Disease Outbreaks, Healthcare Utilization, and On-Time Immunization in the First Year of Life
joint with Jessamyn Schaller and Teny M. Shapiro
Forthcoming at Journal of Health Economics
This paper examines the determinants of parental decisions about infant immunization. Using the exact timing of vaccination relative to birth, we estimate the effects of local pertussis outbreaks occurring in-utero and during the first two months of life on the likelihood of on-time initial immunization for pertussis and other diseases. We find that parents respond to changes in perceived disease risk: pertussis outbreaks within a state increase the rate of on-time receipt of the pertussis vaccine at two months of age, particularly among low-socioeconomic status (SES) subgroups. In addition, we find that pertussis outbreaks increase the likelihood of immunization against other vaccine-preventable diseases. Spillover effects in low-SES subgroups are as large as direct effects and are present only for vaccines given during the same visit as the pertussis vaccine, which suggests that provider contact may be a key factor in infant vaccination decisions in poor families.
Link to January 2019 Draft
The Timing of Teenage Births: Estimating the Effect on High School Graduation and Later Life Outcomes
joint with Danielle Sandler
Demography 56.1 (2019): 345-365
We examine the long-term outcomes for a population of teenage mothers who give birth to their children around the end of high school. We compare the mothers whose high school education was interrupted by childbirth, because the child was born before her expected graduation date to mothers who did not experience the same disruption to their education. We find that mothers who give birth during the school year are 5.4 percentage points less likely to complete their high school education, are less likely to be married, and have more children than their counterparts who gave birth just a few months later. The wages for these two sets of teenage mothers are not statistically different, but with a lower likelihood of marriage and more children, the households of the treated mothers are more likely to fall below the poverty threshold. While differences in educational attainment have narrowed over time, the differences in labor market outcomes and family structure have remained stable.
Link to Paper
Getting a Sporting Chance: Title IX and the Intergenerational Transmission of Health
Health Economics 26 (2017): 1583-1600
We know that healthier mothers tend to have healthier infants, but we do not know how much of that relationship reflects the intergenerational transmission of genetic attributes versus environmental influences. From a policy perspective, it is crucial to understand which environmental influences are important, and whether investments in one generation affect outcomes for the next. I use variation in the implementation of Title IX to measure the effects of increased athletic opportunities on the health of infants. Babies born to women with greater athletic opportunities as teenagers have babies that are healthier at birth. They are less likely to be born of low or very low birthweight, and have higher Apgar scores.
Link to Paper
Missed Signals: The Effect of ACT College-Readiness Measures on Educational Attainment
joint with Andrew Foote and Teny M. Shapiro
Economics of Education Review 46 (2015): 39-51
In the face of shrinking government budgets and a growing need to train a high-skilled labor force, policymakers have become increasingly interested in cost-effective measures that induce more students to apply to and enroll in college. In this paper, we use a regression discontinuity design to identify the causal effect of students receiving information about their own college-readiness after taking the ACT on their subsequent enrollment and class-taking decisions. Using data from Colorado, where all high school students are required to take the ACT, we find that students who receive information that they are college-ready in a subject are no more likely to attend college than those that do not receive this information. We discuss possible reasons for this finding, such as the lack of visibility or salience of the signal.
Link to Paper
What a Difference a Day Makes: Quantifying the Effects of Birth Timing Manipulation on Infant Health
joint with Teny M. Shapiro
Journal of Health Economics 33 (2014): 139-158
Scheduling births for non-medical reasons has become an increasingly common practice in the United States and around the world. We exploit a natural experiment created by child tax benefits, which rewards births that occur just before the new year, to better understand the full costs of elective c-sections and inductions. Using data on all births in the U.S. from 1990 to 2000, we first confirm that expectant parents respond to the financial incentives by electing to give birth in December rather than January. We find that most of the manipulation comes from changes in the timing of c-sections. Small birth timing changes, even at full-term, lead to lower birthweight, a lower Apgar score, and an increase in the likelihood of being low birthweight.
Link to Paper
Maternal Sleep and Infant Health Outcomes joint with Teny M. Shapiro
Estimating the Health Impacts of WIC: A Regression Discontinuity Approach (with Marianne Bitler, Janet Currie, Hilary Hoynes and Barton Willage)
The Effects of Maternal Education on Infant and Maternal Health: New Causal Evidence (with Ji Yan)
Work in Progress
Housing First Charlotte-Mecklenburg Research & Evaluation Project (with M. Lori Thomas, Joanne Carman, Ashley Clark and Justin Lane)