Health Economics

May 7, 2010
Program Director Michael Grossman of City University of New York and NBER Research Associate Ted Joyce of Baruch College, Organizers

Ted Joyce, and Ruoding Tan and Yuxiu Zhang, City University of New York
Changes in Teen Fertility Following Access to the Pill and Abortion in the Early 1970s

Joyce, Tan, and Zhang show that recent studies on the "power of the pill" have not adequately accounted for the role of abortion on teen fertility in the years between 1970 and 1973. They use rediscovered data on abortions performed in New York State in 1971 and 1972 by age, race, and state of residence to demonstrate the impact of legal abortion services in New York prior to Roe v. Wade on teen fertility rates as far away as Montana. Their results strongly suggest that it was access to legalized abortion services and not policies allowing young, unmarried women access to the pill that caused birth rates of young women to fall in the early 1970s. Their findings do not refute the impact of the pill on the well-being of women, but they do call into question the identification strategy upon which recent estimates are based.

Anna Aizer, Brown University and NBER, and Laura Stroud, Brown University
Education, Knowledge and the Evolution of Disparities in Health (NBER Working Paper No. 15840)

Aizer and Stroud study how advances in scientific knowledge affect the evolution of disparities in health. Their focus is the 1964 Surgeon General's Report on Smoking and Health – the first widely publicized report of the negative effects of smoking on health. Using an historical dataset that includes the smoking habits of pregnant women in 1959-66, they find that immediately after the 1964 Report, more educated mothers immediately reduced their smoking as measured by both self-reports and serum cotinine levels while the less educated mothers did not, and the relative health of their newborns likewise increased. The researchers also find strong peer effects in the response to information: after the 1964 report, educated women surrounded by other educated women were more likely to reduce smoking relative to those surrounded by less educated women. Over time, the education gradient in both smoking and newborn health continued to increase, peaking in the 1980s and then shrinking, eventually returning to initial levels. These results can explain why in an era of great advancements in medical knowledge, health disparities may actually increase, at least initially.

Joshua Graff Zivin, University Of California, San Diego and NBER, and Matthew Neidell, Columbia University and NBER

The Impact of Environmental Conditions on Worker Productivity

William N. Evans, University of Notre Dame and NBER, and Timothy J. Moore, University of Maryland
The Short-Term Mortality Consequences of Income Receipt

Many studies of the life-cycle/permanent income hypothesis find that households increase their consumption after the receipt of income payments. Consumption can increase adverse health events, such as traffic accidents, heart attacks and strokes. Evans and Moore examine the short-term mortality consequences of income receipt. They find that mortality increases following the arrival of monthly Social Security payments, regular wage payments for military personnel, the 2001 tax rebates, and Alaska Permanent Fund dividend payments. The increase in short-run mortality is large, potentially eliminating some of the protective benefits of additional income.

Christopher Carpenter, University of California, Irvine and NBER, and Sabina Postolek and Casey Warman, Queen's University
Public-Place Smoking Laws and Exposure to Environmental Tobacco Smoke (ETS) in Public Places (NBER Working Paper No. 15849)

A recent report suggests that laws restricting smoking in public places reduce acute myocardial infarction, presumably by reducing exposure to environmental tobacco smoke (ETS). Carpenter, Postolek, and Warman study adoption of these laws in Canada using data that include questions about respondents' ETS exposure in bars, restaurants, and other places. They find that these laws had no effects on smoking but induced extremely large and statistically significant reductions in exposure to ETS in bars and restaurants for both non-smokers and smokers. Their results indicate wide latitude for health improvements in the United States if smoking were banned in public places.

Gautam Gowrisankaran, University of Arizona and NBER; Karen Norberg, Washington University in St. Louis and NBER; Steven Kymes, Dustin Stwalley and William Peck, Washington University in St. Louis; and Michael Chernew, Harvard University and NBER

The Impact of Insurance-Based Wellness Incentives on Hospitalizations and Medical Care Use