Publications
"The Enduring Effects of Racial Discrimination on Income and Health: Evidence from American Civil War Veterans" Journal of Economic Literature (forthcoming). with Shari Eli and Trevon Logan
Media mentions: VoxEU.
Media mentions: VoxEU.
"Public drug insurance and children’s mental health: Risk-specific responses to lower out- of-pocket treatment costs" Health Economics (2022) 1-21. with Jill Furzer, Maripier Isabelle, and Audrey Laporte
"Mortality of Puerto Ricans in the USA post Hurricane Maria: an interrupted time series analysis" BMJ Open (2022) 12:e058315. with Gustavo Bobonis and Mario Marazzi
Media mentions: NBC News
Media mentions: NBC News
"Political polarization and cooperation during a pandemic" Health Economics (2022) 1-25. with Kirsten Cornelson.
"Inequality in Mortality: Updated Estimates from the United States, Canada and France" Fiscal Studies (2021) 42#1. with Michael Baker, Janet Currie, Hannes Schwandt, and Josselin Thuilliez.
Working Papers
"Is It All Relative? The Health Impacts of Changes to Absolute and Relative Income" (2021) with Maripier Isabelle
This paper aims to disentangle absolute and relative income effects on health, with a focus on mental health. To identify the effect of a change of one's position in the income distribution, we exploit the heterogeneous effects of exogenous movements in the price of oil on the distribution of income. Using hospitalization records linked to census data, we find that oil workers who have many neighbours in the oil industry are less likely, and non-oil workers more likely, to seek hospitalization after oil prices rise. We examine a number of possible explanations for this finding. We show that it is unlikely to be due to a decline in these individuals' real purchasing power. It is consistent, however, with a relative income effect on health. Our results shed new light on mechanisms through which income inequality might affect people's well-being.
"The Long Arm of the Clean Air Act: Pollution Abatement and COVID-19 Racial Disparities", (2020) with Jill Furzer
This paper investigates the role of long-term exposure to fine particulate pollution (PM 2.5) on COVID-19 disparities. To isolate the effect of PM 2.5, we leverage pollution spillovers from neighbouring counties not meeting Clean Air Act-set maximums on acceptable pollution levels. We find a 1-unit increase in cumulative exposure to PM 2.5 increased COVID-19 deaths by 43.5%. PM 2.5 exposure carries an additional race-specific mortality effect of 6.8%-16% for counties with a high proportion of minority or Black residents. However, counties just above CAA pollution thresholds, which had significant pollution reductions over time, saw a full standard deviation reduction in COVID-19 deaths per 100,000. Counties with higher representation of minority or Black residents saw reductions in deaths by 1.50 and 1.15 standard deviations, respectively. Nevertheless, these protective effects insufficiently compensate for the still higher levels of pollution exposure in counties with more Black or minority residents and the more consequential impact of pollution for these communities.
Pharmaceutical promotion, physician response, and opioid abuse: Identifying the role of physicians in the opioid crisis
This paper investigates the role of physicians and their prescriptions in the opioid epidemic. In order to disentangle the supply behaviour of doctors from the demand behaviour of patients, I leverage the staggered introduction of Medicaid expansion across states to exogenously shift opioid supply. Crucially, I argue that Medicaid expansion is composed of two distinct periods. The first is the pre-expansion announcement period. I argue that during the pre-expansion period, because eligible individuals have yet to receive their coverage there is no change in patient demand or disease burden. However, once the policy is announced, physicians and pharmaceutical firms may change their supply-side behaviour in anticipation of future profits from Medicaid expansion. The second period captures the de-facto expansion of health insurance, which is likely to affect patient demand for pharmaceutical products. Focusing my analysis on the announcement period, I show that pharmaceutical firms respond in advance of policy implementation, increasing the number and value of promotions of opioid products to physicians. These effects are driven by counties with the largest program-eligible population. Using difference-in-differences, I identify an increase in prescription opioid sales over this same period. I also find that increased promotions and prescriptions are associated with an increase in opioid-related deaths in the short-run, which do not appear to be persistent 1 year post-announcement.
This paper investigates the role of physicians and their prescriptions in the opioid epidemic. In order to disentangle the supply behaviour of doctors from the demand behaviour of patients, I leverage the staggered introduction of Medicaid expansion across states to exogenously shift opioid supply. Crucially, I argue that Medicaid expansion is composed of two distinct periods. The first is the pre-expansion announcement period. I argue that during the pre-expansion period, because eligible individuals have yet to receive their coverage there is no change in patient demand or disease burden. However, once the policy is announced, physicians and pharmaceutical firms may change their supply-side behaviour in anticipation of future profits from Medicaid expansion. The second period captures the de-facto expansion of health insurance, which is likely to affect patient demand for pharmaceutical products. Focusing my analysis on the announcement period, I show that pharmaceutical firms respond in advance of policy implementation, increasing the number and value of promotions of opioid products to physicians. These effects are driven by counties with the largest program-eligible population. Using difference-in-differences, I identify an increase in prescription opioid sales over this same period. I also find that increased promotions and prescriptions are associated with an increase in opioid-related deaths in the short-run, which do not appear to be persistent 1 year post-announcement.
Work in Progress
"Does Diversity Increase Trust in Science?: Addressing Vaccine Hesitancy Through Representation", with Kirsten Cornelson (Draft available upon request)
While the scientific community largely supports the safety and efficacy of the COVID-19 vaccines, willingness to receive them among the general public has lagged. One possible explanation for this disconnect is that the general public distrusts the objectivity of scientists, particularly given beliefs are typically split along ideological lines. In this paper, we present experimental findings that relate the effectiveness of scientific communication on the COVID-19 vaccine to the identity and diversity of scientists conveying the message. By randomly varying the demographic and political/religious orientation of scientists conveying a positive message about the safety and efficacy of the COVID-19 vaccine, we measure changes in the willingness of participants to receive a vaccine. Our results suggest that we can reduce vaccine hesitancy with relatively simple informational interventions. In particular, statements from scientists who differed from each other demographically (and, to a lesser extent on signals of political orientation) increased participants' willingness to receive the vaccine. We hypothesize that individuals interpret agreement among scientists with different backgrounds as reflecting a more informative signal of consensus within the scientific community.
"Revealing Infant Death Diagnosis Bias Following the Back-to-Sleep Campaign" with Ismael Mourifié and Marc Henry