This paper provides new evidence of the impacts of early life exposure to the 1918 pandemic with old-age mortality by analyzing data from the National Longitudinal Mortality Study (n ~ 220,000). The specifications used year and quarter of birth indicators to assess the effects of timing of pandemic exposure and used Cox proportional hazard models for all-cause mortality outcomes. The findings suggest evidence of excess all-cause mortality for cohorts born during 1918 and mixed evidence for cohorts born in 1917 and 1919. Therefore, contrary to some existing research, the results suggest no consistent evidence of the importance of specific windows of exposure by gestation period.
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EXAMINING THE LONG TERM MORTALITY EFFECTS OF EARLY HEALTH SHOCKS
March 2014
Working Paper Number:
CES-14-19
A growing literature in economics and other disciplines has tied exposure to early health shocks, particularly in utero influenza, to reductions in a variety of socioeconomic and health outcomes over the life course. However, no current evidence exists that examines this health shock on mortality because of lack of available data. This paper uses newly released files from the large, representative National Longitudinal Mortality Study to explore the mortality effects of the 1918 influenza pandemic for those in utero. While the results on socioeconomic outcomes mimic those in the literature, showing reductions in completed schooling and income fifty years following influenza exposure, the findings also suggest no effect on overall mortality or by categories of cause-of-death. These results are counter-intuitive in their contrast with the many reported effects on cardiovascular health as well as the literature linking education with later mortality
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Geographic Disparities in Alzheimer's Disease and Related Dementia Mortality in the US: Comparing Impacts of Place of Birth and Place of Residence
January 2025
Working Paper Number:
CES-25-11
Objective: Building on the hypothesis that early-life exposures might influence the onset of Alzheimer's Disease and Related Dementia (ADRD), this study delves into geographic variations in ADRD mortality in the US. By considering both state of residence and state of birth, we aim to discern the comparative significance of these geospatial factors.
Methods: We conducted a secondary data analysis of the National Longitudinal Mortality Study (NLMS), that has 3.5 million records from 1973-2011 and over 0.5 million deaths. We focused on individuals born in or before 1930, tracked in NLMS cohorts from 1979-2000. Employing multi-level logistic regression, with individuals nested within states of residence and/or states of birth, we assessed the role of geographical factors in ADRD mortality variation.
Results: We found that both state of birth and state of residence account for a modest portion of ADRD mortality variation. Specifically, state of residence explains 1.19% of the total variation in ADRD mortality, whereas state of birth explains only 0.6%. When combined, both state of residence and state of birth account for only 1.05% of the variation, suggesting state of residence could matter more in ADRD mortality outcomes.
Conclusion: Findings of this study suggest that state of residence explains more variation in ADRD mortality than state of birth. These results indicate that factors in later life may present more impactful intervention points for curbing ADRD mortality. While early-life environmental exposures remain relevant, their role as primary determinants of ADRD in later life appears to be less pronounced in this study.
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Age, Sex, and Racial/Ethnic Disparities and Temporal-Spatial Variation in
Excess All-Cause Mortality During the COVID-19 Pandemic: Evidence from Linked Administrative and Census Bureau Data
May 2022
Working Paper Number:
CES-22-18
Research on the impact of the COVID-19 pandemic in the United States has highlighted substantial racial/ethnic disparities in excess mortality, but reports often differ in the details with respect to the size of these disparities. We suggest that these inconsistencies stem from differences in the temporal scope and measurement of race/ethnicity in existing data. We address these issues using death records for 2010 through 2021 from the Social Security Administration, covering the universe of individuals ever issued a Social Security Number, linked to race/ethnicity responses from the decennial census and American Community Survey. We use these data to (1) estimate excess all-cause mortality at the national level and for age-, sex-, and race/ethnicity-specific subgroups, (2) examine racial/ethnic variation in excess mortality over the course of the pandemic, and (3) explore whether and how racial/ethnic mortality disparities vary across states.
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Mortality in a Multi-State Cohort of Former State Prisoners, 2010-2015
February 2022
Working Paper Number:
CES-22-06
Previous studies report that individuals who have been imprisoned have higher mortality rates than their demographic counterparts in the general population, particularly non-Hispanic white former prisoners. Most of these studies have been based on a single state's prison system, and the extent to which their findings can be generalized has not been established. In this study we explore the role that race/Hispanic origin, other demographic characteristics, and custodial/ criminal history factors have on post-release mortality, including on the timing of deaths. We also assess whether conditional release to community supervision or reimprisonment may explain the higher post-release mortality found among non-Hispanic whites. In the second part of the analysis, we estimate standardized mortality ratios (SMRs) by sex, age group, and race/Hispanic origin using as reference the U.S. general population. The data come from state prison releases from the Bureau of Justice Statistics' (BJS) National Corrections Reporting Program (NCRP). The NCRP records were linked to the Census Numident to identify deaths occurring within five years from prison release. We also linked NCRP records to previous decennial censuses and survey responses to obtain self-reported race and Hispanic origin if available. We found that non-Hispanic white former prisoners were more likely to die within five years after prison release and more likely to die in the initial weeks after release compared to racial minorities and Hispanics. Reimprisonment, age at release, and a history of multiple prison terms had a similar influence on the odds of dying across all race/Hispanic origin groups. Other factors, such as the type of release and the duration of the last term in prison, were associated with higher risks of mortality for some groups but not for others.
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Planning Parenthood: The Affordable Care Act Young Adult Provision and Pathways to Fertility
January 2017
Working Paper Number:
CES-17-65
This paper investigates the effect of the Affordable Care Act young adult provision on fertility and related outcomes. The expected effect of the provision on fertility is not clear ex ante. By expanding insurance coverage to young adults, the provision may affect fertility directly through expanded options for obtaining contraceptives as well as through expanded options for obtaining pregnancy-, birth-, and infant-related care, and these may lead to decreased or increased fertility, respectively. In addition, the provision may also affect fertility indirectly through marriage or labor markets, and the direction and magnitude of these effects is difficult to determine. This paper considers the effect of the provision on fertility as well as the contributing channels by applying difference-in-differences-type methods using the 2008-2010 and 2012-2013 American Community Survey, 2006-2009 and 2012-2013 Centers for Disease Control and Prevention abortion surveillance data, and 2006-2010 and 2011-2013 National Survey of Family Growth. Results suggest that the provision is associated with decreases in the likelihood of having given birth and abortion rates and an increase in the likelihood of using long-term hormonal contraceptives.
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RESIDENTIAL MOBILITY ACROSS LOCAL AREAS IN THE UNITED STATES AND THE GEOGRAPHIC DISTRIBUTION OF THE HEALTHY POPULATION
February 2014
Working Paper Number:
CES-14-14
Determining whether population dynamics provide competing explanations to place effects for observed geographic patterns of population health is critical for understanding health inequality. We focus on the working-age population where health disparities are greatest and analyze detailed data on residential mobility collected for the first time in the 2000 US census. Residential mobility over a 5-year period is frequent and selective, with some variation by race and gender. Even so, we find little evidence that mobility biases cross-sectional snapshots of local population health. Areas undergoing large or rapid population growth or decline may be exceptions. Overall, place of residence is an important health indicator; yet, the frequency of residential mobility raises questions of interpretation from etiological or policy perspectives, complicating simple understandings that residential exposures alone explain the association between place and health. Psychosocial stressors related to contingencies of social identity associated with being black, urban, or poor in the U.S. may also have adverse health impacts that track with structural location even with movement across residential areas.
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Every Breath You Take, Every Dollar You'll Make: The Long-Term Consequences of the Clean Air Act of 1970
September 2013
Working Paper Number:
CES-13-52
This paper examines the long-term impacts of in-utero and early childhood exposure to ambient air pollution on adult labor market outcomes. We take advantage of a new administrative data set that is uniquely suited for addressing this question because it combines information on individuals' quarterly earnings together with their counties and dates of birth. We use the sharp changes in ambient air pollution concentrations driven by the implementation of the 1970 Clean Air Act Amendments as a source of identifying variation, and we compare cohorts born in counties that experienced large changes in total suspended particulate (TSP) exposure to cohorts born in counties that had minimal or no changes. We nd a signi cant relationship between TSP exposure in the year of birth and adult labor market outcomes. A 10 unit decrease in TSP in the year of birth is associated with a 1 percent increase in annual earnings for workers aged 29-31. Most, but not all, of this effect is driven by an increase in labor force participation. In present value, the gains from being born into a county affected by the 1970 Clean Air Act amount to about $4,300 in lifetime income for the 1.5 million individuals born into
these counties each year.
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Fighting Fire with Fire(fighting Foam): The Long Run Effects of PFAS Use at U.S. Military Installations
December 2024
Working Paper Number:
CES-24-72
Tens of millions of people in the U.S. may be exposed to drinking water contaminated with perand poly-fluoroalkyl chemicals (PFAS). We provide the first estimates of long-run economic costs from a major, early PFAS source: fire-fighting foam. We combine the timing of its adoption with variation in the presence of fire training areas at U.S. military installations in the 1970s to estimate exposure effects for millions of individuals using natality records and restricted administrative data. We document diminished birthweights, college attendance, and earnings, illustrating a pollution externality from military training and unregulated chemicals as a determinant of economic opportunity.
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Using Linked Data to Investigate True Intergenerational Change: Three Generations Over Seven Decades
August 2018
Working Paper Number:
carra-2018-09
It is widely thought that immigrants and their families undergo profound cultural and socioeconomic changes as a consequence of coming into contact with U.S. society, but the way this occurs remains unclear and controversial due in large part to data limitations. In this paper, we provide proof of concept for analyses using linked data that allow us to compare outcomes across more 'exact' family generations. Specifically, we are able to follow immigrant parents and their children and grandchildren across seven decades using census and survey data from 1940 to 2014. We describe the data and linkage methodology, evaluate the representativeness of the linked sample, test a method for adjusting for biases that arise from non-representative linkages, and describe the size, diversity, and socioeconomic characteristics of the linked sample. We demonstrate that large sample sizes of linked data will likely permit us to compare several national origin groups across multiple generations.
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Air Quality, Human Capital Formation and the Long-term Effects of Environmental Inequality at Birth
May 2017
Working Paper Number:
carra-2017-05
A growing body of literature suggests that pollution exposure early in life can have substantial long term effects on an individual's economic well-being as an adult, however the mechanisms for these effects remain unclear. I contribute to this literature by examining the effect of pollution exposure on several intermediate determinants of adult wages using a unique linked dataset for a large sample of individuals from two cohorts: an older cohort born around the 1970, and a younger cohort born around 1990. This dataset links responses to the American Community Survey to SSA administrative data, the universe of IRS Form 1040 tax returns, pollution concentration data from EPA air quality monitors and satellite remote sensing observations. In both OLS and IV specifications, I find that pollution exposure at birth has a large and economically significant effect on college attendance among 19-22 year olds. Using conventional estimates of the college wage premium, these effects imply that a 10 'g/m3 decrease in particulate matter exposure at birth is associated with a $190 per year increase in annual wages. This effect is smaller than the wage effects in the previous literature, which suggests that human capital acquisition associated with cognitive skills cannot fully explain the long term wage effects of pollution exposure. Indeed, I find evidence for an additional channel working through non-cognitive skill -pollution exposure at birth increases high school non-completion and incarceration among 16-24 year olds, and that these effects are concentrated within disadvantaged communities, with larger effects for non-whites and children of poor parents. I also find that pollution exposure during adolescence has statistically significant effects on high school non-completion and incarceration, but no effect on college attendance. These results suggest that the long term effects of pollution exposure on economic well-being may run through multiple channels, of which both non-cognitive skills and cognitive skills may play a role.
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