Research fields: Health Economics, Public Economics, Labor Economics, Applied Microeconomics
My research studies how health-related policies affects individual behavior and downstream outcomes, with a focus on family planning, risky behaviors, and public health interventions. I use quasi-experimental methods to estimate causal effects of policy changes, often leveraging variation in access to contraception, taxation, and pharmaceutical markets.
Publications
Can Expanding Contraceptive Access Reduce Adverse Infant Health Outcomes? Journal of Human Resources. (Forthcoming).
Previous version: IZA DP No. 17146
Abstract: This paper uses the implementation of a privately funded family planning program in Colorado to demonstrate that expanding access to long-acting reversible contraceptives to lower income women creates positive selection in the health of the children being born, reducing the rates of extremely preterm births and infant mortality. My most conservative estimates suggest reductions of 1.1 extremely preterm births and 0.9 infant deaths per 1,000 live births, with the largest reduction in deaths due to Sudden Infant Death Syndrome. This suggests that expanding contraceptive access could help close the infant mortality gap between the U.S. and other leading economies.
Contraceptive Access and Infant Health Outcomes. Journal of Health Economics. Volume 104. December, 2025. Article 103081.
Previous version: IZA DP No. 17320. Replication Package.
Abstract: This paper documents an important unintended consequence of expanding contraceptive access; it reduces the rates of adverse infant health outcomes. I study a large family planning initiative in the St. Louis metropolitan area that provided thousands of long-acting reversible contraceptives (LARCs) to reproductive-age women at no cost. Using a synthetic difference-in-differences design, I find that the program led to substantial improvements in infant health, reducing extremely preterm births by 2.18 and infant deaths by 1.74 per 1,000 live births, reductions of approximately 20% for each outcome. I find meaningful reductions for both Black and White mothers, though the effects on Black mothers are less precisely estimated and are smaller as a percentage of the baseline rates, particularly for extremely preterm births.
When Beer is Safer than Water: Beer Availability and Mortality from Water-Borne Illnesses, with Francisca Antman. Journal of Development Economics. Volume 171, October 2024. Article 103343.
Media coverage: Economist Writing Every Day.
Previous version: IZA DP No. 17164.
Abstract: We investigate the impact of beer on mortality during the Industrial Revolution in 18th century England. Due to the brewing process, beer represented an improvement over available water sources during this period prior to the widespread understanding of the link between water quality and human health. Using a wide range of identification strategies to derive measures of beer scarcity driven by tax increases, weather events, and soil quality, we show that beer scarcity was associated with higher mortality, especially in the summer months when mortality was more likely to be driven by waterborne illnesses related to contaminated drinking water. Wealso leverage variation in inherent water quality across parishes using two proxies for water quality to show that beer scarcity resulted in greater deaths in areas with worse water quality. Together, the evidence indicates that beer had a major impact on human health during this important period in economic development.
Soda Taxes, Consumption, and Health Outcomes for High School Students. Economics Letters. Volume 234. January 2024. Article 111507
Abstract: This paper uses new data from the Youth Risk Behavioral Surveillance System (YRBS) survey to assess whether the sugar-sweetened beverage taxes passed in Philadelphia, San Francisco, and Oakland have led to health improvements among high school students in these cities. I find that students in Philadelphia reduced their consumption by over one soda per week and that this reduction has remained constant or even grown over the first four years since the tax was implemented. I estimate that average BMI went down by 1.3% by 2021 across the three cities and that these effects are larger among female and non-white students.
Do Sugar-Sweetened Beverage Taxes Improve Public Health for High School Aged Adolescents? Health Economics. Volume 32 (1). January 2023. Pages 47– 64.
Media Coverage: Medical Xpress, US News
Abstract: Sugar-sweetened beverage taxes have become an increasingly popular policy to combat the worldwide obesity epidemic, but relatively little is known about their impact on health outcomes, particularly among high school aged students. In this paper, I use public-use data from the Youth Risk Behavioral Surveillance System to determine whether high school students living in three of the American cities which have implemented Sugar-sweetened beverage taxes have experienced public health improvements. Using an event-study design that compares outcomes in treated districts to a group of similar control districts, I find reductions in soda consumption in Philadelphia and average body mass index in Philadelphia, San Francisco and Oakland, with suggestive evidence that the improvements are concentrated among female and non-white respondents in both cases.
Salary Disclosure and Individual Effort: Evidence from the National Hockey League. Journal of Economic Behavior and Organization. Volume 202, October 2022, Pages 471-497.
Media Coverage: The Economist, Wall Street Journal, Harvard Business Review, The Journal (podcast), Fortune, Wired
Abstract: In late January, 1990, the salary of every National Hockey League (NHL) player was suddenly disclosed, ending a decades-long culture of pay secrecy. I find that underpaid players respond to this new information by reallocating effort from defense to offense, which is more highly compensated within the league. Underpaid players begin scoring more, but allow their teams to get scored on by even more than the additional goals they provide. Asymmetrically, overpaid players do not become more defensive-minded. Consistent with reference-dependent utility theory, I find suggestive evidence that this shift is more pronounced for underpaid players who play for teams with higher overall payrolls, as these players likely have a larger discrepancy between their actual salary and their reference point.
Expanded Contraceptive Access Linked to Increase in College Completion Among Women in Colorado, with Sara Yeatman, Amanda Stevenson, Katie Genadek, Jane Menken and Stefanie Möllborn. Health Affairs. Volume 41:12. December, 2022. Pages 1754-1762.
Media Coverage: The Hill, Medical Xpress, ScienMag
Abstract: Public subsidies for contraception are often justified by assertions regarding their benefits for women’s lives, yet there is limited contemporary evidence supporting these assertions. Beginning in 2009 the Colorado Family Planning Initiative abruptly expanded access to the full range of contraceptive methods through Colorado’s Title X family planning clinics. Using eleven years of American Community Survey data linked to data from two decennial censuses, we assessed whether exposure to the program led to improvements in college completion among women. Exposure to the Colorado Family Planning Initiative at high school ages was associated with a population-level increase of 1.8–3.5 percentage points in women’s on-time bachelor’s degree attainment, which represents a 6–12 percent increase in women obtaining their degrees compared with earlier cohorts. Federal and state policies restricting or expanding access to the full range of contraceptive methods can affect women’s attainment of higher education in addition to their reproductive health.
Working Papers
Playing it Safe? The Effect of Abortion Bans on Sexual Behavior, with Caitlin Myers and David Munro. NBER WP No. 35333.
Abstract: We estimate the effect of total abortion bans enacted after Dobbs v. Jackson Women's Health on sexual behavior. Using synthetic and standard difference-in-differences designs, we analyze gonorrhea rates and over-the-counter contraceptive purchases as indicators of sexual activity and contraceptive use. We find that total abortion bans reduced gonorrhea rates by 21\% among the population aged 15--44 and increased condom purchases by 5.4\%. County-level analyses suggest the response reflects awareness of state policy rather than changes in travel distance to providers. These findings are consistent with a framework in which abortion restrictions increase the perceived cost of unprotected sex, inducing more cautious behavior.
Subscriptions to Prescriptions: Louisiana's Progress Toward Eliminating Hepatitis C, with Barton Willage and Bethany Lemont. NBER WP No. 33617. Reject and resubmit at the Journal of Public Economics.
Media Coverage: NBER Digest
Abstract: Hepatitis C is a major public health concern due to its high rates of infection and mortality. Recent breakthroughs in pharmaceuticals not only have the potential to cure hepatitis C but could also cause large positive health externalities through reduced transmission. The high cost of these drugs under traditional reimbursement schemes create large obstacles to care, but a recent first-of-its-kind two-part tariff system in Louisiana aims to circumvent these obstacles using a modified subscription model with an exclusive pharmaceutical provider. Under this model, the medication is provided at no marginal cost to the state to cover the state's Medicaid and incarcerated population. This creates an incentive for Louisiana to aggressively test and treat as many patients as possible in order to maximize the benefits of this agreement. Using a number of different data sources, we implement synthetic control and event-study specifications, and find that detection and treatment of hepatitis C increased dramatically, with meaningful reductions in hepatitis C-related mortality and liver transplants after this agreement. Finally, after calculating the Marginal Value of Public Funds of this agreement, we find that the program more than pays for itself.
Soccer's Record on the Road: The Effect of Late-Night Sporting Events on Fatal Car Accidents, with Peter Nencka and Noah Meyers-Richter. IZA DP No. 18050.
Abstract: Sleep deprivation imposes significant public health and economic burdens. While researchers studying events like daylight saving time have quantified the impacts of population-wide sleep shifts, less is known about the consequences of acute, voluntary, and recreation-driven sleep loss. This paper investigates this gap by studying the 2002 FIFA World Cup, hosted in South Korea and Japan. The extreme time difference meant that US-based fans sacrificed significant sleep to watch live matches. We track fatal accidents in areas with large German populations on days when the German national soccer team played early morning games. Germany has by far the largest number of Americans who trace their ancestry to a foreign country, and they made it to the final of this World Cup. Areas with greater than 30% German heritage experienced increases in fatal car accidents of 35% relative to control areas after German games. The effects are dose-dependent and rise as the share of the German population increases. Our results are larger for crucial tournament games and non-alcohol-related incidents, consistent with sleep-deprived driving. Effects are driven by male drivers, mirroring World Cup viewer demographics. Placebo tests using the 2006 World Cup, where no games were played during normal U.S. sleeping hours, confirm that sleep disruption, not the sporting event itself, drives our findings.
The Fertility Reduction Effect of the Colorado Family Planning Initiative by Age and Parity, with Amanda Stevenson, Sara Yeatman, Katie Genadek, Jane Menken, Stefanie Möllborn, and Leslie Root. Revised and resubmitted at Health Economics.
Abstract: We use restricted-access birth records from the National Vital Statistics System (NVSS) to document the full age and parity fertility effects of the Colorado Family Planning Initiative (CFPI). Funded by an anonymous donor in 2008, the CFPI provided access in Title 10 clinics to every FDA approved method of contraception for free to anyone living below 200% of the federal poverty line. Previous research has demonstrated important effects on the fertility at ages 15-29. We separately estimate the statewide fertility effect of the CFPI across all ages (15-44) for all births and for first and non-first births using the synthetic control method. We find large and statistically significant reductions in birthrates for 15-24-year-olds that largely line up with other recent studies, but we find important heterogeneity across parity. For teenagers, we find reductions in first birthrates of about 9%, but much larger reductions in non-first birthrates of 17-25%. We also find reductions in overall fertility for 20-24 and 25-29-year-olds, but these are entirely driven by reductions of 5-9% in non-first birthrates, with no significant changes in first births. For 30-39-year-olds, we find small but statistically significant reductions in fertility of 3-7% across parity levels, and we find a 6% reduction in fertility for 40-44-year-olds, likely driven by a combination of long-acting reversible contraceptives and sterilizations.
The Returns to Regulatory Redundancy: Evidence from Tobacco 21, with Michael Pesko and Christian Saenz.
Abstract: We consider the impact of state laws that prohibit conduct already barred under federal law. In particular, we examine the effectiveness of state minimum legal sales laws for tobacco, or tobacco 21 laws, implemented after the federal T21 law in December 2019. Using difference--in--differences modeling that exploits the staggered implementation of tobacco 21 legislation (T21) in 28 states after 2019, we find that these state T21 laws consistently have little to no effect on smoking and vaping among adults ages 18 to 20, nor for high school youth. Our findings indicate that state T21 laws offer little marginal benefit under a unified federal T21 regime. We discuss voluntary compliance as a likely explanation for these findings.
Works in Progress
The Long-Term Effects of the Black Panther Party's Free Breakfast Program, with Nora Kenawy and Barton Willage.
Educational and Labor Market Impacts of Changes in Access to Family Planning Services and Potential Policy Mediators, with Riley Acton, Daniel Marthey, Maranna Yoder, and Jiee Zhong.
When the Moon Makes You Drive Like You've Had Too Much Wine: The Lunar Cycle and Fatal Car Crashes, with Luke Koulouris and Addie Taylor.
Linking Tax Records to the Census to Measure the Incidence of Poverty, with Amanda Stevenson, Sara Yeatman, Katie Genadek, Jane Menken, Stefanie Möllborn, and Leslie Root.
Closing the Border: The Impact of Restricting US-Mexico Border Crossings on Employment Outcomes, with Francisca Antman and Alexander Imhof.
Resting Papers
Tobacco 21 Laws, Prenatal Smoking, and Birth Outcomes, IZA DP #17765
Soda Taxes, BMI and Obesity: Evidence from Seattle, with Anja Gruber. IZA DP #17716