Natural Health
The rising income gradient in life expectancy in Sweden over six decades
Johannes Hagen et al.
Proceedings of the National Academy of Sciences, 8 April 2025
Abstract:
This study examines the long-term association between income and life expectancy in Sweden between 1960 and 2021. The study is based on register data that include all Swedish permanent residents aged 40 y and older. The results show that the gap in life expectancy between the top and bottom income percentiles widened substantially: For men, it increased from 3.5 y in the 1960s to 10.9 y by the 2010s, and for women, from 3.8 y in the 1970s to 8.6 y by the 2010s. Despite a reduction in income inequality and an expansion of social spending from the 1960s to the 1990s, health inequality continuously increased over the period under study. The changes of the relation between real income and life expectancy, the so-called Preston curve, reveal a much faster improvement in life expectancy in the upper half of the income distribution than suggested by the cross-sectional relation between income and life expectancy. Analysis of causes of death identified circulatory diseases as the main contributor to improved longevity, while cancer contributed more to the increased gap in life expectancy for women and equally for men. Finally, analysis of the change in the income gradient in avoidable causes of death showed the strongest contribution of preventable causes, both for men and women.
Does Despair in Young Adulthood Predict Mortality?
Iliya Gutin & Lauren Gaydosh
Demography, April 2025, Pages 365-379
Abstract:
The trend of increasing U.S. working-age (25–64) mortality is well-documented. Yet, our understanding of its causes is incomplete, and analyses are often limited to using population data with little information on individual behaviors and characteristics. One characterization of this trend centers on the role of despair as a catalyst for self-destructive behaviors that ultimately manifest in mortality from suicide and substance use. The role of despair in predicting mortality at the individual level has received limited empirical interrogation. Using Cox proportional hazards models with behavioral risk factors and latent variable measures of despair in young adulthood (ages 24–32 in 2008–2009) as focal predictors, we estimate subsequent mortality risk through 2022 (298 deaths among 12,277 individuals; 177,628 person-years of exposure). We find that suicidal ideation, suicide attempts, illegal drug use, and prescription drug abuse in young adulthood predict all-cause, suicide, and drug poisoning mortality. Notably, all four domains of despair (cognitive, emotional, biosomatic, and behavioral) and overall despair predict all-cause mortality and mortality from drug poisoning and suicide. This research note provides new empirical evidence regarding the relationship between individual despair and mortality, improving our understanding of the life course contributors to working-age mortality.
Pandemic preparation without romance: Insights from public choice
Alex Tabarrok
Public Choice, forthcoming
Abstract:
The COVID-19 pandemic, despite its unprecedented scale, mirrored previous disasters in its predictable missteps in preparedness and response. Rather than blaming individual actors or assuming better leadership would have prevented disaster, I examine how standard political incentives -- myopic voters, bureaucratic gridlock, and fear of blame -- predictably produced an inadequate pandemic response. The analysis rejects romantic calls for institutional reform and instead proposes pragmatic solutions that work within existing political constraints: wastewater surveillance, prediction markets, pre-developed vaccine libraries, human challenge trials, a dedicated Pandemic Trust Fund, and temporary public–private partnerships. These mechanisms respect political realities while creating systems that can ameliorate future pandemics, potentially saving millions of lives and trillions in economic damage.
Reducing Nutritional Disparities Through Targeted Pricing: Evidence from a Large Restaurant Chain
Weijia (Daisy) Dai, Ginger Zhe Jin & Ben Zou
NBER Working Paper, April 2025
Abstract:
Nutritional disparities across socioeconomic groups contribute to health inequality in the U.S. This paper studies the role of heterogeneous consumer preferences in food choices and explores pricing policies that can promote healthier eating among disadvantaged consumers. Using detailed transaction-level data from a large fast-food restaurant chain, we show that consumers in disadvantaged neighborhoods tend to choose less healthy, higher-calorie items. We estimate a mixed logit discrete choice model to identify consumer preference heterogeneity across demographic groups. Lower-SES consumers display higher price sensitivity across items with varying nutritional quality and show flexibility in substituting between healthy and less healthy options. Counterfactual simulations show that modest, targeted price adjustments in disadvantaged neighborhoods can be an effective tool to reduce nutritional disparities across neighborhoods, with little impact on restaurant revenue or profits.
The Impact of Smoking Bans in Bars on Alcohol Consumption and Smoking
Anne Burton
Journal of Law and Economics, February 2025, Pages 183-214
Abstract:
Governments implemented smoking bans in bars to target smoking-related externalities, but these bans may also affect drinking. This paper studies smoking bans’ effects on alcohol consumption and smoking behavior. I estimate a difference-in-differences model that exploits spatial and temporal variation in smoking bans. Bans result in a 1-drink-per-month (5 percent) increase in intensive-margin alcohol consumption and no economically meaningful effects on smoking. Effects on alcohol consumption are concentrated among current and former smokers. These results imply that smoking bans lead to unintended consequences in the form of increased alcohol consumption.
To stream or not to stream? Watching TV while eating promotes increased calorie consumption, but using a smartphone does not
Angela Incollingo Rodriguez, Mira Kirschner & Lorena Nunes
Physiology & Behavior, 15 May 2025
Method: Under the guise of being a study about multitasking, this research experimentally tested the influence of using technology (either TV or a smartphone) while eating compared to while eating undistracted among college students (N = 114).
Results: Participants ate significantly more while watching TV versus while not. This difference was not observed among those using a smartphone.
Trends in Incidence of Syphilis Among US Adults from January 2017 to October 2024
Duy Do et al.
American Journal of Preventive Medicine, forthcoming
Methods: Using Truveta Data -- a large, diverse database of electronic health records from US healthcare systems -- monthly syphilis incidence from January 2017 to October 2024 was calculated. Poisson regression models were used to assess trends, with adjustments for the early COVID-19 pandemic period.
Results: The analysis included 56,980,788 adults and 21,180 first-time syphilis cases, with a cumulative incidence of 35.9 per 100,000 person-years. Overall, incidence increased from 1.26 per 100,000 person-years in January 2017 to 4.88 in July 2022, then plateaued and declined to 2.47 by October 2024. The decline was larger among populations with high syphilis burdens, including men, younger adults, individuals identifying as American Indian/Alaskan Native or Native Hawaiian/Pacific Islander, those with behaviors associated with STI acquisition, those using Pre-exposure prophylaxis (PrEP) for HIV prevention, and individuals living with HIV. Conversely, incidence rose among populations with lower burdens: those without behaviors associated with STI acquisition, PrEP use, or living with HIV – implying a shift in the transmission dynamics.
Effects of income on infant health: Evidence from the expanded child tax credit and pandemic stimulus checks
Wei Lyu, George Wehby & Robert Kaestner
Journal of Health Economics, May 2025
Abstract:
During the COVID-19 pandemic, the federal government issued stimulus checks and expanded the child tax credit. These payments varied by marital status and the number of children in the household. We exploit this plausibly exogenous variation in income during pregnancy to obtain estimates of the effect of income on infant health. Data are from birth certificates and the sample focuses on mothers with high school or less education. The main estimates indicate that pandemic cash payments had virtually no statistically significant, or clinically or economically meaningful effects on infant health (birth weight, gestational age, and fetal growth outcomes), at least for the range of payments received by most mothers.
A natural experiment on the effect of herpes zoster vaccination on dementia
Markus Eyting et al.
Nature, forthcoming
Abstract:
Neurotropic herpesviruses may be implicated in the development of dementia. Moreover, vaccines may have important off-target immunological effects. Here we aim to determine the effect of live-attenuated herpes zoster vaccination on the occurrence of dementia diagnoses. To provide causal as opposed to correlational evidence, we take advantage of the fact that, in Wales, eligibility for the zoster vaccine was determined on the basis of an individual’s exact date of birth. Those born before 2 September 1933 were ineligible and remained ineligible for life, whereas those born on or after 2 September 1933 were eligible for at least 1 year to receive the vaccine. Using large-scale electronic health record data, we first show that the percentage of adults who received the vaccine increased from 0.01% among patients who were merely 1 week too old to be eligible, to 47.2% among those who were just 1 week younger. Apart from this large difference in the probability of ever receiving the zoster vaccine, individuals born just 1 week before 2 September 1933 are unlikely to differ systematically from those born 1 week later. Using these comparison groups in a regression discontinuity design, we show that receiving the zoster vaccine reduced the probability of a new dementia diagnosis over a follow-up period of 7 years by 3.5 percentage points (95% confidence interval (CI) = 0.6–7.1, P = 0.019), corresponding to a 20.0% (95% CI = 6.5–33.4) relative reduction. This protective effect was stronger among women than men. We successfully confirm our findings in a different population (England and Wales’s combined population), with a different type of data (death certificates) and using an outcome (deaths with dementia as primary cause) that is closely related to dementia, but less reliant on a timely diagnosis of dementia by the healthcare system. Through the use of a unique natural experiment, this study provides evidence of a dementia-preventing or dementia-delaying effect from zoster vaccination that is less vulnerable to confounding and bias than the existing associational evidence.
The effect of smoking cessation on mental health: Evidence from a randomized trial
Katherine Meckel & Katherine Rittenhouse
Journal of Health Economics, March 2025
Abstract:
One in nine Americans smokes cigarettes, and a disproportionate share of smokers suffer from mental illness. Despite this correlation, there exists little rigorous evidence on the effects of smoking cessation on mental health. We re-use data from a randomized trial of a smoking cessation treatment to estimate short and long-term impacts on previously un-analyzed measures of mental distress. We find that smoking cessation increases short-run mental distress, while reducing milder forms of long-run distress. We provide suggestive evidence on mechanisms including physical health, marriage, employment and substance use. Our results suggest that cessation efforts and mental health supports are complementary interventions in the short run and provide new evidence of welfare gains from cessation in the long run.
Cigarette Taxes and the Household Budget
Michael Darden et al.
NBER Working Paper, May 2025
Abstract:
We study the effects of cigarette excise taxes on smokers’ household budgets. In a randomized survey experiment, smokers respond to tax increases by adjusting cigarette shopping behaviors, substituting towards other tobacco products, and reducing both discretionary and human capital-related expenditures. Using Consumer Expenditure Survey data and a quasi-experimental design, we find cigarette taxes reduce smoking prevalence but increase cigarette expenditures among continuing smokers. Additionally, a $1 increase in cigarette taxes causes a 2.12% decline in human capital-related expenditures among below median income smokers. Our work uncovers important unintended consequences of cigarette taxes, particularly for low-income individuals.