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Although they comprise a relatively small subset of all traffic deaths, hit‐and‐run (HR) fatalities are both contemptible and preventable. We analyze longitudinal data from 1982 to 2008 to examine the effects of blood alcohol concentration (BAC) laws on HR traffic fatalities. Our results suggest that lower BAC limits may have an unintended consequence of increasing HR fatalities, whereas a similar effect is absent for non‐HR fatalities. Specifically, we find that the adoption of a 0.08 BAC limit is associated to an 8.3% increase in HR fatalities. This unintended effect is more pronounced in urban areas and during weekends, which are typical settings for HR incidents. [ABSTRACT FROM AUTHOR]

We investigate whether state health insurance parity laws adopted in the 1990s and 2000s for substance use disorder (SUD) treatment reduce traffic fatalities in the United States. Impaired driving is a major contributing factor to US traffic fatalities. State health insurance parity laws compel private insurers to cover SUD treatment more generously—on par with physical health services. We employ 21 years of administrative data from the Fatality Analysis Reporting System. We estimate both two-way fixed-effects regressions and an interaction-weighted estimator that is robust to potential bias attributable to heterogenous and dynamic treatment effects with staggered policy adoption. Our findings indicate that state parity law passage reduces overall traffic fatality rates by 2.8 percent, with larger effects for fatalities that involve alcohol. These findings suggest that state regulations requiring private insurers to equitably cover SUD treatment can improve traffic safety. [ABSTRACT FROM AUTHOR]

This study investigates the associations between self-assessed adverse labor market events (experiencing problems with coworkers, employment changes, financial strain) and health. Longitudinal data are obtained from the National Epidemiological Survey of Alcohol and Related Conditions. Our findings suggest problems with coworkers, employment changes, and financial strain are associated, respectively, with a 3.1 percent (3.3 percent), 0.9 percent (0.2 percent), and 4.5 percent (5.1 percent) reduction in mental health among men (women). Associations are smaller in magnitude and less significant for physical health.

ObjectiveTo analyze the associations between Axis II (A2) disorders and two measures of health care utilization with relatively high cost: emergency department (ED) episodes and hospital admissions.Data source/study settingWave I (2001/2002) and Wave II (2004/2005) of the National Longitudinal Survey on Alcohol and Related Conditions (NESARC).Study designA national probability sample of adults. Gender-stratified regression analysis adjusted for a range of covariates associated with health care utilization.Data collectionThe target population of the NESARC is the civilian noninstitutionalized population aged 18 years and older residing in the United States. The cumulative survey response rate is 70.2 percent with a response rate of 81 percent (N=43,093) in Wave I and 86.7 percent (N=34,653) in Wave II.Principal findingsBoth men and women with A2 disorders are at elevated risk for ED episodes and hospital admissions. Associations are robust after adjusting for a rich set of confounding factors, including Axis I (clinical) psychiatric disorders. We find evidence of a dose-response relationship, while antisocial and borderline disorders exhibit the strongest associations with both measures of health care utilization.ConclusionsThis study provides the first published estimates of the associations between A2 disorders and high-cost health care utilization in a large, nationally representative survey. The findings underscore the potential implications of these disorders on health care expenditures.

We examine the impact of Axis II personality disorders (PDs) on body weight. PDs are psychiatric conditions that develop early in life from a mixture of genetics and environment, are persistent, and lead to substantial dysfunction for the affected individual. The defining characteristics of PDs conceptually link them with body weight, but the direction of the relationship likely varies across PD type. To investigate these links, we analyze data from Wave II of the National Epidemiological Survey of Alcohol and Related Conditions. We measure body weight with the body mass index (BMI) and a dichotomous indicator for obesity (BMI≥30). We find that women with PDs have significantly higher BMI and are more likely to be obese than otherwise similar women. We find few statistically significant or economically meaningful effects for men. Paranoid, schizotypal, and avoidant PDs demonstrate the strongest adverse impacts on women's body weight while dependent PD may be protective against elevated body weight among men. Findings from unconditional quantile regressions demonstrate a positive gradient between PDs and BMI in that the effects are greater for higher BMI respondents.

This study focuses on sources of youth decision-making and examines paths through which these factors may affect delinquent behavior. Using longitudinal Add Health data, we explore the mediating mechanisms linking several antecedents of decision-making, thoughtfully reflective decision-making (TRDM), and crime. We find that various adverse factors (i.e., family and school stressful conditions, depression, sleep problems) reduce the ability of adolescents to be thoughtful and reflective, which leads to higher levels of criminal behavior. By contrast, involvement in conventional activities (i.e., hobbies, religious activities) is found to foster TRDM, which reduces delinquency. Our study calls for an integration of perspectives in criminology, cognitive psychology, and neuroscience to better explain the relationship between decision-making and crime. Policy implications are discussed. [ABSTRACT FROM AUTHOR]

The legal landscape for marijuana in the United States has changed dramatically over the last three decades. While several studies have examined the relationship between marijuana legalization and traffic fatalities, some of the research is becoming outdated and existing evidence remains mixed. Our research revisits the topic with two updates. First, our study includes states that legalized marijuana more recently and provides updated evidence on the effects of marijuana legalization. Second, considering recent discussions about the limitations of difference‐in‐differences designs, we employ alternative estimators that are robust to heterogeneous and dynamic treatment effects. Overall, our alternative estimators suggest either a smaller reduction (i.e., 3.9% drop in the overall fatality rate) or no change in traffic fatalities associated with legalizing marijuana for medical use, compared to the two‐way fixed‐effect estimator. We find no significant impact on traffic fatalities associated with legalizing marijuana for recreational use. [ABSTRACT FROM AUTHOR]

Objective: Public and private stakeholders of substance abuse treatment services require economic cost data to guide program evaluations and funding decisions. Background: Rigorous cost assessments have been conducted for several treatment programs across the United States, but a systematic and comprehensive evaluation of programs in a particular state has never been attempted. Research Design: The present study recruited all publicly funded treatment programs in the State of Florida and administered the Brief Drug Abuse Treatment Cost Analysis Program. Subjects: A total of 175 programs participated in the study, representing a 71% response rate. Measures: Annual, weekly, and episode costs are estimated by modality. Conclusion: The study procedures and empirical findings from this research can be used by program evaluators and government officials in Florida and other states as they develop service reimbursement algorithms and initiate more extensive evaluations of publicly funded substance abuse treatment programs. (Contains 3 tables and 3 notes.)

Although many economic analyses of adolescents have examined the costs of risky behaviors, few have investigated the gains that young people derive from such actions, particularly in terms of social payoffs for complying with peer behavior. This paper studies the relationship between adolescents' use of alcohol (relative to that of their peers) and popularity at school. We use data from the National Longitudinal Study of Adolescent Health, a rich and nationally representative survey with detailed information on social networks. Our findings suggest that adolescents are socially rewarded for conforming to their peers' alcohol use and penalized (to a lesser degree) for increasing their consumption above that of their peers. Male adolescents are rewarded for keeping up with their peers' drinking and for getting drunk. Female adolescents are rewarded for drinking per se, but not necessarily for keeping up with their peers. The results offer new information on peer influence and have implications for substance abuse interventions at school and in the community.

This paper examines the effects of alcohol use on high school students' quality of learning. We estimate fixed-effects models using data from the National Longitudinal Study of Adolescent Health. Our primary measure of academic achievement is the student's grade point average (GPA) abstracted from official school transcripts. We find that increases in alcohol consumption result in small yet statistically significant reductions in GPA for male students and in statistically non-significant changes for females. For females, however, higher levels of drinking result in self-reported academic difficulty. The fixed-effects results are substantially smaller than OLS estimates, underscoring the importance of addressing unobserved individual heterogeneity. (Contains 6 tables.)

Although numerous studies have documented the long-term effects of childhood victimization on mental health in adulthood, few have directly examined potential mediators and moderators of this association. Using data from the Welfare, Children, and Families project (1999)--a probability sample of 2,402 predominantly black and Hispanic low-income women with children living in Boston, Chicago, and San Antonio--we predict psychological distress in adulthood with measures of physical assault and sexual coercion before age 18. Building on previous research, we test the mediating and moderating influences of emotional support, instrumental support, and self-esteem. Although we observe no indirect effects of physical assault, the effect of sexual coercion is partially mediated by instrumental support and self-esteem. We also find that the effects of physical assault and sexual coercion are moderated (buffered) by emotional support and self-esteem. (Contains 4 tables.)

The chronic and relapsing nature of substance abuse points to the need for continuing care after a primary phase of treatment. This article reviews the economic studies of continuing care, discusses research gaps, highlights some of the challenges of conducting rigorous economic evaluations of continuing care, and offers research guidelines and recommendations for future economic studies in this emerging field. Rigorous economic evaluations are needed by health care providers and policy makers to justify the allocation of scarce resources to continuing care interventions. The adoption of cost-effective continuing care services can reduce long-term consequences of addiction, thereby potentially increasing overall social welfare. (Contains 2 tables.)