Exercise, Physical Activity, and Exertion over the Business Cycle

As economic recessions reduce employment and wages, associated shifts in time and income constraints would be expected to also impact individuals’ health behaviors. Prior work has focused exclusively on recreational exercise, which typically represents only about 4% of total daily physical exertion. The general presumption in these studies is that, because exercise improves health, if unemployment increases exercise it must also improve health. Yet a person may be laid off from a physically demanding job, exercise more, and still be less physically active than when employed. Thus the relevant question is whether unemployment leads persons to become more physically active. We study this question with the American Time Use Survey (2003-2010), exploring the impact of the business cycle (and specifically the Great Recession) on individuals’ exercise, other uses of time, and physical activity during the day. We also utilize more precise measures of exercise (and all other physical activities), which reflect information on the duration as well as intensity of each component activity, than has been employed in past studies. Using within-state variation in employment and unemployment, we find that recreational exercise tends to increase as employment decreases. In addition, we also find that individuals substitute into television watching, sleeping, childcare, and housework. However, this increase in exercise as well as other activities does not compensate for the decrease in work-related exertion due to job-loss. Thus total physical exertion, which prior studies have not analyzed, declines. These behavioral effects are strongest among low-educated males, which is validating given that the Great Recession led to some of the largest layoffs within the manufacturing, mining, and construction sectors. Due to the concentration of low-educated workers in boom-and-bust industries, the drop in total physical activity during recessions is especially problematic for vulnerable populations and may play a role in exacerbating the SES-health gradient during recessions. We also find some evidence of intra-household spillover effects, wherein individuals respond to shifts in spousal employment conditional on their own labor supply.

Isolating the Effect of Major Depression on Obesity: Role of Selection Bias

There is suggestive evidence that rates of major depression have risen markedly in the U.S. concurrent with the rise in obesity. The economic burden of depression, about $100 billion annually, is under-estimated if depression has a positive causal impact on obesity. If depression plays a causal role in increasing the prevalence of obesity, then policy interventions aimed at promoting mental health may also have the indirect benefits of promoting a healthy bodyweight. However, virtually the entire existing literature on the connection between the two conditions has examined merely whether they are significantly correlated, sometimes holding constant a limited set of demographic factors. This study utilizes multiple large-scale nationally-representative datasets to assess whether, and the extent to which, the positive association reflects a causal link from major depression to higher BMI and obesity. While contemporaneous effects are considered, the study primarily focuses on the effects of past and lifetime depression to bypass reverse causality and further assess the role of non-random selection on unobservable factors. There are expectedly no significant or substantial effects of current depression on BMI or overweight/obesity, given that BMI is a stock measure that changes relatively slowly over time. Results are also not supportive of a causal interpretation among males. However, among females, estimates indicate that past or lifetime diagnosis of major depression raises the probability of being overweight or obese by about seven percentage points. Results also suggest that this effect appears to plausibly operate through shifts in food consumption and physical activity. We estimate that this higher risk of overweight and obesity among females could potentially add about 10$9.7 billion) to the estimated economic burden of depression.

Unusual presentation: fracture neck femur in 18 months old child

An 18 months old child was brought to the emergency department with alleged history of trauma due to hit by two wheeler and sustained injury over right hip. Child was not able to move the right lower limb. Physical examination of child revealed contusion over right hip region and injury over perineal region. There was no active vaginal bleeding. Rest of the systemic examination was normal. Routine blood was normal. On X-ray of pelvis with both hip showed fracture of neck femur on right side without any pelvic injury. Patient was treated with hip spica cast and complete bed rest for 1 month. After 1 month of the treatment, on follow-up the patient was able to weight bear and fractured was united on X-ray

Orthopaedic aspect of anatomy and radiology of proximal femur

Femoral pathology is common in relation to the orthopedic. There is complex anatomy of the proximal femur and hip joint. So, its knowledge regarding anatomy and radiological correlation is necessary to the well-known fact for the orthopedics for the routine day to day practice. This review article briefly illustrates important anatomical and radiological aspect of the proximal femur

Intended and Unintended Effects of E-cigarette Taxes on Youth Tobacco Use

Over the past decade, rising youth use of e-cigarettes and other electronic nicotine delivery systems (ENDS) has prompted aggressive regulation by state and local governments. Between 2010 and 2019, ten states and two large counties adopted ENDS taxes. Applying a continuous treatment difference-in-differences approach to data from two large national datasets (Monitoring the Future and the Youth Risk Behavior Surveillance System), this study explores the impact of ENDS taxes on youth tobacco use. We find that ENDS taxes reduce youth e-cigarette consumption, with estimated e-cigarette tax elasticities of -0.06 to -0.21. However, we estimate sizable positive cigarette cross-tax elasticities, suggesting economic substitution between cigarettes and e-cigarettes for youth. These substitution effects are particularly large for frequent cigarette smoking. We conclude that the unintended effects of ENDS taxation may more than fully offset any public health gains

State drug control spending and illicit drug participation

The purpose of this article is to estimate the effect of state criminal justice expenditures and state public health expenditures on deterring illicit drug use. The empirics are based on a demand-and-supply model of drug markets. The effect of a given expenditure on criminal justice or public health programs is dependent on the magnitude of the resulting shifts in the two functions and the demand price elasticity. A reduced form of the demand-and-supply model is also estimated. The data employed come from the 1990 and 1991 National Household Surveys on Drug Abuse (NHSDA). Data on state and local spending for drug-related criminal justice and drug-related public health programs were merged with the NHSDA. The main findings from the regression results are that drug control spending reduces drug use. However, the results suggest that for marijuana users, the marginal cost of drug control exceeds the social benefits of drug control. This may not be the case for users of other illicit drugs. Spending for drug enforcement by police and drug treatment is found most effective in deterring drug use. However, spending for correctional facilities is never significant, which suggests that a more efficient method of reducing drug use might be to reduce correctional facilities spending and increase spending on treatment. © Western Economic Association International

The Unintended Effects of Ban-the-Box Laws on Crime

Ban-the-box (BTB) laws, which prevent employers from asking prospective employees about their criminal histories at initial job screenings, are intended to increase employment opportunities and reduce incentives for crime. This study is the first to comprehensively explore the relationship between BTB laws and arrests. Using data from the National Incident-Based Reporting System, we find that BTB laws are associated with a 16 percent increase in criminal incidents involving Hispanic male arrestees. This finding is supported by parallel analysis using the National Longitudinal Survey of Youth 1997 and is consistent with BTB-law-induced job loss due to employer-based statistical discrimination. We find less evidence that BTB laws increase property crime among African American men. Supplemental analyses from the American Community Survey suggest that barriers to welfare participation among Hispanic men may partially explain this result. Our estimates suggest that BTB laws generate approximately $350 million in additional annual crime costs

The Unintended Effects of Ban-the-Box Laws on Crime

Ban-the-box (BTB) laws, which prevent employers from asking prospective employees about their criminal histories at initial job screenings, are intended to increase employment opportunities and reduce incentives for crime. This study is the first to comprehensively explore the relationship between BTB laws and arrests. Using data from the National Incident-Based Reporting System, we find that BTB laws are associated with a 16 percent increase in criminal incidents involving Hispanic male arrestees. This finding is supported by parallel analysis using the National Longitudinal Survey of Youth 1997 and is consistent with BTB-law-induced job loss due to employer-based statistical discrimination. We find less evidence that BTB laws increase property crime among African American men. Supplemental analyses from the American Community Survey suggest that barriers to welfare participation among Hispanic men may partially explain this result. Our estimates suggest that BTB laws generate approximately $350 million in additional annual crime costs

Did California's Shelter-In-Place Order Work? Early Coronavirus-Related Public Health Effects

On March 19, 2020, California Governor Gavin Newsom issued Executive Order N-33-20 2020, which required all residents of the state of California to shelter in place for all but essential activities such as grocery shopping, retrieving prescriptions from a pharmacy, or caring for relatives. This shelter-in-place order (SIPO), the first such statewide order issued in the United States, was designed to reduce COVID-19 cases and mortality. While the White House Task Force on the Coronavirus has credited the State of California for taking early action to prevent a statewide COVID-19 outbreak, no study has examined the impact of California's SIPO. Using daily state-level coronavirus data and a synthetic control research design, we find that California's statewide SIPO reduced COVID-19 cases by 125.5 to 219.7 per 100,000 population by April 20, one month following the order. We further find that California's SIPO led to as many as 1,661 fewer COVID-19 deaths during the first four weeks following its enactment. Back-of-the-envelope calculations suggest that there were about 400 job losses per life saved during this short-run post-treatment period

The Contagion Externality of a Superspreading Event: The Sturgis Motorcycle Rally and COVID-19

Large in-person gatherings without social distancing and with individuals who have traveled outside the local area are classified as the "highest risk" for COVID-19 spread by the Centers for Disease Control and Prevention (CDC). Between August 7 and August 16, 2020, nearly 500,000 motorcycle enthusiasts converged on Sturgis, South Dakota for its annual motorcycle rally. Large crowds, coupled with minimal mask-wearing and social distancing by attendees, raised concerns that this event could serve as a COVID-19 "super-spreader." This study is the first to explore the impact of this event on social distancing and the spread of COVID-19. First, using anonymized cell phone data from SafeGraph, Inc. we document that (i) smartphone pings from non-residents, and (ii) foot traffic at restaurants and bars, retail establishments, entertainment venues, hotels and campgrounds each rose substantially in the census block groups hosting Sturgis rally events. Stay-at-home behavior among local residents, as measured by median hours spent at home, fell. Second, using data from the Centers for Disease Control and Prevention (CDC) and a synthetic control approach, we show that by September 2, a month following the onset of the Rally, COVID-19 cases increased by approximately 6 to 7 cases per 1,000 population in its home county of Meade. Finally, difference-in-differences (dose response) estimates show that following the Sturgis event, counties that contributed the highest inflows of rally attendees experienced a 7.0 to 12.5 percent increase in COVID-19 cases relative to counties that did not contribute inflows. Descriptive evidence suggests these effects may be muted in states with stricter mitigation policies (i.e., restrictions on bar/restaurant openings, mask-wearing mandates). We conclude that the Sturgis Motorcycle Rally generated public health costs of approximately $12.2 billion