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Hospital Treatment Rates and Spill-Over Effects: Does Ownership Matter?

January 1, 2014

This paper studies the effect of hospital ownership on treatment rates allowing for spatial correlation among hospitals. Competition among hospitals and knowledge spillovers generate significant externalities which we try to capture using the spatial Durbin model. Using a panel of 2342 hospitals in the 48 continental states observed over the period 2005 to 2008, we find significant spatial correlation of medical service treatment rates among hospitals. The paper also shows mixed results on the effect of hospital ownership on treatment rates that depends upon the market structure where the hospital is located and which varies by treatment type.

Health Information and Social Security Entitlements

December 1, 2013

This study examines whether new health information, obtained through medical screening, affects entitlements to Social Security benefits. Random assignment of information is derived from a unique feature of the Continuous National Health and Nutrition Examination Survey. To examine the effect of information on entitlements, the survey data are matched to administrative data from the Social Security Administration. The results suggest that new health information leads to delayed entitlements, particularly among workers near the early retirement age.

The Allocation of Time in Sleep: A Social Network Model with Sampled Data

November 1, 2013

We analyze peer effects in sleeping behavior using a representative sample of U.S.teenagers from the National Longitudinal Survey of Adolescent Health. The sampling design of the survey causes the conventional 2SLS estimator to be inconsistent. We extend the NLS estimator in Wang and Lee (2013a) to estimate network models with sampled observations on the dependent variable. When accounting for sampling, we find that the sleeping behavior of the friends is important to shape own sleeping behavior, besides the impact of individual, family and friend characteristics.

Measuring Social Unrest Based on Income Distribution

October 1, 2013

This paper develops a social unrest measure by revising Esteban-Ray (1994, Econometrica) polarization index. For the purpose of measuring more effectively the level of social unrest that is generated by separation of income classes, the new index allows for asymmetry between the rich and the poor groups' alienation feeling against the other, and it constructs a more effective group identification function. To facilitate statistical inferences, asymptotic distribution of the proposed measure is also derived using results from U-statistics, and an easy-to-implement jackknife-based variance estimation algorithm is obtained. Since the new index is general enough to include the Esteban-Ray index and the Gini index for group data as special cases, the asymptotic results can be readily applied to these popular indices. Evidence based on the Panel Study of Income Dynamics data suggests that the level of social unrest has generally increased over the sample period of 1981-2005, particular since the late 1990's, and the increase is statistically significant.

Peer Effects in the Demand for Housing Quality

September 1, 2013

Using detailed data on friendship networks within neighborhoods, we investigate the importance of social interactions in one's own residential neighborhood in the demand for housing quality. We find evidence consistent with the presence of peer effects, especially for households living in urban areas. Our findings are in line with the prediction of a model where conformity preferences are the key element underlying economic outcomes that involve interactions with peers.

The Effects of School Desegregation on Teenage Fertility

September 1, 2013

The school desegregation efforts following the historic Supreme Court ruling in Brown v. Board of Education (1954) represent one of the most important social policy initiatives of the 20th century. Despite a large research literature on desegregation and educational outcomes, its effects on the lives of individuals are still not fully understood. In this paper we examine the effects of desegregation on the fertility of teenagers. Our findings suggest that desegregation increased the fertility of African American teens and is unrelated to the fertility of white teens.

The Effects of Disability Insurance: Evidence from Social Security's Disabled-Widow Program

October 1, 2012

This study measures the effect of disability insurance on labor supply and health insurance coverage. The effect is identified by a policy in 1990 that increased the generosity of Social Security's disabled-widow program. Using data from the Current Population Survey, the results suggest that, in this context, disability benefits led to a one-to-one decline in labor force participation, employment, and private insurance coverage. The results imply that the demand for disability benefits may not reflect a latent demand for public health insurance.

Family Structure and the Economic Wellbeing of Children

August 1, 2012

An extensive literature that examines the relationship between family structure and children's outcomes consistently shows that living with a single parent is associated with negative outcomes. Few studies, however, directly test the relationship between family structure and outcomes for the child once he/she reaches adulthood. We directly examine, using the Panel Study of Income Dynamics, whether family structure during childhood is related to the child's economic wellbeing both during childhood as well as adulthood. Our findings suggest that the economic wellbeing of children of mothers who experience a marital dissolution and remarry are no different from the children of mothers who are continuously married. However, the children of mothers whose marriages dissolve but who do not remarry experience large declines in their income over their first ten years of life. We also show that while the children of never married mothers earn a lot less as adults than the children of married parents, these differences can largely be explained by demographic and socioeconomic factors. Finally, our findings suggest that children who have mothers who experience a marital dissolution and who do not remarry have economic losses that persist into adulthood. Robustness checks using family fixed effects models support this result.

Medical Technology and the Production of Health Care

March 1, 2011

This paper investigates the factors that determine differences across OECD countries inhealth outcomes, using data on life expectancy at age 65, over the period 1960 to 2007. We estimate a production function where life expectancy depends on health and social spending, lifestyle variables, and medical innovation. Our first set of regressions includes a set of observed medical technologies by country. Our second set of regressions proxy technology using a spatial process. The paper also tests whether in the long-run countries tend to achieve similar levels of health outcomes. Our results show that health spending has a significant and mild effect on health out- comes, even after controlling for medical innovation. However, its short-run adjustments do not seem to have an impact on health care productivity. Spatial spill overs in life expectancy are significant and point to the existence of interdependence across countries in technology adoption. Furthermore, nations with initial low levels of life expectancy tend to catch up with those with longer-lived populations.

The Effective Target of the Social Security Disability Benefits Reform Act of 1984

January 1, 2009

A substantial portion of the rise in Social Security Disability Insurance rolls since 1984 has been attributed to the Social Security Disability Benefits Reform Act. Using data from the National Health Interview Survey, this paper examines who the Act effectively targeted. The analysis shows that new enrollees were demonstrably taller than previous enrollees, suggesting that the Act expanded eligibility to individuals in better health and socioeconomic circumstances However, the estimated effect of increased SSDI eligibility on employment is low, suggesting that the Act targeted males who would have otherwise been unemployed.

Public Sentiment and Tobacco Control Policy

May 1, 2008

The well-documented correlation between cigarette excise taxes and cigarette demand may not be entirely causal if excise taxes reflect public sentiment towards smoking. I consider whether proxies for smoking sentiment -- the prevalence of smoking by education and intention to quit statuses -- are correlated with support for and implementation of tobacco control laws. I find that cigarette excise taxes are most sensitive to the prevalence of educated smokers who do not want to quit. Additionally, when proxies for public sentiment are included, the estimated elasticity of cigarette demand declines from -2.0 to -1.3.

The Effect of Disability Insurance on Health Investment: Evidence from the VA Disability Compensation Program

May 1, 2008

This paper examines whether individuals respond to monetary incentives to detect latent medical conditions. The effect is identified by an amendment to Title 38 that deemed diabetes associated with Agent Orange exposure a compensable disability under the VA's Disability Compensation program. Since a diagnosis is a requisite for benefit eligibility, and nearly one-third of diabetics remain undiagnosed, the advent of disability insurance may have encouraged the detection of diabetes among the previously undiagnosed population. Evidence from the National Health Interview Survey suggests that the policy increased the prevalence of diabetes by 2.7 percentage points among veterans.