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Discussion Paper
Distribution of COVID-19 Incidence by Geography, Race, and Income
In this post, we study whether (and how) the spread of COVID-19 across the United States has varied by geography, race, income, and population density. Have urban areas been more affected by COVID-19 than rural areas? Has population density mattered in the spread? Has the coronavirus's impact varied by race and income? Our analysis uncovers stark demographic and geographic differences in the effects of the pandemic thus far.
Working Paper
Indian Residential Schools, Height, and Body Mass Post-1930
We study the effects of Canadian Indian residential schooling on two anthropometric measures of health during childhood: adult height and body weight. We use repeated cross sectional data from the 1991 and 2001 Aboriginal Peoples Survey and leverage detailed historical data on school closures and location to make causal inferences. We ?nd evidence that, on average, residential schooling increases adult height and the likelihood of a healthy adult body weight for those who attended. These effects are concentrated after the 1950s when the schools were subject to tighter health regulations and ...
Working Paper
Just What the Nurse Practitioner Ordered: Independent Prescriptive Authority and Population Mental Health
We examine whether relaxing occupational licensing to allow nurse practitioners (NPs)?registered nurses with advanced degrees?to prescribe medication without physician oversight is associated with improved population mental health. Exploiting time-series variation in independent prescriptive authority for NPs from 1990?2014, we find that broadening prescriptive authority is associated with improvements in self-reported mental health and decreases in mental-health-related mortality, including suicides. These improvements are concentrated in areas underserved by psychiatrists and among ...
Working Paper
Intergenerational Health Mobility in the US
Studies of intergenerational mobility have largely ignored health despite the central importance of health to welfare. We present the first estimates of intergenerational health mobility in the US by using repeated measures of self-reported health status (SRH) during adulthood from the PSID. Our main finding is that there is substantially greater health mobility than income mobility in the US. A possible explanation is that social institutions and policies are more effective at disrupting intergenerational health transmission than income transmission. We further show that health and income ...
Working Paper
The Impact of Car Pollution on Infant and Child Health: Evidence from Emissions Cheating
Car exhaust is a major source of air pollution, but little is known about its impacts on population health. We exploit the dispersion of emissions-cheating diesel cars?which secretly polluted up to 150 times as much as gasoline cars?across the United States from 2008-2015 as a natural experiment to measure the health impact of car pollution. Using the universe of vehicle registrations, we demonstrate that a 10 percent cheating-induced increase in car exhaust increases rates of low birth weight and acute asthma attacks among children by 1.9 and 8.0 percent, respectively. These health impacts ...
Working Paper
The Evolution of Health over the Life Cycle
We construct a unified objective measure of health status: the frailty index, defined as the cumulative sum of all adverse health indicators observed for an individual. First, we show that the frailty index has several advantages over self-reported health status, particularly when studying health dynamics. Then we estimate a stochastic process for frailty dynamics over the life cycle. We find that the autocovariance structure of frailty in panel data strongly supports a process that allows the conditional variance of frailty shocks to increase with age. Our frailty measure and dynamic process ...
Discussion Paper
Can Community Development Improve Health? Emerging Opportunities for Collaboration between the Health and Community Development Sectors
The two sectors of community development and health have long worked in the same neighborhoods, but they have not always worked together. This is starting to change, due in part to a growing recognition among health experts of the social, economic, and environmental factors that drive health outcomes. These social determinants of health have become the basis for new collaborations between community development and health professionals. This paper introduces professionals in both sectors to this emerging area of practice through a series of case studies of innovators in the southeastern United ...
Discussion Paper
Medicare and Financial Health across the United States
Consumer financial strain varies enormously across the United States. One pernicious source of financial strain is debt in collections—debt that is more than 120 days past due and that has been sold to a collections agency. In Massachusetts, the average person has less than $100 in collections debt, while in Texas, the average person has more than $300. In this post, we discuss our recent staff report that exploits the fact that virtually all Americans are universally covered by Medicare at 65 to show that health insurance not only improves financial health on average, but also is a major ...