Aims Most US states use certificate-of-need (CON) programs in an attempt to slow the growth of health care spending. The objective of this study is to evaluate how CON in fact affects health care spending. Subjects and methods With 1980–2009 state-level data on spending from the National Health Expenditure Accounts, this article uses fixed-effects regressions to evaluate how the presence and scope of state CON laws affect these spending outcomes. Results This article estimates that CON laws lead to a statistically significant 3.1% increase in total spending and finds that this increase is primarily driven by spending on physicians. Conclusion Rather than decreasing health care spending as intended, it appears that CON laws actually increase it. To the extent that policy makers wish to restrain health care spending, they may wish to repeal these laws.

In 2003, President George W. Bush enacted the Healthy Forest Restoration Act (P.L. 108-148) (HFRA), expediting the preparation and implementation of hazardous fuels reduction efforts, if communities created community wildfire protection plans (CWPPs). CWPPs contextually define the wildland-urban interface (WUI) and evaluate risk. Additionally, CWPPs identify and prioritize both public and private land mitigation projects. However, CWPPs are only one strategy in reducing wildfire risk. Research also suggests codifying wildfire risk reduction efforts into land use regulations, such as comprehensive planning, building and zoning codes, and subdivision guidelines. This study uses document analysis and cumulative odds ordinal logistic regressions to answer the following questions: 1) how well are CWPP wildfire planning best practices integrated, 2) how well are wildfire risk reduction best practices incorporated into land use regulations, and 3) what social, economic, demographic and geographic factors predict the level of best practice integration of CWPP inputs and outputs? While the regression results proved to statistically insignificant, the study found several interesting trends. First, the WUI is still growing geographically. Second, the WUI is also increasing in population. Third, there is a small positive correlation between the increase in WUI seasonal home growth and increased composite scores (CWPP wildfire planning score + local governance wildfire land use regulations), suggesting it may be a leverage point for increased wildfire risk reduction planning. Fourth, there is a small negative correlation between longer homeowner tenure and the composite score, suggesting that wildfire risk reduction perceptions among long-time residents are complex. The results suggest that counties are not fully integrating CWPP or land use best practices. Both CWPPs and land use regulations can both improve by expanding their frames of reference from single development protectionism frames to include ecosystem health and incorporating more than one frame at a time. Additionally, counties must ensure frequent and timely update cycles, to better include emerging best practices and provide a sense of urgency to the process. Expanding frames requires a broader collective of participation. Noticeably absent from both the CWPP and comprehensive planning process were licensed land use professionals (e.g., architects, landscape architects, planners, surveyors, and civil engineers) who perform development work within each county. Counties should engage with licensing bodies to ensure professionals are adequately prepared to address health, safety, and welfare best practices to mitigate wildfire. As such professional licensure for health, safety, and welfare could be an expanded wildfire frame. When incorporating expanded frames, goals and objectives should be edited to be specific, measurable, achievable, relevant and timed (SMART). Finally, this study suggests the integration of the CDC's social vulnerability index (SVI) into risk mapping efforts and an expanded anticipatory development risk evaluation process. The form and content of this abstract are approved. I recommend its publication

In her book “No Kids: 40 Good Reasons Not to Have Children”, Corinne Maier puts into question the idealized notion of parenthood as a natural behavior. She asks her childless readers whether they are prepared to give up their time, money, and friends for the “vicious little dwarves” that will treat them like their servant and end up resenting them. In contrast to Corinne Maier, Jody Day, in her book “Living the Life Unexpected: 12 Weeks to Your Plan B for a Meaningful and Fulfilling Future Without Children”, states that “Across the globe, millions of women are reaching their mid-forties without having had a child, (…) most didn’t choose this and are silently struggling in a life they didn’t foresee. Most people think that women who aren’t mothers either couldn’t have or didn’t want children: the truth is much more complex.” In the list of arguments and situations discussed in these two books for the general public, many speak to the theory of fertility as it has been developed since Malthus (1807), Sadler (1830), and Becker (1960)..

This chapter examines the relationship between logistics industry workers and access to industry jobs. Over recent decades the location of logistics jobs has shifted as the industry has consolidated into larger warehouse and distribution centers. We conduct a case study of the Los Angeles Region and identify the locations of jobs, existing workers, and potential workers—those who would be qualified to work in the industry. We find that logistics jobs are held by a greater share of race/ethnic minorities than the workforce as a whole, but the share of women is much lower than the workforce as a whole. Logistics jobs are more spatially clustered than workers, and job access by car is orders of magnitude greater than access by public transit. Public transit would have to be greatly improved, perhaps by using new platform-based services that could operate more efficiently in low density environments, in order to become a viable option for accessing logistics jobs.

There is a wide-spread concern that technical change may spur social conflicts, especially if workers are replaced with machines. To empirically analyze whether job destruction drives protests, we study a historical example of a revolutionary new technology: the adoption of electricity. Focusing on the gradual roll-out of the Swedish electricity grid between 1900 and 1920 enables us to analyze 2,487 Swedish parishes in a difference-in-differences framework. Proximity to large-scale water-powered electricity plants is used to instrument for electricity adoption. Our results confirm that the labor saving nature of electricity was followed by an increase of local conflicts in the form of strikes. But displaced workers were not likely to initiate conflicts. Instead, strikes were most common in sectors with employment growth. Similarly,we find that the strikes were of an offensive rather than a defensive nature. Thus, electrification did not result in rebellions driven by technological anxiety. It rather provided workers with a stronger bargaining position from which they could voice their claims through strikes.

This dissertation presents studies of the interaction of health policies and labor markets, including issues of occupational choice, labor demand, and compensating differentials. In the first essay, Health Insurance and the Supply of Entrepreneurs: Evidence from the ACA Medicaid Expansion, I examine whether the expansion of Medicaid eligibility under the Affordable Care Act increases the supply of entrepreneurs as measured by self-employment. Using the 2003–2017 Current Population Survey and focusing on childless adults in low-income households, I apply difference-in-differences, propensity score weighting, and instrumental variable (IV) methods. I find that expanding Medicaid eligibility raises the self-employment rate by 0.8 to 1.6 percentage points, without increasing self-employment exit. IV estimates imply that covered individuals have 8 to 11 percentage points higher probability to become self-employed. Exploiting additional variation by spousal coverage or poor health of individuals or their spouse within triple difference specifications, I also find evidence that the underlying mechanism of the effect was through the reduction of entrepreneurship lock. The results suggest that limited access to health insurance may be a barrier to entrepreneurship...

Immigrant women's labour market participation remains a long standing concern in the context of developed countries. Bangladeshi women are persistently reported to be one of the lowest participant groups in formal labour market in the UK. Where there is plethora of research to point out this fact, hardly any persuasive explanation is offered to unfold the phenomenon. The intrinsic bond between the rhetoric of citizenship and identities as immigrant is blurred in the surge of literatures. In this milieu, present chapter contributes to develop the understanding of the complex notion of citizenship and its implication in labour market participation, broadly on immigrant women and narrowly on Bangladeshi immigrant women. It reveals how ‘identity shaped by citizenship discourse' influences one of the important indicators of economic empowerment - market participation.

Income inequality is a suboptimal measure of inclusion at the city level. A low level of inequality can reflect the exclusion or displacement of low income residents, or it can reflect a lack of opportunity overall. Using data for 274 U.S. cities for the years 1980, 1990, 2000, and 2010, we create more complete measures of both economic and racial inclusion. We then compare these inclusion measures with the Gini coefficient using a within estimator for cities over time. Results indicate that inequality and inclusion are not highly correlated and often trend in opposite directions. Most concerning is that reductions in income inequality are associated with reductions in the percent and number of residents of color within a city, suggesting that changes in income inequality capture the displacement of residents rather than true improvements to quality of life.

Traffic safety issues often impede bicyclist and pedestrian trips, preventing potential users from realizing the benefits of active transport. Traditional active transportation safety analyses, however, take a reactive approach to traffic safety, only accounting for people currently walking or bicycling by analyzing crashes, injuries, and fatalities. This begs the question: which populations are most affected by traffic safety issues neglected by traditional crash analyses? To answer this, we developed a tool to proactively measure perceived traffic safety issues. We focused on child pedestrian and bicycle trips to and from schools in Denver, Colorado by measuring the number of children that would encounter roads perceived as unsafe. We converted these perceptions into barriers in a geographic information system network analysis to estimate trip suppression and used that as a proactive indicator of traffic safety. We finally examined—reactively and proactively—the socio-demographics of those affected via linear regression models and bivariate choropleth mapping. Results of both analyses suggest that negative impacts are borne disproportionately by low-income, low-education, Hispanic, and black neighborhoods. Proactive analyses results identified perceived safety issues in north and northeast Denver neighborhoods neglected by reactive analyses results. Findings suggest the inequitable distribution of traffic safety issues identified in past crash-based literature is graver than conventional reactive analysis would lead one to believe. By incorporating the proactive tool into traditional traffic safety analyses, we hope to better define the places and people that could most benefit from traffic safety improvements, thereby more effectively facilitating the benefits of walking . . .

Despite remarkable progress toward gender equality over the past half-century, the stalled convergence in the gender wage gap after the mid-1990s remains a puzzle. This study provides new insights into this puzzle by conducting the first large-scale investigation of the uneven impact of the rise of programming in the labor market for men and women since the mid-1990s. We argue that the increasing reliance on programming has favored men's economic status relative to women's and therefore may help explain the slow convergence of the gender wage gap. We differentiate between two effects: (1) the composition effect, wherein men experience a greater employment growth in programming-intensive occupations relative to women, and (2) the price effect, wherein the wage returns to programming intensity increase more for men than women. Our empirical analysis documents a strong relationship between the rise of programming and the slow convergence of the gender wage gap among college graduates. Counterfactual simulations indicate that the absence of the composition and price effects would have reduced the gender wage gap over the past two decades by an additional 14.70 percent. These findings call attention to the role gender institutions play in shaping the uneven labor market impact of technological change.

Geothermal heat pumps (GHPs), also referred to as ground-source heat pumps or Geo-exchange, have been proven capable of producing large reductions in energy use and associated carbon emissions for space conditioning and water heating in buildings. However, the current adoption rate of GHPs in the United States is still low, and GHPs receive little attention from either the public or policy makers. This report gives an overview of the status of GHP technology and its application in the United States, cost and performance of the state-of-the art GHP systems, barriers preventing wider adoption, and technologies under development that have potential to help overcome these barriers. This report also presents an assessment of the technical potential of applying GHP systems in businesses and homes in the United States. The assessed technical potential includes energy savings, carbon emissions reductions, and consumer energy cost savings. This assessment is based on energy consumption data obtained from the latest residential and commercial buildings energy consumption surveys conducted by the US Department of Energy’s Energy Information Administration (EIA). It uses the energy savings data of GHP systems compared with existing conventional heating, ventilation, and air-conditioning (HVAC) systems, which were obtained from numerous published case studies and validated computer simulations. The impacts of various climate and geological conditions, as well as the efficiency and market share of existing conventional . . .

With the approach of Census 2020, the census’ accuracy in measuring the country’s population has received increasing attention. Young children are known to be particularly poorly counted. I estimate undercount of native-born children age 0-5 using a variant of Demographic Analysis, a technique long employed by the Census Bureau to evaluate census measurement of the full population. Using PUMS data, rather than the full 100 percent counts used by Census, I show that infants are undercounted in the 1990 PUMS by 20 percent for non-blacks and 30 percent for blacks. I also compute undercount by state of birth, a statistic not reported by Census, and show rates vary widely by state and race. By adjusting the PUMS weights for the undercount of children and performing several empirical analyses using these undercount-adjusted weights, I demonstrate the implications the undercount of children has for the measurement of child poverty.

Using a panel of tract-level bilateral commuting flows, I estimate the causal effect of Los Ange-les Metro Rail on commuting between connected locations. Unique data, in conjunction with a spatial general equilibrium model, isolate commuting benefits from other channels. A novel strategy interacts local innovations with intraurban geography to identify all model parameters (local housing and labor elasticities). Metro Rail connections increase commuting between locations containing (adjacent to) stations by 15% (10%), relative to control routes selected using proposed and historical rail networks. Other margins are not affected. Elasticity estimates suggest relatively inelastic mobility and housing supply. Metro Rail increases welfare $146 million annually by 2000, less than both operational subsidies and the annual cost of capital. More recent data show some additional commuting growth.

This masters’ thesis aims to examine the impact of the legalization of marijuana for recreational use on the death toll from opioid misuse in the state of Colorado. This investigation was done using the Synthetic Controls Method via data collected primarily from the CDC and IPUMS databases. The results indicate that the 2012 legalization policy in Colorado appears to reduce the number of deaths due to opioid overdoses.

Sociologists have long viewed spatial assimilation as a measure of minorities’ socioeconomic progress. While assimilation increases as socioeconomic status (SES) improves, blacks remain more highly segregated than any other race/ethnic group. I use the locational attainment model to determine whether black immigrants—like their U.S.‐born counterparts—are highly segregated. This paper broadens the segregation literature by determining: (1) black immigrant segregation patterns after controlling for individual‐level characteristics, (2) the extent to which segregation varies by location, and (3) if racial segregation has the same socioeconomic consequences for U.S.‐ and foreign‐born blacks. I find that black immigrants face high racial and socioeconomic segregation in mainly Caribbean settlement areas. However, black immigrants in all but two predominantly African settlement areas experience no segregation. Essentially, I find that there is a great deal of diversity in black immigrants’ segregation patterns stemming from differential treatment in the housing market based on African immigrants’ higher SES and/or African immigrants’ residential choices. Results in the two outlier African settlement areas (Minneapolis and Washington, D.C.) suggest that entry visa may play an important role in black segregation.

Changes in partnership patterns among Asian Americans reflect their level of cultural and socioeconomic assimilation. Although Asian Americans are an extremely diverse group, relatively little research has explored their subgroup variations in partnership patterns. Using the 2012-2016 American Community Survey, this study examines ethnic and generational differences in marriage and cohabitation patterns among six major Asian groups. We find significant ethnic variations in declining marriage rates over generations, particularly among Asian American women. Indian and Vietnamese exhibit the largest generational decline in marriage, while Japanese and Koreans show the smallest. We also find ethnic differences in the relative importance of the postponement of partnership formations and the rise in cohabitation in explaining the generational decline in marriage. Our findings suggest that not all Asian Americans assimilate at the same pace, and thus should be operationalized as a disaggregate unit.

This study investigates the outcomes out-of-pocket payments (OOPP) produce in terms of income-related disparities in unmet health needs (UHN) due to inability to pay and highlights the commodifying effect of OOPP in European healthcare systems. It merges micro data from the European Union Statistics on Income and Living Conditions survey (EU-SILC) for 2005–2012, with macro data from the World Bank, Organisation for Economic Co-operation and Development (OECD) and World Health Organization (WHO). Our results show that, first, across all European countries and years under study, income determines whether a person reports an occasion within the last year where she needed medical treatment or examination but did not receive it due to inability to pay. Second, the more a country relies on OOPP as a means of healthcare financing, the higher the proportion of respondents who report UHN. Third, the share of OOPP amplifies the effect of income considerably. While the poorest decile has a 2 percentage points higher predicted probability of suffering from financially determined UHN than the richest decile in a country with relatively low OOPP (11% of total health expenditure), this difference soars up to 10 percentage points in a country with relatively high OOPP (25%).

The purpose of this paper is to investigate how to measure primarily new growth determinants, which incorporate new technologies (Industry 4.0), global value chains, changing population structure with ageing, which affect the performance of firms. The focus is not on the theoretical linkages (these have been provided in (Redek, Domadenik, et al., 2019)), but primarily on the challenges on measuring new growth determinants using existing data sources. The possible data sources are discussed at three levels: macro level, industry level and firm level. Table S1 summarizes the main available data at different levels (national, industry and firm level) and Table S2 matches the new sources against key data criteria. The paper also discusses each of the data source in more detail and provides an overview of key productivity estimation methods, studying also the appropriateness of these data for such analysis.

I investigate the medium-and long-run effects of tractor adoption on local labor markets and individual farmers. Using crop mix as an instrument for tractor adoption, I find that for each farm resident susceptible to tractor exposure as of 1910, 0.4 farm residents had moved off the farm by 1930 and 0.5 had moved off by 1940. Simultaneously , manufacturing employment grew by 0.2 jobs for each susceptible farm resident. To investigate long run consequences for individual farmers,

We examine the U.S. internal migration response to increased import competition following the granting of Permanent Normal Trade Relations to China in 2001. Using a variety of data sets and empirical approaches, we find that local labor markets most exposed to the policy change experienced a relative reduction in population growth over the following decade. The majority of the effect occurs at a lag of seven to ten years and is most pronounced among young individuals and low-education groups. Such population adjustments should influence the interpretation of evidence in the growing literature on import competition and local labor markets.