Three essays on the economics of immigration and health

This thesis analyzes different sources of disparities in health and access to care among immigrants and ethnic minorities in the United States. The first chapter studies the generational worsening observed in the birth outcomes of Hispanics in the United States. Despite their lower socio-economic status, Hispanic immigrants in the United States initially have better health outcomes than natives. However, while their socio-economic status improves over time and across generations, their health deteriorates. This phenomenon is commonly known as the "Hispanic health paradox.'' There is an open debate about whether the observed convergence is explained by selection on health or by the adoption of less healthy lifestyles. This paper uses a unique dataset linking the birth records of two generations of Hispanics born in California and Florida (1975-2009), to analyze the mechanisms behind the generational decline in birth outcomes. The second chapter (joint with Emily R. Gee) investigates the role of ethnic networks and the effect of providing online information in foreign-language in facilitating Medicaid take-up among immigrants in the US. Many low-income immigrants are uninsured yet eligible for public health insurance. In this paper, we examine whether language barriers and network effects can explain disparities in insurance Medicaid participation. Using the 2008 and 2009 American Community Survey, we show that linguistic networks facilitate Medicaid enrolment among non-English speaking adults. The third chapter analyzes the effect of food-environment on maternal weight gain and pregnancy outcomes. This paper studies how changes in the quality of food environment affect maternal and child health. Similarly to Currie et al. (2009), I use mother fixed-effects and exploit over time variation in the proximity to different set of restaurants. Results show that proximity to Mexican restaurants is associated with a lower likelihood of excessive weight gain among US born mothers

If you don’t snooze you lose health and gain weight: evidence from a regression discontinuity design

Sleep deprivation is increasingly recognized as a public health challenge. While several studies provided evidence of important associations between sleep deprivation and health outcomes, it is less clear whether sleep deprivation is a cause or a marker of poor health. This paper studies the causal effects of sleep on health status and obesity exploiting the relationship between sunset light and circadian rhythms and using time-zone boundaries as an exogenous source of variation in sleep duration and quality. Using data from the American Time Use Survey, we show that individuals living in counties on the eastern side of a time zone boundary go to bed later and sleep less than individuals on the opposite side of the time zone boundary. These findings are driven by individuals whose biological schedules and time use are constrained by social schedules (i.e., work schedules, school starting times). Exploiting these discontinuities, we find evidence that sleep deprivation increases the likelihood of reporting poor health status and the incidence of obesity. Our results suggest that the increase in obesity is explained by both changes in eating behavior and a decrease in physical activity

Immigration may reduce the time you wait to see the doctor

Migrants’ access to the NHS is part of an ongoing debate in the UK, with the Home Secretary recently arguing that it is “obvious” that migration has an impact on the availability of NHS services. Looking at the impact of immigration on NHS waiting times, Osea Giuntella, Catia Nicodemo and Carlos Vargas-Silva explain that services in areas with a rising migrant population actually have reduced waiting times

The Effects of age and job protection on the welfare costs of inflation and unemployment: a source of ECB anti-inflation bias?

This paper extends the well known Di Tella et al. (2001 and 2003) analyses on the welfare costs of inflation and unemployment based on self-reported happiness data by looking at age and job market characteristic splits in a sample which includes more recent years and new countries. With both one and two stage estimating procedures we find support for the hypothesis that the relative welfare cost of unemployment versus inflation is higher than one (in contrast with the “equal-to-one” implicit assumption of the Misery Index). We also observe that the relative cost of unemployment is much higher in intermediate age cohorts and in low job protection countries. This might contribute to explain the higher concern for the level of economic activity of central bankers in countries with younger population and more flexible labour markets

The Economic Benefit of Data-Communication Technology on the New York Metroplex Area

The aim of this paper is to estimate the economic benefit for the New York Metroplex area of the controller-to-pilot communication standard known as Data-Communication. RAMS simulation software was first used to evaluate the potential impact of the new technology on airport operations in the three airports of LaGuardia, Newark and John F. Kennedy. The new technology would allow for a greater number of operations and reduce the average hourly workload for air traffic controllers. We employ a two steps procedure. First, we estimate a benefit function per number of hourly operations. Second, using the empirical distribution of hourly operations and the benefit function found in step one, we compute the average daily benefit from the technology as the reduced cost from delays plus the net effect on controllers workload due to its implementation. The procedure is applied at each airport individually and to the metroplex area as a whole. Our estimates show that the introduction of Data-Comm would yield significant savings in the New York Metroplex area

Does Broadband Internet Affect Fertility?

The spread of high-speed (broadband) Internet epitomizes the digital revolution. Using German panel data, we test whether the availability of broadband influences fertility choices in a low-fertility setting well known for the difficulty in combining work and family life. We exploit a strategy devised by Falck and colleagues to obtain causal estimates of the impact of broadband on fertility. We find positive effects of broadband availability on the fertility of highly educated women aged 25\u201345. We further confirm this result using county-level data on total fertility. We show that broadband access significantly increases the share of women reporting home- or part-time working. Furthermore, we find positive effects on time spent with children and overall life satisfaction. Our findings are consistent with the hypothesis that access to broadband allows highly educated women, but not the less educated, to reconcile career and motherhood, which may promote a \u2018digital divide\u2019 in fertility

The midlife crisis

This paper documents a longitudinal crisis of midlife among the inhabitants of rich nations. Yet middle-aged citizens in our data sets are close to their peak earnings, have typically experienced little or no illness, reside in some of the safest countries in the world, and live in the most prosperous era in human history. This is paradoxical and troubling. The finding is consistent, however, with the prediction -- one little-known to economists of Elliott Jaques (1965). Our analysis does not rest on elementary cross-sectional analysis. Instead the paper uses panel and through-time data on, in total, approximately 500,000 individuals. It checks that the key results are not due to cohort effects. Nor do we rely on simple life-satisfaction measures. The paper shows that there are approximately quadratic hill-shaped patterns in data on midlife suicide, sleeping problems, alcohol dependence, concentration difficulties, memory problems, intense job strain, disabling headaches, suicidal feelings, and extreme depression. We believe the seriousness of this societal problem has not been grasped by the affluent world’s policy-makers

The Effects of Immigration on NHS Waiting Times

This paper analyzes the effects of immigration on waiting times for the National Health Service (NHS) in England. Linking administrative records from Hospital Episode Statistics (2003-2012) with immigration data drawn from the UK Labour Force Survey, we find that immigration reduced waiting times for outpatient referrals and did not have significant effects on waiting times in accident and emergency departments (A&E) and elective care. The reduction in outpatient waiting times can be explained by the fact that immigration increases natives' internal mobility and that immigrants tend to be healthier than natives who move to different areas. Conversely, we observe higher outpatient waiting times in places to which native internal migrants have moved. Finally, we find evidence that immigration increased waiting times for outpatient referrals in more deprived areas outside of London. The increase in average waiting times in more deprived areas is concentrated in the years immediately following the 2004 EU enlargement and disappears in the medium term (e.g., 3 to 4 years)

Immigration and the Reallocation of Work Health Risks

This paper studies the effects of immigration on the allocation of occupational physical burden and work injury risks. Using data for England and Wales from the Labour Force Survey (2003-2013), we find that, on average, immigration leads to a reallocation of UK-born workers towards jobs characterized by lower physical burden and injury risk. The results also show important differences across skill groups. Immigration reduces the average physical burden of UK-born workers with medium levels of education, but has no significant effect on those with low levels. These findings, together with the evidence that immigrants report lower injury rates than natives, suggest that the reallocation of tasks could reduce overall health care costs and the human and financial costs typically associated with workplace injuries