Publications

Objective

To determine whether the Supplemental Nutrition Assistance Program (SNAP), which addresses food insecurity, can reduce health care expenditures.

To systematically review and meta-analyze evidence of nonpharmacological interventions for postoperative pain management after total knee arthroplasty.

Objective: The purpose of this study was to evaluate the impact of objective isolation and loneliness on Medicare spending and outcomes. Method: We linked Health and Retirement Study data to Medicare claims to analyze objective isolation (scaled composite of

This paper studies how in utero exposure to maternal stress from family ruptures affects later mental health. We find that prenatal exposure to the death of a maternal relative increases take-up of ADHD medications during childhood and anti-anxiety and depression medications in adulthood. Further, family ruptures during pregnancy depress birth outcomes and raise the risk of perinatal complications necessitating hospitalization. Our results suggest large welfare gains from preventing fetal stress from family ruptures and possibly from economically induced stressors such as unemployment.

For forty years, the Tuskegee Study of Untreated Syphilis in the Negro Male passively monitored hundreds of adult black males with syphilis despite the availability of effective treatment.

Achieving gender equality in education is an important development goal.  We tested the hypothesis that the gender gap in adolescent education is accentuated by illnesses among young children in the household.

In December 2015, a Boston Globe investigation of Massachusetts General Hospital (MGH) sparked investigations into concurrent and overlapping surgery. Overlapping surgery refers to operations performed by the same primary surgeon such that the start of one surgery overlaps with the end of another. A qualified practitioner finishes noncritical aspects of the first operation while the primary surgeon moves to the next operation.

Missed evidence-based monitoring in high-risk conditions (e.g., cancer) leads to delayed diagnosis. Current technological solutions fail to close this safety gap. In response, we aim to demonstrate a novel method to identify common vulnerabilities across clinics and generate attributes for context-flexible population-level monitoring solutions for widespread implementation to improve quality.

The global financial crisis starting in 2007 prompted national governments around the world, and notably many within the European Union, to implement austerity measures. Similar to structural adjustment programs (SAPs) implemented throughout the developing world since the 1980s, much of the pressure to adopt and enforce austerity measures has been levied by global financial institutions such as the IMF.

The new United States administration’s first budget proposal, previewed in March and released in May, 2017, includes deep cuts to foreign aid, cycling this thorny issue back into the American limelight.

This paper examines the long-term impacts of early childhood exposure to air pollution on adult outcomes using U.S. administrative data. We exploit changes in air pollution driven by the 1970 Clean Air Act to analyze the difference in outcomes between cohorts born in counties before and after large improvements in air pollution relative to those same cohorts born in counties that had no improvements. We find a significant relationship between pollution exposure in the year of birth and later life outcomes.

Cultural taboos can restrict student learning on topics of critical importance. In India, such taboos have led multiple states to ban materials intended to educate youth about HIV, putting millions at risk. We present the design of TeachAIDS, a software application that leverages cultural insights, learning science, and affordances of technology to provide comprehensive HIV education while circumventing taboos.

With nearly half of U.S. births occurring out of wedlock, understanding how parents navigate their relationship options is important. This paper examines the consequences of a large exogenous change to parental relationship contract options on parental behavior and child well-being. Identification comes from the staggered timing of state reforms that substantially lowered the cost of legal paternity establishment. I show that the resulting increases in paternity establishment are partially driven by reductions in parental marriage.

Medical malpractice reform appears to be back on the federal policy agenda. The appointment of Tom Price, a long-time proponent of tort reform, as secretary of health and human services, in conjunction with Republican control of both houses of Congress, has created fertile conditions for several Republican proposals that have languished for years without the requisite support. Although it has been debated many times, a major federal foray into medical liability, a state-based area of law, would be unprecedented. The prospect raises several questions: Which reforms are on the table?

Historically, improvements in the quality of municipal drinking water made important contributions to mortality decline in wealthy countries. However, water disinfection often does not produce equivalent benefits in developing countries today. We investigate this puzzle by analyzing an abrupt, large-scale municipal water disinfection program in Mexico in 1991 that increased the share of Mexico’s population receiving chlorinated water from 55% to 85% within six months.

We study how agents respond to performance incentives according to key personality traits (conscientiousness and neuroticism) through a field experiment offering financial incentives for improving maternal and neonatal health outcomes to rural Indian doctors. More conscientious providers performed better – but improved less – under performance incentives.  The effect of the performance incentives was also smaller for providers with higher levels of neuroticism.

Most civilian casualties in war are not the result of direct exposure to bombs and bullets; they are due to the destruction of the essentials of daily living, including food, water, shelter, and health care. These “indirect” effects are too often invisible and not adequately assessed nor addressed by just war principles or global humanitarian response.

Importance  Colorectal cancer is the second leading cause of cancer death in the United States. In 2016, an estimated 134 000 persons will be diagnosed with the disease, and about 49 000 will die from it. Colorectal cancer is most frequently diagnosed among adults aged 65 to 74 years; the median age at death from colorectal cancer is 68 years.

Objective  To update the 2008 US Preventive Services Task Force (USPSTF) recommendation on screening for colorectal cancer.