Working Papers

“State-Mandated School-Based BMI Assessments and Self-Reported Adolescent Health Behaviors” Revisions Requested at Journal of Policy Analysis and Management

I provide novel evidence on the role of imperfect information in shaping childhood obesity. From 2003-2017, 24 states began requiring schools to perform Body Mass Index assessments on students. Using the 1991-2017 National and State Youth Risk Behavior Surveys and a difference-in-differences identification strategy, I show that these assessments increased the likelihood that teen girls described themselves as overweight and reported that they were trying to lose weight. These changes were driven by overweight teens, suggesting that the assessments did improve awareness about BMI status. I do not detect meaningful changes in exercise, calorie-limiting behaviors, or BMI, which suggests that combating childhood obesity will require more than correcting imperfect information about clinical weight thresholds.

“Market Responses to Vaccine Recommendations” with Laura E. Henkhaus and Emily C. Lawler

We provide novel evidence on how patients and firms respond to government-endorsed health recommendations. In 2014, the Advisory Committee on Immunization Practices recommended that elderly adults receive the pneumococcal vaccine Prevnar 13. Using a difference-in-differences strategy, we show that the recommendation increased pneumococcal vaccination among targeted adults and also had broader market impacts: the manufacturer (Pfizer) increased direct-to-consumer advertising, consumers increased Prevnar-related information search, and targeted adults were more connected to the health care system. Overall, the recommendation increased both Medicare Part B drug expenditures and Pfizer sales by approximately $1 billion annually, with little to no observable health benefits.

“Government Recommendations and Health Behaviors: Evidence from Breast Cancer Screening Guidelines” with Emily C. Lawler

We provide novel evidence on how health care decision-making responds to changes in government recommendations by studying the United States Preventive Services Task Force’s 2009 decision to stop recommending mammogram screenings for women aged 40-49. Using a difference-in-differences identification strategy, we find post-period reductions in mammography for targeted women relative to their older counterparts. We also identify large spillovers onto women aged 35-39 who were subsequently less likely to receive a mammogram recommendation or a mammogram. Additional analyses suggest the revision reduced overdiagnosis of early-stage tumors. Finally, we find that the 2009 update increased confusion about recommendations for preventing cancer.

Work in Progress

“Public Funding and Disease Prevention: Evidence from Funding Awards to Promote HPV Vaccination” with Christopher S. Carpenter and Emily C. Lawler

“Pharmacists’ Scope-of-Practice and HPV Vaccine Take-Up”

“Sanctuary Cities and Infant Health” with Catalina Amuedo-Dorantes and Yang Song