Despite the relative infrequency of successful city-county consolidation campaigns, local government officials and reformers continue revisiting the possibilities and perceived benefits associated with consolidation. While studies analyzing campaigns for and against consolidation efforts exist, little is known beyond factors at the city and/or county level. For this reason, it is important to dig deeper and explore the differences at smaller geographic levels. Utilizing demographic, geographic, and electoral data, this study examines the factors which contribute to support (or opposition) to consolidation at the voting precinct-level in reform efforts over the last two decades. Results indicate that factors related to higher levels of education, home values, and larger Hispanic populations tend to increase the vote share in favor of consolidation, while areas with larger median household incomes demonstrate lower levels of support. These findings help extend our understanding of boundary change and voting in local referenda in the United States.

I analyze how Chinese import competition impacts community college enrollments in US commuting zones by using the variation of import exposure across the United States. After controlling for broader changes in the US economy, the findings show that there is fairly large and positive effect on enrollments for men between the years 1990 and 2007. The results for female enrollments are small or negative. However, these results for both men and women are imprecisely estimated. The findings of this paper resemble previous findings in the literature, namely Greenland and Lopresti (2016), Ferriere et. al (2021), and Lee (2021) which demonstrate increases in high school graduation rates and college enrollments. At the same time, due to the demographics of community colleges, these results expand insight on the human capital adjustment of lower income individuals caused by import competition (Kane & Rouse, 1995).

The U.S. Census Bureau plans to use a new disclosure avoidance technique based on differential privacy to protect respondent confidentiality for the 2020 Decennial Census of Population and Housing. Their new technique injects noise based on a number of parameters into published statistics. While the noise injection does protect respondent confidentiality, it achieves the protection at the cost of less accurate data. To better understand the impact that differential privacy has on accuracy, we compare data from the complete-count 1940 Census with multiple differentially private versions of the same data set. We examine the absolute and relative accuracy of population counts in total and by race for multiple geographic levels, and we compare commonly used measures of residential segregation computed from these data sets. We find that accuracy varies by the global privacy-loss budget and the allocation of the privacy-loss budget to geographic levels (e.g., states, counties, enumeration district) and queries. For measures of segregation, we observe situations where the differentially private data indicate less segregation than the original data and situations where the differentially private data indicate more segregation than the original data. The sensitivity of accuracy to the overall global privacy-loss budget and its allocation highlight the fundamental importance of these policy decisions. Data producers like the U.S. Census Bureau must collaborate with users not only to determine the most useful set of parameters to receive allocations of the privacy-loss budget, but also to provide documentation and tools for users to gauge the reliability and validity of statistics from publicly released data products. If they do not, producers may create statistics that are unusable or misleading for the wide variety of use cases that rely on those statistics.

Introduction: In the 1930s, Black, working-class, and immigrant neighborhoods were color coded on maps (i.e., redlining) indicating investment risk, which negatively impacted mortgage attainment/homeownership for these groups and led to long-standing segregation by race/ethnicity and socioeconomic status. Limited studies have investigated the health impacts of redlining, particularly among older adults who tend to stay closer to their residences. This study examines whether older adults in historically redlined neighborhoods report less neighborhood walking and whether associations vary by race/ethnicity and income. Methods: The sample included 4,651 individuals aged ≥65 years from the 2017 U.S. National Household Travel Survey. U.S. Census tract‒based redlining scores were 1=best, 2=still desirable, 3=definitely declining, and 4=hazardous. Multivariable negative binomial regression tested the associations between redlining and neighborhood walking/day in the overall sample and with stratification by poverty status (analyzed in 2022). Results: Participants were on average aged 73 years, and 11% were African/American Black, 75% were White, 8% were Hispanic/Latinx, and 6% were of other race/ethnicity. Participants reported a mean of 7.1 neighborhood walking minutes/day (SD=20.6), and 60% lived in definitely declining or hazardous neighborhoods. Individuals in hazardous neighborhoods (versus those in best neighborhoods) reported less neighborhood walking (prevalence ratio=0.64; 95% CI=0.43, 0.97). Among those living in poverty, living in definitely declining and hazardous neighborhoods was associated with less neighborhood walking (prevalence ratio=0.39 [95% CI=0.20, 0.79] and 0.39 [95% CI=0.18, 0.82], respectively). Conclusions: Less neighborhood walking was reported among individuals living in neighborhoods with a historic redlining score of definitely declining or hazardous. Future studies using larger, more diverse cohorts may elucidate whether associations differ by race/ethnicity and geographic location/city.

Youth unemployment is a rising concern for many countries across the world. The gap between youth and adult is even wider in Sub-Saharan Africa than the world average. There might be several reasons to explain, yet this chapter focuses on one controversial potential reason: immigration. This continent has experienced considerable migration flows and one could expect that immigration worsens labour market conditions for native youth. Uganda as one of the Sub-Saharan countries is investigated to see if immigrants have a significant impact on unemployment probability of young Ugandans using cross-sectional census data for the years of 1991, 2002, and 2014. Data set was drawn from IPUMS-International. Findings indicate that regional share of immigrants does not have a significant large effect on unemployment probability of youth in Uganda. A further investigation showed that higher share of immigrants in a given region lowers the probability of being not in the labour force across specifications. This means immigrants do not push native youth out of the labour force in the Uganda case.

More than 3.1 million immigrants reside in New York City, comprising more than a third of the city’s total population. The boroughs of Brooklyn and Queens are home to nearly 940,000 and more than 1 million immigrants, respectively. According to the New York City Department of Health and Mental Hygiene’s (DOHMH) Community Health Survey (CHS), foreign-born New Yorkers have poorer health and less access to healthcare than their US-born counterparts. For this study, the Center for Migration Studies of New York (CMS) focused on six neighborhoods in these two boroughs whose immigrant residents were identified by a previous CMS study, Virgin and Warren (2021), as most at risk of poor health outcomes: Brooklyn • Bay Ridge/Dyker Heights • Bushwick • Sunset Park/Windsor Terrace Queens • Elmhurst/South Corona • Flushing/Whitestone/Murray Hill • Jackson Heights/North Corona Immigrants comprise between 31 to 63 percent and undocumented immigrants comprise between 5 to 18 percent of the total populations in these neighborhoods. Though many of New York City’s health and social service programs are open to all residents, immigrants – especially the undocumented – remain at greater risk of poor health outcomes than US-born residents due to other barriers to access to healthcare. The CMS research team conducted a survey of 492 immigrants across these six neighborhoods and convened one focus group to collect data on immigrants’ health and well-being. CMS also surveyed 24 service providers including community health clinics, health-focused communitybased organizations (CBOs), and hospitals that work with immigrants in the studied neighborhoods. Analysis of these data, together with the US Census Bureau’s American Community Survey (ACS) and the DOHMH's CHS, provides insight into the factors that affect immigrants’ health and wellbeing across these neighborhoods. This study highlights several social determinants of health that likely contribute to the native-immigrant health gap. Finally, the study describes steps that can be taken to close this gap. The report offers the following top-line findings: Self-reported Health: • Immigrant respondents on average said they were in good health. Respondents from Mexico, Hong Kong, and Bangladesh had the worst self-reported average health. Among the neighborhoods studied, immigrant respondents from Flushing/Whitestone/Murray Hill had the worst self-reported health. Social Determinants of Immigrants’ Health in New York City: A Study of Six Neighborhoods in Brooklyn and Queens | June 2022 3 Access to Care: • Thirty-seven percent of immigrant respondents said they needed to access healthcare1 in the last 12 months but did not receive it. • Service providers identified different barriers than did immigrants to accessing healthcare for physical health concerns. The top three reasons immigrants said they did not receive the necessary physical healthcare were: 1. Lack of health insurance; 2. Inability to afford care; and 3. Inability to take time off due to work, childcare, or other responsibilities. By contrast, the top three reasons immigrant service providers said immigrants did not receive needed physical healthcare were: 1. Language barriers; 2. Fear of revealing documentation status; and 3. Inability to afford services. • These findings suggest that service providers overestimate the role culture plays as a barrier to immigrants receiving mental healthcare. • The top three reasons immigrants reported for not seeking mental health services were: 1. Inability to take time off due to work, childcare, or other responsibilities; 2. Lack of health insurance; and 3. Inability to afford services. By contrast, the top three reasons service providers said immigrants do not receive needed mental health services were: 1. Fear of stigma; 2. Cultural reasons; and 3. Language barriers. Cost was one of the top deterrents for immigrants in seeking medical care. More than half of respondents said the out-of-pocket costs or high-deductibles on their medical insurance plan “sometimes” or “regularly” discouraged them from seeking medical treatment. Twenty-nine percent of respondents said they had reduced spending on food or other essential items to cover the cost of healthcare in the previous year. Income: • Citizens, both US-born and naturalized, in New York City have much higher average earnings than legal noncitizens and undocumented immigrants. This large earnings gap between 1 "healthcare" refers to seeing a general practitioner, specialist doctor, dentist, or mental health professional, or using prescription or over-the-counter drugs. Social Determinants of Immigrants’ Health in New York City: A Study of Six Neighborhoods in Brooklyn and Queens | June 2022 4 citizens and noncitizens held across the six neighborhoods with the exception of Elmhurst/ South Corona, where the difference in earnings between citizens and noncitizens was smaller than in the other neighborhoods. Overall earnings for workers in Elmhurst/South Corona were the lowest of all the neighborhoods studied. Occupation: • Immigrant respondents who were exposed to mental and physical safety hazards at work were more likely to have a long-standing physical or mental illness. Education: • Immigrants with a lower level of education are less likely to have health insurance. While the gap in insurance coverage between the high- and low-educated is large among people of all immigration and citizenship statuses, it is especially pronounced among the undocumented. Between 2015 and 2019, 69 percent of undocumented immigrants in New York City with less than a 9th grade education had no health insurance compared to 25 percent of undocumented college graduates. Limited English Proficiency: • More than 69 percent of immigrants who speak Spanish and more than 75 percent who speak Chinese2 at home in the six neighborhoods have limited English proficiency. • English language proficiency is associated with immigrants’ likelihood of seeking out needed care, but it was not reported as a primary barrier among immigrant respondents to receiving healthcare. Some immigrants – especially Cantonese-, Hindi-, and Mandarin-speakers – reported language barriers to be a problem in accessing healthcare. Those immigrant groups, together with Urdu-speakers, were the most likely to report discrimination on the basis of language when seeking care. • Limited English proficiency may be a barrier to obtaining private health insurance, immigrants with limited English proficiency are more likely to use public health insurance or health insurance alternatives than remain uninsured. Food Insecurity: • Cost is the primary barrier which prevents immigrants from healthy eating. Nearly a quarter of immigrants across the six neighborhoods reported being food insecure (defined as going without eating at least once in the past month due to lack of resources) primarily due to a lack of funds to buy food, particularly healthy food. • Immigrants living in Bushwick and Jackson Heights/North Corona are more likely to live in areas considered “food deserts,” or live in areas without access to fresh food within a mile of their house. • Service providers reported lack of nearby fresh produce to be more of a barrier to healthy eating than did immigrants. Neighborhood Conditions: • Immigrants were asked about whether they felt safe in their neighborhoods and whether the following were problems in their neighborhood: access to public transportation, crime, lack of 2 Mandarin or Cantonese. Social Determinants of Immigrants’ Health in New York City: A Study of Six Neighborhoods in Brooklyn and Queens | June 2022 5 green spaces, litter, noise, pollution, and traffic. Better neighborhood quality along these metrics, was associated with better self-reported health among immigrants. Traffic was the top-reported problem overall across the neighborhoods, followed by noise, pollution, litter, and crime. • Distance and lack of transportation were reported as barriers to accessing healthcare among immigrants in Bushwick, Elmhurst/South Corona, and Flushing/Whitestone/Murray Hill. Discrimination: • Immigrants reported facing discrimination in their communities, which sometimes prevented them from seeking healthcare. Among those who said they had needed to see a healthcare professional3 in the previous 12 months but did not, 17 percent said fear of discrimination was one of the reasons they let their ailments go untreated. • Discrimination on the basis of race in seeking healthcare was the form of discrimination most reported by immigrants, followed by discrimination based on nationality/citizenship. Use of New York City Services: • Approximately half of immigrant respondents had heard of NYC Care, a public program that provides low- to no-cost healthcare for residents who do not qualify or cannot afford health insurance. Just over a third of respondents had heard of the Mayor’s Office of Community Mental Health (formerly ThriveNYC), a city-led mental health service network, and ActionNYC, a city program providing free immigration legal service, regardless of status. About a quarter of respondents used NYC Care, and less than a fifth of respondents used ThriveNYC and ActionNYC. Those who used these programs were satisfied with them. Based on these findings, CMS offers the following recommendations to improve immigrants’ health outcomes across the six neighborhoods studied: • The Biden Administration should continue the marketplace provisions of the American Rescue Plan Act of 2021.4 Part of this Act made Affordable Care Act (“Obamacare”) plans more affordable and expanded access to them by reducing the percentage of household income that people must spend on the benchmark for the plan and providing premium tax credits to households meeting more than 400 percent of the federal poverty level. • Governor Hochul should ensure that New York State proposed legislation which includes “Coverage for All” is enacted. This …

We consider large, permanent shocks to individual occupations whose arrival date is uncertain. We are motivated by the advent of self-driving trucks, which will reduce demand for truck drivers dramatically. Using a bare-bones overlapping generations model, we examine an occupation facing a risk of obsolescence. We show that workers must be compensated to enter the occupation - receiving what we dub "obsolescence rents" - while employment in the occupation falls and becomes older. We investigate the market for teamsters at the dawn of the automotive truck as an 'a propos parallel to truckers themselves, as self-driving trucks crest the horizon. We find that as widespread adoption of trucks drew nearer, the number of teamsters fell, the occupation became 'grayer,' and teamster wages rose, as predicted by the model.

This paper evaluates the impact of reproductive health care restrictions on women's labor market outcomes in the United States. We exploit the variation in restrictions on reproductive health care services across U.S. states and over time by using individual level data on fertility and labor market outcomes and state level data on reproductive health care restrictions. We apply a difference-indifferences framework using two-way fixed effects and expect that restrictions on reproductive services affect labor market outcomes through their effect on fertility. First stage estimations suggest that being exposed to more restrictive reproductive services increases the fertility rate with 9.1 percent in general, and an increase of 10.3 percent for black women when estimating subgroup effects. We find no evidence of a general effect on employment or hours worked, but some evidence that black women are employed to a lesser extent than other women when they are exposed to more restrictive reproductive health care services.

Introduction: This report examines partnership rates among the US population by race and ethnicity from 1990 to 2017. Methods: This report uses the American Community Survey PUMS (Public Use Microdata Series) data for all years released by the Census Bureau and reorganized for public use by the Minnesota Population Center, University of Minnesota, IPUMSusa, (https://usa.ipums.org/usa/index.shtml). See Public Use Microdata Series Steven Ruggles, J. Trent Alexander, Katie Genadek, Ronald Goeken, Matthew B. Schroeder, and Matthew Sobek. Integrated Public Use Microdata Series: Version 5.0 [Machine-readable database]. Minneapolis: University of Minnesota, 2017. Discussion: Over the past thirty years, the general proportion of married men and women in the United States declined from 60% to 50%. In contrast, the cohabitation rate increased (from about 4% to about 7%) as well as the unpartnered population rate (from 37% to 45%) during the same period. The percentage of young Latino adults (individuals between the ages of 18 and 34) who were married decreased from 50% among Latinos and 59% among Latinas in 1990 to 28% and 35% respectively in 2017. In 1990, Cubans had the highest percentage of marriages, followed by Mexicans, Dominicans, Salvadorans, and Puerto Ricans.

Does two-party competition in the United States lead to improved human welfare spending? The debate over the merits of competition has gained traction yet again in the study of American politics. Gerald Gamm and Thad Kousser suggest that from 1880 to 1980 two-party competition led to desirable outcomes like increased education, transportation, and health spending. The modern panel data presented here suggest the spending effects do not persist beyond 1980 up through 2020, and also, there is a negative effect on economic growth stemming from state-level partisan competition. The reversal of the historical trend is justified by predictions from existing formal models: at particularly high levels of baseline political competition, the effect of additional competition on growth is ambiguous.

Lake Erie is a hotspot for large harmful algal blooms, which damage human health, degrade natural habitats, and impair industries reliant on the lake. The Maumee River watershed, the largest in the Great Lakes, often acts as a major driver for these blooms, as it is the largest contributor of nutrients to the lake, mainly attributed to intense agricultural activity. Consequently, surficial transport of phosphorus and nitrogen within the Maumee River watershed has been extensively studied. However, there has been very little research into the role of groundwater here, especially groundwater modeling studies. Here, I evaluate the literature that has explored nutrient transport to Lake Erie, with a focus on the Maumee River watershed, and examine groundwater nutrient transport. This knowledge will inform nutrient management decisions, especially those regarding future and legacy nutrient loads. In Chapter 1, I review the current state of literature on hydrologic nutrient modeling in the Lake Erie Basin. I highlight common themes in the literature and detail prominent gaps. Specifically, I focus on the role of groundwater in nutrient modeling studies within the Maumee River watershed and recommend future directions for research. In Chapter 2, I create a spatially explicit, process-based groundwater model of the Maumee River watershed. This model allows me to quantify the contributions of groundwater in the context of total basin loading. I then quantify the role of legacy nutrient accumulation by reducing input loads in a projected future scenario. This research completes the nutrient budget by highlighting ‘hidden’ groundwater nutrient loads and informs the timescale of subsurface nutrient management.

This paper addresses the uneven employment effects on older Americans (aged 50–75) of the COVID-19 pandemic. Drawing on monthly Current Population Survey data from January through December 2020, we take an intersectional and life course approach to study the labor market effects of COVID-19 on older Americans. First, we chart monthly labor force states throughout 2020 for older adult subgroups defined by age, gender, and race/ethnicity. We then examine transitions out of and into work from one month to the next. We find gendered age-graded declines in employment, increases in unemployment, and increases in the proportions of people in their 50s reporting they are not in the labor force for other reasons (NILF-other), most dramatically for Asian and Hispanic women. There is little change in age-graded retirement from before to during the pandemic, regardless of gender or race/ethnicity, though there are education-level effects, with those without a college degree more likely to retire in the face of COVID-19. White men with a college degree are the most apt to retain their work engagement.

How do ethnic religious organizations influence immigrants’ assimilation in host societies? This paper offers the first systematic answer to this question by focusing on Italian Catholic churches in the US between 1890 and 1920, when four million Italians moved to America, and antiCatholic sentiments were widespread. Relying on newly collected data on the presence of Italian Catholic churches across counties over time, we implement a difference-in-differences design. We find that Italian churches reduced the social assimilation of Italian immigrants, lowering intermarriage, residential integration, and naturalization rates. We provide evidence that stronger coordination within the Italian community and natives' backlash and negative stereotyping can explain these effects. Despite the negative effects on Italians' social assimilation, Italian churches had ambiguous effects on immigrants' economic outcomes, and increased children's literacy and ability to speak English.

The profile of households receiving rental assistance has changed over time, yet much of the policy and political dialogue surrounding rental assistance has not. Understanding the changing profile of subsidized households is important to evaluating the role of rental subsidies, particularly in the context of neighborhood access. This paper analyzes how the composition of subsidized households has changed over time, and how this relates to existing measures of neighborhood opportunity. We find that since 2000, the share of subsidized households headed by seniors grew, while the share with children dropped. In particular, households using vouchers used to be young relative to the general population and to households in other housing subsidy programs but have aged rapidly. We also find that current neighborhood amenity measures do not reflect these changes, and we use a national analysis and a case study of southeastern Pennsylvania to test alternative metrics.

I study the effects of US salary history bans which restrict employers from inquiring about job ap-plicants' pay history during the hiring process, but allow candidates to voluntarily share information. Using a difference-indifferences design, I show that these policies narrowed the gender pay gap significantly by 2 p.p., driven almost entirely by an increase in female earnings. The bans were also successful in weakening the auto-correlation between current and future earnings, especially among job-changers. I provide novel evidence 1 showing that when employers could no longer nudge candidates for information , the likelihood of voluntarily disclosing salary history decreased among job applicants and by 2 p.p. more among women. I then develop a salary negotiation model with asymmetric information, where I allow job applicants to choose whether to reveal pay history, and use this framework to explain my empirical findings on disclosure behavior and gender pay gap.

This dissertation is the culmination of a four-year project on local governments and local economic activity during the Great Depression in the United States (1929 - 1937). Chapter 1 investigates how U.S. municipal governments coped during the Depression and studies whether debt-induced financial constraints affected local public good provision. Local governments in the U.S. issue debt to fund infrastructure projects and provide important public services to residents. When a financial crisis occurs, financially leveraged cities can suffer distress and curtail public spending, which may lead to out-migration by households. I collect novel archival panel data on cities and municipal bonds during the 1920s and 1930s and examine local public good provision during the Depression. I find that distressed cities significantly lowered public good provision - roughly 20 percent of the drop in expenditure can be explained through a re-allocation of budgets towards debt repayment. In addition, I find suggestive evidence that households subsequently relocated away from distressed cities in response. In Chapter 2, I shift my attention to school districts. We know that investment in formal schooling varies with macroeconomic conditions that alter the resources available and the opportunity cost of education. I study whether recessions can serve a long-run benefit to youth by pushing them out of the labor market and back into school and investigate if education spending cuts attenuate this effect. I collect novel archival data on youth unemployment and school quality during the Depression and study how each affected overall high school graduation rates and average earnings across U.S. cities during the last stage of the High School Movement. My difference-in-differences empirical strategy attempts to explain the within-city variation in high school graduation rates across cohorts using across-city variation in unemployment and public education spending. I find that worsening local labor markets for youth significantly increased their secondary school attendance and graduation rates while education spending cuts decreased them, but to a smaller extent. The effect is most prominent for youth from lower socioeconomic backgrounds. I estimate that 80 thousand urban youth obtained a high school diploma due to the Depression, and 7.5 thousand dropped out due to school district expenditure cuts. Finally, in Chapter 3, I explore a central question of the Great Depression: what was the local economic effect of banking failures? Economic recovery from financial crises is typically slower than from other crises, possibly due to credit rationing by financial intermediaries. I study whether lender-of-last-resort policies of the Atlanta Federal Reserve Bank during the Great Depression eased firms’ financial constraints using a novel database of local economic conditions from 1927 to 1937. My identification strategy relies on the willingness of the Federal Reserve to extend credit in some regions and not in others and plausibly exogenous placement of Federal Reserve boundaries. I find evidence that Fed intervention stymied banking panics, but I do not, surprisingly, find any meaningful effect of Fed policies on local economic outcomes.

Objective: Examine characteristics of pandemic meal site (n = 602) location and meals served per site in Maryland, Spring 2020, following federal/state waivers for local meal site placement decision-making. Methods: Using geographic information systems, we connected meal sites to census tract-level data and generated service areas from sites and distances from population-weighted census tract centroids to the closest pandemic meal site. Regression analysis determined associations of census tract pandemic meal site count and meals served per site with socioeconomic and demographic variables. Results: Census tracts with more meal sites were urban (P < 0.001), food deserts (P < 0.001), and had higher percentages of children in poverty (P < 0.001). Sites serving fewer meals were in food deserts (P < 0.001) and areas with more children in poverty (P < 0.001). Conclusions and Implications: Waivers allowing local meal site placement decision-making supported meal sites in high-need areas. Geospatial approaches could optimize site locations to ensure maximum reach to populations in need. Additional supports may be needed to ensure children in poverty areas receive meals distributed at these sites.

Background: Tobacco dependence, alcohol abuse, depression, distress, and other adverse patient-level influences are common in head and neck cancer (HNC) survivors. Their interrelatedness and precise burden in comparison with survivors of other cancers are poorly understood. Methods: National Health Interview Survey data from 1997 to 2016 were pooled. The prevalence of adverse patient-level influences among HNC survivors and matched survivors of other cancers were compared using descriptive statistics. Multivariable logistic regressions evaluating covariate associations with the primary study outcomes were performed. These included 1) current cigarette smoking and/or heavy alcohol use (>14 drinks per week) and 2) high mental health burden (severe psychological distress [Kessler Index ≥ 13] and/or frequent depressive/anxiety symptoms). Results: In all, 918 HNC survivors and 3672 matched survivors of other cancers were identified. Compared with other cancer survivors, more HNC survivors were current smokers and/or heavy drinkers (24.6% [95% CI, 21.5%-27.7%] vs 18.0% [95% CI, 16.6%-19.4%]) and exhibited a high mental health burden (18.6% [95% CI, 15.7%-21.5%] vs 13.0% [95% CI, 11.7%-14.3%]). In multivariable analyses, 1) a high mental health burden predicted for smoking and/or heavy drinking (odds ratio [OR], 1.4; 95% CI, 1.0-1.9), and 2) current cigarette smoking predicted for a high mental health burden (OR, 1.7; 95% CI, 1.2-2.3). Furthermore, nonpartnered marital status and uninsured/Medicaid insurance status were significantly associated with both cigarette smoking and/or heavy alcohol use (ORs, 1.9 [95% CI, 1.4-2.5] and 1.5 [95% CI, 1.0-2.1], respectively) and a high mental health burden (ORs, 1.4 [95% CI, 1.1 -1.8] and 3.0 [95% CI, 2.2-4.2], respectively). Conclusions: Stakeholders should allocate greater supportive care resources to HNC survivors. The interdependence of substance abuse, adverse mental health symptoms, and other adverse patient-level influences requires development of novel, multimodal survivorship care interventions.

In the aftermath of World War I, U.S. discourse was animated by the concern that demobilized soldiers, having experienced the world outside of their hometowns, would resist returning to farms and to their preinduction occupations. Did military service really encourage an occupational shift? Were rural individuals especially susceptible to and was emplacement in foreign locales especially culpable for this change, as popular culture suggested? Focusing on North Dakota, a state with unusually detailed World War I records, this article uses a novel linked census–military data set and statistical analysis to examine how individuals’ place-based military experience might have inflected their postwar occupational mobility. Whereas univariate models support the contemporary perception that farm boys with overseas service were less likely to remain in agriculture, increasingly complex models suggest more nuanced interpretations, with civilian individual and contextual characteristics and their interaction being significantly predictive of farm leaving. Addressing substantive gaps in World War I historiography by contextualizing neglected subpopulations, this research also shows the value of using quantitative methods to engage with critical military geographies. Operationalizing theories of place–individual co-constitution through the analysis of longitudinal, individual data demonstrates how interest in soldiers’ experiences and in the spatiotemporally distant effects of war can be productively intertwined.