This dissertation contains three chapters on adult mental health and pain in the contemporary United States, paying special attention to social inequalities therein. In the first chapter I use data from the 2002-2014 National Health Interview Survey Linked Mortality Files (NHIS-LMF) to explore sociodemographic differences in the intersection of physical and psychological pain (referred to as the “pain–distress nexus”) and its relationship to mortality among adults ages 25 to 64. I find the combination of both high distress and high pain is most prevalent and most strongly predictive of mortality among socioeconomically disadvantaged, non-Hispanic Whites. In the second chapter I use data from the 2015, 2017, and 2019 Behavior Risk Factor Surveillance Survey (BRFSS) to examine associations between informal caregiving and self-rated pain intensity among middle-aged and older adults with provider-diagnosed arthritis. I find that informal caregiving status is associated with higher pain intensity. Among informal caregivers, caring for a spouse/partner, providing care for 5+ years, providing care for 20+ hours/week, and helping with personal care or household tasks were all linked to higher pain intensity. Associations were stronger for male caregivers than for female caregivers. In the third chapter, I use data from the 2002-2018 National Health Interview Survey (NHIS) to examine and decompose trends in mental distress among non-Hispanic White and Black adults aged 25-44 and 45-64. I find that mental distress significantly increased over time among all groups. Steep increases in mental distress among Whites, particularly among those aged 25-44, suggest narrowing Black-White disparities over time. My decomposition analyses reveal that changes in population composition, specifically the increase in heavy alcohol use and physical pain, largely explained the increase in mental distress among Blacks, while the increase in mental distress remained largely unexplained among Whites. Together, these three chapters illustrate the intricate nature of inequalities in psychological and physical pain.

Platform work is still a relatively new feature of US labor markets. The limitations of existing data sources have made it challenging to study these workers. This dissertation examines the economic conditions and labor market outcomes experienced by these workers using the underutilized Federal Reserve’s Survey of Household Economics and Decisionmaking (SHED). Chapter one shows that platform workers have lower and more volatile household incomes, hampering their ability to meet their economic obligations. This economic precarity is most pronounced for those who combine platform work with informal work, like dog walking, babysitting, or day labor. Chapter two shows that platform work tends to be one-off employment, with only 21% of workers who participate in one year also participating in the subsequent year. It also shows that platform workers experience additional employment churn in formal labor markets. Again, these negative outcomes are magnified for those who also do informal work. The third chapter argues that poor outcomes in formal labor markets and lacking social safety nets drive participation in platform work. It shows that a 1% increase in the state-level unemployment rate corresponds with a 0.53% increase in the probability that a worker will do platform work. Together, these results characterize platform labor as an exploitative set of labor relations in the sense that it attracts the economically vulnerable, quickly churns through them, and does not leave them any better off for their participation. To address this, I argue that platform workers be incorporated into existing social safety net schemes, like unemployment insurance, to address their economic vulnerability directly while providing them with more viable alternatives to platform labor.

In this essay, we report our empirical investigation of potential differences between early-marrieds (ages 20-24), who are more aligned with a cornerstone marriage model, and later-marrieds (25+), who are more aligned with a capstone model, on a wide range of marital outcomes. To do so, we employ three recent datasets with large, nationally representative samples. Overall, our analyses demonstrate no empirical reasons to favor capstone marriage over cornerstone marriage. It is important to note that our definition of cornerstone marriage is for those who married in their early 20s (not in their teens).

The literature has traditionally focused on the local unemployment rate one faces at the beginning of their career to measure how initial economic conditions affect long-run outcomes. However, the unemployment rate moves in response to changes in labor supply or labor demand. Using JOLTS State Estimates for job openings, hires, and separations along with Local Area Unemployment Statistics, I test how changes in more direct measures of demand at labor market entry affect long run outcomes. I find that for every one point increase in the local unemployed-to-job-opening ratio, annual earnings are reduced by 4.53% and remain depressed for 13 years. Conversely, I find that a one percentage point increase in the local job openings rate or the local quits rate, increases initial annual earnings by 8.15% and 14.23%, respectively.

Advancing prior research that treated college graduates as a homogeneous group, we investigate heterogeneity in assortative mating patterns across baccalaureate degree fields. As baccalaureate degree fields are related to occupation, an important question remains about whether field-of-study homogamy begets occupational homogamy. We drew on the school-to-work transition literature, which shows that baccalaureate degree fields differ in their linkages to a targeted or diffuse set of occupational destinations. We analyzed 34,373 college-educated newlyweds from the 2009–2019 American Community Surveys. Log-linear analysis revealed a tendency for college graduates, especially those in vocational specific fields (fields that have targeted connections to specific occupations; e.g., law, health, and education), to marry a spouse in the same field. In addition, occupational homogamy was more likely to occur among couples with two spouses in the same vocational specific field than among couples with two spouses in different fields. By examining patterns and implications of field-of-study assortative mating, this study underlines the importance of horizontal stratification of higher education in shaping meeting opportunities and highlights how pathways from field of study to occupation structure marriage markets.

Technological change leads employers to transform their demand for workforce skills, with dramatic consequences for the distribution of economic prosperity and the future of work. However, different technologies can place different and even opposing pressures on skill demand and organizational structure: they may drive increased or decreased division of labor or make workers of different skill levels more or less competitive with machines. To understand and respond to these changes, the objective of the research in this dissertation is to develop and explore frameworks for thinking about technological change in relation to labor and organizations. This dissertation seeks to address four questions of interest (in each of four corresponding chapters) for our understanding of technology change, labor outcomes and opportunities for policy and strategy. 1) What are the implications of two simultaneous technological changes (automation, parts consolidation) for labor skill demand within an occupation? 2) Why and how do technological changes differ in their effects on skill demand? 3) How are the effects of technology change modified when applied to tasks of different types? 4) How might organizational structure and technical uncertainty provide different opportunities for worker participation in new technology development and implementation?

We classify and analyze 200,000 US congressional speeches and 5,000 presidential communications related to immigration from 1880 to the present. Despite the salience of antiimmigration rhetoric today, we find that political speech about immigration is now much more positive on average than in the past, with the shift largely taking place between World War II and the passage of the Immigration and Nationality Act in 1965. However, since the late 1970s, political parties have become increasingly polarized in their expressed attitudes toward immigration, such that Republican speeches today are as negative as the average congressional speech was in the 1920s, an era of strict immigration quotas. Using an approach based on contextual embeddings of text, we find that modern Republicans are significantly more likely to use language that is suggestive of metaphors long associated with immigration, such as “animals” and “cargo,” and make greater use of frames like “crime” and “legality.” The tone of speeches also differs strongly based on which nationalities are mentioned, with a striking similarity between how Mexican immigrants are framed today and how Chinese immigrants were framed during the era of Chinese exclusion in the late 19th century. Overall, despite more favorable attitudes toward immigrants and the formal elimination of race-based restrictions, nationality is still a major factor in how immigrants are spoken of in Congress.

This article examines the consequences and causes of low enrollment of Black patients in clinical trials. We develop a simple model of similarity-based extrapolation that predicts that evidence is more relevant for decision-making by physicians and patients when it is more representative of the group that is being treated. This generates the key result that the perceived benefit of a medicine for a group depends not only on the average benefit from a trial, but also on the share of patients from that group who were enrolled in the trial. In survey experiments, we find that physicians who care for Black patients are more willing to prescribe drugs tested in representative samples, an effect substantial enough to close observed gaps in the prescribing rates of new medicines. Black patients update more on drug efficacy when the sample that the drug is tested on is more representative, reducing Black-White patient gaps in beliefs about whether the drug will work as described. Despite these benefits of representative data, our framework predicts that those who have benefited more from past medical breakthroughs are less costly to enroll in the present, leading to persistence in who is represented in the evidence base.

This article offers the first empirical evidence that labor force exit rates rise when workers’ relative earnings fall. The model takes into account that a job not only provides economic security but also affirms a worker’s social status, which is tied to their relative position in the labor market. Based on the results, the decline in relative earnings for non-college prime-age men over the last four decades is estimated to have raised their labor force exit propensity by 0.49 percentage point, accounting for 44 percent of the total growth in their labor force exit rate during this period.

Over eight million jobs were lost in the Great Recession, creating widespread economic hardship. This paper documents a novel and robust empirical regularity that highly concentrated local labour markets experienced larger employment declines during the Great Recession. Through setting up a model with heterogeneous firms facing idiosyncratic productivity shocks, I show that firm size distribution summarised by the Herfindahl- Hirschman index plays a crucial role in the reallocation of workers, and it magnifies negative idiosyncratic shocks and attenuates positive ones. I undertake a series of empirical tests to rule out alternative explanations, and show that large employment losses in concentrated labour markets are not driven by highly concentrated industry locations being hit harder during the Great Recession, having smaller labour markets or higher firm leverage ratios. The effect of concentration level is larger in sectors with higher labour supply elasticity, or a higher variance of productivity shocks, and rises during the Great Recession compared to other periods, consistent with my model’s predictions.

In many bioscience studies, it is common to encounter count data with a large number of zeros that Poisson regression model or standard zero-in ated Poisson (ZIP) regression model do not fit well. Generalized zero-in ated Poisson (GZIP) regression mixture model can handle the data with excess zeros and overdispersion caused by unobserved heterogeneity. For the parameter estimation, expectation-maximization (EM) algorithm with iteratively reweighted least sqaures (IRLS) method is used. We applied GZIP regression mixture model into two health-related data, Behavioral Risk Factor Surveillance System (BRFSS) data and Integrated Public Use Microdata Series (IPUMS) census data, and compared the performance of the models using AIC and BIC to find the best mixture model.

This critical community-engaged mixed methods study quantifies worker mistreatment on day labor corners in Bryan, Texas, and examines how day laborers resist labor exploitation. Day laborers seek work in open air spot markets. The work is precarious, with temporary and unregulated employment relations, weak enforcement, and poor working conditions. In this weak penalty and labor enforcement regime, labor violations are not surprising. Contrary to dominant theories, however, we argue that demand-side (industry) characteristics are more important for explaining the prevalence of labor violation than supply-side (worker characteristics). We use the Central Texas Day Labor Survey (2012-2021), 210 ethnosurveys consisting of 55% unauthorized workers, 24% authorized workers, and 20% Latinx, Black, and White citizens. We find that higher indices of labor violations and work abuse are not associated with lower-status workers; all workers, irrespective of legal status or citizenship, experienced abuse by employers. Demand-side characteristics were partially associated with higher levels of wage theft and mistreatment. In terms of wages, we found a gradation of wages with the lowest for unauthorized immigrants, then authorized immigrants, Latinx citizens, Black citizens, and lastly White citizens. Finally, workers collectively fight back against injustice by warning each other about unscrupulous employers.

Big data analytics has opened new avenues in economic research, but the challenge of analyzing datasets with tens of millions of observations is substantial. Conventional econometric methods based on extreme estimators require large amounts of computing resources and memory, which are often not readily available. In this paper, we focus on linear quantile regression applied to “ultra-large” datasets, such as U.S. decennial censuses. A fast inference framework is presented, utilizing stochastic sub-gradient descent (S-subGD) updates. The inference procedure handles cross-sectional data sequentially: (i) updating the parameter estimate with each incoming "new observation", (ii) aggregating it as a Polyak-Ruppert average, and (iii) computing a pivotal statistic for inference using only a solution path. The methodology draws from time series regression to create an asymptotically pivotal statistic through random scaling. Our proposed test statistic is calculated in a fully online fashion and critical values are calculated without resampling. We conduct extensive numerical studies to showcase the computational merits of our proposed inference. For inference problems as large as (n, d) ∼ (107 , 103 ), where n is the sample size and d is the number of regressors, our method generates new insights, surpassing current inference methods in computation. Our method specifically reveals trends in the gender gap in the U.S. college wage premium using millions of observations, while controlling over 103 covariates to mitigate confounding effects

The gender education gap has undergone a transition in the post-war period, from favoring men to favoring women. As a result, in 30% of young American couples, the wife is more educated than the husband. These “married down” women display substantially higher employment rates, relative to women with husbands with the same or higher level of educational attainment. We argue that the interaction between work and marital decisions can explain the higher employment rates of women who marry down. Returns to experience are key in this mechanism, since they lock in early employment choices. We formulate a dynamic life cycle model of marriage and divorce, with endogenous labor supply decisions, and structurally estimate it using NLSY79. We show that returns to experience account for 45% of the employment gap between married down women and married up women. The estimates further suggest that the changes in educational sorting patterns across cohorts can explain 11% of the rise in married women's employment between the 1945 and 1965 cohorts. Finally, we simulate a shift from joint to individual taxation. The model predicts a larger increase in married down women's employment rate.

Background: Since its 2012 inception, the U.S. Centers for Medicare & Medicaid Services Hospital Readmissions Reduction Program (HRRP) has espoused cost-effective health-care delivery by financially penalizing hospitals with excessive 30-day readmission rates. In this study, we hypothesized that socioeconomic factors impact readmission rates of patients undergoing spine surgery.Methods: In this study, 2,830 patients who underwent a spine surgical procedure between 2012 and 2018 were identified retrospectively from our institutional database, with readmission (postoperative day [POD] 0 to 30 and POD 31 to 90) as the outcome of interest. Patients were linked to U.S. Census Tracts and ZIP codes using the Geographic Information Systems (ArcGIS) mapping program. Social determinants of health (SDOH) were obtained from publicly available databases. Patient income was estimated at the Public Use Microdata Area level based on U.S. Census Bureau American Community Survey data. Univariate and multivariable stepwise regression analyses were conducted. Significance was defined as p < 0.05, with Bonferroni corrections as appropriate.Results: Race had a significant effect on readmission only among patients whose estimated incomes were < $ 31,650 (χ 2= 13.4, p < 0.001). Based on a multivariable stepwise regression, patients with estimated incomes of < $ 31,000 experienced greater odds of readmission by POD 30 compared with patients with incomes of > $ 62,000; the odds ratio (OR) was 11.06 (95% confidence interval [CI], 6.35 to 15.57). There were higher odds of 30-day readmission for patients living in neighborhoods with higher diabetes prevalence (OR, 3.02 [95% CI, 1.60 to 5.49]) and patients living in neighborhoods with limited access to primary care providers (OR, 1.39 [95% CI, 1.10 to 1.70]). Lastly, each decile increase in the Area Deprivation Index of a patient's Census Tract was associated with higher odds of 30-day readmission (OR, 1.40 [95% CI, 1.30 to 1.51]).Conclusions: Socioeconomically disadvantaged patients and patients from areas of high social deprivation have a higher risk of readmission following a spine surgical procedure.Level of Evidence: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Atopic dermatitis (AD), or eczema, is a chronic, inflammatory skin disease affecting 10.2% of adults in the United States.1 Some patients with AD use complementary and alternative medicine (CAM) for the adjuvant treatment of their disease.2 Although many studies have demonstrated a promising role of certain CAM modalities in the management of AD, others have shown limited efficacy and negative side effects of various CAM therapies.3 Given the inconclusive evidence for the efficacy of various CAM therapies, it is important to determine the extent of CAM use among adults with AD. This study aims to describe CAM use among adults with eczema and to compare CAM use in adults with and without eczema.

This paper documents the persistence of Southern slave owners in political power after the American Civil War. Using data from Texas, we show that former slave owners made up more than half of all state legislators until the late 1890s. Legislators with slave-owning backgrounds were more likely to be Democrats and voted more conservatively even conditional on party membership. A county’s propensity to elect former slave owners was positively correlated with cotton production, but negatively with Reconstruction-era progress of blacks. Counties that elected more slave owners also displayed worse educational outcomes for blacks in the early twentieth century.

We supplement the ‘Idea Production Function’ (IPF) with measures of R&D capital. We construct a time series of R&D capital stock in the US (1968-2019) based on cumulated R&D investment. We estimate the IPF with patent applications as R&D output, allowing for a flexible treatment of unit productivity of R&D capital and R&D labor. We find that the elasticity of substitution between R&D input factors is 0.7 − 0.8 and significantly below unity. This implies that R&D capital is an essential factor in producing ideas, complementary to R&D labor. We also identify a systematic positive trend in R&D labor productivity at about 1% per year on average and a cyclical trend in R&D capital productivity. Our results suggest that instead of ‘ideas getting harder to find’, there is an increasing scarcity of R&D capital needed to find them.

We document changes in U.S. children’s family household composition from 1968 to 2017 with regard to the number and types of kin that children lived with and the frequency of family members’ household entrances and departures. Data are from the U.S. Panel Study of Income Dynamics (N = 30,412). Children experienced three decades of increasing instability and diversification in household membership, arriving at a state of “stable complexity” in the most recent decade. Stable complexity is distinguished by a decline in the number of coresident parents; a higher number of stepparents, grandparents, and other relatives in children’s households; and less turnover in household membership compared with prior decades, including fewer sibling departures. College-educated households with children were consistently the most stable and least diverse. On several dimensions, household composition has become increasingly similar for non-Hispanic Black and White children. Children in Hispanic households are distinct in having larger family sizes and more expected household entrances and departures by coresident kin.

Are heterogeneous labor market outcomes a product of markets efficiently allocating resources or the result of structural market failures which should be corrected through well-crafted policy? In order to address this fundamental question in modern economics, we must first understand the forces which shape individuals’ earnings, employment, and occupational choices. This collection of essays provides new evidence to support several novel channels which influence labor markets. First, I evaluate the connection between technological change and labor market outcomes by bringing new data and methods to study the mechanization of American agriculture in the early 20th century. Using an instrumental variables estimation strategy, I find that exogenous increases in exposure to technological change generated occupational displacement for incumbent laborers, increased income inequality, and had important impacts on intergenerational mobility for the children of affected workers. Additionally, I investigate the connection between low-opportunity neighborhoods and public housing residents’ labor market outcomes. Leveraging quasi-random variation in neighborhood quality due to a public housing demolition, I find that residents’ wages increased after moving to higher-opportunity neighborhoods and that more intense supportive services improved post-move employment. Taken together, these essays provide new evidence that both large-scale factors like new technologies and local factors like neighborhood quality contribute to heterogeneity in labor market outcomes both historically and up to the present day.