I provide novel evidence on how youth-targeted anti-obesity policies affect health behaviors. From 2003 to 2017, 32 states passed laws requiring schools to perform annual Body Mass Index (BMI) assessments on students. Though intended to correct imperfect information by providing teens and their parents with a report stating whether the child is overweight or obese, there is concern that these assessments may induce body dysmorphia and increase the incidence of eating disorders. Using the 1991-2017 National and State Youth Risk Behavior Surveys, I show that mandated school-based BMI 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 and obese girls holding more accurate views of their body types, suggesting that the assessments were successful in improving awareness about BMI and overweight status. While I do not detect changes in exercise, I show that teen girls with a negative body image were more likely to report calorie-limiting behaviors, such as dieting, fasting, and using diet pills. I do not detect changes in BMI, indicating that combating childhood obesity will require more than correcting imperfect information about clinical weight thresholds.
Falling childhood vaccination rates, the re-emergence of previously eradicated diseases, and the COVID-19 pandemic have raised important questions regarding the degree to which people may opt out of mandatory vaccination for religious or personal reasons. This paper provides novel evidence on how the scope of policies repealing non-medical vaccine exemptions affects exemptions, vaccination rates, and vaccine-hesitant information seeking behavior. First, I show that policies repealing at least some non-medical exemptions reduced the share of kindergartners with at least one exemption by 2-3 percentage points. This change was larger in states prohibiting all non-medical exemptions compared to states repealing personal exemptions but allowing for religious objections, suggesting that vaccine-hesitant parents in these latter states substituted toward religious exemptions. Indeed, these latter states experienced increased internet search activity for the phrase ‘religious exemption.’ Next, I show that while policies prohibiting all non-medical exemptions increased coverage of four school-entry vaccines (MMR, DTP, hepatitis B, and polio) by 1.7-2.9 percentage points, the estimates for policies repealing personal exemptions but allowing for religious objections were smaller in magnitude and often statistically insignificant. These results suggest that policymakers hoping to increase vaccine coverage should be mindful that their goals may be undermined by vaccine-hesitant parents continuing to utilize whatever exemptions remain at their disposal.
Work in Progress
“‘There She Is, Your Ideal’: Negative Social Comparisons and Health Behaviors” with Christopher S. Carpenter
“Bad Lighting: Effects of Youth Indoor Tanning Prohibitions” with Christopher S. Carpenter and Michelle Marcus
“Pharmacists’ Scope-of-Practice and HPV Vaccine Take-Up”