Unhealthy
Sleep Duration Among US Adolescents, 1991–2023
Rachel Widome et al.
Pediatrics, forthcoming
Methods: Data were drawn from a nationally representative study, Monitoring the Future, measurement years 1991–2023, which represented cohorts of adolescents born from approximately 1972 to 2011 (n = 401 160). Outcomes were 2 self-reported survey items, one addressing sleep duration and another on subjective sleep sufficiency. Age-period-cohort models were estimated and sociodemographic differences in trends were examined.
Results: Adolescent sleep duration declined with increasing age during every period. Adolescents at every age in the last 10 years were more likely to report inadequate sleep duration compared with teens at those same ages in earlier decades. The period 2021–2023 had the lowest prevalences of getting 7 or more hours of sleep at every age (ranging from 37.2% at age 12 or 13 to 22.3% at 18 or 19). Disparities in sleep duration between non-Hispanic Black and Hispanic/Latino adolescents and their white peers, and between teens whose parents were more vs less educated, emerged and/or grew steadily over time. For instance, Black and white adolescents in 1991–1995 were equally likely to report 7 or more hours of sleep per night (odds ratio [OR] = 0.99 [0.92, 1.07]), but by 2023, Black teens were less likely to report this (OR = 0.79 [0.67, 0.93]).
The Opioid Epidemic and Presidential Elections
Nicole Siegal
American Journal of Health Economics, forthcoming
Abstract:
This paper examines the relationship between early exposure to the opioid epidemic and voting behavior in U.S. presidential elections. After its 1996 national release, OxyContin quickly penetrated local markets, contributing to addiction, economic disruption, and community distress that may have increased demand for political change. I exploit cross-state variation in triplicate prescription laws, which required physicians to produce an additional copy of each opioid prescription for state monitoring and shaped differential exposure to the emergence of OxyContin. In following elections, states without triplicate prescription laws experienced a 2.60 percentage point higher Republican vote share relative to states with these policies. The voting response was nearly twice as large in areas with lower baseline GOP support, approximately three times larger in Southern compared to non-Southern states, and more pronounced in counties with lower employment rates. The results indicate that state policy environments associated with greater opioid exposure were followed by persistent shifts in presidential voting patterns toward the Republican Party.
Pain and Gain: The Opioid Crisis and Financial Adviser Misconduct
Hugh Hoikwang Kim et al.
University of South Carolina Working Paper, May 2026
Abstract:
We document how the opioid crisis reshapes professional conduct in a domain far removed from public health: financial adviser misconduct. Using transaction-level prescription opioid distribution data merged with adviser misconduct records from 2006 to 2019, we find that a one-standard-deviation increase in county-level per capita oxycodone distribution raises the probability of misconduct by 6 percent relative to the sample mean. The staggered adoption of Prescription Drug Monitoring Programs provides a supply-side shock that reduces misconduct accordingly. The evidence is consistent with a social-norm erosion mechanism: opioid exposure predicts lower local social capital and more first-time violations by previously unblemished advisers.
The Effects of GLP-1 Use on Mental Health, Self-rated Health, Employment and Marriage
Robert Kaestner & Cuiping Schiman
NBER Working Paper, May 2026
Abstract:
In this article, we exploit the recent, rapid diffusion of the use of GLP-1 drugs among individuals with diabetes to measure the effect of the use of these drugs on mental health, self-rated health, employment, and marriage. The documented large weight loss from GLP-1 use may plausibly affect these outcomes and evidence of these broader impacts of GLP-1 use is necessary to evaluate their full value. Estimates are obtained using a longitudinal (within-person) regression approach. Results indicate that GLP-1 use is not meaningfully associated with mental health, self-rated health, employment, and marriage. Overall, our analysis adds new evidence about how GLP-1 use is affecting the lives of individuals with diabetes.
Obesity rise plateaus in developed nations and accelerates in developing nations
NCD Risk Factor Collaboration
Nature, 14 May 2026, Pages 510-518
Abstract:
Global reporting of obesity is commonly based on comparisons over multiple decades and lacks a granular and systematic analysis of its dynamics. We used 4,050 population-based studies with measured height and weight data on 232 million participants to assess the worldwide dynamics of obesity from 1980 to 2024. The rise in obesity decelerated in school-aged children and adolescents throughout the 1990s in many high-income countries, and subsequently plateaued in most at age-standardized prevalences spanning 20 percentage points, from 3–4% for girls in Japan, Denmark and France to 23% for boys in the USA. There were indications of a small decline in obesity in children and adolescents in some high-income western countries (for example, Italy, Portugal and France) since the 2000s. Similar trends were seen in some countries in Central and Eastern Europe. In adults, the rise in obesity slowed down in high-income western countries about a decade after children, followed by a plateau or possibly a small reversal of the rise in some countries (for example, Spain). In most low-income and middle-income countries, the annual absolute change in prevalence has remained stable or increased over time, even though prevalence has surpassed that of high-income countries. These highly varied dynamics suggest that the social, economic and technological trends that influence the availability, affordability and use of different foods may have helped control the rise in obesity in high-income countries, but require policy interventions in low-income and middle-income countries.
A century of suicide: Insights from long-term data in the United States
Nina de Lacy et al.
Proceedings of the National Academy of Sciences, 5 May 2026
Abstract:
The 2024 National Strategy for Suicide Prevention identifies suicide as “an urgent and growing public health crisis” driven partly by mental health and overdose rates, the COVID-19 pandemic, and declining social connectedness. Yet, data constraints have limited long-term investigations of suicide trends. Acknowledging limits in data sequence continuity, we constructed the Suicide Trends and Archival Comparative Knowledgebase (STACK), harmonizing data from 1900–2021. Coupling visualizations with Joinpoint regressions, we examine the contemporary suicide crisis in historical perspective. Data reveal patterns that both support and challenge prevailing understandings of suicide risk, trends, and drivers. Overall, we document a cyclical, dampening, and downward-trending pattern of suicide over 120 y, contrasting sharply with trends in other causes of death. However, this trend is offset by a sharp rise and unique patterning for persons under 35, beginning in the mid-to-late 1950s. The contemporary “youth crisis” spans a broader age range and begins much earlier than typically acknowledged. Each successive generation faces risk at younger ages, accompanied by a startling rise in suicide by hanging since the 1980s among both males and females. Despite ongoing concerns about rural populations and the elderly, living in large metropolitan areas (versus suburban and rural areas) and being older have recently emerged as protective factors. While analyses by race or rurality remain limited to the last half century because of data availability, the long-term temporal, geographic, and sociodemographic complexity of suicide mortality trends offers critical insights and intriguing avenues for next-generation research, treatment, and prevention efforts.
Mortality Rates by Race and Ethnicity Among People with Disabilities
Madeline Helfer, Becky Staiger & Jessica Van Parys
NBER Working Paper, May 2026
Abstract:
This paper uses Medicaid claims data from 2017-2021 to measure racial/ethnic disparities in mid-life mortality among low-income adults with disabilities receiving Supplemental Security Income (SSI). We find that American Indian and Alaska Native and White SSI recipients have the highest age-adjusted mid-life mortality rates (2.9% and 2.6%, respectively), followed by Black and Hispanic recipients (2.3% and 1.9%), and then Asian recipients (1.6%). We also find differences in diagnosed chronic conditions, "despair-related" conditions, substance use disorders, and disabling conditions by race/ethnicity. Controlling for these differences attenuates the White-Hispanic, White-Asian, and AIAN-White mortality gaps; however, differences in clinical diagnoses by race do not affect the White-Black mortality gap. Our results show that within a socioeconomically vulnerable population, Black adults outlive Whites.
Recreational Marijuana Laws and Racial Disparities: New Evidence on Arrests and Deaths of Despair
Zachary Fone, Gokhan Kumpas & Joseph Sabia
Journal of Law and Economics, May 2026, Pages 251-284
Abstract:
Proponents of recreational marijuana laws (RMLs) argue that expanding legal access to marijuana may serve an important social justice objective by reducing racial disparities in arrest rates. Using data from the Uniform Crime Reports and a generalized difference-in-differences approach, we find support for this claim: RML adoption is associated with a reduction of 498–561 marijuana arrests per 100,000 persons (over 90 percent) among Black adults and a reduction of 128–145 arrests (78–88 percent) among White adults. However, we find no evidence that RML adoption reduces racial disparities in nonmarijuana drug arrests or arrests for property and violent crimes, and post-RML reallocation of policing resources to fight nonmarijuana drug crime and violent crime may, in some circumstances, widen these racial disparities. Finally, RMLs reduce opioid-related mortality among non-Hispanic Whites relative to Blacks and Hispanics, consistent with the hypothesis that those hardest hit at the outset of the US opioid epidemic disproportionately gain from recreational marijuana legalization.
Mystery shopper assessments of cannabis retailer practices and regulatory compliance in five U.S. states, 2025
Carla Berg et al.
Drug and Alcohol Dependence, forthcoming
Methods: This mystery shopper study assessed 130 cannabis retailers in 5 cities (Los Angeles [LA], California; Las Vegas [LV], Nevada; Denver, Colorado; Portland, Oregon; Seattle, Washington) in summer 2025. Researchers recorded: 1) age verification; and 2) retail staff responses to inquiries about: a) use for anxiety, sleep, pregnancy-related nausea, etc.; b) use-related risks/cautions; c) interstate cannabis transport; and d) availability of derived intoxicating cannabis products (DICPs) and ‘mushrooms’ (psilocybin).
Results: Mystery shoppers were asked for ID at 87.7% of retailers. When asked, most (>88%) retail staff responded that cannabis helps with anxiety and insomnia. While 40.8% warned against use for pregnancy-related nausea, 36.2% suggested it helps and 24.6% said it depends on the person/situation. Over half (58.5%) warned against driving post-use, but 50.0% said it depends (on person/situation). When asked about interstate transport, several indicated not to (42.3%) and/or it was illegal (39.2%); however, 44.6% indicated ways to pack cannabis to be undetectable, and 27.7% said not to worry about getting caught. Retail staff generally indicated DICPs are not as safe as delta-9 THC (27.7%) or are illegal (20.0%). The majority said mushrooms were illegal (67.7%), but 53.8% indicated they were easy to obtain, and 29.2% suggested their mental health benefits.
Exploring the quantitative impact of medical marijuana dispensaries on residential sale prices in Oklahoma
Joshua Clark & Michael Delgado
Empirical Economics, April 2026
Abstract:
Medical marijuana was legalized in Oklahoma as recently as 2018, and since then Oklahoma has rapidly grown to have the largest number of medical marijuana dispensaries of any states in the USA. What have been the impacts of this rapid proliferation of legalized medical marijuana? We use a hedonic pricing model to assess how legalized marijuana dispensary activity (both distance to the nearest dispensary and the number of nearby dispensaries) has impacted residential property values. The dataset spans six different counties from across the State of Oklahoma, and we explore a variety of different regression specifications to rigorously explore the effects of dispensary activity on local residents. While we find evidence of some heterogeneity in the dispensary effects, one broad finding is that residents prefer not to live in immediate proximity to a dispensary but prefer access to dispensaries moderately distanced from their home. Understanding these broad trends and the localized heterogeneity in effects are important for residents and policymakers alike in Oklahoma and in other states that may be considering similar legislation.