The United States’ population is rapidly changing, but the ways in which political scientists measure and understand representation have not kept apace. Marginal shifts in descriptive representation over the past two decades have run counter to widely espoused ideals regarding political accessibility and democratic competition. A central assumption often made by academics, and the public, has been that groups which are otherwise disadvantaged in politics may leverage their communities’ numerical size as a political resource to gain influence. To this end, many studies of racial descriptive representation find that a larger minority population is associated with a higher likelihood of a racial minority running for and/or winning. However, these positive relationships between population growth and descriptive representation are tempered by an extensive literature documenting limits on racial minority groups’ political incorporation. Moreover, current frameworks for understanding group competition or patterns of descriptive representation are silent about whether shifts in racial demographics may also have an effect on the balance of representation between women and men. These contradictions in debates over representation, and how groups gain influence, undermine the notion that eventually, marginalized groups will be fully incorporated into politics. White women have had de jure access to the voting franchise in the United States since 1920. In the intervening period, women have made up approximately half the population, and outnumbered male voters in every presidential election since 1964. Yet, women have held a quarter or less of all state legislative seats across the country for well over two decades, and only reached 100 members of Congress in 2014. The case for eventual incorporation is similarly dubious when we consider the racial composition of elected bodies. The racial balance of American communities is in flux largely due to Asian and Latina/o immigration, which will continue to be the case into the forecastable future. Presently, Asian Americans and Latina/os make up 23 percent of the U.S. population and are the two fastest growing racial groups in the country. Members of these immigrant communities hold less than ten percent of all state legislative seats, and a similar fraction of seats in the 115th Congress. Taken together, these yawning gaps between presence in the population and representation in elected office strongly suggest that “time” alone may be an insufficient remedy for underrepresentation. Moreover, for those who are living in the United States now, the current demographic makeup of state legislatures—which includes over 7500 elected seats nationally—raises doubts about their representative legitimacy. Asian American and Latina/o women and men typically have socioeconomic experiences, political perspectives and policy priorities that are distinct from that of their most likely descriptive representative—a White man. At the same time, state legislatures have been veritable policy engines for bills and resolutions related to immigration and immigrants in recent years. The National Council of State Legislatures reports that in 2015 state legislatures enacted 216 laws and passed 274 resolutions related to immigrants and immigration. Even as these bodies write, debate, and pass legislation targeting immigrant communities, Asian Americans and Latina/os are rarely in the room. Researchers increasingly point to the scarcity of female or racial minority candidates as a key explanatory factor, but seldom examine issues related to race and gender at the same time. As a result, the extant scholarship obscures the outsized effects that White men’s candidacies have in defining American elections, and overlooks the distinct challenges that women of color face in getting on the ballot. This dissertation examines the intersecting roles of race and gender in elections, with particular attention to how they may be changing as immigrant communities become a larger proportion of the American population. I analyze the Gender Race and Communities in Elections dataset, which encompasses all state legislative general election winners and candidates from 1996- 2015, and includes demographic information for candidates and their district populations. This original dataset provides the first opportunity to simultaneously analyze descriptive representation in state legislatures, for women and men in the four largest racial groups, at the national level. I also present the results of a national survey of state legislators, and in-depth interviews with political elites, in order to reveal race-gendered, informal, processes of candidate development and deterrence. I also show that practical opportunities to compete in elections are sharply, and simultaneously, constrained by candidates’ race and gender. These constraints are most evident in the lopsided distribution of racial populations across districts, the uneven candidate development efforts of civic and political organizations, and the dominance of men in elite political networks, across racial groups. Based on my examination of Asian American and Latina/o candidates in elections, I advance a Race-Gendered Model for understanding the persistence of underrepresentation in state legislatures. I conceptualize elections as competitions for descriptive representation, and account for the disparate social and political experiences of women and men from different racial groups. Within this framework, race and gender simultaneously constrain potential candidates’ access to elections, producing a frequent absence of competition for descriptive representation. This model uses an intersectional approach to explain why Asian American and Latina/o women and men do not run more often, and why the majority of ballots are made up exclusively of White male candidates. I demonstrate that the increasing “strength in numbers” of Asian American and Latina/o communities has primarily served as a resource for increasing the racial diversity of men in statehouses—to the limited extent that racial diversity has increased at all. I also show that the most advantaged descriptive group, White men, benefits from an absence of competition in most electoral contests. At the same time, the fastest growing groups of women—Asian Americans and Latinas— are also the groups most frequently excluded from competing. The Race-Gendered Model expands the intellectual terrain available to answer longstanding questions in the study of women and racial minorities’ underrepresentation. Along the way, I argue that it is necessary to simultaneously consider why White men’s overrepresentation is similarly persistent. More broadly, the theory of competition presented in this dissertation shifts away from a central focus on the advantages and disadvantages groups face during election campaigns. Instead, I argue that the choices voters face in electing a descriptive representative are limited long before election day.

The study is rooted in the recognition that while multilingual children are frequently the object of sociolinguistic studies, the parenting of multilinguals has not yet received the attention it deserves in its own right. We obtained an account of multilingual parenting under conditions of dispersed migration using inductive methodology to analyse interviews conducted with 20 mothers of teenagers with a Polish family background living in Regensburg, Germany since birth or infancy. The article presents a typology of the parents' axiological attitudes to parenting, involving the relative primacy of values, such as child autonomy, child security, parent-child relations, the nation, and extended family that affect the decision of whether and to what extent the Polish language is being passed on to their children. This is followed by a related typology of conative attitudes to its intergenerational transmission. The latter does not stop at the behavioural aspects, i.e. the extent to which Polish is cultivated in interactions with the child, but also indicates the dichotomous motivations for suppressing or marginalizing Polish – submission to social pressure or communicative advantages. The key aspect of the study pertains to the relationships between the axiological attitudes to parenting and the conative attitudes towards the intergenerational transmission of Polish. Finally, it is indicated that the decision to stop using the minority language in parent–child communication, while controversial and much criticised, may be a rational response to the social risks as perceived by the parents.

Background: Early-life socioeconomic status (SES) may play a role in cancer risk in adulthood. However, measuring SES retrospectively presents challenges. Parental occupation on the birth certificate is a novel method of ascertaining early-life SES that has not been applied in cancer epidemiology. Methods: For a Baby-Boom cohort born from 1945-1959 in two Utah counties, individual-level Nam-Powers SES (Np-SES) was derived from parental industry/occupation reported on birth certificates. Neighborhood SES was estimated from average household income of census tract at birth. Cancer incidence was determined by linkage to Utah Cancer Registry records through the Utah Population Database. Hazard ratios (HR) for cancer risk by SES quartile were estimated using Cox proportional hazards regression. Results: Females with low Np-SES at birth had lower risk of breast cancer compared with those in the highest Np-SES group [HRQ1/Q4 =0.83; 95% confidence interval (CI), 0.72-0.97; HRQ2/Q4 =0.81; 95% CI, 0.69-0.96]. Np-SES was inversely associated with melanoma (HRQ1/Q4 =0.81; 95% CI, 0.67- 0.98) and prostate cancer (HRQ1/Q4 =0.70; 95% CI, 0.56- 0.88). Women born into lower SES neighborhoods had significantly increased risk for invasive cervical cancer (HRQ1/Q4 =1.44; 95% CI, 1.12-1.85; HRQ2/Q4 =1.33; 95% CI, 1.04-1.72). Neighborhood SES had similar effects for melanoma and prostate cancers, but was not associated with female breast cancer. We found no association with SES for pancreas, lung, and colon and rectal cancers. Conclusions: Individual SES derived from parental occupation at birth was associated with altered risk for several cancer sites. Impact: This novel methodology can contribute to improved understanding of the role of early-life SES on cancer risk.

This study investigated the relationship between specific cognitive patterns of strengths and weaknesses (PSWs) and the errors children make in reading, writing, and spelling tests from the Kaufman Test of Educational AchievementThird Edition (KTEA-3). Participants were selected from the KTEA-3 standardization sample based on five cognitive profiles: High Crystallized Ability paired with Low Processing Speed and Long-Term Retrieval (High Gc), Low Crystallized Ability paired with High Processing Speed and Long-Term Retrieval (High Gs/Glr), Low Orthographic Processing (Low OP), Low Phonological Processing (Low PP), and Low Phonological Processing paired with Low Orthographic Processing (Low PP_OP). Error factor scores for all five groups were compared on Reading Comprehension and Written Expression; the first four groups were compared on Letter & Word Recognition, Nonsense Word Decoding, and Spelling, and the first three groups were compared on Phonological Processing. Significant differences were noted among the patterns of errors demonstrated by the five groups. Findings support the notion that students with diverse cognitive PSWs display different patterns of errors on tests of academic achievement.

The resilience of social, biophysical, and technological systems is of increasing scholarly and practical import. Guided by scholarship on disaster resilience, environmental inequality, and urban service inequality, we advance the study of “unequal resilience” in a critical infrastructure - the electric grid. We analyze inequality in electricity outage duration at the census block group level using data from the U.S. Census, the U.S. Geological Survey, and a U.S. electrical utility's database of power outages from 2002 to 2004. Our intersectional approach identifies a factor variable of American Indian disadvantage as a correlate of average outage duration – suggesting possible support for an institutional bias hypothesis. However, spatial error regression models demonstrate that unequal resilience within our study area is most consistently explained by proximity to priority assets (i.e., hospitals), average downstream customers affected by outages, and environmental conditions (i.e., the seasonality of outages). These results are consistent with existing research on utilities' response to power outages, and more broadly with the bureaucratic decision rules perspective on service inequalities. We discuss the implications of our findings for future research and energy policy.

Suburban schools have been undergoing rapid demographic changes in recent years with a sharp increase in the percentages of students from minority backgrounds. The growing number of students from disadvanatged economic backgrounds, single-parent families, and recently arrived non-English-speaking families have presented challenges to suburban schools. The growth in disparities in social and economic capital associated with ethnicity is illustrated in two very different suburban school districts in one New York County.

This thesis argues that the British Industrial Revolution, which marked the beginning of sustained modern economic growth, was facilitated by the blossoming in eighteenth and early nineteenth century Britain of the world’s first infrastructure for commercial R&D, composed of a network of ‘Knowledge Access Institutions’ (KAIs): scientific societies, ‘mechanics institutes’, public libraries, masonic lodges and other organisations. This infrastructure lowered the cost of access to knowledge for scientists, inventors and entrepreneurs, raising the productivity of R&D and encouraging a sustained increase in R&D effort. This contributed to the acceleration in technological innovation that lay behind the transition to modern economic growth. First, I define the concept of KAIs and explain how they affected the rate of economic growth. Second, I present detailed data on the KAI infrastructure and estimate its effect on the rate of technological innovation during the British Industrial Revolution, using newly constructed spatial datasets on British patents between 1700 and 1852 and exhibits at the Great Exhibition of 1851. Third, I argue that KAIs were largely exogenous to industrialisation, rooted instead in the intellectual developments of the Scientific Revolution and European Enlightenment. Fourth, I show that the prevalence of Knowledge Access Institutions was correlated with the emergence of modern economic growth across countries in the late nineteenth century and that the cost of access to knowledge was a binding constraint to economic progress shared by many countries during this period. Finally, based on the case of late nineteenth century US manufacturing, I investigate the extent to which the emergence of modern economic growth depended on the incentives to innovate rather than the capabilities lent by access to knowledge and other factors. The thesis suggests that the sharp fall in the cost of access to knowledge that we are currently experiencing may give rise to an acceleration in the rate of technological innovation in the coming decades and that policymakers should direct some effort towards mitigating the potentially harmful effects of rapid technological change.

This essay attributes an 1815 condemnation of fornication, published in Vermont, to Lemuel Haynes (1753-1833). Redressing a deficit of scholarly attention to sexuality in early African American print culture, it contextualizes Haynes's document within a spectrum of similar texts, and notes the variety of print culture instruments available to early African American authors, including anonymous publication, financial subscription, and publishing under a white author's name.

The paper aims to identify the factors influencing variation in house price growth rate in Metropolitan and Micropolitan Statistical Areas in the United States. It helps to identify how town characteristics interact with macroeconomic conditions to influence volatility. Towns are defined as college, retirement and industrial towns based on demographic data and low elasticity based on housing supply elasticity. Macroeconomic factors studied are both at a local and national level. I have built a GARCH model to estimate volatility for each year of each CBSA. Using the predicted volatility a panel data regression model is used to study the impact of these macroeconomic variables across these towns. The results show that national macroeconomic variables affect volatility whereas local variables are not statistically significant for all towns. Also the business cycles and housing cycles impact volatility in these towns differently.

We derive a sufficient statistics optimal income tax formula in a general model that incorporates unemployment and endogenous wages, to study the shape of the tax and transfer system at the bottom of the income distribution. The sufficient statistics are the macro employment response to taxation and the micro and macro participation responses. We estimate these statistics using policy variation from the U.S. tax and transfer system. Our results suggest that the optimal tax more closely resembles a Negative Income Tax than an Earned Income Tax Credit relative to the case where unemployment and wage responses are not taken into account.

This report assesses the needs and challenges of African immigrants1 living in the New York City, Washington, D.C., and Atlanta metropolitan areas, and the efforts of organizations in these regions to serve them. This research was conducted on behalf of Priority Africa Network (PAN), a national organization whose mission is to “inform, educate and mobilize people in support of the peoples of Africa for sustained peace; economic, political, and social justice; and democratic development.”2 As a network committed to mobilizing US solidarity with . . .

The striking contrast between two Chicago neighborhoods Hyde Park and Englewood which exist side by side is a prime example of what Edward Soja calls socially produced geographies of institutionalized racial segregation and what David Harvey terms as territorial injustice. Hyde Park with about 26,705 mostly white residents is a thriving economic center that has realized gains in property values and commercial investment. Nearby Woodlawn and Englewood have experienced declining populations, lower densities, lower property values, and increased vacancies that border Hyde Park, creating clear spatial lines of uneven development. Englewood and Woodlawn have one asset that Hyde Park does not: two public transit rail lines, the Green Line and the Red Line. In this thesis, I ask the question, can rapid transit be used to challenge uneven development and segregation in low income communities? I argue that public transit does not create growth, it merely redistributes it, and without the necessary development preconditions, the maximized benefits of public rapid transit in segregated communities will be hindered by persistent racial and residential segregation. I provide evidence to support that unless there is an intentional effort in . . .

In cross-sectional American census data, we document that isolated cities tend to have less wage inequality. To explain this correlation and other correlations between population and wages, we build an equilibrium empirical model that incorporates high and low-skill labor, costly trade, and both agglomeration and congestion forces. The model bridges the gap between the spatial inequality literature which abstracts from geography, and the economic geography literature which abstracts from inequality. We find that geographical location explains 9.2% of observed variation in wage inequality across American cities. In counterfactual experiments, we find that reductions in domestic trade costs benefit all American workers and decrease welfare inequality. We also examine the effects on inequality and welfare of both regional and national skill-biased technology shocks. We find that in larger cities wage inequality grows more than welfare inequality.

This paper develops a novel approach to examine how an important public good alters the equilibrium distribution of both people and prices in an urban setting: mass transportation infrastructure. I model a city as a collection of housing and labor markets that are connected by commuting and assemble a unique panel dataset that incorporates commuting flows, wages at place of work, and housing costs. I interact distance with constructed labor demand shocks to provide a plausibly exogenous source of variation in commuting patterns and recover price elasticities of supply and demand for labor and housing. The structural elasticities are then used to separately estimate the impact of the introduction of a transit station on supply and demand in local housing and labor markets. The model generates counterfactual prices and populations in the absence of mass transportation, permitting welfare analysis. I implement this approach to study the first phase of subway and rail construction in Los Angeles, a large, car-oriented city, between 1990 and 2000. High-dimensional fixed effects results indicate that the introduction of a new transit connection decreases the cost of commuting between locations with transit stations by 6.1%, increasing equilibrium commuting by 5.3% between connected locations. The increase in labor supply dominates a smaller disamenity effect. Because the LA Metro effectively lowers the utility cost of commuting over a portion of the consumer’s location choice set, it generates significant welfare benefits for workers by 2000. Only in generous specifications, however, do welfare benefits exceed annualized construction costs and operation subsidies.

he study of segregation is essential for understanding how place influences life outcomes. Traditional segregation indices rely heavily on the use of areal units for calculation, which risks introducing both measurement and interpretation error. Using individual-level data avoids many of the problems facing traditional area-level indices. However, few segregation indices currently exist that can utilize such data. Given that our understanding is only as good as our measurement, it is imperative that our measures accurately reflect our perceptions of segregation. Utilizing the recent release of the complete 1940 Census count data, this article details a new individual-level segregation measure— the Shortest Path Isolation (SPI) index. The SPI index captures the degree of racial isolation experienced by an individual, both regarding distance and interpersonal contact. With West Philadelphia as a sample study area, this article highlights the benefits of the SPI index for studying segregation at the individual-level.

In this brief, we focus on the effects the proposed policy changes could have on individuals with disabilities and individuals with chronic conditions that could become disabling. We begin by discussing the likely effects on coverage and access to care, and then review the potential effects the coverage changes would have on employment. Health insurance is crucial for people with disabilities, because timely access to medical care helps them manage their complex health needs. Yet, many with disabilities report significant problems accessing care (Henning-Smith et al. 2013; Iezzoni 2011; Smith 2008; Hanson et al. 2003; Iezzoni et al. 2011; Miller et al. 2014). As noted by the National Council on Disability in January 2016: “For people with disabilities and their families, the quality, availability, and types of health care and-long term services available to a person can have profound consequences on many other areas of life, including where one lives and how one pursues or maintains employment.”

Diabetes has become one of the most common, costly, and preventable health problems diagnosed among all Americans (Centers for Disease Control [CDC], 2015a). Twenty-nine million individuals (9.3% of the population) have diabetes; this figure includes both diagnosed and undiagnosed diabetes cases (American Diabetes Association, 2014a,b). Diabetes is highly prevalent among Latinos in the United States; it is the fifth leading cause of death among this population (National Center for Health Statistics, 2011a). Yet, most people with diabetes do not die from diabetes per se; most people with diabetes die from cardiovascular disease. Given the large number of Latinos in the United States (i.e., 56.6 million) (United States Census Bureau, 2016), and the shift in migration patterns of Latinos to places other than the south (Krogstad, Passel, & Cohn, 2016), social workers will need to provide culturally competent services to heterogeneous Latino subgroups whose health beliefs, values, and practices may be different from their own. The purpose of this study is to assess how socioeconomic, psychological, and cultural factors affect cardiovascular disease risk among Latinos with diabetes. The present study was guided by the following questions: what are the experiences of Latinos in accessing and utilizing health services and treatment?; how do Latino subgroups’ experiences with diabetes complications differ when considering biological, psychological and cultural factors?; what are the risk and protective factors that reduce or increase access to health care for people with diabetes?; and what are the risk and protective factors that reduce or increase the risk of cardiovascular disease risk for people with diabetes?. The following theory, health behavior model, and frame work of preventive strategies were used to identify psychosocial factors that protect or increase Latinos’ risk to diabetes and cardiovascular disease: the Ecological Systems Theory, Andersen’s Health Behavior Model of Health Service Use, and Haddon and Baker’s framework of preventative strategies. A crosssectional design, utilizing data from the 2014 Integrative Health Interview Series (IHIS), was used (Minnesota Population Center and State Health Access Data Assistance Center, 2015). There were 24,909 individuals who have self-identified as Latinos in the 2014 IHIS data set; however, only participants who self-identified as an individual with diabetes were selected from the data set. Aspects that are considered important in accessing health care include: having a usual source of care; not having a delay in care; being able to afford health care services and medications; not being worried about affording medication and health bills; being able to find health care provider and services; and having and being able to afford health insurance coverage (Office of Disease Prevention and Health Promotion, 2014; U.S. Department of Health & Human Services, Agency for Healthcare Research and Quality, Rodriguez, 2011). Most participants in this study had a usual source of care and were covered by health insurance; thus, very few experienced delay in accessing health care services, nor were they worried about affording medication and health bills. Differences were found when Latinos were compared on numerous psychosocial factors (i.e., education, psychological distress, access to health care, physical activity, body mass index, self-rated health, internet based health literacy, and cardiovascular disease risk) based on citizenship status, length of residence, language of interview, and Latino background. Furthermore, five salient factors were identified as direct factors associated with cardiovascular disease risk among Latinos with diabetes: age, sex, psychological distress, physical activity, and acculturation. Furman, Negi, Iwamoto, Rowan, Shukraft, and Gragg (2009) provide a review of issues that social workers working with Latinos should be aware of, and recommend that social workers keep up with the current Latino literature. Findings from this study provided numerous implications and recommendations with a concentration on research, policy, and practice. In terms of research, there appears to be a serious need to a) advocate for the increased representation of Latinos from diverse countries of origin; b) the need of improved measures of acculturation; c) the need to assess the Latino health paradox for each Latino subgroups; d) standardization of data collected on Latino population; and e) propose that data on genetic and racial differences be included in epidemiological studies (Rodriguez et al., 2014). As for policy, the researcher identified policies that directly and indirectly affect Latinos access to health care, and provided recommendations to improve Latinos’ access to health and mental health care. In regards to practice, the results suggest that social workers and related providers in health care settings should take into consideration a beneficial recommendation by Rodriguez el al. (2014) encouraging initiatives that: a) increase access to health care and offer assistance to help with the financial burden of attributed to diabetes and cardiovascular disease treatment; b) encourage diabetes and cardiovascular disease risk knowledge; and c) promote health behaviors that reduce the risk of diabetes and cardiovascular disease risk.

The share of children with Medicaid/CHIP coverage at the time of the survey 1 increased by 8.9 percentage points between 2008 and 2015, from 27.3 percent to 36.2 percent, while the share of uninsured children declined by 49.5 percent. In 2015, 64.1 percent of children in fair or poor health had Medicaid/CHIP coverage at the time of the survey. An estimated 6.8 million more children had Medicaid/CHIP coverage in 2015 than in 2008.  Financial barriers declined over this period for children covered by Medicaid/CHIP. » Between 2008 and 2015, the share of children covered by Medicaid or CHIP who did not receive needed medical care because their families could not afford it decreased 2.3 percentage points to 7.6 percent, and the share of children who delayed care because of cost decreased 1.0 percentage points to 1.1 percent. » Between 2011 and 2015, 2 the share of children in families that reported having problems paying medical bills decreased 7.4 percentage points to 21.6 percent, and the share of children in families that reported being unable to pay medical bills decreased 5.5 percentage points to 13.8 percent. » Between 2008 and 2015, the share of children who had routine checkups increased 3.8 percentage points to 85.0 percent, and the share of children who had seen a dentist in the past year increased 8.8 percentage points to 81.2 percent. » Nearly all children covered by Medicaid/CHIP had a usual source of care (95.4 percent in 2015), and just over one in ten Medicaid/CHIP-covered children saw a specialist (11.0 percent in 2015), but these shares did not change significantly over time.  Access to providers improved among children covered by Medicaid/CHIP. » Between 2008 and 2015, the share of children who delayed care for reasons other than cost decreased 2.7 percentage points to 11.5 percent. This decrease was driven by declines in care delays related to long waits at the doctor's office, inconvenient doctor's office hours, and difficulty reaching the doctor's office by phone. » Only 1.5 percent of children had trouble finding a doctor in 2015. Between 2011 and 2015, 3 the share of children who were told a doctor was not accepting new patients decreased 1.0 percentage points to 2.0 percent, and the share told that a doctor did not accept their insurance type decreased 1.8 percentage points to 2.8 percent. As children's Medicaid/CHIP enrollment increased by almost a third (32.6 percent) and adult Medicaid enrollment also expanded significantly (85.7 percent), the children's uninsured rate fell by 49.5 percent, and financial access, provider access, and receipt of routine care improved among children covered by Medicaid/CHIP. Congress is now considering cuts to federal funding for Medicaid and CHIP that could jeopardize these gains in coverage and access for children. If the cuts are approved, fewer children may be covered by Medicaid/CHIP, and those who are covered may see their care deteriorate.

Prior telephone surveys have reported two main reasons for opposition to the Affordable Care Act (ACA): distrust of government and opposition to the universal coverage mandate. The authors set out to elucidate the reasons for this opposition. This article describes how the authors used qualitative methods with semistructured interviewing as a principal investigative method to gather information from people they met while bicycling across the United States from April through July 2016. During this time, the authors conducted open-ended, semistructured conversations with people they met as they rode their bicycles from Washington, DC, to Seattle, Washington. Informants were chosen as a convenience sample. One hundred sixteen individuals participated as informants. The majority of comments were negative toward the ACA. Conversations were categorized into four themes, which included the following: (1) The ACA has increased the cost of health insurance; (2) government should not tell people what to do; (3) responsibility for ACA problems is diffuse; and (4) the ACA should not pay for other people's problems. These face-to-face conversations indicated that opposition to the ACA may be due to the fact that many Americans have experienced an increase in the cost of insurance either through increased premiums or greatly increased deductibles. They blame this increase in cost on the ACA, President Obama, the government or insurance companies, and the inclusion of "others" in insurance plans. The authors discuss how these findings can influence medical education curricula to better prepare future physicians to discuss health policy issues with patients.

This paper exploits the non-linearity in the level of minimum wages across U.S. States created by the coexistence of federal and state regulations to identify the impact of immigration on the labor market outcomes of native workers. We find that the effects of immigration on the wages and employment of native workers within a given state-skill cell are more negative in U.S. States with low minimum wages (i.e., where the federal minimum wage is binding). We also find that high minimum wages tend to reduce the displacement effect of native workers (i.e., out-of-state migration) caused by immigration. The results are robust to instrumenting immigration and state effective minimum wages, and to implementing a difference-in-differences approach comparing U.S. States where effective minimum wages are fully determined by the federal minimum wage over the whole period considered (2000-2013) to U.S. States where this is never the case. Taken together, our results underline the important role played by minimum wages in mitigating the adverse labor market effects of low-skilled immigration.