Objective Diversity in the training environment for health professionals is associated with improved abilities for graduates to care for diverse populations. Thus, a goal for health professional training programs, including pharmacy schools, should be to pursue representation among graduates that mirrors that of their communities. Methods We evaluate racial and ethnic diversity among graduates of Doctor of Pharmacy (PharmD) programs across the United States (US) over time. Using a “Diversity Index”, we quantify the relative racial and ethnic representation of each program’s graduates compared with that of college-age graduates nationally and within the geographic region of the respective pharmacy school. Results Over the past decade, the number of US PharmD graduates increased by 24%. During this time, the number of Black and Hispanic PharmD graduates significantly increased. Still, representation of minoritized populations among graduates continues to be significantly lower compared with US benchmark populations. Only 16% of PharmD programs had a Diversity Index that matched or exceeded their benchmark comparator Black or Hispanic populations. Conclusion These findings highlight the significant opportunity that exists to increase the diversity of graduates of US PharmD programs to better reflect the diversity of the US population.

The COVID-19 pandemic, with millions of Americans compelled to stay home and work remotely, presented an opportunity to explore the dynamics of social relationships in a predominantly remote world. Using the 1972–2022 General Social Surveys, we found that the pandemic significantly disrupted the patterns of social gatherings with family, friends, and neighbors but only momentarily. Drawing from the nationwide ego-network surveys of 41,033 Americans from 2020 to 2022, we found that the size and composition of core networks remained stable, although political homophily increased among nonkin relationships compared to previous surveys between 1985 and 2016. Critically, heightened remote communication during the initial phase of the pandemic was associated with increased interaction with the same partisans, although political homophily decreased during the later phase of the pandemic when in-person contacts increased. These results underscore the crucial role of social institutions and social gatherings in promoting spontaneous encounters with diverse political backgrounds.

In the wake of the Great Recession, Georgetown University researchers projected that 58 percent of Tennessee jobs would require education beyond high school by 2020 (Carnevale et al., 2013). This inspired the “Drive to 55” in Tennessee—the goal to have at least 55 percent of the working-age population hold a postsecondary certificate or degree by 2025. The state invested considerable resources in providing new pathways and encouraging completion of a variety of credentials and degree programs, largely focused on two-year college credentials.

The spatial distribution of people is incredibly concentrated: 8 percent of the US population lives in the ten largest US cities, but those cities take up less than 0.1 percent of total US land area. Why this concentration? More generally, what determines the distribution of people and economic activity across space? And how can economic policies affect the spatial distribution of economic activity? This essay will show that these questions can be answered through the familiar lens of supply and demand curves. We begin by applying this intuition to the well-known Rosen-Roback framework (Rosen 1979; Roback 1982). But as we will discuss, the distribution of economic activity in this early spatial model depends only on local geography, not on what happens to other regions. For example, a change in one location—say, a large infrastructure investment that improves its productivity—is predicted to have an identical impact on all other locations, regardless of where they are. Thus, intuitive spatial features like where a location is located on a map and who its neighbors are entirely absent: it is a spatial model where space does not matter. In reality, spatial linkages create rich interactions between locations. One implication of these interactions is that a large infrastructure investment that improves the productivity in one location will have greater impacts on close-by locations than locations further away. To account for such spatial linkages, we extend the intuition of the Rosen-Roback model to modern economic geography frameworks where locations are connected through the flow of goods, based on our earlier work in Allen and Arkolakis (2014). In this framework, the economic fate of a location depends not only on its own “local” geography but also on the local geography of its neighbors, the effect of which is mediated by the strength of the economic ties, creating a “global geography.” Despite this added complexity, we show the same tools based on supply and demand used to understand predictions of the earlier Rosen-Roback framework extend readily to a globally integrated world. This globally integrated framework can be applied to understand both the direct and indirect impacts of real world economic policies that change either the local or global geography. We discuss how the framework can be applied to spatial data, while also highlighting the most common pitfalls and offering strategies for traversing them. Finally, we provide a brief overview of the many ways in which this framework has been applied thus to understanding the spatial distribution of economic activity, as well as pointing out several interesting and still unexplored questions for future researchers. To keep the discussion as straightforward and accessible as possible, we relegate all mathematical details and derivations to the Appendix, where we also provide a companion Matlab toolkit to help researchers apply these techniques on their own.

The private vehicle is, for most developed countries, the prevalent commuting mode of workers, and one of the main source of CO2 emissions. The choice of the mode of transport for commuting trips clearly depends on individual preferences, and it may be that pro-environmental attitudes and values are related to environmental awareness and minimization of harm to the environment. This paper explores how pro-environmental attitudes and values relate to commuting behaviors, using data from the American Time Use Survey for the period 2003-2019. We focus on the time spent commuting, and on commuting modes. The results show that, net of observable factors, regions in which social attitudes are more pro-environmental are related to longer commuting times, but also to a higher percentage of active commuters and public transit commuters. These results suggest that policies aimed at shifting pro-environmental social values may help in reducing the use of private vehicles and encourage green means of transport, in order to reduce the environmental costs of commuting.

The U.S. is undergoing a long-term decline in entrepreneurship. We show that this slow-down in entrepreneurship has been more pronounced for skilled individuals – those with a college degree. We document new facts on the skill-biased nature of declining entrepreneurship and propose that it is a response to the rising worker skill premium observed over the same period. In support of this, we find that workers' earnings grew faster than entrepreneurs', particularly for skilled individuals, discouraging the pursuit of entrepreneurship. To quantify the impact of the skill premium on entrepreneurship, we develop a model of occupational choice with worker heterogeneity. In the model, a rising skill premium – driven by skill-biased technological change – contributes little in lowering entrepreneurship. Instead, around 70% of the observed decline in entrepreneurship is driven by skill-neutral technological change and a rising share of college graduates. A rise in the skill premium interacts with these forces to generate the skill-biased decline, and in doing so, shifts the composition of entrepreneurs towards the unskilled, lowering average entrepreneurial productivity. Our findings suggest an integral role for the changing income structure of workers in driving the broader decline in business dynamism in the U.S.

Despite contributing to host country economies, there is limited examination of self-employed female immigrants in the literature. While human, social, and financial capital are important for entrepreneurship in general, given immigrant women’s intersectional identities, the potential exists for these factors to affect them differently. This study uses US data obtained from Integrated Public Use Microdata Series (IPUMS) to empirically test the relationship of human, social, and financial capital on female immigrants’ self-employment and compares these relationships with US-born women and male immigrants. While the results are mixed, overall, the findings suggest that female immigrants’ odds of being self-employed, in relation to their levels of human, social, and financial capital, are influenced to a greater extent by their immigrant identity than their gender identity. Implications for future research and public policy are discussed.

Purpose Substantial out-of-pocket costs for hearing aids constitute a barrier to hearing health care accessibility for older adults among whom prevalence of hearing loss is high. This study is the first to estimate the proportion of Americans with functional hearing loss for which out-of-pocket expenditures for hearing aids would be unaffordable at current average costs and determine how affordability varies by sociodemographic factors. Materials and methods We utilized data from the 2016 American Community Survey to determine the proportion of adults with functional hearing loss for whom hearing aids would constitute ≥3% of annual income or have post-purchase income below a poverty standard. Chi-square tests were used to identify differences in affordability outcomes by sociodemographic characteristics. Results Results indicated that an average bundled cost of $2500 would constitute a catastrophic expense for 77% of Americans with functional hearing loss (N = 7,872,292) and would add an additional 4% of the population into poverty for the year (N = 423,548). Affordability outcomes varied significantly by age, race, sex, educational attainment and geographic location. Conclusions Hearing aids were unaffordable for three-fourths of Americans with functional hearing loss, and their purchase would result in impoverishment for hundreds of thousands of individuals. Reductions in out-of-pocket hearing aid costs to $500 or $1000 would alleviate affordability issues for many Americans with hearing loss. Future federal and state policy should address poor rates of insurance coverage for hearing care, specifically among Medicare and Medicaid, to reduce out-of-pocket costs for hearing care particularly for older adults.

Although women’s empowerment is one of the key concepts in development, it has proven challenging to measure it. Empirical studies have tended to focus on a cause-and- effect analysis of empowerment and using composite measures to compare different national contexts. More recent works suggest new conceptual and methodological approaches to women’s empowerment that better reflect contextual factors, intersectionality, and life course perspectives.

Previous research on the long-term effects of redlining in the United States has found that areas receiving a D grade have lower homeownership rates and home values as well as declines in population density. Here, we focus on the heterogeneity of such impacts. Using Home Owners’ Loan Corporation descriptive data, we categorize D-graded neighborhoods according to initial population composition. We then compare neighborhood outcomes over time and across regions. We find that receiving a D grade is not a universal predictor of either lower homeownership rates or increased racial segregation. D-graded areas that only noted immigrant populations did not have lower homeownership rates or higher black populations by 2000 than C-graded neighborhoods. These results point to the fact that redlining was interacting with localized trends of discrimination and residential mobility, rather than redlining causing differential trajectories in neighborhoods.

Even before the global health and economic crisis unleashed by COVID, a lifetime of systemic disparities deeply impacted the health and economic security of older women of color-especially those with low incomes, who have disabilities, who are immigrants, and who are LGBTQ people. Throughout the pandemic, older women of color experienced high levels of unemployment, lost household income, were overrepresented among essential workers, and served as caregivers. Older women of color, moreover, weathered illness and struggled to aford food, shelter, and health care during the pandemic. In 2023, older women of color are dealing with the ongoing efects of COVID-all while experiencing an uneven economic recovery, rising costs of food and housing, and continued barriers to accessing needed health care, including reproductive health care. They are also negatively impacted by the persistent failure of policymakers to make critical improvements to income supports and robust public investments in the care infrastructure, afordable and accessible housing, and universal, comprehensive health care. This issue brief analyzes recent data about the employment, incomes, and health of older women of color and highlights policy solutions that are targeted to support the economic security and health of older women of color.

Social Security Disability Insurance and Supplemental Security Income, the United States' two primary disability income support programs, each offer a pathway to public health insurance in addition to cash benefits. This implies that expansions in public health insurance availability, such as the ACA's Medicaid expansions, may impact disability program participation and employment of people with disabilities. However, prior research has yielded mixed results as to the impact of Medicaid expansion on these outcomes. Using a stacked difference-indifferences design and data from the Current Population Survey, we demonstrate that the ACA's Medicaid expansions increased SSDI receipt among individuals ages 50-64 with physical, self-care and independent living disabilities, consistent with a "job unlock" mechanism. Exploiting the longitudinal nature of the CPS, we show that treatment effects are heterogeneous and concentrated among persons with ongoing disabilities (as opposed to new disabilities) as reported on the CPS's 6-question functional impairment sequence. We also show suggestive evidence of a reduction in SSI, but find that it is sensitive to specification and data preparation choices, which we illustrate through comparison with other recent work. Effects on employment are inconclusive. Our findings provide further evidence of work capacity among SSDI beneficiaries.

Economists have long recognized the importance of human capital in economic growth. In this series of papers, I study how various institutions of human capital formation affected economic development in a variety of contexts prior to 1900. These include both formal institutions of human capital formation such as universities and informal institutions such as apprenticeships. The first chapter examines the role of European universities during the late Middle Ages and early modern eras, starting with the creation of the University of Bologna in the late 12th century. These “formal” institutions of human capital focused on the teaching of law and supplied the civil service and justice systems of their home cities with trained legists. I find that cities which hosted universities had faster population growth than similar cities without universities, suggesting that universities were associated with higher levels of economic development. The second chapter contrasts the formal university with an informal human capital institution—the English apprenticeship. Though England was the cradle of Europe’s industrialization, it had far fewer universities per capita than peer nations on the continent. However, it had a well-developed system of apprenticeship which some scholars have theorized was the main means of human capital incubation and transmission during the Industrial Revolution. English cities with more apprenticeships during the 18th century tended to have a greater degree of labor force specialization in the mid-19th century. The final chapter examines the role of the land-grant college system, which was established in the mid-19th century in the United States. In addition to their primary role of providing postsecondary education to students, these institutions added a second channel for the creation of human capital: research to boost the productivity of the nation’s farms. American counties more firmly embedded within the land-grant college network tended to have a better-educated populace and a more specialized labor force; however, counties more exposed to land-grant colleges saw no improvements in agricultural productivity.

Background: Metabolic syndrome varies by socio-demographic characteristics, with younger (18–29 years) and older (50–69 years) Hispanic/Latino having higher prevalence compared to other groups. While there is substantial research on neighborhood influences on cardiometabolic health, there are mixed findings regarding the effects of gentrification and few studies have included Hispanic/Latinos. The role of neighborhood income inequality on metabolic health remains poorly understood. Objectives: Examined associations of neighborhood gentrification and income inequality with metabolic syndrome (MetSyn) using data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Design, Setting and Participants: The HCHS/SOL is a community-based cohort of adults of Hispanic/Latinos (aged 18–74). Analyses included 6710 adults who did not meet criteria for MetsS at baseline (2008–2011) and completed the visit 2 examination (2014–2017). Poisson regressions estimated odds ratios (IRR) and 95% confidence intervals (CI) for neighborhood gentrification and change in income inequality with MetSyn incidence. Main outcome and exposure measures: Gentrification was measured with an index that included changes (2000 to 2006–2010) in education, poverty, and income. Change in neighborhood income inequality (2005–2009 to 2012–2016) was measured using the Gini coefficient of income distribution. MetSyn was defined using National Cholesterol Education Program Adult Treatment Panel III criteria. Results: Among 6647 Hispanic/Latino adults, 23% (N = 1530) had incident MetSyn. In models adjusted for socio-demographic, health insurance status, and neighborhood characteristics, gentrification (IRR, 1.00, 95%CI, 0.96–1.03) and income inequality change (IRR, 1.00, 95%CI, 0.99–1.00) were not associated with MetSyn at visit 2. There was no association between cross-sectional income inequality (2005–2009) and MetSyn at visit 2 (IRR, 0.97, 95%CI, 0.82–1.15). Conclusion: Neighborhood gentrification and income inequality change were not associated with incidence of MetSyn over 6 years among Hispanic/Latino adults. This study demonstrated that income-based residential changes alone may not be sufficient to explain neighborhood influences on health outcomes among this population.

We examine one of the secondary effects of the granting of Permanent Normal Trade Relations (PNTR) to China in October 2000: lower than expected house price appreciation. We consider housing prices for 2,800 US counties in a panel data setting for the years 1990 to 2020. We and that the 2000 PNTR trade event caused house prices to appreciate 6 to 8 percent less in highly trade-exposed counties within 2 to 3 years of the trade event and that the slower appreciation persisted to 2020. The size of the trade impact is highly robust to various sensitivity checks.

There is growing concern over the causes and consequences of imperfect competition in labor markets, particularly labor markets with many lower-skilled, lower-paid employees. Some show that rising monopsony power accounts for wage stagnation and rising wage inequality (Deb, Eeckhout, Patel, & Warren 2022, 2023) and for an income redistribution away from rural households (Rubens 2023). As a result, understanding the channels and dynamics of employer market power remains key from welfare standpoint and for designing appropriate policies to address labor market inequities (Executive Order, The White House 2021). In this paper, we study one channel using a production function estimation approach (De Loecker & Warzynski 2012) to quantify and characterize labor markdowns in the US food retail sector.

Single parenting has been a growing type of family structure both in Western countries and Eastern ones. Changing economic and social conditions have contributed to this growth. Poverty or worsening welfare is also a growing concern in society. This study, therefore, investigates whether being a single parent is associated with a poverty risk. To do so, The Current Population Survey (CPS) which is a commonly used data source applied in social science from Integrated Public Use Microdata Series (IPUMS) database were utilised. Being a reliable source with large sample sizes and various subjects covered in the U.S. population makes IPUMS widely preferable data source with micro level data on individuals and household. This empirical investigation, therefore, relies on IPUMS CPS data to explain poverty risk of single parents. Findings reveal that being a single parent is significantly associated with being below the poverty line. Additionally, sex, age, employment status, education level, race, and citizenship status were found to be significant to explain poverty.

Early care and education (ECE) programs for children prior to kindergarten in California are provided through a mixed delivery system that includes licensed home- and center-based programs as well as school settings. Parents make decisions about what type of program(s) their children attend based on a combination of factors such as culturally affirmative practices, cost, schedule, and location. Most ECE services must be purchased by parents; public funding is limited, and if subsidized access to early care and education is available, it is typically linked to income eligibility. As a result, many children who qualify for ECE don’t have access. Furthermore, the financial resources available to a program often depend on what families can afford to pay, not necessarily the true costs to provide services. The requirements, experience, and supports for educators vary widely across settings, depending more on funding sources and regulatory status and less on what educators and children may need. This situation is typical across the ECE system for children from infancy through preschool, though California has made substantial changes in providing preschool for four-year-olds. Transitional Kindergarten (TK) was introduced into this mix in the 2012-13 school year. As of the 2022-23 school year, TK became the only free, universal ECE program in California available for four-year-olds. In this brief, we compare the experiences of educators who lead their respective classrooms.

Using state-year-level variation from the Great Depression we show that adverse economic conditions experienced in early life are associated with worse labor market outcomes in prime-age years and worse economic wellbeing, morbidity, and mortality at older ages. These effects become more pronounced as surviving cohort members age, suggesting disparities in the acceleration of age-related physiological damage. Using multiple data sources, we analyze potential mechanisms in childhood and midlife. After evaluating changes in fertility and mortality rates for Depressionera birth cohorts, we conclude that these effects likely represent lower bound estimates of the true impacts of the economic shock on long-term outcomes.

The prolonged longevity has not only increased the duration of work lives but also the number of choices for the processes of retirement transition. One of the common options for these processes is called bridge jobs, defined as any paid labor market activities that connect one’s career and complete withdrawal from the labor force. While the increasing need for studies on bridge jobs, there are relatively few studies done from an economic perspective. In this dissertation, I mainly focused on bridge jobs as an important phase of the work lives that older workers go through. The first two chapters investigated the effects of switching occupations in later life, as bridge jobs, on retirement and health outcomes of American midlife workers. I distinguish occupational switching into two types: (1) switching to physically more demanding occupations and (2) switching to physically less demanding occupations. To explain the differences in the outcomes between the two types of occupational switching, I integrated the concepts of the two economics models: the Grossman model of health demand and the theory of compensating wage differential. I used the Health and Retirement Study and two-way fixed effects event study regression to complete the analyses. The results are consistent with the theoretical predictions. First, switching to physically less demanding occupations reduces the probability of complete retirement and improves physical health outcomes. Second, switching to physically more demanding occupations reduces the probability of complete retirement only if it involves wage raise, Last, switching to physically more demanding occupations deteriorates the physical health outcomes if it involves wage reduction. These studies contribute to the retirement literature by reemphasizing the importance of job characteristics, such as physical demandingness, which matters in older workers’ retirement transition. In the last chapter, I investigated the effect of occupational licensing on the decision of having bridge jobs. Occupational licensing is known to have several impacts on the labor market through its supply restriction, training and investment, and higher wages and fringe benefits. Extending these impacts to the labor market of older workers who are at the time of leaving their career jobs, I analyzed how being licensed affects the choices of bridge jobs during the process of retirement transitions. To conduct this study, I used the IPUMS Current Population Study and the Survey of Income and Program Participation and used coarsened exact matching and propensity score matching to obtain the effect of occupational licensing. The results are also consistent with the theoretical predictions. Licensed workers are less likely to choose any bridge jobs that involve the loss of career job advantages - occupation-specific human capital and tenure effect - such as switching occupations or leaving career job employers while they are more likely to choose bridge jobs that do not involve such loss: reducing work hours within the same occupation and employer. This is one of the first studies that evaluate the impact of public policies that are not directly related to retirement, such as Social Security and Medicare, on the process of retirement transition.