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on Health Economics |
| By: | David Card; Jesse Rothstein; Moises Yi |
| Abstract: | We use data on 44, 000 twin pairs observed as adolescents in the 2000 Census, linked to their earnings 20 years later, to study the heritability of labor market outcomes. We extend the Classical Twins Design (CTD), which identifies heritability from contrasts between monozygotic and dizygotic twins, to settings where an analyst does not observe zygosity but can measure outcomes for same-sex and opposite-sex twins. We also allow for the presence of a family- and sex-specific component affecting same-sex siblings but only partly shared by opposite-sex siblings. Our extended model identifies heritability from the difference-in-differences of same-sex vs. opposite-sex twins vs. siblings. The estimates indicate strong heritability (h² approximately 0.36) of log earnings. Using an AKM (Abowd et al., 1999) decomposition that separates the person-specific component of earnings from employer-specific pay premiums, we find that both components are heritable. The heritability of employer pay premiums, however, is mainly driven by same-sex twins who work at the same firm, suggesting that social interactions may lead to an over-estimate of the genetic component in earnings. Excluding siblings who work together leads to estimates of the heritability of log earnings that are 15% lower. Similar biases may be present in CTD-based estimates of heritability for other social outcomes like education. |
| JEL: | C31 D31 J24 J31 J62 |
| Date: | 2026–09 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:35746 |
| By: | Matthew S. Johnson; David Levine; Michael W. Toffel |
| Abstract: | Regulatory inspections might affect entities nearby those inspected. Such spillovers are difficult to identify because regulators target inspections and neighboring establishments face correlated shocks. We exploit the U.S. Occupational Safety and Health Administration’s Site-Specific Targeting (SST) program, which generated quasi-random variation in inspections among workplaces with injury rates near a discrete cutoff. An SST inspection reduced injuries at uninspected same-ZIP-code establishments by an estimated 11 percent—an effect roughly as large as the direct effect on the inspected establishment. Because spillovers extend to multiple nearby establishments, they avert several times as many injuries as the inspection’s direct effect. |
| JEL: | I18 J28 L51 |
| Date: | 2026–08 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:35646 |
| By: | Manasi Deshpande; Alessandra Voena; Jason B. Weitze |
| Abstract: | We estimate the effect of receiving Supplemental Security Income (SSI) in childhood on adult outcomes using multiple sources of variation. Using variation across and within two quasi-experiments, we find that the program has heterogeneous effects that vary with the parental earnings response to SSI benefits: the program has positive effects on children when parents do not adjust their labor supply in response to SSI income (meaning household income increases), but zero or negative effects on children when parents offset the transfer by reducing earnings (meaning household income remains constant or falls). These results suggest that, relative to parent non-work time, income is crucial in the human capital production of low-income children with disabilities. We estimate a model of maternal labor supply and child human capital formation to quantify the relative importance of these channels. Our findings indicate that 1) the income effects of SSI on children's human capital are substantial, with a limited role for perverse incentive effects from conditioning benefits on disability status, and 2) parental work on net improves children's outcomes by increasing household resources, despite the potential decrease in parental time. |
| JEL: | I38 J13 J14 J22 J24 |
| Date: | 2026–09 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:35725 |
| By: | Priyanka Anand; Tran Thi Phu-Duyen; Sita Slavov |
| Abstract: | We examine how information affects the choice between Social Security Disability Insurance (DI) and Old-Age Insurance (OAI) benefits for people between 62 and full retirement age. We find that receiving an initial Social Security statement, which provides recipients with personalized estimated benefit amounts available from DI and OAI, increases the probability of applying for both programs among those with a work-limiting health condition or a low work ability index, and this response is concentrated among people who are further from full retirement age. The increase in DI applications is split between applications for DI only and applications for both programs. |
| JEL: | D83 H55 J14 |
| Date: | 2026–09 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:35748 |
| By: | Johannes Geyer; Peter Haan; Mia Teschner-Hofmann; Felix Weinhardt |
| Abstract: | Rising life expectancy and demographic change have increased the share of older workers, making their health and productivity central to aging societies. We study whether longer working lives translate into investments in work-related health before retirement. Exploiting a pension reform in Germany in a Regression Discontinuity Design, we show that women facing longer careers are more likely to apply for work-related rehabilitation, particularly those in poorer health or with weaker labor market attachment. Despite higher application and approval rates, this demand does not translate into higher rehabilitation completion. Together with intermediate outcomes, our findings are most consistent with capacity constraints in program delivery. |
| Keywords: | Rehabilitation, Aging Societies, Health Investments, Pension Reform |
| JEL: | H55 I12 J26 |
| Date: | 2026 |
| URL: | https://d.repec.org/n?u=RePEc:diw:diwwpp:dp2179 |
| By: | Anuj Gangopadhyaya; Cuiping Schiman; Robert Kaestner |
| Abstract: | While recent research has provided evidence that the Medicaid expansions of the Affordable Care Act (ACA) reduced mortality, there is no evidence on the effect of the Affordable Care Act (ACA) net of the Medicaid expansions on mortality. This is an important gap in knowledge because the ACA significantly increased health insurance coverage in non-expansion states. In this article, we exploit the large increase in health insurance coverage brought forth by the ACA to examine the effect of the ACA and Medicaid expansions on mortality. Unlike prior studies that relied solely on geographic variation in Medicaid expansions to estimate the net effect of the expansion, we use a novel empirical approach that allows us to investigate the effect of the ACA net of Medicaid expansion on mortality, the incremental effect of the Medicaid expansion, and the overall effect of the ACA including Medicaid expansion. We use longitudinal data from the NHIS Linked Mortality Files (LMF) and a nationally representative sample of 40 to 58-year-olds combined with a difference-in-differences and a difference-in-differences-in-differences research design to obtain estimates of the effect of the ACA on mortality. We find no evidence that the Medicaid expansions had a beneficial effect on mortality but do find that the ACA net of Medicaid expansion reduced mortality. |
| JEL: | H75 I13 I14 I18 |
| Date: | 2026–09 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:35751 |
| By: | Iñaki Aldasoro; Sebastian Doerr; Daniel Rees |
| Abstract: | Artificial intelligence (AI) and robots have the potential to offset the macroeconomic consequences of an ageing workforce, but the ability to automate jobs depends on which industries are ageing. AI and robots substitute most readily for jobs in industries with younger workforces (eg finance), while older, high-employment industries (eg agriculture, health) have less scope for automation. A new ageing–automation scorecard for over 130 economies shows that some of the fastest-ageing economies may face more substantial challenges in easing demographic pressures through automation. |
| Date: | 2026–08–26 |
| URL: | https://d.repec.org/n?u=RePEc:bis:bisblt:135 |
| By: | Crossan Cooper; Katja Seim; Jintaek Song |
| Abstract: | We study the first statewide SNAP restrictions on sweetened beverages and candy. Restricted spending falls 11 percent; calories and sugar fall 5–8 percent. Substitution is asymmetric: eligible fruit drinks partly offset soda declines, while candy restrictions reduce purchases of eligible snacks. Retailers barely change shelf prices. Losing SNAP’s sales-tax exemption raises tax-inclusive prices only 1.9 percent. Spending declines are larger at retailers with greater SNAP use and remain large online, where checkout stigma is less salient. Nationwide adoption would impose 13 percent of the out-of-pocket burden of an equivalent excise tax, while welfare gains reach roughly $1.1 billion annually. |
| JEL: | H30 I18 I38 |
| Date: | 2026–09 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:35739 |
| By: | Robinson, Elizabeth; Howarth, Candice; Zhou, Yanxi; Dasgupta, Shouro |
| Abstract: | Climate change is already having a measurable impact on labour forces across the globe, with far reaching implications for economic growth, worker health and productivity, firm profitability, poverty and inequality, and food security, to name but a few. This study quantifies UK workers’ perceptions of the impacts of heat on their health and the extent to which and how behavioural and infrastructural adaptation measures reduce their perceived negative impacts of extreme heat. We collected data during the UK 2024 and 2025 summers, just after periods of anomalous heat, surveying over 2, 000 people each year in the UK labour force when their recollection of the heat episode was fresh in their memories. Using microeconometric analysis and controlling for a rich set of demographic, occupational, and adaptation covariates, our results clearly show that workers perceive their health to be harmed by anomalously high temperatures, and both workers and employers rely on a wide range of adaptation measures to protect their health. However, these measures are only partially effective. For example, a 1°C positive temperature anomaly from the long-term average on average increased the probability of a worker reducing their hours by 9.9% and their effort by 9.5%; but for those workers who received advanced alerts of heat episodes, those probabilities are 6.2% and 6.7%, respectively. Advanced heat alerts also reduced the probability of workers reporting adverse health effects by approximately 5 percentage-points. |
| Keywords: | heat stress;labour force;temperature;adaptation |
| JEL: | R14 J01 |
| Date: | 2026–09–07 |
| URL: | https://d.repec.org/n?u=RePEc:ehl:lserod:140641 |
| By: | Katherine Eriksson; Peter Zhixian Lin; Gregory Niemesh |
| Abstract: | In the late nineteenth century, Americans feared that crowded immigrant neighborhoods were spreading disease through industrial cities. We study this claim using newly constructed town-level panel data from Massachusetts, 1860 to 1915, a setting uniquely suited to this exercise because its early vital registration system allows consistent measurement of mortality before national registration became widespread. Using a shift-share instrumental variable strategy based on historical settlement patterns, we estimate the effect of local exposure to immigration on mortality. The relevant question is not whether immigrant families themselves experienced higher mortality, but whether immigration altered the local disease environment more broadly. We find that increases in the foreign-born share significantly raised infant and child mortality, with the infant effect falling disproportionately on the post-neonatal period. Mechanical changes in the composition of births by parent nativity account for only a portion of the estimated effect, implying that the results are not driven primarily by higher mortality among immigrant births. Instead, the evidence is consistent with increased exposure to immigrants, communicable disease, and spillovers to children of native-born parents. These findings highlight immigration as one factor shaping the mortality transition in crowded high-mortality environments. |
| JEL: | I10 J13 N31 |
| Date: | 2026–09 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:35743 |
| By: | Randall Akee; Emilia Simeonova |
| Abstract: | There is substantial heterogeneity in economic, educational, and health outcomes among American Indians, shaped by factors such as geographic location (urban vs. rural), resource endowments, and historical experiences with federal policies. Nonetheless, there is clear evidence that historical policies, including forced relocation, boarding schools, and assimilation efforts, have had long-lasting negative effects on human capital development and intergenerational mobility in these populations. Recent decades have seen improvements in some areas, particularly where tribes have exercised greater self-governance and implemented innovative economic development strategies. This paper emphasizes that a “one-size-fits-all” approach is inadequate for analyzing the sources and potential remediation of disparities across various outcomes between Native populations and descendants of later arrivals. A unique challenge is that the measurement and analysis of American Indian outcomes are complicated by issues of racial and tribal identification, data limitations, and changing definitions. These challenges can obscure true trends and make it difficult to evaluate the effectiveness of policies or programs, underscoring the need for more precise and disaggregated data. This essay comments on the need for caution and clarity in the use and analysis of data for this population in both historical and contemporary settings. |
| JEL: | J0 N3 O10 |
| Date: | 2026–09 |
| URL: | https://d.repec.org/n?u=RePEc:nbr:nberwo:35730 |
| By: | Lefebvre, Mathieu; Onder, Harun; Pestieau, Pierre; Ponthière, Gregory; Suzuki, Emi |
| Abstract: | Because the poor face higher mortality, they are under-represented in the samples used to measure poverty. This paper quantifies this missing poor bias across 92 developing and least developed countries by comparing observed headcount poverty rates with counterfactual rates that would prevail if all individuals enjoyed the survival conditions of the top income class. Using income distributions and life expectancy by wealth quintile, we find the bias to be substantial and highly heterogeneous, from negligible in parts of Central Asia to 15 percentage points in Bolivia and 36 in Bhutan. Aggregated, the correction reveals an invisible continent of more than 116 million uncounted poor, large enough to reverse international poverty rankings. Instrumenting health system coverage with malaria ecology, we then show that universal health coverage causally reduces both the bias and the steepness of the income-mortality gradient through which it arises. A ten point gain in coverage lowers the bias by about one percentage point, three times the OLS estimate. Progress toward universal health coverage therefore yields a second dividend, correcting a measurement distortion concentrated where deprivation is deepest. |
| Keywords: | poverty, measurement, mortality, missing poor bias |
| JEL: | I32 J11 J17 |
| Date: | 2026 |
| URL: | https://d.repec.org/n?u=RePEc:zbw:glodps:1822 |
| By: | Michelle Escobar Carías (Newcastle University); Victoria Baranov (University of Melbourne); Sonia Bhalotra (University of Warwick); Pietro Biroli (University of Bologna); Joanna Maselko (University of North Carolina) |
| Abstract: | Does past treatment for depression create resilience to future shocks? We study a randomized CBT-based intervention for prenatally depressed mothers in Pakistan and exploit variation in COVID-19 restriction stringency six years after childbirth. Treated women were protected against restriction-induced anxiety, depression, comorbidity, and functional impairment. Protection extended to spousal relationships, offsetting restriction-driven declines in relationship quality and increases in marital conflict. This resilience operates through psychological channels: the intervention builds locus of control and self-efficacy, strengthens family and partner support, and reduces how overwhelmed women feel when shocks arrive. The resulting psychological capital has returns well beyond the treated condition. |
| Keywords: | Resilience, mental health, functioning, spousal conflict, restrictions JEL codes: G18, I12, J12, J16 |
| Date: | 2026 |
| URL: | https://d.repec.org/n?u=RePEc:wrk:warwec:1626 |