Healthy Folks
The Rise in American Pain: The Importance of the Great Recession
Sneha Lamba & Robert Moffitt
NBER Working Paper, July 2023
Abstract:
A significant literature has documented trend increases in pain among Americans over the last two or three decades. There is no single explanation seeming to work well for the increase. We show that, rather than resulting from a smooth upward trend, the increase was almost entirely concentrated in the 2007-2010 period, the time of the Great Recession, a result not uncovered in prior work. The disproportionate increase in pain among the less educated is also shown to have occurred primarily at the time of the Recession, with either little or no trend before or after. The Recession jump occurred only at older ages and, by cohort, primarily only at the ages when they experienced the Recession. However, the jump is difficult to explain, for while there was a temporary decline in employment during the Recession, it is unclear why it should be followed by a permanent increase in pain. We assess a number of explanations related to family structure, the deterioration of family life, hysteresis, and biopsychosocial channels. While some factors have potential explanatory power, the rise in pain continues to be mysterious and deserves further research in light of our new findings.
The highs and the lows: Recreational marijuana laws and mental health treatment
Alberto Ortega
Health Economics, forthcoming
Abstract:
Recreational marijuana laws (RMLs) continue to grow in popularity, but the effects on mental health treatment are unclear. This paper uses an event-study within a difference-in-differences framework to study the short-run impact of state RMLs on admissions into mental health treatment facilities. The results indicate that shortly after a state adopts an RML, they experience a decrease in the average number of mental health treatment admissions. The findings are driven by white, Black, and Medicaid-funded admissions and are consistent for both male and female admissions. The results are robust to alternative specifications and sensitivity analysis.
Environmental inequality and disparities in school readiness: The role of neurotoxic lead
Jared Schachner & Geoffrey Wodtke
Child Development, forthcoming
Abstract:
Developmental science has increasingly scrutinized how environmental hazards influence child outcomes, but few studies examine how contaminants affect disparities in early skill formation. Linking research on environmental inequality and early childhood development, this study assessed whether differences in exposure to neurotoxic lead explain sociodemographic gaps in school readiness. Using panel data tracking a representative sample of 1266 Chicago children (50% female, 16% White, 30% Black, 49% Hispanic, μage = 5.2 months at baseline, collected 1994–2002), analyses quantified the contribution of lead contamination to class and racial disparities in vocabulary skills and attention problems at ages 4 and 5. Results suggested that lead contamination explains 15%–25% and 33%–66% of the disparities in each outcome, respectively, although imprecise estimates preclude drawing firm inferences about attention problems.
To What Extent are Trends in Teen Mental Health Driven by Changes in Reporting? The Example of Suicide-Related Hospital Visits
Adriana Corredor-Waldron & Janet Currie
NBER Working Paper, July 2023
Abstract:
Rising reports of suicidal behaviors in children and adolescents have led to the recognition of a youth mental health crisis. However, reported rates can be influenced by access to screening and changes in reporting conventions, as well as by changes in social stigma. Using data on all hospital visits in New Jersey from 2008-2019, we investigate two inflection points in adolescent suicide-related visits and show that a rise in 2012 followed changes in screening recommendations, while a sharp rise in 2016-2017 followed changes in the coding of suicidal ideation. Rates of other suicidal behaviors including self-harm, attempted suicides, and completed suicides were essentially flat over this period. These results suggest that underlying suicide-related behaviors among children, while alarmingly high, may not have risen as sharply as reported rates suggest. Hence, researchers should approach reported trends cautiously.
The effect of e-cigarette taxes on prepregnancy and prenatal smoking
Rahi Abouk et al.
Journal of Policy Analysis and Management, forthcoming
Abstract:
E-cigarette taxes are an active area of legislation and have important regulatory implications by proxying e-cigarette accessibility. We examine the effect of e-cigarette taxes on prepregnancy and prenatal smoking using the near-universe of births to mothers conceiving between 2013 and 2019 in the United States. Using fixed effect regressions, we show that e-cigarette taxes increase prepregnancy and prenatal smoking. We also find evidence that e-cigarette taxes reduce prepregnancy and 3rd trimester e-cigarette use. Finally, we show that e-cigarette taxes increase news coverage of e-cigarettes and raise perceptions of risk of e-cigarettes.
The human milk component myo-inositol promotes neuronal connectivity
Andrew Paquette et al.
Proceedings of the National Academy of Sciences, 25 July 2023
Abstract:
Effects of micronutrients on brain connectivity are incompletely understood. Analyzing human milk samples across global populations, we identified the carbocyclic sugar myo-inositol as a component that promotes brain development. We determined that it is most abundant in human milk during early lactation when neuronal connections rapidly form in the infant brain. Myo-inositol promoted synapse abundance in human excitatory neurons as well as cultured rat neurons and acted in a dose-dependent manner. Mechanistically, myo-inositol enhanced the ability of neurons to respond to transsynaptic interactions that induce synapses. Effects of myo-inositol in the developing brain were tested in mice, and its dietary supplementation enlarged excitatory postsynaptic sites in the maturing cortex. Utilizing an organotypic slice culture system, we additionally determined that myo-inositol is bioactive in mature brain tissue, and treatment of organotypic slices with this carbocyclic sugar increased the number and size of postsynaptic specializations and excitatory synapse density. This study advances our understanding of the impact of human milk on the infant brain and identifies myo-inositol as a breast milk component that promotes the formation of neuronal connections.
Accelerometer-Derived “Weekend Warrior” Physical Activity and Incident Cardiovascular Disease
Shaan Khurshid et al.
Journal of the American Medical Association, 18 July 2023, Pages 247-252
Design, Setting, and Participants: Retrospective analysis of UK Biobank cohort study participants providing a full week of accelerometer-based physical activity data between June 8, 2013, and December 30, 2015.
Exposures: Three MVPA patterns were compared: active weekend warrior (active WW, ≥150 minutes with ≥50% of total MVPA achieved in 1-2 days), active regular (≥150 minutes and not meeting active WW status), and inactive (<150 minutes). The same patterns were assessed using the sample median threshold of 230.4 minutes or more of MVPA per week.
Main Outcomes and Measures: Associations between activity pattern and incident atrial fibrillation, myocardial infarction, heart failure, and stroke were assessed using Cox proportional hazards regression, adjusted for age, sex, racial and ethnic background, tobacco use, alcohol intake, Townsend Deprivation Index, employment status, self-reported health, and diet quality.
Results: A total of 89 573 individuals (mean [SD] age, 62 [7.8] years; 56% women) who underwent accelerometry were included. When stratified at the threshold of 150 minutes or more of MVPA per week, a total of 37 872 were in the active WW group (42.2%), 21 473 were in the active regular group (24.0%), and 30 228 were in the inactive group (33.7%). In multivariable-adjusted models, both activity patterns were associated with similarly lower risks of incident atrial fibrillation (active WW: hazard ratio [HR], 0.78 [95% CI, 0.74-0.83]; active regular: 0.81 [95% CI, 0.74-0.88; inactive: HR, 1.00 [95% CI, 0.94-1.07]), myocardial infarction (active WW: 0.73 [95% CI, 0.67-0.80]; active regular: 0.65 [95% CI, 0.57-0.74]; and inactive: 1.00 [95% CI, 0.91-1.10]), heart failure (active WW: 0.62 [95% CI, 0.56-0.68]; active regular: 0.64 [95% CI, 0.56-0.73]; and inactive: 1.00 [95% CI, 0.92-1.09]), and stroke (active WW: 0.79 [95% CI, 0.71-0.88]; active regular: 0.83 [95% CI, 0.72-0.97]; and inactive: 1.00 [95% CI, 0.90-1.11]). Findings were consistent at the median threshold of 230.4 minutes or more of MVPA per week, although associations with stroke were no longer significant (active WW: 0.89 [95% CI, 0.79-1.02]; active regular: 0.87 [95% CI, 0.74-1.02]; and inactive: 1.00 [95% CI, 0.90-1.11]).
Unemployment, Alcohol and Tobacco Use: Separating State Dependence from Unobserved
Monica Deza
NBER Working Paper, July 2023
Abstract:
Previous literature presents mixed evidence on the effect of alcohol consumption on labor market outcomes. On one hand, heavy alcohol consumption has been shown to have detrimental effects on labor market outcomes. On the other hand, moderate consumption is positively associated with wages and employment. Despite substantial reduced form evidence, previous literature has not been able to separately identify the causal pathways linking moderate versus heavy alcohol use to labor market performance due to the lack of natural experiments that only target moderate versus heavy drinking, as well as limitations of available structural methods that model state dependence and unobserved heterogeneity. This study develops a multiple-equation dynamic discrete choice ordered logit model, which allows separate identification of the contribution of state dependence (within and between outcomes) and unobserved heterogeneity. I apply this newly-developed model to differentiate the effects of moderate and heavy drinking, after accounting for other correlated unobserved heterogeneity. This study finds that moderate alcohol use increases employment, which is consistent with moderate alcohol consumption being a venue for social capital accumulation. Policies that target alcohol consumption separately by dosage level may be beneficial to employment in ways that have not previously been expected.
In Utero and Childhood Exposure to Alcohol and Old Age Mortality: Evidence from the Temperance Movement in the US
Hamid Noghanibehambari & Jason Fletcher
Economics & Human Biology, forthcoming
Abstract:
Previous research suggests the relevance of in-utero insults and early-life circumstances for a wide array of life cycle outcomes. This research note joins this strand of studies by exploring the long-run mortality effects of in-utero and early-life exposure to alcohol accessibility. In so doing, we take advantage of the prohibition movement during the early part of the twentieth century that generated quasi-natural reductions in alcohol consumption. We use Social Security Administration Death Master Files linked to the full-count 1940 census and compare the longevity of male individuals exposed to the prohibition during in-utero and early childhood (1900-1930) as a result of statewide and federal alcohol ban to those wet counties after the law change to before. The results suggest an intent-to-treat effect of 0.17 years higher longevity as a result of prohibition. A back-of-an-envelope calculation suggests a minimum treatment-on-treated effect of 1.7 years impact. Furthermore, we show that these effects are not driven by other county-level demographic and socioeconomic changes, endogenous selection of births, and preexisting trends in the outcome. Our findings contribute to the growing body of research that explores the in-utero and childhood circumstances on long-term health outcomes.
Later-life Mortality and the Repeal of Federal Prohibition
David Jacks et al.
NBER Working Paper, July 2023
Abstract:
Despite a recent and dramatic re-evaluation of the health consequences of alcohol consumption, very little is known about the effects of in utero exposure to alcohol on long-run outcomes such as later-life mortality. Here, we investigate how state by year variation in alcohol control arising from the repeal of federal prohibition affects mortality for cohorts born in the 1930s. We find that individuals born in wet states experienced higher later-life mortality than individuals born in dry states, translating into a 3.3% increase in mortality rates between 1990 and 2004 for affected cohorts.