Papers Containing Tag(s): 'National Health Interview Survey'
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Viewing papers 1 through 10 of 13
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Working PaperMaternal and Infant Health Inequality: New Evidence from Linked Administrative Data
November 2022
Working Paper Number:
CES-22-55
We use linked administrative data that combines the universe of California birth records, hospitalizations, and death records with parental income from Internal Revenue Service tax records and the Longitudinal Employer-Household Dynamics file to provide novel evidence on economic inequality in infant and maternal health. We find that birth outcomes vary nonmonotonically with parental income, and that children of parents in the top ventile of the income distribution have higher rates of low birth weight and preterm birth than those in the bottom ventile. However, unlike birth outcomes, infant mortality varies monotonically with income, and infants of parents in the top ventile of the income distribution---who have the worst birth outcomes---have a death rate that is half that of infants of parents in the bottom ventile. When studying maternal health, we find a similar pattern of non-monotonicity between income and severe maternal morbidity, and a monotonic and decreasing relationship between income and maternal mortality. At the same time, these disparities by parental income are small when compared to racial disparities, and we observe virtually no convergence in health outcomes across racial and ethnic groups as income rises. Indeed, infant and maternal health in Black families at the top of the income distribution is markedly worse than that of white families at the bottom of the income distribution. Lastly, we benchmark the health gradients in California to those in Sweden, finding that infant and maternal health is worse in California than in Sweden for most outcomes throughout the entire income distribution.View Full Paper PDF
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Working PaperContext Diversity Effects Can Generalize Across Social Domains: Relating Racial Diversity to Implicit Associations of Sexual Orientation
September 2022
Working Paper Number:
CES-22-41
We examined whether contextual exposure to ethnoracial diversity relates to mental associations in other social domains. County-level metrics of racial diversity and segregation computed from restricted-use U.S. Census Bureau American Community Survey data were linked to a geolocated measure of sexual orientation implicit bias from over 825,000 respondents across the United States (2015-2021). Multilevel models detected a negative relationship between context racial diversity and stereotypic implicit associations to sexual orientation, with the greatest transfer observed at high segregation. Given the non-representative nature of the sample, we computed survey weights to account for state and national demographic distributions. Weighted models revealed a robust association with context racial diversity but did not detect an interaction with segregation. These results support the hypothesis that exposure to social diversity in one domain can generalize to less stereotypic mental associations in another, and they bolster the need for socially contextualized research on human cognition.View Full Paper PDF
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Working PaperMeasuring the Impact of COVID-19 on Businesses and People: Lessons from the Census Bureau's Experience
January 2021
Working Paper Number:
CES-21-02
We provide an overview of Census Bureau activities to enhance the consistency, timeliness, and relevance of our data products in response to the COVID-19 pandemic. We highlight new data products designed to provide timely and granular information on the pandemic's impact: the Small Business Pulse Survey, weekly Business Formation Statistics, the Household Pulse Survey, and Community Resilience Estimates. We describe pandemic-related content introduced to existing surveys such as the Annual Business Survey and the Current Population Survey. We discuss adaptations to ensure the continuity and consistency of existing data products such as principal economic indicators and the American Community Survey.View Full Paper PDF
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Working PaperNew Evidence on the Impacts of Early Exposure to the 1918 Influenza Pandemic on Old-Age Mortality
January 2018
Working Paper Number:
CES-18-06
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.View Full Paper PDF
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Working PaperRevisiting the Economics of Privacy: Population Statistics and Confidentiality Protection as Public Goods
January 2017
Working Paper Number:
CES-17-37
We consider the problem of determining the optimal accuracy of public statistics when increased accuracy requires a loss of privacy. To formalize this allocation problem, we use tools from statistics and computer science to model the publication technology used by a public statistical agency. We derive the demand for accurate statistics from first principles to generate interdependent preferences that account for the public-good nature of both data accuracy and privacy loss. We first show data accuracy is inefficiently undersupplied by a private provider. Solving the appropriate social planner's problem produces an implementable publication strategy. We implement the socially optimal publication plan for statistics on income and health status using data from the American Community Survey, National Health Interview Survey, Federal Statistical System Public Opinion Survey and Cornell National Social Survey. Our analysis indicates that welfare losses from providing too much privacy protection and, therefore, too little accuracy can be substantial.View Full Paper PDF
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Working PaperMedicare Coverage and Reporting
December 2016
Working Paper Number:
carra-2016-12
Medicare coverage of the older population in the United States is widely recognized as being nearly universal. Recent statistics from the Current Population Survey Annual Social and Economic Supplement (CPS ASEC) indicate that 93 percent of individuals aged 65 and older were covered by Medicare in 2013. Those without Medicare include those who are not eligible for the public health program, though the CPS ASEC estimate may also be impacted by misreporting. Using linked data from the CPS ASEC and Medicare Enrollment Database (i.e., the Medicare administrative data), we estimate the extent to which individuals misreport their Medicare coverage. We focus on those who report having Medicare but are not enrolled (false positives) and those who do not report having Medicare but are enrolled (false negatives). We use regression analyses to evaluate factors associated with both types of misreporting including socioeconomic, demographic, and household characteristics. We then provide estimates of the implied Medicare-covered, insured, and uninsured older population, taking into account misreporting in the CPS ASEC. We find an undercount in the CPS ASEC estimates of the Medicare covered population of 4.5 percent. This misreporting is not random - characteristics associated with misreporting include citizenship status, year of entry, labor force participation, Medicare coverage of others in the household, disability status, and imputation of Medicare responses. When we adjust the CPS ASEC estimates to account for misreporting, Medicare coverage of the population aged 65 and older increases from 93.4 percent to 95.6 percent while the uninsured rate decreases from 1.4 percent to 1.3 percent.View Full Paper PDF
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Working PaperEmployer-Sim Microsimulation Model: Model Development and Application to Estimation of Tax Subsidies to Health Insurance
December 2014
Working Paper Number:
CES-14-46
Employment-related health coverage is the predominant form of health insurance in the nonelderly, US population. Developing sound policies regarding the tax treatment of employer-sponsored insurance requires detailed information on the insurance benefits offered by employers as well as detailed information on the characteristics of employees and their familes. Unfortunately, no nationally representative data set contains all of the necessary elements. This paper describes the development of the Employer-Sim model which models tax-based health policies by using data on workers from the Medical Expenditure Panel Survey Household Component (MEPS HC) to form synthetic workforces for each establishment in the Medical Expenditure Panel Survey Insurance Component (MEPS IC). This paper describes the application of Employer-Sim to estimating tax subsidies to employer-sponsored health insurance and presents estimates of the cost and indcidence of the subsidy for 2008. The paper concludes by discussing other potential applications of the Employer-Sim model.View Full Paper PDF
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Working PaperEXAMINING 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 mortalityView Full Paper PDF
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Working PaperComplex Survey Questions and the Impact of Enumeration Procedures: Census/American Community Survey Disability Questions
April 2009
Working Paper Number:
CES-09-10
This paper explores challenges relating to the identification of the population with disabilities,focusing on Census Bureau efforts using the 2000 Decennial Census Long-Form (Census 2000) and 2000-2005 American Community Survey (ACS). In particular, the analyses explore the impact of survey methods on responses to the work limitation (i.e., employment disability) question in these two Census products. Building on the research of Stern (2003) and Stern and Brault (2005), we look for further evidence of misreporting of an employment disability by specific sub-populations using the participation in the Supplemental Security Income program as an exogenous employment disability status indicator along with a subset of ACS disability questions. We expand upon these earlier studies by examining both false-positive and falsenegative reports of employment disability by implementing logit estimations to examine the role of respondent/enumerator error on the accuracy of the employment disability response. In this manner, we enhance our understanding of Census 2000 and ACS responses to employment disability questions through an exploration of the role of enumeration procedures in two types of misclassifications, as well as by evaluating existing data and estimates to uncover characteristics that might make an individual more likely to misreport an employment disability.View Full Paper PDF
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Working PaperThe Effects of Smoking in Young Adulthood on Smoking and Health Later in Life: Evidence Based on the Vietnam Era Draft Lottery
September 2008
Working Paper Number:
CES-08-35
An important, unresolved question for health policymakers and consumers is whether cigarette smoking in young adulthood has significant lasting effects into later adulthood. The Vietnam era draft lottery offers an opportunity to address this question, because it randomly assigned young men to be more likely to experience conditions favoring cigarette consumption, including highly subsidized prices. Using this natural experiment, we find that military service increased the probability of smoking by 35 percentage points as of 1978-80, when men in the relevant cohorts were aged 25-30, but later in adulthood this effect was substantially attenuated and did not lead to large negative health effects.View Full Paper PDF
