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We examine the impact of the US drug crisis on children's living arrangements. Because factors that lead to drug use could also alter family structure, we instrument for the intensity of the drug crisis with cross-state exposure to marketing of the prescription opioid at the epicenter of the crisis. We find that the crisis increased the likelihood that a child lives away from a parent or in a household headed by a grandparent. Our results suggest that if drug use had remained at 1996 levels, 1.5 million fewer children aged 0-16 would have lived away from a parent in 2015., (Copyright © 2022. Published by Elsevier B.V.)

The COVID-19 pandemic in the US has been particularly devastating for nursing home residents. A key question is how have some nursing homes been able to effectively protect their residents, while others have not? Using data on the universe of US nursing homes, we examine whether establishment quality is predictive of COVID-19 mortality. Higher-quality nursing homes, as measured by CMS overall five-star rating, have substantially lower COVID-19 mortality through September of 2020. Quality does not predict the ability to prevent any COVID-19 resident or staff cases, but higher-quality establishments prevent the spread of resident infections conditional on having one. Preventing COVID-19 cases and deaths may come at some cost, as high-quality homes have substantially higher non-COVID deaths. The positive correlation between establishment quality and non-COVID mortality is strong enough that high-quality homes also have more total deaths than their low-quality counterparts and this relationship has grown with time. As of late April 2021, five-star homes have experienced 8.4 percent more total deaths than one-star homes., (Copyright © 2022. Published by Elsevier B.V.)

We examine the impact of early state and local COVID-19 policies to encourage social distancing. Outcomes are daily foot traffic at establishments spanning ten key industries, across which transmission risk varies substantially. Policies include state of emergency declarations, blunt general restrictions such as stay-at-home (SAH) orders, and targeted rules such as restrictions on bars, restaurants, entertainment venues, and schools. Exploiting variation in the timing of policies in difference-in-difference models, we show that much of the decline in foot traffic early in the pandemic was due to private precautionary behavior. SAH orders explain almost none of the foot traffic decline in industries with high risk of virus transmission, but they do explain a substantial share of the decline in moderate- to low-risk industries such as outdoor sports and visits to parks. Targeted restrictions tend to impact intended industries, as well as complementary ones. We show that the impact of targeted restrictions is largest in counties with no SAH restrictions, suggesting that better targeting of public restrictions can have important efficiency gains., (Copyright © 2021 Elsevier B.V. All rights reserved.)

We exploit the discontinuity in age when children start kindergarten generated by state eligibility laws to examine whether relative age is a significant determinant of ADHD diagnosis and treatment. Using a regression discontinuity model and exact dates of birth, we find that children born just after the cutoff, who are relatively old-for-grade, have a significantly lower incidence of ADHD diagnosis and treatment compared with similar children born just before the cutoff date, who are relatively young-for-grade. Since ADHD is an underlying neurological problem where incidence rates should not change dramatically from one birth date to the next, these results suggest that age relative to peers in class, and the resulting differences in behavior, directly affects a child's probability of being diagnosed with and treated for ADHD., (Copyright © 2010 Elsevier B.V. All rights reserved.)

We test whether the heightened mortality after the death of a spouse represents correlation or causation by examining the heterogeneity in the bereavement effect based on the spouse's cause of death. Some causes of death are correlated with socioeconomic characteristics while others are not. Equality in the bereavement effect across these two types of death would signal a causal relationship while no bereavement effect for uncorrelated causes of death would indicate an omitted variables bias. Results indicate that the observed effect for women is subject to an omitted variables bias but the estimates for men indicate a causal relationship.

Using an interrupted time series design and a census of births in California over a 6-year period, we show that state and federal laws passed in the late 1990s designed to increase the length of postpartum hospital stays reduced considerably the fraction of newborns that were discharged early. The law had little impact on re-admission rates for privately insured, vaginally delivered newborns, but reduced re-admission rates for privately insured c-section-delivered and Medicaid-insured vaginally delivered newborns by statistically significant amounts. Our calculations suggest the program was not cost saving.

In January 2004, a California law passed in 1999 became effective regulating minimum nurse to patient ratios in hospital units. This legislation was prompted by results from previous research showing higher adverse patient outcomes when hospital nurse/patient ratios are low. In this study, we use a census of hospital discharges in California over the 1996-2000 period to estimate the impact of hospital staff levels on adverse events by examining whether outcomes are correlated with the number of admissions in the hospital over the next 2 days. Because hospital staff levels are determined in advance, a large influx of patients to a hospital over the next 2 days will reduce the effective staff levels for patients admitted previously. We focus on the outcomes of patients admitted on Thursdays because hospital admissions are the most variable on Friday and Saturday and hospital staffs are lowest during the weekend. We find some evidence that large shocks to admissions on Friday and Saturday tend to reduce the length of stay and increase the chance of a subsequent readmission, but these coefficients are very small. We find quantitatively small and statistically insignificant effects of Friday and Saturday admission shocks on mortality rates of patients admitted on Thursdays. These results suggest that the portion of the California law designed to guarantee adequate staffing when the patient census increases unexpectedly should have little impact on patient outcomes.

This paper presents the first econometric estimate of the lifesaving benefit of automobile child restraint use legislation. In contrast to previous econometric analyses of traffic safety regulations, modified count data models are employed to account for the rarity of childhood fatalities. Results of the modeling suggest that legislation reduces childhood car-occupant fatalities by 39% for infants, and 30% among toddlers. A simple simulation indicates that such legislation is currently saving the lives of about 160 children per year in the United States.