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.     

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.     

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.     

Sexual Identity,Same‐Sex Relationships,and Labour Market Dynamics: New Evidence from Longitudinal Data in Australia

Using newly collected data on sexual identity from the Household, Income and Labour Dynamics in Australia Survey, this study examines the relationship between sexual identity and labour market outcomes. Our findings show that gay males are: (i) less likely to be continuously employed than their heterosexual counterparts, and (ii) face an annual earnings penalty of 16–21%. There are also important differences in earnings dynamics for men who transition into (or out of) same‐sex versus opposite‐sex live‐in relationships. Individual fixed effects estimates show that opposite‐sex partnerships are associated with increased earnings for men, while same‐sex partnerships are associated with small declines in earnings that are statistically indistinguishable from zero. For women, we find evidence of an earnings premium for lesbians, driven largely by increased labour supply on the intensive margin.     

The wage impact of undocumented workers: Evidence from administrative data

Using administrative, individual level, longitudinal data from the state of Georgia, this article finds that rising shares of undocumented workers results in higher earnings for documented workers, but by a small amount. A one percentage point increase in the share of undocumented workers in a documented worker's county/industry results in an average wage boost of 0.44%. Within the firm, a one percentage point increase in the percent of undocumented workers employed by the firm boosts wages by 0.09% (0.11, 0.12, and 0.04 in low, medium, and high skill firms, respectively). Potential explanations for a positive wage impact are discussed.     

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.     

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.     

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.     

Effects of Family,Friends, and Relative Prices on Fruit and Vegetable Consumption by African Americans

We investigate the effects of parents, best friends, and relative prices on fruit and vegetable consumption by African American youths using behavioral data from the Family and Community Health Study and area‐specific food prices from the Quarterly Food‐at‐Home Price Database. We construct a simultaneous equation ordered probit model that accounts for social interactions in fruit and vegetable consumption and specific aspects of the available food intake data. We estimate statistically significant endogenous consumption effects between a youth and a parent. Lower relative prices tend to increase intakes, particularly in the case of vegetables; however, the statistical significance of these effects is marginal. The results indicate the existence of social multipliers in fruit and vegetable consumption in African American families. The presence of these multipliers supports the design of youth‐parent–based interventions to increase fruit and vegetable intake by African Americans. Additionally, intake also may be increased through relative price reductions.     

Estimating the Aboriginal Population in Early Colonial Australia: The Role of Chickenpox Reconsidered

Noel Butlin radically altered the debate about the pre-colonial Aboriginal population when he provided a set of hypothetical demographic scenarios, which nonetheless were both grounded in economic theory or human ecological considerations and broadly consistent with what we know about the historical record. This research builds on Butlin's legacy by exploring how his scenarios are consistent with both the medical understandings of the infectiousness and mortality of various diseases and the history of settlement. Another contribution from this paper is to highlight the possible role of chickenpox in the Aboriginal depopulation in the early colonial period.     

Socioeconomic Determinants of Child Health: Empirical Evidence from Indonesia

This paper characterizes the socioeconomic determinants of child health using height‐for‐age z‐score (HAZ), a long‐run measure of chronic nutritional deficiency. We construct a panel data that follows children between ages 3 and 59 months in 1993 through the 1997 and 2000 waves of the Indonesian Family Life Survey. We use this data to identify the various child‐level, household‐level and community‐level factors that affect children's health. Our findings indicate that household income has a large and statistically significant role in explaining improvements in HAZ. We also find a strong positive association between parental height and HAZ. At the community level, we find that provision of electricity and the availability of paved roads are positively associated with improvements in HAZ. Finally, in comparison to community‐level factors, household‐level characteristics play a large role in explaining the variation in HAZ. These findings suggest that policies that address the demand‐side constraints have greater potential to improve children's health outcomes in the future.     

Unemployment and Health Behaviors over the Business Cycle: A Longitudinal View

We examine the first-order internal effects of unemployment and nonemployment on a range of health behaviors during the most recent recession using longitudinal data from the Panel Study of Income Dynamics and the National Longitudinal Survey of Youth-1979. Ours is the first study to analyze the effect of own-unemployment on energy intake, energy expenditure, and the net effect (body mass index) using longitudinal records. Exploiting information enveloping the recent steep recession and prolonged recovery is valuable since recent job losers will modify their behavior little if they expect soon to be re-employed, whereas if they expect joblessness to last, they will adjust to a possibly prolonged decline in income and increase in nonwork time. We find that becoming unemployed is associated with a small increase in leisure-time exercise, a moderate decrease in smoking, and a substantial decline in total physical activity. We also find that unemployment and nonemployment are associated with a decline in purchases of fast food. Together, these results imply that both energy consumption and expenditure may decline in the United States during recessions, the net result being essentially no change in body weight. There is considerable heterogeneity in these effects across specific health behaviors, across the intensive and extensive margins, across the outcome distribution, and across gender.     

Social Network and Weight Misperception among Adolescents

It is recognized that public health intervention targeted toward changing lifestyle behaviors to reduce overweight status is a considerable challenge. It is important that individuals recognize their overweight status as a health risk in order for an effective change in lifestyle behaviors to occur, and growing evidence suggests that actual weight and perception of weight status often do not match, especially among adolescents. In this article, we explore the extent to which exposure to heavier peers and parents affects misperception of their own weight status by adolescents. Using data from a nationally representative sample of adolescents, we estimated instrumental variable models with school‐level fixed effects to account for bidirectionality of peer influence and environmental confounders. Our results indicate that individuals who live in an environment that exposes them to overweight/obese parents and heavier peers tend to misperceive their weight status and think of themselves to be of lower weight than they actually are. Our analysis also revealed differential effects by gender and type of peers.     

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.     

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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Family size,labor supply,and job prestige: Evidence from three decennial censuses in China

This study investigates the relationship between family size and parents’ labor market performance, measured by labor supply and occupational prestige scores, based on three census waves in 1990, 2000, and 2010. To address the endogeneity problem of family size, we use the indicator of twins at first birth as an instrumental variable. Our results suggest that in nuclear households, family size affects the labor market performance only of mothers, not of fathers, with the negative effects fading and gradually disappearing over time. More specifically, an increase in family size decreases female labor supply in the 1990 wave, leads to lower prestige scores among working mothers in the 2000 wave, and has no impact on labor supply or occupational prestige scores in the 2010 wave. Our subsample analysis indicates that the negative effects of family size are more severe for parents of households with all children under seven years old and for husbands or wives with lower education level than that of their partners. In addition, we find that the negative effects of family size on parental labor market outcomes are not observed in extended households, especially when no grandparents are aged 65 years or older.     

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.     

Identifying the causal effect of alcohol abuse on the perpetration of intimate partner violence by men using a natural experiment

Intimate partner violence (IPV) is widespread and has substantial negative consequences. Researchers have documented a strong positive correlation between alcohol abuse and IPV. However, alcohol abuse is potentially endogenous to IPV. We deal with this problem by exploring a unique instrumental variable—the September 11 terrorist attack—in Wave III of the National Longitudinal Study of Adolescent Health. Ordinary least squares results confirm a strong positive correlation between alcohol abuse and IPV. However, our two‐stage least squares results are statistically insignificant. These results indicate that alcohol abuse might not have a causal effect on IPV and, therefore, have important policy implications.     

LINKING POVERTY AND INCOME SHOCKS TO RISKY SEXUAL BEHAVIOUR: EVIDENCE FROM A PANEL STUDY OF YOUNG ADULTS IN CAPE TOWN

Is there a link between household income and income stress, and risky sexual behaviour of young people? Anecdotal and qualitative evidence suggests this may be the case, but there is little quantitative research measuring this relationship. We use two waves of new data from the Cape Area Panel Study to investigate this link for 2,993 African and coloured youths aged 14 to 22 in 2002. In the process, we discuss one type of research design that could allow for a causal interpretation of the effect of income poverty on HIV risk. This design plausibly separates out the effect of income stress from the effect of living in a poor household by comparing behaviours across households with and without negative economic shocks, conditional on baseline income. Our results indicate that females in poorer households are more likely to be sexually active in 2002 and more likely to sexually debut by 2005. In addition, girls in households experiencing negative economic shocks are more likely to reduce condom use between 2002 and 2005. However, they are less likely to have multiple partners in 2002 or have transitioned to multiple partners by 2005. Males who experienced a negative shock are more likely to have multiple partners. Despite the tight research design for assessing shocks, the findings on the impacts of shocks do not generate clear recommendations for policy. There appears to be no systematic difference in condom use at last sex by household income levels or income shocks.