Lectures 2 & 3 Flashcards
Think back to Almond, Douglas, and Janet Currie. “Killing me softly: The fetal origins hypothesis” What is the Fetal origins hypothesis?
Argues that the in utero environment, nutrition in particular, “programs” the fetus to have particular metabolic characteristics, which can lead to future disease.
These effects are persistent and can remain latent for many years before manifesting themselves
Consider the paper - Almond, Douglas
“Is the 1918 influenza pandemic over? Long-term effects of in utero influenza
exposure in the post-1940 US population”
What was the research question, main observations and what were the main findings?
They tested the fetal origins hypothesis using the 1918 influenza pandemic in the US
It arrived in the fall of 1918 and largely subsided by January 1919 implying that cohorts born months apart faced different infection rates.
Mortality rates varied widely across states in the country, suggesting there were within cohort differences in fetal exposure to the pandemic
The pandemic lead to worse educational and labor market outcomes:
- Schooling was reduced by 0.25 years
- Graduation rates fell by 0.03 pp
- Income fell about 6%
- Poverty increased by 1.5 pp
Consider the paper - Butikofer, Aline, and Kjell G. Salvanes
“Disease control and inequality reduction: Evidence from a tuberculosis testing and
vaccination campaign” What was the research question, main observations and what were the main findings?
Research area was to study the impact of a TB testing and vaccination program that commenced in Norway in 1947 - vaccinations became compulsory
Teenagers had the highest rates of new active TB infections in 1946 before the campaign and by 1960 this dropped to below the population average.
- Large variation in across municipalities meant that highly infected areas saw a larger decline in TB infection rates.
- The campaign boosted school attendance and is expected to have long term effects on accumulated human capital
- Effects on education seem modest compared to effects in earnings so other channels are likely at play (such as physical health as it directly impact job pay)
- They also find that education and earnings effects persist onto the next generation
Consider the paper - Almond, Douglas, Lena Edlund, and Marten Palme
“Chernobyl’s subclinical legacy: prenatal exposure to radioactive fallout and school
outcomes in Sweden”: What was the research question, main observations and what were the main findings?
Investigate the effect of exposure to 1986 Chernobyl fallout in Sweden - weather conditions caused it to receive about 5% of the accident’s cesium fallout.
Furthermore, variation in rainfall levels while the radioactive plume was over Sweden created geographic variation in the levels of fallout.
- Focus of study was on cohort between 8 - 25 weeks of gestation (developmental phase of fetus) at the time of the accident, born in the fall of 1986.
- Placebo are those born between Feb-May 1986 (not affected by disaster)
They test for health outcomes (birth weight, hospitalizations during childhood) and educational outcomes (test performance in compulsory middle school and grade performance in high school)
Results:
- Find a drop in average grades and an even larger drop in mathematics grades - Results are stronger in family fixed effects model (siblings compared) which implies that parents respond by allocating less to affected child which reinforces the initial shock.
- Similarly negative effects observed on high school grades but of lower magnitude presumably due to positive selection.
- No differences in health outcomes.
Consider the paper - Feyrer, James, Dimitra Politi, and David N. Weil
“The cognitive effects of micronutrient deficiency: Evidence from salt iodization in
the United States”: What was the research question, main observations and what were the main findings?
Physiological studies suggest that iodine deficiency has a negative effect on cognitive function at all ages, particularly detrimental during gestation - WHO claims that iodine deficiency is the leasing cause for preventable mental retardation in the world
This paper looks at the Nationwide distribution of iodine fortified salt which began in 1924 in the US and the effect it had using military data collected during WWI and II on the IQ scores.
They use goiter (small lumps on neck cause by the thyroid gland swelling due to iodine deficiency) as a indication of Iodine intake.
Results:
- High rates of iodine are associated with a lower goiter prevalence
- For recruits from high goiter states (low iodine) , they observed an increased in average test score of one sd.
- sudden large intake of iodine can cause iodine-induced hyperthyroidism, which is fatal; they estimate that iodization caused at least 10,000 deaths over 1925-1942 and they find a large rise in thyroid-related deaths in iodine deficient regions.
Consider the paper - Lundborg, Petter, Dan-Olof Rooth, and Jesper Alex-Petersen
“Long-term effects of childhood nutrition: Evidence from a school lunch reform”: What was the research question, main observations and what were the main findings?
They evaluate a program that rolled out school lunches free of charge to all pupils in Swedish primary school between 1959-1969 which imposed strict nutritional standards on the meals.
Studied the outcomes from income and education registers, the military enlistment registers, and other medical registers. The program was rolled our in a staggered way in the country causing variation in years of exposure within the cohort.
Results:
- Free school lunches throughout primary school are associated with 3% higher income; due to effects on education and health: 0.28 more years of schooling and 1.5 pp higher probability of attending university
- gained around 0.6-0.7 cm in height
- children in the lowest quartile of household income benefitted the most and had a 5.8% increase in income.
- Do not find that birth weight and other health outcomes of the next generation was affected by exposure.
Consider the paper - Marcus, Michelle
“Testing the water: Drinking water quality, public notification, and child outcomes”: What was the research question, main observations and what were the main findings?
The study combines the data on water quality violations and detailed geographic information on community water supply system service from North Carolina.
- focus on violations in the water supplied to a residential post code
- distinguish between acute and monthly violations where the former require immediately notifying the public
investigate the costs in terms of:
- avoidance behavior: purchase of bottled water
- direct health
- other health proxies
Results:
- Bottled water sales increase only during acute coliform violations when public notice is required within 24 hours
- Monthly coliform violations increase the purchase of common stomach remedies and of ER admissions for gastrointestinal illness
IMPORTANT:
- The effect is stronger for (younger) school age children and led to higher levels of school absenteeism
- no negative effects for acute violations so avoidance seems to work.
Consider the paper - Nilsson, J. Peter
“Alcohol availability, prenatal conditions, and long-term economic outcomes”: What was the research question, main observations and what were the main findings?
investigated a policy that temporarily allowed the sale of strong beer in regular grocery stores in certain regions of Sweden at the end of 1968 (but was repelled after only 8.5 months).
- 21 was the legal age of drinking but beer purchases at regular stores was legal from 16 years of age
This paper considers as affected those children born in reform region conceived by young mothers before the policy (exposed in utero from 1st half of pregnancy) and uses administrative data to assess the effects on educational and labor market outcomes as well as military data for cognitive outcomes
Results:
- Large increase in the consumption of strong beer
- The policy change had a stronger negative effect on boys in particular
- Prenatal exposure to the policy decreases both average cognitive and non cognitive test scores
- Affected individuals are also more likely to collect welfare payments as adults
- Effects are driven by the group of low socio economic status individuals suggesting that higher parental resources cushion the effect.
Consider the paper - Black, Sandra, Paul Devereux, and Kjell G Salvanes
“From the Cradle to the Labor Market? The Effect of Birth Weight on Adult Outcomes”: What was the research question, main observations and what were the main findings?
The study uses data from Norway on all births, linking birth registries with data on birth-weight to administrative and military records from later life outcomes.
- Use a well-established methodology which compares the outcomes of genetically identical twins with different birth weights (differences in birth-weight are due to differences in utero nutrition intake which are thought to be random
Results:
- Within twin comparisons show that a 10% increase in birth-weight
- increases the IQ score by 0.06
- increases the probability of high school completion by close to 1 pp.
- Raises full time earnings by 1.5% for women
IMPORTANT:
Outcomes improve as birth weight rises but the relationship is non-linear: very low weight babies have substantially worse outcomes
- Figlio et al. find something similar with negative relationships between weight and test scores holding through elementary and middle school years
- they find the effects are determined in childhood or early school years
- high quality schools improve outcomes for all children more or less equally
Consider the paper - Bharadwaj, Prashant, Katrine Vellesen Loken, and Christopher Neilson “Early life health interventions and academic achievement”: What was the research question, main observations and what were the main findings?
Evaluates the Very Low Birth Weight (less than 1,500 grams) classification, which assigns infants special care at a specific birth weight cutoff .
Use a Regression Discontinuity analysis (RDD) to compare children right below (received special care) to children right above the cutoff (did not receive cutoff) in order to argue that inequalities in health care starting at birth can affect later life outcomes.
- Children below 1,500 grams are 4.4 (3.1) percentage points less likely to die within a year compared to children just above 1.500 grams in Chile (Norway)
- Gains in test performance are around 0.15-0.22 sd depending on the outcome
- A similar study found that exposure to lead is linked to cognitive deficits and behavioral problems in children
- The study takes advantage of a US policy that recommends that children aged 1/2 are tested and if lead levels above a certain threshold are found twice this triggers an intervention.
- They use an RDD to compare children whose lead levels are twice above (eligible) to those whose lead levels are once above (ineligible) the threshold.
- They find that eligibility before school start is associated with higher primary and middle school performance; negative lead effects are largely reversed.
Consider the paper - Amarante, Veronica, Marco Manacorda, Edward Miguel, and Andrea Vigorito “Do Cash Transfers Improve Birth Outcomes? Evidence from Matched Vital Statistics, Program, and Social Security Data: What was the research question, main observations and what were the main findings?
Studies the impact of in utero exposure to a Uruguayan unconditional cash transfer targeted towards the poor called PANES which was in place between 2005-2007
Eligible households were entitled to a monthly cash transfer whose value was originally set a 102$ PPP terms
Program assignment depended on a discontinuous function of a baseline predicted income score. They compare the children’s outcomes depending on mothers being above or below the eligibility threshold.
IMPORTANT RESULTS:
- Program exposure significantly reduces the incidence of a range of birth weights below 3000 grams, effects grow at a lower birth-weights and show an overall 20% drop in the probability of being low-weight.
-Find no evidence that the program resulted in higher healthcare utilization or better quality health care usage.
- Find suggestive evidence that improved maternal nutrition is driving the results
- 11.6% of female participant experienced substantial undernutrition
- did not affect the gestation period but still increased fetal growth
also consistent with evidence from the US showing that the intro of the Food Stamp Program resulted in higher birthweight.
Consider the paper - Aizer, Anna, Shari Eli, Joseph Ferrie, and Adriana Lleras-Muney
“The Long-Run Impact of Cash Transfers to Poor Families”: What was the research question, main observations and what were the main findings?
Studied the Mother’s pension program (1911-1935) - the first govt sponsored welfare program for poor mothers with dependent children in the US
Gathered data on thousands of accepted and rejected applicants 1900-1925: long panel data allow tracing the later life outcomes of their children
Studied the effects on children’s longevity, probability of being underweight, educational attainment and income
IMPORTANT RESULTS:
- Estimates show that children of accepted applicants lived approximately one year longer
-Effect is stronger for those with a predicted income below the median
- Accepted boys receive 0.3-0.4 more years of schooling and are more likely to have graduated high school
- Accepted boys have on average 14% higher income in young adulthood
- accepted boys have a higher weight and BMI and lower probability of being underweight.
-Similar study analyzed one off 2500 euro unconditional universal cash transfer in Spain given to all new mothers in Span after July 1 2007.
- They find no effect of the income shock on a variety of health outcomes from birth to middle school and no effect on test scores during primary school
– The lack of effect is likely due to no targeting of the program and its unconditional nature; also maternity leave, health and child care are universal in Spain so financial resources do not determine access
Consider the paper - Reichert, Arndt R
Obesity, weight loss, and employment prospects: Evidence from a
randomized trial: What was the research question, main observations and what were the main findings?
In a 4 month RCT in Germany with obese individuals (with BMI over 30) where treated individuals received upto 150 or 200 euros for reaching target weight.
They argue that the monetary rewards only create incentives to reach target weight but do not alter substantially the household budget
They study the effect of weight loss on the probability of finding a job for those who are at the time of experiment
IMPORTANT RESULTS:
- the financial incentives had an effect and treated reduced their BMI more that the control
- Obese women who lose weight improve their employment prospects
- No significant effect for men
- A reduction in BMI increases the probability of remaining employed and (though insignificant) of finding employment among women
- Self assessed physical well-being (confidence): improves for women as weight declines but not for men
Consider the paper - Jolivet, Gregory, and Fabien Postel-Vinay “A Structural Analysis of Mental Health and Labor Market Trajectories”: What was the research question, main observations and what were the main findings?
investigates the question of how mental health effects labor market trajectories, while allowing for job characteristics to affect mental health as well.
- feedback from mental health to work and vice versa
- Focus on heterogeneity with respect to age so distinguish between effects at 30-50
IMPORTANT RESULTS:
- Losing a median-wage/ medium stress job at age 30 causes a very persistent increase in the probability of being in bad health
- Losing such a job results in higher unemployment rate and substantially lower income after 5 years and this effect is stronger for the old.
-THE EFFECT OF A SEVERE HEALTH SHOCK:
- As the shock increases the disutility of working it increases the probability of being unemployed for up to 5 years for later with the effect being smaller for the young
the willingness to pay for non-stressful jobs is much higher for older workers in sever health
The effect of an increase in the job stress content:
- Permanently raises the probability to be in bad health by up to 3-4%
- not significant for jobs that pay relatively well, but results in a higher chance of unemployment for workers in low paying occupations.
Consider the paper - French, Eric, and John Bailey Jones “Health, health insurance, and retirement: a survey”: What was the research question, main observations and what were the main findings?
Focuses on single measure of health at old age: mortality
-investigates how an increase in mortality (or bad health more generally) affects retirement decisions
- can increase the utility from leisure
- can lower productivity resulting in lower wage offers
- lower life expectancy means one does not need to accumulate so much wealth
- if health is sufficiently bad one may qualify for disability benefits
Despite recent increases in life expectancy, old age employment has been declining; reversal in many countries since 1990
- linked to the generosity of the public pension schemes during the period
- Employment rates are significantly lower for the unhealthy
- but even if unhealthy men did not work at all their declining health could explain only a fraction of retirement
IMPORTANT:
– The healthy earn slightly more at each age but this likely understates the true effect of health on wages due to individuals exiting employment when health worsens.
Consider the paper - Blundell, R., Britton, J., Dias, M. C., & French, E. “The impact of health on labor supply near retirement”: What was the research question, main observations and what were the main findings?
contribution is to combine objective measures (health conditions) with subjective ones (self- reported health status) using data on older individuals from the US and England to highlight the importance of the institutional setting; compare low and high education individuals.
Results:
- Health deterioration explains between 3% and 15% of the employment decline in old age
Changes in health explain:
- A higher share of the decline in employment among the high school dropouts (less educated) than among those with college degrees (demands of the job)
- A higher share of the decline in employment among men than among women (particularly among the less educated)
- A higher share of the decline in employment in Europe than in the US.
Consider the paper - Maestas, Nicole, Matt Messel, and Yulya Truskinovsky
“Caregiving and Labor Supply: New Evidence from Administrative
Data”: What was the research question, main observations and what were the main findings?
This study documents the dynamic effects around the start of caregiving using survey data on care provision and labor market outcomes form administrative sources
- Compares caregivers to individuals who have smiilar demographics as well as earnings and employment trajectories for a decade before the start of the episode
IMPORTANT RESULTS:
- Find that the start of caregiving coincides with decreases in employment and earnings: large differences between men and women
-Men experience large downward swings in earning and employment before the start of the caregiving episode
- Women experience immediate reductions in earning and employment at the onset of the episode; return to precaregiving trends within 5 years
Consider the paper - Fadlon, Itzik, and Torben Heien Nielsen “Family labor supply responses to severe health shocks: Evidence from Danish administrative records”: What was the research question, main observations and what were the main findings?
Studies the consequences of fatal and severe non fatal health events on the spousal labor supply responses of immediate family members.
IMPORTANT RESULTS:
- Find a significant rise in spousal labor supply after a fatal event particularly when the diseased had a large share of household income and govt transfers are weak: driven by widows
- Upon a non fatal event, if household post-transfer (disability insurance) income declines only slightly and there is no spousal labor supply response on average.
- Four years after the event, the increase in the surviving spouses’ participation amounts to 7.6% and the increase in annual earnings is 6.8%
- The sick person’s annual earning drop with 18%, total household income with 3.4%
