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Analysts who have concluded that inequality in life expectancy is increasing have generally focused on life expectancy at age 40 to 50. However, we show that among infants, children, and young adults, mortality has been falling more quickly in poorer areas with the result that inequality in mortality has fallen substantially over time. This is an important result given the growing literature showing that good health in childhood predicts better health in adulthood and suggests that today's children are likely to face considerably less inequality in mortality as they age than current adults. We also show that there have been stunning declines in mortality rates for African-Americans between 1990 and 2010, especially for black men. The fact that inequality in mortality has been moving in opposite directions for the young and the old, as well as for some segments of the African-American and non-African-American populations argues against a single driver of trends in mortality inequality, such as rising income inequality. Rather, there are likely to be multiple specific causes affecting different segments of the population.
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There is continuing controversy about the extent to which publicly insured children are treated differently than privately insured children, and whether differences in treatment matter. We show that on average, hospitals are less likely to admit publicly insured children than privately insured children who present at the ER and the gap grows during high flu weeks, when hospital beds are in high demand. This pattern is present even after controlling for detailed diagnostic categories and hospital fixed effects, but does not appear to have any effect on measurable health outcomes such as repeat ER visits and future hospitalizations. Hence, our results raise the possibility that instead of too few publicly insured children being admitted during high flu weeks, there are too many publicly and privately insured children being admitted most of the time.
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We use United States birth record data to estimate the effect of e-cigarette minimum legal sale age laws on cigarette use and birth outcomes for pregnant teenagers. While these laws may have reduced e-cigarette use, we hypothesize that these laws may have also increased cigarette use during pregnancy by making it more difficult to use e-cigarettes to reduce/quit smoking. We use cross-sectional and panel data models to find that e-cigarette minimum legal sale age laws increase underage pregnant teenagers' smoking by 2.1 percentage points. The laws may have also modestly improved select birth outcomes, perhaps by reducing overall nicotine exposure from vaping and smoking combined.
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We construct a unique individual-level longitudinal dataset linking preschool blood lead levels with third grade test scores for eight birth cohorts of Rhode Island children born between 1997 and 2005. Using these data, we show that reductions of lead from even historically low levels have significant positive effects on children's reading test scores in third grade. Our preferred estimates use the introduction of a lead remediation program as an instrument in order to control for the possibility of confounding and for considerable error in measured lead exposures. The estimates suggest that a one unit decrease in average blood lead levels reduces the probability of being substantially below proficient in reading by 3.1 percentage points (on a baseline of 12 percent). Moreover, as we show, poor and minority children are more likely to be exposed to lead, suggesting that lead poisoning may be one of the causes of continuing gaps in test scores between disadvantaged and other children.
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Analysts who have concluded that inequality in life expectancy is increasing have generally focused on life expectancy at age 40 to 50. However, we show that among infants, children, and young adults, mortality has been falling more quickly in poorer areas with the result that inequality in mortality has fallen substantially over time. This is an important result given the growing literature showing that good health in childhood predicts better health in adulthood and suggests that today's children are likely to face considerably less inequality in mortality as they age than current adults. We also show that there have been stunning declines in mortality rates for African-Americans between 1990 and 2010, especially for black men. The fact that inequality in mortality has been moving in opposite directions for the young and the old, as well as for some segments of the African-American and non-African-American populations argues against a single driver of trends in mortality inequality, such as rising income inequality. Rather, there are likely to be multiple specific causes affecting different segments of the population.
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There is continuing controversy about the extent to which publicly insured children are treated differently than privately insured children, and whether differences in treatment matter. We show that on average, hospitals are less likely to admit publicly insured children than privately insured children who present at the ER and the gap grows during high flu weeks, when hospital beds are in high demand. This pattern is present even after controlling for detailed diagnostic categories and hospital fixed effects, but does not appear to have any effect on measurable health outcomes such as repeat ER visits and future hospitalizations. Hence, our results raise the possibility that instead of too few publicly insured children being admitted during high flu weeks, there are too many publicly and privately insured children being admitted most of the time.
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Teenagers under the age of 18 could legally purchase e-cigarettes until states passed e-cigarette minimum legal sale age laws. These laws may have curtailed pregnant teenagers ability to use e-cigarettes for smoking cessation and increased prenatal cigarette smoking rates as a result. We investigate the effect of e-cigarette minimum legal sale age laws on prenatal cigarette smoking and birth outcomes for underage rural teenagers using data on all births from 2010 to 2016 from 32 states. We find that e-cigarette minimum legal sale age laws increased prenatal smoking in a given trimester by 0.6 percentage points (pp) overall. These effects were disproportionately concentrated in pre-pregnancy smokers. There was little evidence of the laws having any effect on pre-pregnancy non-smokers, suggesting that ENDS MLSAs increased prenatal smoking rates by reducing cigarette smoking cessation instead of by causing new cigarette smoking initiation. Our results may indicate an unmet need for assistance with smoking cessation among pregnant teenagers.
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We construct a unique individual-level longitudinal dataset linking preschool blood lead levels with third grade test scores for eight birth cohorts of Rhode Island children born between 1997 and 2005. Using these data, we show that reductions of lead from even historically low levels have significant positive effects on children's reading test scores in third grade. Our preferred estimates use the introduction of a lead remediation program as an instrument in order to control for the possibility of confounding and for considerable error in measured lead exposures. The estimates suggest that a one unit decrease in average blood lead levels reduces the probability of being substantially below proficient in reading by 3.1 percentage points (on a baseline of 12 percent). Moreover, as we show, poor and minority children are more likely to be exposed to lead, suggesting that lead poisoning may be one of the causes of continuing gaps in test scores between disadvantaged and other children.
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