Seminar Series

The increase in public insurance eligibility caused by the Affordable Care Act (ACA ) Medicaid expansions may have had spillover effects to other public assistance programs. We explore the impact of the ACA on the Earned Income Tax Credit (EITC), the Supplemental Nutrition Assistance Program (SNAP), and Temporary Assistance to Needy Families (TANF). Our research design uses variation in Medicaid eligibility that occurs on either side of state borders: we examine county-level administrative measures of EITC and SNAP participation in contiguous county pairs that cross state lines and individual data on program participation from the American Community Survey (ACS) in contiguous sub-state geographic units. This approach allows us to focus narrowly on differences arising from the ACA Medicaid expansion choice, implicitly controlling for local economic trends that could affect safety net participation. Our results suggest that the Medicaid expansion increased participation in SNAP and TANF, and possibly in the EITC. The ACS analysis suggests that safety net impacts are mainly due to participation conditional on eligibility rather than from eligibility changes stemming from labor supply responses. It appears that ACA Medicaid eligibility reduced the marginal cost of applying in SNAP, particularly facilitating enrollment in places with low 2013 SNAP take-up rates. Our results demonstrate the potential for spillovers across safety net programs.

This paper revisits the cyclical nature of births and infant health and investigates to what extent the relationship between aggregate labor market conditions and birth outcomes is mitigated by unemployment insurance (UI). We introduce a novel empirical test of standard neoclassical models of fertility that directly tests the prediction of opposite-signed income and intertemporal substitution effects of business cycles by examining the interaction of the aggregate unemployment rate with a measure of potential income replacement from UI. Our results show that as UI benefit generosity reaches 100 percent income replacement, there is no effect of the unemployment rate on births. This implies that the well-documented cyclical nature of births is about access to liquidity. We also provide novel evidence that infant health is countercyclical based on timing of conception, but procyclical based on time in utero. The negative relationship between the in utero aggregate unemployment rate and infant health also disappears when potential UI replacement rates reach 100 percent. Our results imply that the social insurance provided by UI has a pro-natalist effect and improves the health and economic well-being of the next generation.

Dementia risk appears to be greater in socioeconomically disadvantaged neighborhoods, but the reasons why remain unclear. Dr. Reuben investigates social determinants of healthy brain development and aging, focusing on modifiable environmental factors such as air and water quality, natural amenities, and features of the built environment. This talk will focus on Dr. Reuben's recent work investigating neighborhood-based disparities in dementia risk, which seem to result from the geographic aggregation of dementia risk factors (such as poor sleep, diet, and mental health) decades before clinical symptoms typically emerge. Hypotheses about how neighborhoods "get under the skin" will be discussed, along with ideas about how residential neighborhoods may offer potentially novel, scalable opportunities for preventing hard to treat diseases of the aging brain.

I have a $1 billion wager on whether by the year 2150 at least one person will have lived to the age of 150 years. In the more than twenty years since I made the wager, no one has approached the longevity record of 122 years set by Jeanne Calment back in 1997. Yet, I remain optimistic about my chances of winning. This talk will describe four emerging biomedical breakthroughs that support my optimism. There are also reasons to be cautious in one's optimism, mainly having to do with flaws in the way that basic biological breakthroughs are translated to the clinic and the community. My talk will not only describe these emerging breakthroughs but will also elaborate on flaws in our current translational approaches and how to overcome those flaws.

We investigate whether racial disparities in health outcomes worsen as hospitals reach capacity, when rationing on the basis of provider and system biases may become more salient. Using time-stamped electronic health records from two large hospitals, we find that in-hospital mortality increased substantially for Black patients when hospitals approached capacity, but not for White patients. Strain-related increases in racial mortality gaps largest for high-risk patients. We provide evidence of rationing on the basis of wait times, documenting a startling fact: sicker Black patients waited longer for care than healthier White patients at all capacity levels.

The warnings of potential climate migration first appeared in the scientific literature in the late 1970s when increased recognition that disintegrating ice sheets could drive people to migrate from coastal cities. Since that time, scientists have modelled potential climate migration without integrating other population processes, potentially obscuring the demographic amplification of this migration. Climate migration could amplify demographic change -- enhancing migration to destinations and suppressing migration to origins. Additionally, older populations are the least likely to migrate and climate migration could accelerate population aging in origin areas. Here, we investigate climate migration under sea-level rise (SLR), a single climatic hazard, and examine both the potential demographic amplification effect and population aging by combining matrix population models, flood hazard models, and a migration model built on 40 years of environmental migration in the US to project the US population distribution of US counties.

The REWARD study asks whether and how exposure to neighborhood-level disadvantage shapes health inequities via epigenetic mechanisms. REWARD draws on data from the Survey of the Health of Wisconsin (SHOW), a uniquely rich dataset that combines social and health survey measures with residential histories spanning up to five decades, spatio-temporally linked neighborhood conditions, and epigenetic clocks constructed based on DNA methylation in whole blood.

Schools are expected to equip students with the skills to climb the socioeconomic ladder. This paper examines teachers' contributions to this process. To this end, we explore the determinants of Chile's college admission test for the universe of test takers between 2013 and 2021. The analysis exploits unique and rich matched teacher-student data gathered from multiple administrative information sources, allowing us to account for student, school, and teacher characteristics. We implement different decompositions of the production function of cognitive achievement, including value-added specifications.

Major longitudinal studies of aging, including the Survey of Health and Ageing in Europe (SHARE), have used retrospective life history (RLH) interviews to collect earlier life course exposures. However, reliability of RLH data has not been comprehensively evaluated against prospectively collected information. We present initial results from an adaptation of the SHARE RLH interview, fielded with the long-running American's Changing Lives (ACL) study (ACL-LIFE). Retrospectively and prospectively collected reports about different kinds of life events and statuses reveal varying levels of mismatch in reports of the occurrence of events like health shocks, bereavement, and others, with even more discordance in the reported count of events and their timing. The implications of these mismatches and their nonrandom occurrence is discussed in the context of life course analyses of the social determinants of health.