Macroeconomic conditions and health-related outcomes in the United States: A metropolitan and micropolitan statistical area-level analysis between 2004 and 2017

Business cycles and healthcare employment

Is healthcare employment recession-proof? We examine the long-standing hypothesis that healthcare employment is stable across the business cycle. We explicitly distinguish between negative aggregate demand and supply shocks in studying how healthcare employment responds to recessions, and show that this response depends largely on the type of the exogenous shock triggering the recession. First, aggregate healthcare employment responds procyclically during demand-induced recessions but remains stable during supply-induced recessions. Second, healthcare utilization drops significantly during demand-induced recessions, explaining the decline in healthcare employment during these periods. Finally, there is significant heterogeneity in the employment responses of the healthcare sub-sectors. While healthcare employment in most sub-sectors responds procyclically during recessions caused by both negative demand and supply shocks, it responds countercyclically in nursing-dominant sectors. Importantly, by isolating the recessionary impact of negative aggregate demand shocks from supply shocks on healthcare employment, we provide new empirical evidence that healthcare employment, in general, is not recession-proof.

Association of cigarette smoking with changes in macroeconomic conditions

This study uses data from the 1987-2022 Behavioral Risk Factor Surveillance System and state-level employment rates from the US Bureau of Labor Statistics to estimate the association between macroeconomic conditions and cigarette smoking. Our finding suggests a positive association, which constantly declined with time after the 2001 recession. We find that a one percentage point increase in the employment rate is associated with a 1.4% higher likelihood of smoking cigarettes in the overall sample but declined to 0.4% among cohorts surveyed from 2011 to 2022. We also find strong positive and heterogeneous associations among sociodemographic groups, except among Blacks and persons aged 65 years and older, among whom there is no association; however, the positive associations consistently decreased among these sociodemographic groups. Consequently, the strong positive association disappeared in several sociodemographic groups in cohorts surveyed over the last decade.

Newborns during the crisis: Evidence from the 1980s' farm crisis

The sudden and jumping interest rate in the early 1980s triggered a severe economic crisis in the US agriculture sector. To identify the effects of wealth losses on the health condition of cohorts born in the midst of the crisis, this paper constructs an instrumental variable for wealth by exploiting the geographic variation in crop production and the timing of the shock. This study finds that wealth losses generates long-lasting health impacts for these newborns. A one percent wealth loss leads to an approximately 0.008 and 0.003 percentage point increase in the low and very low birth weight rates, respectively. In addition, cohorts growing up in areas of greater impacts have worse self-reported health condition before age 17 than others. They also have more metabolic-syndrome issues and smoke more regularly than other cohorts in adulthood. Lower expenditures on food and prenatal care might explain the negative health effects on cohorts born during the crisis. The study shows that households in areas with greater wealth losses have more declining expenditures on food at home and prenatal-care doctor visits.

Economic Vulnerability of Sexual Minorities: Evidence from the US Household Pulse Survey

Despite improvements in the legal and social environment, economic outcomes for LGBTQ individuals suggest a high degree of vulnerability. We use data on over 500,000 individuals collected from July 21, 2021 to May 9, 2022 as part of US Census Bureau’s Household Pulse survey which is the Bureau’s first survey to collect self-reported sexual orientation and gender identity. We use linear probability models to answer several questions related to the economic experience of lesbian, gay and bisexual (LGB) individuals during this time period. We find that lesbian women, bisexual women, and bisexual men were more likely than their heterosexual counterparts to be in a household that experienced pandemic related job loss. Bisexual men were more likely than heterosexual men to have difficulty paying their expenses, experience food insufficiency and experience housing insecurity in the last week. Lesbian and bisexual women were more likely than heterosexual women to report expense difficulty and food insufficiency. The vulnerability we observe may have been exacerbated by the pandemic but appears to be largely due to pre-existing—and likely continuing—inequalities.