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• Vehicle Electronic Stability Control may not be as effective as currently believed, due to possible over-estimation of effects in crash sample studies. • Fatal crashes data from the US was used to test whether the increase in Electronic Stability Control in the vehicle population was associated with a decline in crashes. • The results indicate that the effect in US data might possibly be two thirds the size of previous estimates, possibly much less. Problem: Electronic Stability Control (ESC) is believed to be among the most efficient vehicle safety interventions with reported effects around 50% for fatal single and rollover crashes. However, such estimates have used sample data, which have not controlled for the possibilities of self-selection, behavioral adaptation, increased access to the technology by less safe drivers, and the calculation of effects on very specific categories of crashes. Effects of ESC in the population can therefore be expected to be smaller than is currently believed. Method: National U.S. data for fatal crashes, driving exposure and other control factors, and market penetration of ESC over 1991–2021 were used to calculate whether the trends in fatalities over time in crash rates for singles, rollovers, and fatal crashes in general matched projections from estimates of effectiveness. Results: It was found that downward trends in the relevant crash types were generally present before ESC was introduced, and that the trends thereafter were weaker. Although some trends were consistent with effects of ESC, they were markedly smaller than the projected ones, and could be explained by other factors such as the number of vehicles per capita. At best, the effect for rollovers could be up to two-thirds of previous estimates, no effect was detected for singles, while for all fatal crashes results depended upon the type of analysis performed. These results conflict with conclusions in all published ESC crash sample studies, which have compared vehicles with and without ESC. This discrepancy can be explained by methodological errors in the previous studies using induced exposure methods and self-selected samples. Practical applications: Traffic safety may not be as much improved by technological interventions as believed. Alternative approaches to traffic safety are needed, which do not rely on technology that interferes with driver behavior. [ABSTRACT FROM AUTHOR]

During the late 1800s and early 1900s, Argentina was among the ten richest economies in terms of gross domestic product per capita with the United States being the leading economy most of the time. However, Argentina grew less and was less stable than the United States in a period of over 140 years (1875–2018). Structural breaks (1935 and 1975) were identified in the declining ratio of Argentina's gross domestic product per capita long-term trend to that of the United States, as well as in the long-term per capita growth rates of Argentina (1911 and 1975) and the United States (1935). The declining ratio partly reflects that growth in the United States accelerated after 1935 (during the post-1930 Great Depression recovery and the Second World War years) while it decelerated in Argentina after 1975 (in the context of large government deficits, high inflation, the first oil crisis, and the Latin American debt crisis). A Bayesian estimation model suggests that long-term growth was generally higher and less volatile in the United States than in Argentina, with relatively low spillovers from one country to the other. [ABSTRACT FROM AUTHOR]

Summary: We study the evolution of the cross‐sectional distributions of county‐level per capita income in the United States from 1970 to 2017. We confirm previous findings of convergence in pre‐transfer income during the 1970s and 1980s but present new evidence of rising inequality since the early 1990s, which is characterized by bipolarization. Cross‐county differences in education and industry composition explain much of this recent trend, which almost disappears in post‐transfer incomes. Among the various government transfer programs, medical benefits play the greatest role in making the distribution less unequal. [ABSTRACT FROM AUTHOR]

Whether the activities of lawyers might hamper economic growth has been hotly contested over the past three decades. Contradictory conclusions have flowed from evidence that typically has focused on the impact of lawyers on the growth rates of countries. Disputes over definitions and samples that vary among countries have colored portions of these debates. We surmount many of these issues by adopting a 50-state panel covering the period 2005-2018 for the United States and by utilizing widely accepted variables regarding economic activity and who is considered a lawyer. Further, we utilize two distinct measures of the activity of lawyers and find that an increased presence of lawyers reduces per capita real economic growth. Separately, we also find that an increased presence of lawyers reduces the level of per capita real income. [ABSTRACT FROM AUTHOR]

Retail health clinics (RHCs) have been described as a disruptive model of care delivery. We describe RHC market presence in the United States from 2008 to 2016 with a focus on the characteristics of counties where new clinics open. We merge national data on RHC openings and closings from Merchant Medicine with the Area Health Resources File. We examined county-level counts and ownership of RHCs over time. From 2008 to 2016, we found increasing ownership of RHCs by retail pharmacies, and, contrary to earlier predictions, RHCs continue to be located in affluent counties and did not open in underserved or provider shortage areas. Most new clinics opened in counties where RHCs already had a presence, and these counties also had greater primary care physician, nurse practitioner, and physician assistant density per capita (100,000). As RHCs expand and offer more services, they may place new competitive pressures on nearby primary care providers and practices. [ABSTRACT FROM AUTHOR]

Regional economies are characterized by networks of interactions between individual elements and are thus quintessential complex systems. Analyzing the relatedness of various aspects of regional economies, such as exports, industries, occupations, and technologies, using methods from complexity science is becoming commonplace. However, current work has focused nearly exclusively on regional economic complexity of more urbanized regions within countries, if not entire countries themselves. Smaller urban areas are typically over-looked and rural regions are almost entirely absent from the dialog. This paper seeks to fill this gap by examining smaller urban areas and rural regions from a complexity economics perspective. Analyzing cross-sectional data provides initial insights into the transformation of regional economic connectedness from rural to urban regions. Using a previously developed metric of economic connectivity based the on co-occurrence of economic activities, called tightness, we examine the skills space and industry space of metropolitan, micropolitan, and rural regions in the United States. We find that the least and the most urbanized regions have the highest tightness, and that this is partially due to the share of specialty skills in a "socio-cognitive" lobe of skills space. However, we also find that the composition of skills in the least and most urbanized regions differs markedly. Findings suggest that planners seeking to increase the share of socio-cognitive skills in the local workforce may be constrained by population size, and that regions of moderate population size may be required to first grow industries that require less cognitive skills. Science Highlights • Regional economic tightness and regional economic output are positively correlated, even when controlling for regional population. • Skills tightness is greatest in the least populous and most populous regions while industry tightness is greatest in the most populous regions. • Higher skills tightness is driven partially by the share of socio-cognitive skills in the regional workforce. • The most rural and most urban counties have the highest share of specialty skills in the socio-cognitive lobe of skills space. Policy and Practice Recommendations • Both skills and industrial tightness should be fostered to increase regional per capita output. • Growing jobs that utilize socio-cognitive skills may increase skills tightness and thus regional productivity. • Moderately-urbanized areas typically have a lower share of workers with socio-cognitive skills, and may experience more difficulty growing knowledge-intensive industries. [ABSTRACT FROM AUTHOR]

This study explored the roles of epidemic-spread-related behaviors, vaccination status and weather factors during the COVID-19 epidemic in 50 U.S. states since March 2020. Data from March 1, 2020 to February 5, 2022 were incorporated into panel model. The states were clustered by the k-means method. In addition to discussing the whole time period, we also took multiple events nodes into account and analyzed the data in different time periods respectively by panel linear regression method. In addition, influence of cluster grouping and different incubation periods were been discussed. Non-segmented analysis showed the rate of people staying at home and the vaccination dose per capita were significantly negatively correlated with the daily incidence rate, while the number of long-distance trips was positively correlated. Weather indicators also had a negative effect to a certain extent. Most segmental results support the above view. The vaccination dose per capita was unsurprisingly proved to be the most significant factor especially for epidemic dominated by Omicron strains. 7-day was a more robust incubation period with the best model fit while weather had different effects on the epidemic spread in different time period. The implementation of prevention behaviors and the promotion of vaccination may have a successful control effect on COVID-19, including variants' epidemic such as Omicron. The spread of COVID-19 also might be associated with weather, albeit to a lesser extent. [ABSTRACT FROM AUTHOR]

Objectives: New health technologies are often expensive, but may nevertheless meet standard thresholds for cost effectiveness, a situation exemplified by recent hepatitis C cures. Currently, cost-effectiveness analysis (CEA) does not supply practical means of weighing trade-offs between cost-effectiveness and affordability, particularly when costs and benefits are temporally separated and in health systems with multiple payers, such as the United States. We formally characterized disagreements in CEA theory and identified how these trade-offs are presently addressed in practice.Methods: We surveyed 170 health economics researchers.Results: When presented with a hypothetical cost-effective drug therapy in the United States that would require 20% of a state's Medicaid budget over 5 years, 34% of survey respondents recommended that policy makers fund the drug for all patients and 26% for a subset. By contrast, 26% recommended against funding the drug. We found additional disagreement regarding whether the willingness-to-pay threshold should be based on the budget (42%) or societal preferences (41%) and identified 4 approaches to weighing cost-effectiveness and affordability. A total of 61% of respondents did not believe that the threshold used in their last article (most often 1×-3× per capita gross domestic product) represented either the budget or societal willingness-to-pay threshold.Conclusions: We use these findings to recommend metrics that can inform translation of CEA theory into practice. By contextualizing cost and value, researchers can provide more actionable policy recommendations. [ABSTRACT FROM AUTHOR]

Energy system optimization models (ESOM) simulate energy and emissions changes under different economic and technological scenarios or prospective policy cases. ESOMs and larger integrated assessment models (IAMs) are increasingly being used to project future physical resource demands, but the integration of (non‐energy) physical resource flows or life cycle data into IAMs is far from complete. In this work we demonstrate a method to harness results from the National Energy Modeling System developed by Energy Information Administration (EIA), combined with imputed commodity prices from the UN COMTRADE database, in order to present detailed projections of the physical economy of the United States to 2050. Mass flow results for nine separate scenarios are presented, covering all extraction sectors and manufacturing sectors, with additional disaggregation possible to 4,601 commodities. Results are compared with previous estimates of physical resource flows through the US economy that utilized historical statistics or alternative modeling methods. Overall, the physical resource intensity of the US economy is projected to decrease by an average of 28% per unit of GDP by 2050, suggesting continued decoupling of physical resource use from economic output, but increase by an average of 25% on a per capita basis. These projections have implications for physical resource planning, particularly for materials that have constrained domestic supplies. We also investigate and discuss sources of potential bias and uncertainty in the imputed price estimates and suggest several opportunities to harness the physical resource flow projections for future resource modeling and industrial ecology research. This article met the requirements for a gold‐gold JIE data openness badge described at http://jie.click/badges. [ABSTRACT FROM AUTHOR]

The continuing growth in remittances sent from the United States by Mexican emigrants reveals how important it is to study them. This article analyzes the spatial-temporal distribution of remittances and quantifies the effect of financial inclusion in their distribution in all Mexican municipalities between 2015 and 2020. The authors' methodology is based on a series of latent Gaussian models for competition. Their results show that an important correlation exists between financial inclusion and per capita remittances received on a municipal level, where the effect of geographical proximity is important. This article's originality lies in the use of a Bayesian spatial methodology for analyzing remittance and financial inclusion data on a municipal level. [ABSTRACT FROM AUTHOR]

Objective - This study examines whether a correlation exists between state-wide voting in federal elections and state average per capita visits to public libraries in the U.S. In so doing, it provides insight into the extent to which library patronage is affiliated with political leaning. Methods - An analysis of data from the 2010, 2012, 2014, and 2016 Public Libraries Survey and election results from the 2010, 2012, 2014, and 2016 Presidential and House of Representatives elections (by state) is performed with the assistance of Tableau, a data visualization program. Scatter plots provide a visual representation of the data, while correlation coefficients indicate the strength of relationship between voting and library visits per capita. Results - The findings reveal no significant relationship between public library use and the vote share of a political party in elections among a state's population. Conclusions - The political leaning of a state appears to have no correlation with the frequency of library usage among that state's population. [ABSTRACT FROM AUTHOR]

Introduction: As total health and dental care expenditures in the United States continue to rise, healthcare disparities for low to middle-income Americans creates an imperative to analyze existing expenditures. This study examined health and dental care expenditures in the United States from 1996 to 2016 and explored trends in spending across various population subgroups. Methods: Using data collected by the Medical Expenditure Panel Survey, this study examined health and dental care expenditures in the United States from 1996 to 2016. Trends in spending were displayed graphically and spending across subgroups examined. All expenditures were adjusted for inflation or deflation to the 2016 dollar. Results: Both total health and dental expenditures increased between 1996 and 2016 with total healthcare expenditures increasing from $838.33 billion in 1996 to $1.62 trillion in 2016, a 1.9-fold increase. Despite an overall increase, total expenditures slowed between 2004 and 2012 with the exception of the older adult population. Over the study period, expenditures increased across all groups with the greatest increases seen in older adult health and dental care. The per capita geriatric dental care expenditure increased 59% while the per capita geriatric healthcare expenditure increased 50% across the two decades. For the overall US population, the per capita dental care expenditure increased 27% while the per capita healthcare expenditure increased 60% over the two decades. All groups except the uninsured experienced increased dental care expenditure over the study period. Conclusions: Healthcare spending is not inherently bad since it brings benefits while exacting costs. Our findings indicate that while there were increases in both health and dental care expenditures from 1996 to 2016, these increases were non-uniform both across population subgroups and time. Further research to understand these trends in detail will be helpful to develop strategies to address health and dental care disparities and to maximize resource utilization. [ABSTRACT FROM AUTHOR]

Drawing on two independent datasets, the author examines organized labor's role as a benefactor for community-based charity. A population-level analysis of Michigan data indicates that union member density and union local density are positively associated with per capita donations to regional United Ways. An individual-level analysis of CPS data corroborates the Michigan findings, and in addition reveals that unionists are more likely than non-unionists to be engaged in community affairs and volunteer for charitable organizations. Unionists disproportionately volunteer to provide medical care, fire/ EMS, or protective services; collect and distribute clothing, crafts, or nonfood goods; coach or referee sports; volunteer in music or other arts; tutor or teach; and mentor youth. The findings suggest that unions function in part as vehicles for collectivizing asset and volunteer resources among their members for redistribution to community-based charitable causes, thereby reducing social inequity. [ABSTRACT FROM AUTHOR]

Downscaled climate projections need to be linked to downscaled projections of population and economic growth to fully develop implications for land, natural resources, and ecosystems for future scenarios. We develop an empirical spatiotemporal approach for jointly projecting population and income at the county scale in the United States that is consistent with neoclassical economic growth theory and overlapping labor markets and that accounts for labor migration and spatial spillovers. Downscaled projections generated for the five Shared Socioeconomic Pathways used to support global scenario analysis generally show growth focused around relatively few centers especially in the southeast and western regions, with some areas in the Midwest and northeast experiencing population declines. Results are consistent with economic growth theory and with historical trends in population change and convergence of per capita personal income across US counties. [ABSTRACT FROM AUTHOR]

The article seeks to define the relationship between per capita income and retail sales according to geographic location and to describe the limitations of income statistics when reaching these conclusions. The article distinguishes between the uses of income data, to both indicate standards of living and to determine markets for certain goods and services. The article reports a lack of correlation between the median income per family and retail sales per capita and shows the results of a study to prove this. The article compares the suburban and urban relationship of income and retail sales, but points out that while cities are largely self-sufficient (not closed), they too rely on markets beyond their geographic boundaries.

The article discusses the effects of World War II on the marketing of milk. According to the author, at the time of publication, per capita consumption of milk in the United States is under the daily recommendation by nutrition experts. The author notes that after the war, there was a shift in consumer buying habits, from having milk delivered, to buying milk at the store. Also noted is a reduction in the cost of distribution, innovation in the methods of distribution and new methods of packaging such as paper milk containers and multiple court containers.

The article discusses the use of small area census data in marketing research. The author believes that as units of measurement, cities, metropolitan areas and counties are too small to base per capita figures on. According to the author, the same problem applies to the designation of trade areas using published census data at the time of publication. The author suggests instead, discovering the expenditure patterns for families, and family budget information through the use of consumer panels or consumer interviews.

For patients with chronic lower respiratory disease, hypobaric hypoxia at a high altitude is considered a risk factor for mortality. However, the effects of residing at moderately high altitudes remain unclear. We investigated the association between moderate altitude and chronic lower respiratory disease mortality. In particular, we examined the lower 48 United States counties for age-adjusted chronic lower respiratory disease mortality rates, altitude, and socioeconomic factors, including tobacco use, per capita income, population density, sex ratio, unemployment, poverty, and education between 1979 and 1998. The socioeconomic factors were incorporated into the correlation analysis as potential covariates. Considerable positive (R = 0.235; P <0.001) and partial (R = 0.260; P <0.001) correlations were observed between altitude and chronic lower respiratory disease mortality rate. In the subgroup with high COPD prevalence subgroup, even stronger positive (R = 0.346; P <0.001) and partial (R = 0.423, P <0.001) correlations were observed. Multivariate regression analysis of all available socioeconomic factors revealed that additional knowledge on altitude improved the adjusted R2 values from 0.128 to 0.186 for all counties and from 0.301 to 0.421 for counties with high COPD prevalence. We concluded that in the lower 48 United States counties, even a moderate altitude may pose considerable risks in patients with chronic lower respiratory disease. [ABSTRACT FROM AUTHOR]

Poor mental health creates significant economic costs, in addition to human suffering, and is a growing world-wide concern, especially with an aging population. To estimate the cost of this disease in the U.S., we adopt a conventional economic growth model and include the number of poor mental health days (PMHD) as a right-hand side variable. Controlling for various county-level variables associated with income growth, our results suggest that one additional PMHD is associated with a 1.84 percentage point lower per capita real income growth rate, or $53 billion less total annual income, across the U.S. between 2008 and 2014. This effect is in addition to the income losses associated with the Great Recession. [ABSTRACT FROM AUTHOR]

This study applies wavelet coherency analysis to examine the relationship between the U.S. per capita real GDP and six income inequality measures over the period 1917 to 2012. Wavelet analysis allows the simultaneous examination of correlation and causality between the two series in both the time and frequency domains. Our findings provide robust evidence of positive correlation between the growth and inequality across frequencies. Yet, directions of causality vary across frequencies and evolve with time. Evidence that inequality leads per capita real GDP at both high- and low-frequencies exists for the Top 1 and 10% measures of inequality with little evidence that real GDP per capita leads inequality. In the time-domain, the time-varying nature of long-run causalities implies structural changes in the two series. These findings provide a more thorough picture of the relationship between the U.S. per capita real GDP and inequality measures over time and frequency, suggesting important implications for policy makers. [ABSTRACT FROM AUTHOR]

This paper reviews catch-up growth in various parts of the world, especially in the twentieth century, with a particular focus on what this implies for the Global South. In 1950, US per capita national income, adjusted for purchasing power, was nearly five times the world average. Since then, Western Europe and Japan have closed their per capita income gaps with the USA. East Asia, South Asia and some other developing countries have also started to close their gaps with the West in recent decades. Thus, after well over a century of growing international economic disparities or divergence, the world has witnessed an era of uneven catching up with the North in parts of the South since the mid-twentieth century. [ABSTRACT FROM AUTHOR]

ABSTRACT We measure the effect of resource-sector dependence on long-run income growth using the natural experiment of coal mining in 409 Appalachian counties selected for homogeneity. Using a panel data set (1970-2010), we find a one standard deviation increase in resource dependence is associated with 0.5-1 percentage point long-run and a 0.2 percentage point short-run decline in the annual growth rate of per capita personal income. We also measure the extent to which the resource curse operates through disincentives to education, and find significant effects, but this 'education channel' explains less than 15 percent of the apparent curse. [ABSTRACT FROM AUTHOR]

When regional disparities follow a cyclical short-run pattern, convergence analysis results can be sizably distorted. To tackle this issue, we propose a method based on the extraction of the trend from regional income time series that eschews misleading results when the nature of the cyclical pattern changes over time. Using real per capita personal income data for forty-eight conterminous US states and the distribution dynamics approach, we identify the following three distinct consecutive phases: strong convergence (1930–1970), substantial persistence (1971–1980), and divergence (1981–2010). [ABSTRACT FROM AUTHOR]

Given the federal and state policy initiatives to curb fossil fuel consumption and expand the use of renewable energy sources in the U.S., this study investigates the convergence properties of per capita renewable energy consumption across U.S. states (including the District of Columbia). In addition to cross-sectional tests of β- and σ-convergence, our study employs LM and RALS-LM unit root tests with endogenously determined structural breaks to test for stochastic convergence. Traditional cross-sectional tests indicate that both β- and σ-convergence of per capita renewable energy consumption exists across U.S. states. Moreover, our results also provides clear support for stochastic convergence of per capita renewable energy consumption for a majority of U.S. states (including the District of Columbia) once allowance is made for structural breaks. [ABSTRACT FROM AUTHOR]

Injury-associated deaths have substantial economic consequences in the United States. The total estimated lifetime medical and work-loss costs associated with fatal injuries in 2013 were $214 billion (1). In 2014, unintentional injury, suicide, and homicide (the fourth, tenth, and seventeenth leading causes of death, respectively) accounted for 194,635 deaths in the United States (2). In 2014, a total of 199,756 fatal injuries occurred in the United States, and the associated lifetime medical and work-loss costs were $227 billion (3). This report examines the state-level economic burdens of fatal injuries by extending a previous national-level study (1). Numbers and rates of fatal injuries, lifetime costs, and lifetime costs per capita were calculated for each of the 50 states and the District of Columbia (DC) and for four injury intent categories (all intents, unintentional, suicide, and homicide). During 2014, injury mortality rates and economic burdens varied widely among the states and DC. Among fatal injuries of all intents, the mortality rate and lifetime costs per capita ranged from 101.9 per 100,000 and $1,233, respectively (New Mexico) to 40.2 per 100,000 and $491 (New York). States can engage more effectively and efficiently in injury prevention if they are aware of the economic burden of injuries, identify areas for immediate improvement, and devote necessary resources to those areas. [ABSTRACT FROM AUTHOR]

In this paper, the convergence of income per capita across U.S. metropolitan statistical areas (metros) is examined over the period between 1969 and 2011. We initiate the analysis with multivariate tests for stability, and the existence of unit roots, performed on the ratio of income per capita of a specific metro relative to the cross-sectional average. The tests used were: Multivariate homogeneous Dickey-Fuller, Levin-Lin-Chu (2002), Im-Pesaran-Shin (2003), MKPSS, Bai-Ng (2004) Panic and Hadri-LM tests. The analysis is complemented by the use of the panel stationarity test accounting for structural changes, as proposed by Carrion-i-Silvestre et al. (2005), which our other tests do not incorporate. The study of convergence is important for both economists, as a means to test growth theories and distinguish between different models, as well as policy makers who seek to maximize the utility of their constituents by making use of all information available to them. While, standard unit root tests indicates stationarity of our metric, i.e., the ratio of income per capita of a specific metro relative to the cross-sectional average, the tests of stability suggests divergence, barring the Bai-Ng test. But, given that the tests of stability are more conducive to checking for convergence, we conclude that in the 384 U.S. metros there is a divergence of per capita income. [ABSTRACT FROM AUTHOR]

We have endeavored by means of this economic classification system to recognize and equate for the following factors: 1. Differences in cost of living (which we assume to be related primarily to city size within geographic sections of the country). 2. Spendable income for food products, which we assume to be primarily related to income per capita in the family; and spendable income for personal care items, which we assume to be primarily related to income per wage earner in the family, with a simple average of these two giving a good working index of the family's socio-economic level for analysis of consumption type products. 3. Spendable incomes of families change from period to period and families must be reclassified for analyzing current conditions, while they must be given a single classification for longer range analysis unless it is suspected that shift of income will materially affect end results. In such event, it is possible to make a further division of families into such groups as: A-1. New upper economic half, formerly lower economic half. A-2. Upper economic half both periods. A-3. Formerly upper economic half, now lower economic hair. It is believed that the above system provides for consumption products analysis a workable substitute for the more ideal method of separately computing spendable income for each family on the complex factors of cost differentials for food, clothing, housing, commutation, and personal care. While the method of computation of income will be of somewhat less utility in treatment of national data on durable goods, it is recommended that this system of division of families on convenient percentiles be employed by researchers whenever national or broad regional groupings of data by socio-economic level are required. This method, of course, still permits of description of individual market segments in terms of actual incomes when desired. [ABSTRACT FROM AUTHOR]

This article investigates the effect of remittances on U.S. foreign direct investment (FDI) flows to Latin America and the Caribbean (LAC). It covers 26 countries for the period 1983–2010. The results show a positive and significant impact of remittances on U.S. FDI flows. However, this effect depends upon the level of gross domestic product (GDP) per capita of the host country. On average, the results show that increasing remittances by one standard deviation increases U.S. FDI flows by 0.44 percent a year. Also, host country demand positively affects U.S. FDI flows, which supports the market size hypothesis. [ABSTRACT FROM AUTHOR]

Importance: The increasing cost of prescription drugs in the United States has become a source of concern for patients, prescribers, payers, and policy makers.Objectives: To review the origins and effects of high drug prices in the US market and to consider policy options that could contain the cost of prescription drugs.Evidence: We reviewed the peer-reviewed medical and health policy literature from January 2005 to July 2016 for articles addressing the sources of drug prices in the United States, the justifications and consequences of high prices, and possible solutions.Findings: Per capita prescription drug spending in the United States exceeds that in all other countries, largely driven by brand-name drug prices that have been increasing in recent years at rates far beyond the consumer price index. In 2013, per capita spending on prescription drugs was $858 compared with an average of $400 for 19 other industrialized nations. In the United States, prescription medications now comprise an estimated 17% of overall personal health care services. The most important factor that allows manufacturers to set high drug prices is market exclusivity, protected by monopoly rights awarded upon Food and Drug Administration approval and by patents. The availability of generic drugs after this exclusivity period is the main means of reducing prices in the United States, but access to them may be delayed by numerous business and legal strategies. The primary counterweight against excessive pricing during market exclusivity is the negotiating power of the payer, which is currently constrained by several factors, including the requirement that most government drug payment plans cover nearly all products. Another key contributor to drug spending is physician prescribing choices when comparable alternatives are available at different costs. Although prices are often justified by the high cost of drug development, there is no evidence of an association between research and development costs and prices; rather, prescription drugs are priced in the United States primarily on the basis of what the market will bear.Conclusions and Relevance: High drug prices are the result of the approach the United States has taken to granting government-protected monopolies to drug manufacturers, combined with coverage requirements imposed on government-funded drug benefits. The most realistic short-term strategies to address high prices include enforcing more stringent requirements for the award and extension of exclusivity rights; enhancing competition by ensuring timely generic drug availability; providing greater opportunities for meaningful price negotiation by governmental payers; generating more evidence about comparative cost-effectiveness of therapeutic alternatives; and more effectively educating patients, prescribers, payers, and policy makers about these choices. [ABSTRACT FROM AUTHOR]

This article is designed to explore the effect of bargaining power on the distribution of US economic aid. Conceptualizing US foreign assistance as the outcome of aid-for-policy transactions between the donor and its recipients, it shows why the bargaining issue is an integral part of US economic aid. A two-tiered stochastic frontier analysis (SFA) is then developed to integrate the bargaining effect into our empirical analysis. Applying the model to US economic aid for the period of 1976–2011, I show empirical results that strongly support the bargaining approach. The results show that the bargaining effect explains a fundamental part of the cross-recipient difference in the level of US economic aid. On average, the donor US enjoys more bargaining power. However, a huge variation in bargaining capability on the recipient side is equally noteworthy. As for the contributors to the difference, the statistical results reveal that bargaining efficiency increases with higher per capita income, ongoing civil war, violations of personal integrity rights, and a more democratic regime, on the one hand. Importing heavily from and having an active defense pact with the US, on the other hand, affect bargaining efficiency negatively. [ABSTRACT FROM PUBLISHER]

New benchmark estimates of Black-White income ratios for 1870, 1900, and 1940 are combined with standard post-World War census data. The resulting time series reveals that the pace of racial income convergence has generally been steady but slow, quickening only during the 1940s and the modern Civil Rights era. I explore the interpretation of the time series with a model of intergenerational transmission of inequality in which racial differences in causal factors that determine income are very large just after the Civil War and which erode slowly across subsequent generations.“The problem of the twentieth century is the problem of the color line.” —W. E. B. Du Bois, The Souls of Black Folk [ABSTRACT FROM AUTHOR]

This paper asks whether being located outside the United States lowers research productivity in a data set of foreign-born, U.S.- educated scientists. Instrumenting location with visa status that requires return to home countries, we find a large negative relationship between non-U.S. location and research output for countries with low income per capita but none for countries with high income per capita. This suggests that a scientist exogenously located in a country at the top of the income distribution can expect to be as productive in research as he or she would be in the United States. [ABSTRACT FROM AUTHOR]