics on the health of children in China. We find that birth order, death of elder siblings, use of prenatal care and alcohol consumption by the mother when pregnant have statistically significant effects on the health of children. Although parental education does not have a significant direct effect on child health, it does affect mothers’ behavior during pregnancy and inflfluences the use of health inputs, indirectly impacting the health of children. The research findings have important implications for both family planning programs and broader social policies in China.