Schooling and Labor Market Consequences of the 1970 State Abortion Reforms

This study uses the 1970 state abortion reforms to estimate the effect of teen and out-of-wedlock childbearing on the schooling and labor market outcomes of mothers observed in 1980 and 1990 Census microdata. Reduced-form estimates suggest that state abortion reforms had a negative impact on teen marriage, teen fertility, and teen out- of-wedlock childbearing. The teen marriage effects are largest and most precisely estimated for white women while the teen fertility and out-of-wedlock childbearing effects are largest and most precisely estimated for black women. The relatively modest fertility and marriage consequences of abortion reform for white women do not appear to have changed schooling or labor market outcomes. In contrast, black women who were exposed to abortion reforms experienced large reductions in teen fertility and teen out-of-wedlock fertility that appear to have led to increased schooling and employment rates. Instrumental variables estimates of the effects of teen and out-of- wedlock childbearing on the schooling and employment status of black women, using measures of exposure to abortion reform as instruments, are marginally significant and larger than the corresponding OLS estimates.

The Social and Economic Impact of Native American Casinos

In the late 1980s, a series of legal rulings favorable to tribes and the subsequent passage of the Indian Gaming Regulatory Act of 1988 legalized gaming operations on reservations in many states. Today, there are over 310 gaming operations run by more than 200 of the nations' 556 federally-recognized tribes. Of these operations, about 220 are Las Vegas' style casinos with slot machines and/or table games. We use a simple difference-in-difference framework where we compare economic outcomes before and after tribes open casinos to outcomes over the same period for tribes that do not adopt or are prohibited from adopting gaming. Four years after tribes open casinos, employment has increased by 26 percent, and tribal population has increased by about 12 percent, resulting in an increase in employment to population ratios of five percentage points or about 12 percent. The fraction of adults who work but are poor has declined by 14 percent. Tribal gaming operations seem to have both positive and negative spillovers in the surrounding communities. In counties where an Indian-owned casino opens, we find that jobs per adult increase by about five percent of the median value. Given the size of tribes relative to their counties, most of this growth in employment is due to growth in non-Native American employment. The increase in economic activity appears to have some health benefits in that four or more years after a casino opens, mortality has fallen by 2 percent in a county with a casino and an amount half that in counties near a casino. Casinos do, however, come at some cost. Four years after a casino opens, bankruptcy rates, violent crime, and auto thefts and larceny are up 10 percent in counties with a casino.

The Impact of Income on Mortality: Evidence from the Social Security Notch

There is widespread and longstanding agreement that life expectancy and income are positively correlated. However, it has proven much more difficult to establish a causal relationship since income and health are jointly determined. We use a major change in the Social Security law as exogenous variation in income to examine the impact of income on mortality in an elderly population. The legislation created a notch' in Social Security benefits based upon date of birth; those born before January 1, 1917 generally receive higher benefits than those born afterwards. We compare mortality rates after age 65 for males born in the second half of 1916 and the first half of 1917. Data from restricted-use versions of the National Mortality Detail File combined with Census data allows us to count all deaths among elderly Americans between 1979 and 1993. We find that the higher income group has a statistically significantly higher mortality rate, contradicting the previous literature. We also find that the younger cohort responded to lower incomes by increasing post-retirement work effort. These results suggest that moderate employment has beneficial health effects for the elderly.

(WP 2017-02) The Great Recession and Public Education

We examine the impact of the Great Recession on K-12 education finance and employment and generate five key results. First, nearly 300,000 school employees lost their jobs. Second, schools that were heavily dependent financially on state governments were particularly vulnerable to the recession. Third local revenues from the property tax actually increased during the recession, primarily because millage rates rose in response to declining property values. Fourth, inequality in school spending rose sharply during the Great Recession. Fifth, the federal government’s efforts to shield education from some of the worst effects of the recession achieved their major goal

Changing Labor Market Opportunities for Women and the Quality of Teachers 1957-1992

School officials and policy makers have grown increasingly concerned about their ability to attract and retain talented teachers. A number of authors have shown that in recent years the brightest students at least those with the highest verbal and math scores on standardized tests are less likely to enter teaching. In addition, it is frequently claimed that the ability of schools to attract these top students has been steadily declining for years. There is, however, surprisingly little evidence measuring the extent to which this popular proposition is true. We have good reason to suspect that the quality of those entering teaching has fallen over time. Teaching has remained a predominately female profession for years; at the same time, the employment opportunities for talented women outside of teaching have soared. In this paper, we combine data from four longitudinal surveys of high school graduates spanning the years 1957-1992 to examine how the propensity for talented women to enter teaching has changed over time. We find that while the quality of the average new female teacher has fallen only slightly over this period, the likelihood that a female from the top of her high school class will eventually enter teaching has fallen dramatically from 1964 to 1992 by our estimation, from almost 20% to under 4%.

Estimating the Impact of Medical Innovation: A Case Study of HIV Antiretroviral Treatments

As health care consumes a growing share of GDP, the demand for better evidence regarding the effects of health care treatments and how these vary across individuals is increasing. Estimating this with observational data is difficult given the endogeneity of treatment decisions. But because the random assignment clinical trials (RACTs) used in the FDA approval process only estimate average health effects and do not consider spending, there is no good alternative. In this study we use administrative data from California’s Medicaid program to estimate the impact of HIV antiretroviral treatments (ARVs). We use data on health care utilization to proxy for health status and exploit the rapid takeup of ARVs following their FDA approval. Our estimate of a 68 percent average mortality rate reduction is in line with the results from RACTs. We also find that the ARVs lowered short-term health care spending by reducing expenditures on other categories of medical care. Combining these two effects we estimate the cost per life year saved at $19,000. Our results suggest an alternative method for estimating the real-world effects of new treatments that is especially well-suited to those treatments that diffuse rapidly following their approval

Evaluation of patient perception towards dynamic health data sharing using blockchain based digital consent with the Dovetail digital consent application : a cross sectional exploratory study

Background New patient-centric integrated care models are enabled by the capability to exchange the patient’s data amongst stakeholders, who each specialise in different aspects of the patient’s care. This requires a robust, trusted and flexible mechanism for patients to offer consent to share their data. Furthermore, new IT technologies make it easier to give patients more control over their data, including the right to revoke consent. These characteristics challenge the traditional paper-based, single-organisation-led consent process. The Dovetail digital consent application uses a mobile application and blockchain based infrastructure to offer this capability, as part of a pilot allowing patients to have their data shared amongst digital tools, empowering patients to manage their condition within an integrated care setting. Objective To evaluate patient perceptions towards existing consent processes, and the Dovetail blockchain based digital consent application as a means to manage data sharing in the context of diabetes care. Method Patients with diabetes at a General Practitioner practice were recruited. Data were collected using focus groups and questionnaires. Thematic analysis of the focus group transcripts and descriptive statistics of the questionnaires was performed. Results There was a lack of understanding of existing consent processes in place, and many patients did not have any recollection of having previously given consent. The digital consent application received favourable feedback, with patients recognising the value of the capability offered by the application. Patients overwhelmingly favoured the digital consent application over existing practice. Conclusions Digital consent was received favourably, with patients recognising that it addresses the main limitations of the current process. Feedback on potential improvements was received. Future work includes confirmation of results in a broader demographic sample and across multiple conditions

Income Inequality, the Median Voter, and the Support for Public Education

Using a panel of U.S. school districts spanning 1970 – 2000, we examine the relationship between income inequality and fiscal support for public education. In contrast with recent theoretical and empirical work suggesting a negative relationship between inequality and public spending, we find results consistent with a median voter model, in which inequality that reduces the median voter’s tax share induces higher local spending on public education. We estimate that 12 to 22 percent of the increase in local school spending over this period is attributable to rising inequality.