Kate Musen

In the United States, about six percent of children—and nearly 12 percent of Black children—experience a foster care placement before age 18. Youth who spend time in foster care, and particularly those who age out of the system, attain less education and are less likely to be employed in adulthood than peers from similar socioeconomic backgrounds. In 2012, California introduced extended foster care, allowing eligible youth to remain in care until age 21 instead of exiting at 18. Using a difference-in-differences design comparing affected and unaffected cohorts, I find that each additional year of extended care increases college enrollment by 6 percent and formal employment at ages 24–26 by 4 percent. These effects are concentrated among the most vulnerable youth, including those with more reports of maltreatment and those without relatives to provide care. Non-Hispanic white men are disproportionately represented among these high-vulnerability groups and experience correspondingly larger gains. Conservative estimates indicate that each dollar spent on extended foster care generates at least three dollars in benefits, suggesting that well-designed interventions can also yield meaningful returns in late adolescence—a stage of life where government investments are often thought to be less effective.

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.

Doctors facing similar patients often make different treatment choices. These decisions can have important effects on patient health and health care spending. This paper organizes 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. We discuss training, experience, peer effects, financial incentives, and time constraints, as well as interventions like information, heuristics and guidelines, and technologies such as EMRs and algorithmic decision tools. We conclude that while much has been learned about specific factors influencing decision making, translating this knowledge into improved health care remains an open challenge.

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 one-third 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.

We examine information versus hassle costs in the context of Medicaid prior authorization require- ments for preschool antipsychotic prescribing. Such prescribing increased in the 1990s, despite substantial side effects and the absence of FDA approval. State Medicaid programs began to require prior authorization for antipsychotic prescribing to young children after 2005. We evaluate these policies using hand-collected policy data and national prescription data for 2006-2019. We find that prior authorization reduced prescriptions to children under six by 22-30% in the two years after implementation. There were no effects on privately insured or older children, suggesting little role for information spillovers.

	Accompanying Resource: Medicaid Pharmaceutical Policy Document Database, 2005–2020

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. Using a triple-differences design at the county level—exploiting early-1960s industry employment shares—I find that a one-percentage-point increase in covered employment reduced the infant mortality gap by about 0.16 deaths per 1,000 births (≈1.2% of the mean gap).