Autor, Levy, and Murnane (2003) ask whether vulnerability to automation, measured by task content, can rationalize employment trends. We invert their approach, asking what technological changes rationalize skill content changes. We combine a tractable GE model with three editions of the Dictionary of Occupational Titles, the 1960, 1970, and 1980 Censuses, and March Current Population Surveys to estimate changes in the relative productivity of skills. We conclude that finger-dexterity productivity grew rapidly while abstract-skill productivity lagged, a form of 'skill bias'. Together with substitutability between abstract and routine inputs, these results explain changes in skill use within occupations.

The authors investigate coronavirus disease 2019 (COVID-19) risk factors, suitability of online instruction, politics, and institutions’ finances as rationales guiding instructional delivery decisions for fall 2020, after COVID-19’s emergence. Contributions include estimating multinomial logit regressions with mode of delivery as a categorical variable, integrating resource dependence and crisis response as theoretical frames, and introducing new predictor variables, including a measure of local residential access to broadband Internet. Findings suggest that county populations, local political preferences, and the percentage of revenue derived from auxiliary enterprises were consistent predictors of delivery mode. Political parties of an institution’s governor and congressional representative were predictive of delivery mode for institutions in the lowest tercile of endowment per student but not for institutions in the highest tercile. Bottom-tercile institutions substituted from online to in-person reopening as reliance on revenue from auxiliary enterprises increased, but top-tercile institutions appeared only to substitute from hybrid to in-person or from online to hybrid delivery as revenue from auxiliary enterprises or tuition and fees increased.

This work assesses the possibilities and limitations of reducing poverty among families with children by increasing the work effort of the adults in those families. Following a historical review of family poverty since 1995, the authors present several policy simulations, including increased employment, a higher minimum wage, more generous tax credits, a child allowance, and reduced childcare or medical expenses. Specific policy proposals—including the proposals of the Biden Administration—are assessed using four criteria: reducing child poverty; equitable treatment of the poorest groups; promotion of self-sufficiency; and cost-effectiveness. The authors conclude that while no single policy is able to reduce family poverty by half while meeting the other criteria, several combinations of policies have the potential to do so.

This study explores whether there is a heterogeneous effect of high school college counselors on college application and enrollment. Most research on the impact of counselors has focused on the effect of traditional school counselors and not on high school college counselors, individuals whose primary responsibility is to assist students with application and selection. This study builds on a small vein of research that explores the effectiveness of high school college counselors. Research demonstrates that though application and enrollment in college have increased across the United States population, students with low-income and prospective firstgeneration college students still lag behind their higher-income and continuing-generation peers. Evidence supports that lower-income and continuing-generation students have different information, thoughts, and beliefs about college. Explanations for why these differences exist are theoretically tied to social and cultural capital. For some students, information and support provided by the high school may fill a critical gap in the knowledge and expectations related to college going. This study sought to determine whether college counselors have a differential effect across varying social and cultural capital levels. The study incorporates a causal analytical design, inverse probability weighting, with specifications for effect modification to determine under what conditions an effect is significant. Results show limited evidence of the effectiveness of college counselors in high schools across all moderators. There is some support that prospective first-generation students have an increased probability of enrollment in college if they attend a school with a high school college counselor. Limitations of this study, recommendations for policy and practice, and directions for future research are discussed.

Objectives. To quantify the impact of telemedicine for medication abortion (TMAB) expansion or ban removal on abortion accessibility. Methods. We included 1091 facilities from the 2018 Advancing New Standards in Reproductive Health facility database and Planned Parenthood Web site, among which 241 did not offer abortion as sites for TMAB expansion. Accessibility was defined as the proportion of reproductive-aged women living within a 30-, 60-, or 90-minute drive time from an abortion-providing facility. We calculated accessibility differences between 3 scenarios: (1) facilities offering abortion in 2018 (reference), (2) the reference scenario in addition to all facilities in states without TMAB bans (TMAB expansion), and (3) all facilities (TMAB ban removal). We also stratified by state and urban–rural status. Results. In 2018, 65%, 81%, and 89% of women lived within a 30-, 60-, or 90-minute drive time from an abortion-providing facility, respectively. Expansion and ban removal expanded abortion accessibility relative to the current accessibility scenario (range: 1.25–5.66 percentage points). Women in rural blocks experienced greater increases in accessibility than those in urban blocks. Conclusions. TMAB program and policy changes could expand abortion accessibility to an additional 3.5 million reproductive-aged women. Public Health Implications. Our findings can inform where to invest resources to improve abortion accessibility. (Am J Public Health. 2022;112(8):1202–1211. https://doi.org/10.2105/AJPH.2022.306876) Obtaining a wanted abortion is a determinant of psychological, physical, social, and economic well-being among US women and of social and economic well-being among their children.1–9 (Not all individuals who seek abortion care identify as women. To date, much of the abortion literature has focused on the experience of “women.” When citing past literature reported as including “women,” we use that language. Similarly, the US census data we used included the population of US “women.” When referring to people who received abortion care, we use the term “client.”) Furthermore, abortion is legal, safe, and supported by major medical organizations.10 However, many state-level restrictions on abortion access and provision create barriers to care.11–19 Given these barriers, measuring access to abortion care in the United States is important for public health decision making. One component of access, accessibility (defined by Penchansky and Thomas as “the relationship between the location of supply and the location of clients”20(p128)), is often operationalized as how far people are from health services, regardless of their immediate need for those services. Studies in the United States indicate that implementation of antiabortion policies can decrease abortion accessibility.13,18 In 2008, to overcome a state-imposed physician medication abortion dispensing regulation, Planned Parenthood of the Heartland in Iowa launched a site-to-site telemedicine for medication abortion (TMAB) care delivery model. Under this model, clients visit a health center where an abortion provider is not physically present and meet with a remote clinician via videoconference. As in an in-person medication abortion visit, the clinician answers the client’s questions and may watch as the client is given the first dose of abortion medication. Relative to in-person medication abortion, TMAB is equally or more safe, effective, and acceptable to clients and providers.21–23 Furthermore, in comparison with clients seen at this clinic network before TMAB implementation, those seen after implementation traveled slightly shorter distances.24 Although Planned Parenthood has expanded use of TMAB since 2008 to additional states where the service is not banned, as of 2018 nearly half of Planned Parenthood health centers did not offer any abortion services.25 Furthermore, because of the politicization of abortion, use of telemedicine to deliver medication abortion, including via TMAB services, has been banned in 19 US states.26 We sought to expand on the existing literature by quantifying the potential impact of TMAB expansion, or removal of TMAB bans, on abortion accessibility among all US women of reproductive age.

The misallocation of talent in innovation — “missing Einsteins” — has a first-order impact on growth and welfare. Surname-level empirical analysis combining inventor and census micro-data reveals people from richer backgrounds are more likely to become inventors, but those from high-education backgrounds become more prolific inventors. Motivated by this discrepancy, an endogenous growth model with financial frictions on the household side is developed. Individuals compete for scarce inventor training. The rich can become inventors even if mediocre through excessive credentialing spending. Shutting down credentialing spending raises innovation, growth, welfare, and inequality. Optimal progressive bequest taxes increase growth and welfare, but reduce inequality.

Background Racial and ethnic disparities in delayed medical care due to reasons not related to cost of care remain understudied. We aimed to describe recent 20-year trends in such disparities. Methods The study used data from the National Health Interview Survey from 1999–2018 and included individuals ≥18 years of age. Respondents were categorized by their sex, income, and self-reported race and ethnicity. The main outcomes were trends in disparities in any of 5 specific barriers to timely medical care: inability to get through by phone, no appointment available soon enough, long waiting times, inconvenient doctor’s office/clinic hours, or lack of transportation. Results The study included 590,603 adults (mean age 46.0 [SE, 0.07] years; 51.9% female). Of these, 4.7% were Asian, 11.8% Black, 13.8% Latino/Hispanic, and 69.7% White. In 1999, the proportion reporting any of the barriers to timely medical care was 7.3% among Asian, 6.9% among Black, 7.9% among Latino/Hispanic, and 7.0% among White individuals (P >0.05 for each difference with White individuals). From 1999 to 2018, this proportion increased across all 4 race/ethnicity groups (P<0.001 for each), slightly increasing the disparities between groups. In 2018, compared with White individuals, the proportion reporting any barrier was 2.1 and 3.1 percentage points higher among Black and Latino/Hispanic individuals (P=0.03 and P=0.001, respectively). The racial/ethnic disparities increased mostly among males and were attenuated when stratified by income level. Conclusions From 1999 to 2018, barriers to timely medical care increased for all populations with increasing disparities between racial/ethnic groups. ### Competing Interest Statement Yuan Lu is supported by the National Heart, Lung, and Blood Institute (K12HL138037) and the Yale Center for Implementation Science. Carley Riley has worked as a consultant for the Institute for Healthcare Improvement and Heluna Health. Jeph Herrin reports receiving funding from the Centers for Medicare & Medicaid Services for the development and evaluation of quality measures; from the National Institutes of Health and from the Agency for Healthcare Research and Quality for multiple research projects; from Johnson & Johnson; and from Delta Airlines. In the past three years, Harlan Krumholz received expenses and/or personal fees from UnitedHealth, Element Science, Aetna, Reality Labs, Tesseract/4Catalyst, the Siegfried and Jensen Law Firm, Arnold and Porter Law Firm, Martin/Baughman Law Firm, and F-Prime. He is a co-founder of Refactor Health and HugoHealth, and is associated with contracts, through Yale New Haven Hospital, from the Centers for Medicare & Medicaid Services and through Yale University from Johnson & Johnson. The other co-authors report no potential competing interests. ### Funding Statement This study was self-funded. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: All data used in this study is publicly available and was obtained from the Integrated Public Use Microdata Series Health Surveys (<https://nhis.ipums.org/>). The Institutional Review Board at Yale University exempted the study from review. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data used in this study is publicly available and was obtained from the Integrated Public Use Microdata Series Health Surveys (<https://nhis.ipums.org/>). <https://nhis.ipums.org/>

Objectives In the light of an increasingly diverse older population in the United States, there is an ongoing discussion how cultural factors contribute to individual long-term care (LTC) needs and service use. This study empirically assesses whether the level of acculturation and cultural differences in the importance of the family shape foreign-born immigrants’ intention to use certain LTC services. Methods We correlated immigrants’ intention to use certain LTC services to the cultural strength of family ties that prevails in their region of origin. We used data from the National Health Interview Survey and the World Values Survey/European Values Study for analysis. Multinomial logit models were estimated and predisposing, enabling, and need factors were controlled for. Estimations were weighted to account for the sampling structure and sensitivity analyses were conducted. Results Immigrants from cultures with stronger family ties are significantly more likely to intend the use of LTC options that include the family. Furthermore, immigrants are less likely to intend the use of exclusively family care when having lived in the United States for a longer time. Discussion We conclude that cultural differences in family ties shape immigrants’ intention to use certain LTC services. If policy makers aim at increasing the provision of specific LTC services or support to family caregivers, there should be a careful evaluation of demand-side factors in an increasingly culturally diverse society.

This report examines trends between 1990 and 2014‒18 in the location of populations experiencing poverty, which we define as those with incomes below the federal poverty line, within metropolitan regions in the United States, with a particular focus on the western United States. We explore how growing suburban poverty is distributed across jurisdictional boundaries that shape governance outcomes, including incorporated and unincorporated suburbs. The size of a suburb and its incorporation status affect its position within local-regional political structures, and smaller suburbs may be overlooked by public, private, and nonprofit organizations in the community development field. Size and incorporation status also affect a suburb’s access to certain federal funds, including the Community Development Block Grant (CDBG) program, a key source of funding for local antipoverty programs. Variation in the distribution of populations experiencing poverty across census regions and metropolitan areas has implications for public and philanthropic spending on social services for low- and moderate-income populations. In this report, we first discuss average trends in the distribution of poverty across urban and suburban jurisdictions in five census regions. For comparison, we divide metropolitan areas into five geographies—the largest city in a metro area, other principal cities, large suburban cities, small suburban cities, and unincorporated areas. Next, we profile 14 metropolitan areas in the western United States through “data snapshots” showing changes in poverty rates and racial and ethnic demographics. We conclude by discussing the implications of these trends for community development practitioners seeking to promote economic participation and financial stability among low- and moderate income communities and communities of color.

Purpose: To assess associations between usual source of care (USC) type and health status, healthcare access, utilization, and expenses among adult cancer survivors. Methods: This retrospective cross-sectional analysis using 2013–2018 Medical Expenditure Panel Survey included 2690 observations representing 31,953,477 adult cancer survivors who were currently experiencing cancer and reporting one of five USC types: solo practicing physician (SPP), a specific person in a non-hospital facility, a specific person in a hospital-based facility, a non-hospital facility, and a hospital-based facility. We used logistic regressions and generalized linear models to determine associations of USC type with health status, healthcare access, utilization, and expenses, adjusting for patient demographic and clinical characteristics. Results: All non-SPP USC types were associated with reporting more difficulties contacting USC by telephone during business hours (p < 0.05). Compared to SPP, non-hospital facility was associated with more difficulty getting needed prescriptions (OR: 1.81, p = 0.036) and higher annual expenses ($5225, p = 0.028), and hospital-based facility was associated with longer travel time (OR: 1.61, p = 048), more ED visits (0.13, p = 0.049), higher expenses ($6028, p = 0.014), and worse self-reported health status (OR: 1.93, p = 0.001), although both were more likely to open on nights/weekends (p < 0.05). Cancer survivors with a specific person in a hospital-based facility (vs. SPP) as USC were > twofold as likely (p < 0.05) to report difficulty getting needed prescriptions and contacting USC after hours. Conclusions: Among adult cancer survivors who were currently experiencing cancer, having a non-SPP type of UCS was associated with reporting more difficulties accessing care, worse health, more ED visits, and higher total expenses. Implications for Cancer Survivors: Transitioning to SPP type of USC may result in better healthcare outcomes.

I present causal evidence on the effect of women's entry into occupations on wages in the United States. I construct a shift-share instrument that interacts the dramatic increase in women's educational attainment and workforce participation from 1960 to 2010 with the likelihood that men and women enter each occupation. I find that a 10 percentage-point increase in the female fraction within an occupation leads to an 8 percent decrease in average male wage and a 7 percent decrease in average female wage in the concurrent census year, and an 9 percent decrease in male wages and a 14 percent decrease in female wages over 10 years.

This paper analyzes the employment trajectories of engineering workers-both workers in occupations formally classified as engineering and workers in occupations not formally classified as engineering but where engineering knowledge is important-during the COVID-19 pandemic. We find that the employment rate of workers in engineering occupations fell by 6.6 percentage-points at the onset of the pandemic compared to a 13.1 percentage-point drop among workers in non-engineering jobs, and that workers in jobs where engineering knowledge is important were less likely to suffer employment loss during the pandemic, regardless of whether their occupation is formally classified as a STEM engineering occupation. This suggests that engineering knowledge is beneficial in reducing a worker's unemployment risk during recessions. We also find that industries with the highest share of engineers as workers tended to experience smaller percentage declines in employment during the pandemic compared to overall US employment, although employment in aerospace and motor vehicle manufacturing industries remained over 10% below pre-recession employment as of 2021Q4.

In the United States, African American or non-Hispanic Black infants experienced worst birth outcomes whereas Hispanic and Asian infants have intermediate or similar outcomes compared with non-Hispanic white infants. The findings of better birth outcomes for Hispanic women have been coined the “Hispanic Paradox” given their low education, income, and access to care. New York City (NYC) has a great racial/ethnic diversity with implications for neighborhood racial/ethnic composition on birth outcomes by protecting women from psychosocial stress via social support that may buffer against racial/ethnic discrimination and/or racism. Data from 2012 to 2018 were used to examine the association of NYC women's race/ethnicity and neighborhood racial/ethnic minority composition with adverse birth outcomes (low birthweight [LBW], small for gestational age [SGA], preterm birth and infant mortality); and whether the association between mother's race/ethnicity and each birth outcome differed by neighborhood racial/ethnic composition. Multilevel logistic regression was used to control for the clustering of outcomes within neighborhoods. Black, Asian, and American Indian women have poorer birth outcomes than white women. Infants of Mexican American, Central American, and South American women were less likely to be of LBW whereas the opposite was true for infants of Cuban and other Hispanic women compared with infants of white women. When compared with white women, Mexican American, and South American women were less likely to have an SGA infant whereas Puerto Rican and other Hispanic women were more likely to have an SGA infant. All Hispanic women were more likely to have a preterm birth than white women whereas for infant mortality, greater odds of dying were observed for infants of Puerto Rican, Dominican, and other Hispanic women. Higher neighborhood racial/ethnic minority composition was associated with greater odds of having an adverse outcome. Finally, we observed heterogeneity of the associations between mother's race/ethnicity and birth outcomes by neighborhood racial/ethnic minority composition.

Objective: This study was undertaken to characterize spending for persons classified with seizure or epilepsy and to determine whether spending has increased over time. Methods: In this cross-sectional study, we pooled data from the Medical Expenditure Panel Survey (MEPS) household component files for 2010–2018. We matched cases to controls on age and sex of a population-based sample of MEPS respondents (community-dwelling persons of all ages) with records associated with a medical event (e.g., outpatient visit, hospital inpatient) for seizure, epilepsy, or both. Outcomes were weighted to be representative of the civilian, noninstitutionalized population. We estimated the treated prevalence of epilepsy and seizure, health care spending overall and by site of care, and trends in spending growth. Results: We identified 1078 epilepsy cases and 2344 seizure cases. Treated prevalence was.38% (95% confidence interval [CI] =.34–.41) for epilepsy,.76% (95% CI =.71–.81) for seizure, and 1.14% (95% CI = 1.08–1.20) for epilepsy or seizure. The difference in annual spending for cases compared to controls was $4580 (95% CI = $3362–$5798) for epilepsy, $7935 (95% CI, $6237–$9634) for seizure, and $6853 (95% CI = $5623–$8084) for epilepsy or seizure, translating into aggregate costs of $5.4 billion, $19.0 billion, and $24.5 billion. From 2010 to 2018, the annual growth rate in total spending incurred for seizures and/or epilepsies was 7.6% compared to 3.6% among controls. Significance: US economic burden of seizures and/or epilepsies is substantial and warrants interventions focused on their unique and overlapping causes.

Between 2000 and 2007, the gender gap in earnings in the US real estate sector increased, especially in local markets where house prices appreciated relatively more. Firm frictions and the presence of small children in the household do not explain the widening of the gender gap, while sorting on entry and gender identity in relative income do. First, the industry attracted relatively more females with no prior experience, especially in booming local housing markets. Second, labor supply increased relatively more for experienced males with at least some college education who earn less than their spouses.

New York City is a “welcoming city” that encourages “all New Yorkers regardless of immigration status” to access the public benefits and services for which they qualify (NYC Mayor’s Office of Immigrant Affairs or “MOIA” 2021a). Moreover, it invests significant resources in educating immigrant communities on this core commitment and its lack of participation in federal immigration enforcement activities. However, this report by the Center for Migration Studies of New York (CMS) finds that immigrants in New York City still face significant barriers to accessing public benefits and services. The report is based on CMS research that examined immigrant fear and other barriers in three general areas: the use of public benefits, with a particular focus on the public charge rule; the use of public health services; and access to law enforcement and the courts. The report documents how Trump-era immigration policies perpetuated fear among immigrant communities, in the context of other barriers to accessing services and benefits, and why its detrimental impacts have persisted and outlived the Trump administration. The research included semi-structured interviews with 75 immigrants across all five boroughs of New York City and two focus groups with immigrants in both English and Spanish. The interviews documented the prevalence and impact of fear and other factors that impede (and facilitate) immigrants’ use of public benefits and services. The respondents were from 30 countries across all regions of the world and had varied legal statuses and lengths of stay in the United States. The CMS research team also interviewed 16 social service providers from community-based organizations (CBOs) and New York City agencies, including the Department of Health and Mental Hygiene (NYC DOHMH) and the Human Resources Administration/ Department of Social Services (HRA), and eight healthcare providers and social workers from the city’s public hospital system, NYC Health + Hospitals, who worked with immigrants across the city. The project ran from January 2020 through October 2021, spanning most of the last year of the Trump administration and most of the first year of the Biden administration. Data collection started in November 2020 and extended through the COVID-19 vaccine rollout starting in spring 2021. The report finds that Trump-era anti-immigrant rhetoric and immigration policies, including aggressive enforcement tactics and a new rule on the public charge ground of inadmissibility, exacerbated long-standing fear pertaining to lack of status, family separation, detention, and deportation. The COVID-19 pandemic has further increased the need for services and assistance for all New Yorkers, including immigrants.

Introduction/Aims: We investigated the age-and sex-specific incidence and survival of Medicare beneficiaries with amyotrophic lateral sclerosis (ALS) in patients 66 to 90 years of age. Methods: We identified all incident ALS cases within a population-based sample of Medicare beneficiaries in 2009 (total: 22 000 177 person-years at risk for ALS). We calculated age- and sex-specific incidence in 2009 according to multiple, progressively more stringent case definitions. Our most inclusive definition required one ALS code, whereas the most restrictive definition required at least one additional ALS code more than 6 months after the first code, including one from a neurologist. We identified associated imaging studies and electrodiagnostic testing and followed all cases through the end of 2014 to determine survival. Results: The overall incidence for our most inclusive definition was 22.84 per 100 000 person-years for men and 16.05 per 100 000 person-years for women. The overall incidence was 5.72 per 100 000 person-years for men and 3.99 per 100 000 person-years for women for our most restrictive definition. For our most inclusive definition, fewer than 39.7% of cases ever had an ALS diagnosis from a neurologist, more than 50% had an electrodiagnostic test or imaging study, and 40.1% survived less than 1 year after diagnosis, with 25.5% of these cases surviving no more than 6 months. Cases not meeting the most restrictive definition were more likely than those who did meet the restrictive definition to be older, black, or Asian. Discussion: The oldest and marginalized Medicare beneficiaries diagnosed with ALS are less likely to be included in epidemiological studies with restrictive definitions, but future studies will need to assess the accuracy of diagnosis.

Human Capital Theory pointed out health as a possible return to education. The question at the center of this research is if education can improve health. Replicating the work of Goesling (2007) on new data from the 2000-2022 Current Population Survey (CPS), a cross-sectional probit analysis shows a positive relationship between educational level and self-reported health. This relationship is robust and significant across age groups.

This paper uses data on broadband connections and the production and sales of agricultural products to empirically estimate the impact of improved connectivity on U.S. farming outcomes. The Federal Communications Commission has detailed data on broadband subscriptions from its semi-annual Form 477 collection. The USDA's National Agricultural Statistics Service (NASS) releases a complete census of agriculture every five years to measure agricultural activity. By pairing periodic releases of the Form 477 data collection with information on farm production expenses and crop yields from corresponding releases of the Census of Agriculture, the analysis directly evaluates the benefit of rural broadband development on the U.S. farming industry. Overall, I find evidence of crop yield improvements from increased Internet penetration rates at thresholds of 25 Megabits-per-second download and 3 Megabits-per-second upload speeds. Among the findings, doubling the number of 25+/3+ connections per 1000 households is associated with a 3.79% increase in corn yields, as measured in bushels per acre. I also find some evidence of cost savings at thresholds of 10 Megabits-per-second download and 0.768 Megabits-per-second upload speeds. Doubling the number of 10+/0.768+ connections per 1000 households is associated with a 2.41% decrease in operating expenses per farm operation. The paper also provides an introductory look at changes in the composition and speed thresholds of connectivity available for selected field crops over time.

Food pantries provide groceries to millions of households in the United States every year. Although there is research and information on many other aspects of food pantries, including financial information such as tax valuations for donated food, there is not a literature establishing the economic value of food pantry access for clients and potential clients. We use a valuation approach from environmental economics, revealed preference travel cost modeling, in a novel application to estimate food pantry value. We use a rich administrative dataset from a food bank system in Colorado and estimate demand for pantry visits, exploiting the move of a local pantry to correct for endogeneity bias. We find that the annual value of pantry access to pantry client households is between $600 and $1000, and the value per pantry visit is between $40 and $60. If we assume these values hold nationally, our localized results imply that the collective value of food pantry access among pantry client households may be between $19 billion and $28 billion dollars annually.