Working Papers

Fostering a Gentler Flight from the Nest: Effects of Foster Care Reform on Labor Market Outcomes (Job Market Paper, Draft Available Upon Request)
Abstract: Prior to the introduction of extended foster care in 2012, four to five thousand children aged out of foster care every year in California at age 18. The California Fostering Connections to Success Act (AB 12), which first took effect on January 1, 2012, extended foster care eligibility from up to age 18 to up to age 21 gradually over the course of three years. Using a difference-in-differences design, I estimate the causal effects of AB 12 on college enrollment and earnings for the first youth eligible for extended foster care. I find that each additional year of extended foster care increases the likelihood that youth enroll in any college by three percentage points (6% of the mean) and increases earnings at 24 through 26 by 4.6%. These effects are largely driven by improved outcomes for the most vulnerable youth in foster care. Within the context of foster care, non-Hispanic white men are more likely to have characteristics that indicate high vulnerability, with correspondingly larger treatment effects.

Doctor Decision Making and Patient Outcomes (with Janet Currie and W. Bentley MacLeod)
Accepted at the Journal of Economic Literature
Abstract: Doctors facing similar patients often make different treatment choices. These decisions can have important effects on patient health and health care spending. This paper seeks to organize the recent economics literature on physician decision making using a simple model that incorporates doctor diagnostic and procedural skills, differences in beliefs and patient populations, and incentives. Economic considerations that affect the quality of decision making include training, experience, peer effects, financial incentives and time constraints. We also consider interventions aimed at improving decision making including provision of informational, heuristics and guidelines, and the use of technologies including electronic medical records and algorithmic decision tools. Our review suggests that we have learned a great deal about specific factors that influence doctor decision making but that our knowledge of how to apply that knowledge to improve health care is still quite limited.

A Hard Pill to Swallow: Spillovers of the Opioid Epidemic on Educational Progress
Reject and Resubmit at the Journal of Public Economics
Abstract: Despite a substantial increase in the number of children living in households and exposed to neighbors with opioid addiction in the past two decades, the impacts of this trend on children are poorly understood. This paper provides novel estimates of the causal effects of exposure to the opioid epidemic on educational progress for California students. I develop a new time-varying instrument for prescription opioids derived from Purdue Pharma's evolving marketing strategy, which targeted areas with high rates of different diseases over time. Moving from the 25th to the 75th percentile of instrumented per capita opioids, standardized test scores fall by 0.65--1.57% of the mean. High school exit exam pass rates fall by a greater magnitude. I find no evidence of overall changes in dropout rates, but ninth- and tenth-grade dropout rates increase. Estimates from IV regressions are much larger in magnitude than those using OLS. I find a significant adverse impact of community opioid use on the academic performance of the marginal affected child, highlighting previously overlooked intergenerational consequences of the opioid crisis.

Adding Salt to the Womb: The Benefits of Salt Iodization from Infancy to Adulthood (with Donato Onorato)
Under Review
Abstract: We estimate the effects of the 1924 introduction of iodized salt in the U.S. by exploiting pre-1924 geographic variation in iodine deficiency. Iodized salt reduced infant mortality by 1.1 deaths per 1,000 births (1.6%) for counties at the 75th percentile of iodine deficiency relative to the 25th percentile. These effects are concentrated in urban counties—where iodized salt was disproportionately available—explaining 1/3 of the decline in the urban-rural infant mortality gap in the 1920s. We show that the long-term effects on labor market outcomes are consistently large among urban-born individuals, reconciling conflicting results in the literature.

Minimum Wages and Racial Infant Health Inequality: Evidence from the Fair Labor Standards Act of 1966
Abstract: The Fair Labor Standards Act (FSLA) of 1966 increased the federal minimum wage to $1 in several previously excluded industries starting in 1967. These changes disproportionately affected Black workers, substantially narrowing the racial wage gap over the period of just a few years. In this paper, I use a triple differences approach to evaluate the effect of narrowing the racial wage gap on the infant mortality gap. I estimate the model at the county level, exploiting variation in industry employment shares measured in the early 1960s. Intuitively, counties that pre-reform had higher shares of employment in industries affected by the FLSA of 1966 were more treated by the reform and experienced greater narrowing of the racial wage gap. I find that an increase in covered employment by one percentage point reduced the infant mortality gap by about 0.16 deaths per 1,000 births (or 1.2% of the mean gap).

Work in Progress

Minimum Wages, Early Childhood Environment, and Long-Term Outcomes

Effects of Medicaid Prior Authorization on Child Antipsychotic Prescribing: Information, Spillovers, and Hassle Costs (with Janet Currie)

Psychiatric Care Access and Adolescent Trajectories Across Health and Social Services (with Angie Boy, Renee Brooks, and Abigail Cormier)