Does Ageist Language in Job Ads Predict Age Discrimination in Hiring?

We study the relationships between ageist stereotypes - as reflected in the language used in job ads - and age discrimination in hiring, exploiting the text of job ads and differences in callbacks to older and younger job applicants from a resume (correspondence study) field experiment (Neumark, Burn, and Button, 2019). Our analysis uses computational linguistics and machine learning methods to examine, in a field-experiment setting, ageist stereotypes that might underlie age discrimination in hiring. In so doing, we develop methods and a framework for analyzing textual data, highlighting the usefulness of various computer science techniques for empirical economics research. We find evidence that language related to stereotypes of older workers sometimes predicts discrimination against older workers. For men, we find evidence that age stereotypes about all three categories we consider - health, personality, and skill - predict age discrimination, and for women, age stereotypes about personality predict age discrimination. In general, the evidence that age stereotypes predict age discrimination is much stronger for men, and our results for men are quite consistent with the industrial psychology literature on age stereotypes.

Do State Laws Protecting Older Workers from Discrimination Reduce Age Discrimination in Hiring? Evidence from a Field Experiment

We conduct a resume field experiment in all U.S. states to study how state laws protecting older workers from age discrimination affect age discrimination in hiring for retail sales jobs. We relate the difference in callback rates between old and young applicants to state variation in age and disability discrimination laws. These laws could boost hiring of older applicants, although they could have the unintended consequence of deterring hiring if they increase termination costs. In our preferred estimates that are weighted to be representative of the workforce, we find evidence that there is less discrimination against older men and women in states where age discrimination law allows larger damages, and more limited evidence that there is lower discrimination against older women in states where disability discrimination law allows larger damages. Our clearest result is that these laws do not have the unintended consequence of lowering callbacks for older workers.

The effect of primary care visits on other health care utilization: A randomized controlled trial of cash incentives offered to low income, uninsured adults in Virginia

We conducted a randomized controlled trial, enrolling low-income uninsured adults in Virginia (United States), to determine whether cash incentives are effective at encouraging a primary care provider (PCP) visit, and at lowering utilization and costs. Subjects were randomized to four groups: untreated controls, and one of three incentive arms with incentives of $0, $25, or $50 for visiting a PCP within six months of group assignment. We used the exogenous variation generated by the experiment to obtain causal evidence on the effects of a PCP visit. We observed modest reductions in non-urgent emergency department visits and increased outpatient visits, but no reductions in overall costs. These findings in utilization are consistent with the expectation that PCPs offer an alternative to the emergency department for non-emergent conditions. Total costs did not decline because any savings from avoiding the emergency department were offset by increased outpatient utilization.

The Effects of Provider Choice Policies on Workers' Compensation Costs

OBJECTIVE

To examine the effects of provider choice policies on workers' compensation medical and indemnity costs.

DATA SOURCES/STUDY SETTING

Pooled cross-sectional analysis of administrative claims records for workers with work-related injuries primarily in 2007-2010 across 25 states (n = 4,489,729).

STUDY DESIGN

We used linear and quantile regression analyses to evaluate differences in claim costs (medical and indemnity) based on whether policies give employers or injured workers control over the choice of provider.

PRINCIPAL FINDINGS

We find no difference in average medical costs by provider choice policies, although a distributional analysis indicates higher developed medical costs for the costliest back injury cases in states where workers control provider choice. The evidence for indemnity costs is similar, although the point estimates also indicate (statistically insignificantly) higher average costs when policies give workers more control of the choice of provider.

CONCLUSIONS

Our nuanced evidence suggests that policymakers seeking to reduce workers' compensation costs may need to focus on the highest cost cases in states where policy gives workers more control over the choice of provider, rather than the simpler and broader issue of whether policy gives workers or employers more control.

Small Cash Incentives Can Encourage Primary Care Visits By Low-Income People With New Health Care Coverage

In a randomized controlled trial, we studied low-income adults newly covered by a primary care program to determine whether a cash incentive could encourage them to make an initial visit to a primary care provider. Subjects were randomly assigned to one of four groups: three groups whose members received $10 to complete a baseline survey during an interview and who were randomized to incentives of $50, $25, or $0 to visit their assigned primary care provider within six months after enrolling in the study; and a nonincentivized control group not contacted by the research team. Subjects in the $50 and $25 incentive groups were more likely to see a primary care provider (77 percent and 74 percent, respectively), compared to subjects in the $0 incentive group (68 percent). The effects of the intervention were about twice as large when we compared the proportions of subjects in the $50 and $25 incentive groups who visited their providers and the proportion in the nonincentivized group (61 percent). Cash incentive programs may steer newly covered low-income patients toward primary care, which could result in improved health outcomes and lower costs.

Barriers to Later Retirement for Men: Physical Challenges of Work and Increases in the Full Retirement Age

Policy changes intended to delay retirements of older workers and extend their work lives may run up against barriers owing to rising physical challenges of work as people age. We examine whether physical challenges at work influence employment transitions of older male workers in the age range for which public policy is trying to extend work lives and whether older male workers are able to mitigate these challenges while still remaining employed. The evidence indicates that physical challenges pose a barrier to extending work lives, although some older male workers with physically demanding jobs are able to mitigate these demands—either at new jobs or with the same employer. Our findings suggest that greater accommodation of physical challenges faced by older workers would likely increase the success of policies intended to induce later retirement.

Does Protecting Older Workers From Discrimination Make It Harder to Get Hired? Evidence From Disability Discrimination Laws

We explore the effects of disability discrimination laws on hiring of older workers. A concern with antidiscrimination laws is that they may reduce hiring by raising the cost of terminations and—in the specific case of disability discrimination laws—raising the cost of employment because of the need to accommodate disabled workers. Moreover, disability discrimination laws can affect nondisabled older workers because they are fairly likely to develop work-related disabilities, but are generally not protected by these laws. Using state variation in disability discrimination protections, we find little or no evidence that stronger disability discrimination laws lower the hiring of nondisabled older workers. We similarly find no evidence of adverse effects of disability discrimination laws on hiring of disabled older workers.

Does Eliminating the Earnings Test Increase the Incidence of Low Income Among Older Women?

Reducing or eliminating Social Security’s retirement earnings test (RET) can encourage labor supply of older individuals receiving benefits. However, these reforms can encourage earlier claiming of Social Security benefits, permanently lowering future benefits. We explore the consequences, for older women, of eliminating the RET from the full retirement age to age 69 (in 2000), relying on the intercohort variation in exposure to changes in the RET to estimate these effects. The evidence is consistent with the conclusion that eliminating the RET increased the likelihood of having very low incomes among women in their mid-70s and older—ages at which the lower benefits from claiming earlier could outweigh higher income in the earlier period when women or their husbands increased their labor supply.

Combining Registry, Primary, and Secondary Data Sources to Identify the Impact of Cancer on Labor Market Outcomes

Some cancers are rapidly becoming chronic conditions that are more and more often diagnosed in working-age individuals. The authors developed a research agenda to study the labor market outcomes attributable to detection and treatment for cancer, and research design and data collection strategies to improve upon other research on these questions. In this article, they describe their approach to combining secondary data sources, primary data collection, and cancer registry data to evaluate the impact cancer has on labor market outcomes such as employment, hours worked, wages, and health insurance. They then critically assess how well their study design and data collection strategy accomplished its objectives. The intention is to offer guidance on how researchers, who are interested in the economic consequences of cancer, as well as of other chronic conditions, might develop and execute studies that examine labor market outcomes. As more attention is placed on the economic aspects of disease, the methods used to estimate productivity loss and other economic outcomes attributable to these conditions require careful scrutiny so that reliable findings can be used to shape health care decisions and policy.

WORK CONTINUATION WHILE TREATED FOR BREAST CANCER: THE ROLE OF WORKPLACE ACCOMMODATIONS

Given the short- and long-term disabilities associated with breast cancer and its treatment, the authors investigate the influence of workplace accommodations on the employment and hours worked of women newly diagnosed with breast cancer. Accommodations that allow women to work fewer hours or that ease the burden of work could also generate health benefits by reducing workplace demands and allowing women more time to tend to treatment needs and recovery. In prior research, the authors found modest labor supply impacts on employment for this group of women. Evidence from this study suggests that some accommodations are associated with fewer hours worked, while some are associated with higher employment or hours. In addition, some of the accommodations that may affect hours of work-sometimes positively and sometimes negatively-are associated with positive health benefits.

Does employer-provided health insurance constrain labor supply adjustments to health shocks? New evidence on women diagnosed with breast cancer

Employment-contingent health insurance may create incentives for ill workers to remain employed at a sufficient level (usually full-time) to maintain access to health insurance coverage. We study employed married women, comparing the labor supply responses to new breast cancer diagnoses of women dependent on their own employment for health insurance with the responses of women who are less dependent on their own employment for health insurance, because of actual or potential access to health insurance through their spouse's employer. We find evidence that women who depend on their own job for health insurance reduce their labor supply by less after a diagnosis of breast cancer. In the estimates that best control for unobservables associated with health insurance status, the hours reduction for women who continue to work is 8 to 11% smaller. Women's subjective responses to questions about working more to maintain health insurance are consistent with the conclusions from observed behavior.

The effects of health shocks on employment and health insurance: the role of employer-provided health insurance

Employment-contingent health insurance (ECHI) has been criticized for tying insurance to continued employment. Our research sheds light on two central issues regarding employment-contingent health insurance: whether such insurance "locks" people who experience a health shock into remaining at work; and whether it puts people at risk for insurance loss upon the onset of illness, because health shocks pose challenges to continued employment. We study how men's dependence on their own employer for health insurance affects labor supply responses and health insurance coverage following a health shock. We use the Health and Retirement Study (HRS) surveys from 1996 through 2008 to observe employment and health insurance status at interviews 2 years apart, and whether a health shock occurred in the intervening period between the interviews. All employed married men with health insurance either through their own employer or their spouse's employer, interviewed in at least two consecutive HRS waves with non-missing data on employment, insurance, health, demographic, and other variables, and under age 64 at the second interview are included in the study sample. We then limited the sample to men who were initially healthy. Our analytical sample consisted of 1,582 men of whom 1,379 had ECHI at the first interview, while 203 were covered by their spouse's employer. Hospitalization affected 209 men with ECHI and 36 men with spouse insurance. A new disease diagnosis was reported by 103 men with ECHI and 22 men with other insurance. There were 171 men with ECHI and 25 men with spouse employer insurance who had a self-reported health decline. Labor supply response differences associated with ECHI-with men with health shocks and ECHI more likely to continue working-appear to be driven by specific types of health shocks associated with future higher health care costs but not with immediate increases in morbidity that limit continued employment. Men with ECHI who have a self-reported health decline are significantly more likely to lose health insurance than men with insurance through a spouse. With the passage of health care reform, the tendency of men with ECHI as opposed to other sources of insurance to remain employed following a health shock may be diminished, along with the likelihood of losing health insurance.

Lessons for coverage expansion: a Virginia primary care program for the uninsured reduced utilization and cut costs

The Affordable Care Act will expand health insurance coverage for an estimated thirty-two million uninsured Americans. Increased access to care is intended to reduce the unnecessary use of services such as emergency department visits and to achieve substantial cost savings. However, there is little evidence for such claims. To determine how the uninsured might respond once coverage becomes available, we studied uninsured low-income adults enrolled in a community-based primary care program at Virginia Commonwealth University Medical Center. For people continuously enrolled in the program, emergency department visits and inpatient admissions declined, while primary care visits increased during the study period. Inpatient costs fell each year for this group. Over three years of enrollment, average total costs per year per enrollee fell from $8,899 to $4,569--a savings of almost 50 percent. We conclude that previously uninsured people may have fewer emergency department visits and lower costs after receiving coverage but that it may take several years of coverage for substantive health care savings to occur.

The Age Discrimination in Employment Act and the Challenge of Population Aging

The author reviews evidence on age discrimination in U.S. labor markets and on the effects of the Age Discrimination in Employment Act (ADEA) in combating this discrimination, focusing on the challenge of population aging facing the U.S. economy in coming decades. Combating age discrimination is likely to help in meeting this challenge by encouraging the employment of older individuals. But the author also explores how the rapid aging of the population protected by the ADEA might inhibit the ADEA's effectiveness and raises questions about possible changes in age discrimination policies and enforcement that could enhance the ability of the ADEA to mitigate some of the adverse consequences of population aging.

SPATIAL MISMATCH OR RACIAL MISMATCH?

We contrast the spatial mismatch hypothesis with what we term the racial mismatch hypothesis - that the problem is not a lack of jobs, per se, where blacks live, but a lack of jobs where blacks live into which blacks are hired. We first report new evidence on the spatial mismatch hypothesis, using data from Census Long-Form respondents. We construct direct measures of the presence of jobs in detailed geographic areas, and find that these job density measures are related to employment of black male residents in ways that would be predicted by the spatial mismatch hypothesis - in particular that spatial mismatch is primarily an issue for low-skilled black male workers. We then look at mismatch along not only spatial lines but racial lines as well, by estimating the effects of job density measures that are disaggregated by race. We find that it is primarily black job density that influences black male employment, whereas white job density has little if any influence on their employment. The evidence implies that space alone plays a relatively minor role in low black male employment rates.

Differences in Breast Cancer Diagnosis and Treatment: Experiences of Insured and Uninsured Women in a Safety-Net Setting

To explore how well the safety net performs at eliminating differences in diagnosis and treatment of insured and uninsured women with breast cancer, we compared insured and uninsured women treated in a safety-net setting. Controlling for socioeconomic characteristics, uninsured women are more likely to be diagnosed with advanced disease, requiring more extensive treatment relative to insured women, and also experience delays in initiating and completing treatment. The findings suggest that, despite the safety-net system, uninsured women with breast cancer are likely to require more costly treatment and to have worse outcomes relative to insured women with breast cancer.

Employment-contingent health insurance, illness, and labor supply of women: evidence from married women with breast cancer

We examine the effects of employment-contingent health insurance (ECHI) on married women's labor supply following a health shock. First, we develop a theoretical framework that examines the effects of ECHI on the labor supply response to a health shock, which suggests that women with ECHI are less likely to reduce their labor supply in response to a health shock, relative to women with health insurance through their spouse's employer. Second, we empirically examine this relationship based on labor supply responses to breast cancer. We find that health shocks decrease labor supply to a greater extent among women insured by their spouse's policy than among women with health insurance through their own employer, suggesting that ECHI creates incentives to remain working when faced with a serious illness.

Employment and cancer: findings from a longitudinal study of breast and prostate cancer survivors

We discuss how cancer affected the employment of almost 800 employed patients who participated in a longitudinal study. The greatest reduction in patients' labor supply (defined as employment and weekly hours worked) was observed 6 months following diagnosis. At 12 and 18 months following diagnosis, many patients returned to work. Based on these and other findings related to patients' employment situations, we suggest 4 areas for future research: 1) collection of employment information in cancer studies; 2) research into racial and ethnic minority patients and employment outcomes; 3) interventions to reduce the effects of cancer and its treatment on employment; and 4) investigations into the influence of employment-contingent health insurance on cancer treatment and recovery.

Employment outcomes of men treated for prostate cancer

BACKGROUND

Some organizations recommend prostate cancer screening for men younger than age 65 years, many of whom will be employed when they are diagnosed and treated for prostate cancer. Yet little is known about how prostate cancer and its treatment affect men's employment status. Consequently, we explored employment outcomes 6 and 12 months after the diagnosis of prostate cancer.

METHODS

We collected data from a prospective, population-based, longitudinal cohort of 267 men aged 30-65 years who had been diagnosed with prostate cancer and compared their likelihood of employment to that of men in two population-based control groups of 283 and 256 men without prostate cancer. The study outcomes were, among all participants, employment status and, among patients with prostate cancer, reasons why they remained employed, reasons why their weekly hours worked changed, and work-related disabilities. We predicted employment using probit regression models. In addition, we tested differences between the samples with two-sample Wilcoxon rank sum tests and chi-square tests. All statistical tests were two-sided.

RESULTS

Patients with prostate cancer were 10 percentage points (95% confidence interval [CI] = 2.50 to 17.51 percentage points; P = .009) less likely to be working 6 months after their diagnosis than men without prostate cancer. However, at 12 months after diagnosis, the likelihood of employment for prostate cancer patients and control subjects was not statistically significantly different (P = .771). Some patients reported that cancer and its treatment interfered with their ability to perform physical and cognitive tasks at work 12 months after diagnosis. For example, 26% (95% CI = 18.51% to 33.87%) of men (33 patients) reported that cancer interfered with their ability to perform tasks that involved physical effort.

CONCLUSIONS

Prostate cancer and its treatment appear to have an impact on employment.

Short-term effects of breast cancer on labor market attachment: results from a longitudinal study

In this longitudinal study, we examine the consequences of breast cancer for women's labor market attachment for the 6-month period following diagnosis. Women with breast cancer, with the exception of those having in situ cancer, were less likely to work 6 months following diagnosis relative to a control sample of women drawn from the Current Population Survey. Breast cancer's non-employment effect appears to be twice as large for African-American women. Women with breast cancer who remained working worked fewer hours than women in the control group.

Breast cancer and women's labor supply

OBJECTIVE

To investigate the effect of breast cancer on women's labor supply. DATE SOURCE/STUDY SETTING: Using the 1992 Health and Retirement Study, we estimate the probability of working using probit regression and then, for women who are employed, we estimate regressions for average weekly hours worked using ordinary least squares (OLS). We control for health status by using responses to perceived health status and comorbidities. For a sample of married women, we control for spouses' employer-based health insurance. We also perform additional analyses to detect selection bias in our sample.

PRINCIPAL FINDINGS

We find that the probability of breast cancer survivors working is 10 percentage points less than that for women without breast cancer. Among women who work, breast cancer survivors work approximately three more hours per week than women who do not have cancer. Results of similar magnitude persist after health status is controlled in the analysis, and although we could not definitively rule out selection bias, we could not find evidence that our results are attributable to selection bias.

CONCLUSIONS

For some women, breast cancer may impose an economic hardship because it causes them to leave theirjobs. However, for women who survive and remain working, this study failed to show a negative effect on hours worked associated with breast cancer. Perhaps the morbidity associated with certain types and stages of breast cancer and its treatment does not interfere with work.

Breast cancer survival, work, and earnings

Relying on data from the Health and Retirement Study (HRS) linked to longitudinal social security earnings data, we examine differences between breast cancer survivors and a non-cancer control group in employment, hours worked, wages, and earnings. Overall, breast cancer has a negative impact on employment. However, among survivors who work, hours of work, wages, and earnings are higher compared to women in the control group. We explore possible biases underlying these estimates, focusing on selection, but cannot rule out a causal interpretation. Our research points to heterogeneous labor market responses to breast cancer, and shows that breast cancer does not appear to be debilitating for women who remain in the work force.

Occupational impairment and disability among applicants for Social Security disability benefits in Pennsylvania

OBJECTIVE

The study goal was to assess the extent of workplace-related disease and injury among Social Security Disability Insurance applicants.

METHODS

A convenience sample of 240 consecutive applicants to the Pennsylvania Bureau of Disability Determination was studied to assess the prevalence of work-related disorders. An applicant had a work-related condition if there was a clear statement of a workplace illness or injury associated with the impairment, or if the applicant had worked at an occupation with a high likelihood of exposures known or suspected to contribute to the condition of interest.

RESULTS

Of the 240 applicants, 166 (69%) were awarded disability insurance benefits; a total of 27 (11%) had work-related conditions, including 14 of the 166 (8%) who were found to be disabled. Forty percent of the 27 had a disorder that was musculoskeletal in origin. Of 59 applicants with cancer, 10.2% had some work-related etiological component. Of an estimated 71,680 adult disability insurance applicants in Pennsylvania in 1990, 5134 new insurance beneficiaries had a projected occupationally related disability.

CONCLUSIONS

A substantial number of applicants for disability insurance benefits suffer from an impairment caused or exacerbated by prior workplace exposures. These individuals may serve as sentinel events for initiating follow-up surveillance and prevention activities.

Interpreting demographic effects in duration analyses of first birth intervals

"Estimated demographic effects in proportional hazard models of first birth intervals could reflect time-invariant differences in the risk of a birth, or differences in the timing of a shift in the risk, or both. This paper attempts to distinguish between these possibilities. The procedure is to estimate a more general model than the proportional hazard specification, in which the evolution of the risk of a birth can differ with demographic characteristics. The proportional hazard specification is nested within this more general model. Consequently, the consistency of the data with the 'risk' or the 'timing' interpretation of demographic effects can be tested. The data studied do not lead to a rejection of the proportional hazard specification." Data are from the 1984 U.S. National Longitudinal Survey Youth Cohort and concern 670 women aged 16 or 17 in 1979.

Costs of occupational injury and illness in Pennsylvania

A variety of state and federal data sources are used to estimate two critical components of the annual economic costs of occupational injuries and illnesses in Pennsylvania: foregone earnings of affected workers and medical costs. Foregone earnings costs resulting from occupational injuries and illnesses are estimated at between $1.22 billion and $2.02 billion in 1988. A number of potential adjustments to these estimates widen the range considerably. Estimates of medical costs range from $740 million to $797 million. Combining these two estimates gives total estimated costs of $1.96 billion to $2.82 billion.