Introduction Electronic cigarettes (e-cigarettes) have become increasingly popular in the United States, including among cancer survivors, and the majority of users also endorse conventional cigarette usage. There has been little research on racial disparities of e-cigarette usage among this population. Methods Using data from the National Health Interview Survey (2014–2018), trends in e-cigarette usage by smoking status was estimated among cancer survivors reporting a history of conventional cigarette use. Multivariable logistic regression analyses defined adjusted odds of e-cigarette usage including an interaction term between race*smoking status to assess whether the association between race and e-cigarette usage depended on smoking status. Results Among 8,199 cancer survivors with history of conventional e-cigarette usage, 1,422 (17.3%) also reported using of e-cigarettes. The majority (71.3%) of e-cigarette users were current (versus former) conventional cigarette smoking individuals. White race was associated with higher odds of e-cigarette usage (AOR 2.17, 95% CI 2.00-2.33, p < 0.001), however there was a statistically significant race*smoking status interaction term (p < 0.001) such that this association was only seen among current conventional smoking patients (AOR 1.96, 95% 1.67-2.70, p < 0.001; 50.6% vs. 33.7%). Conclusions Among the oncology population, the majority of e-cigarette users also endorsed active conventional cigarette smoking. In particular, dual usage was highest among White cancer survivors suggesting that e-cigarettes may not be an efficacious tool for smoking cessation among this population. Our findings can can help inform targeted screening and counseling efforts among cancer survivors.

Objective: To investigate whether food insecurity helps explain the association between income and psychological distress and if its role differs by disability status. Design: Using 2011–2017 National Health Interview Survey cross-sectional data (n 102 543), we conducted linear regression models, fully interacted with disability status, to estimate the association between income-to-poverty ratio (IPR) (<1, 1–<2, 2–<4, ≥4) and psychological distress (Kessler 6 (K6) Scale, range: 0–24). Base models adjusted for socio-demographic factors. We then added food security (secure, low and very low), interacted with disability, and conducted post-estimation adjusted Wald tests. Setting: USA. Participants: Nationally representative sample of non-institutionalised adults 18 years and older. Results: The association between income and psychological distress was stronger for people with disabilities. Compared to those in the highest income category (IPR ≥4), poor individuals (IPR < 1) with and without disabilities scored 2·10 (95 % CI (1·74, 2·46)) and 0·81 (95 % CI (0·69, 0·93)) points higher on the K6 Scale, respectively. Accounting for food insecurity reduced the estimated income disparity in psychological distress significantly more among individuals with disabilities (0·96 points or 46 %) than without disabilities (0·34 points or 42 %), decreasing the difference in the income disparity between those with and without disabilities by 48 % (0·62 points). Further, food insecurity more strongly predicted psychological distress for individuals with disabilities independent of socio-economic disadvantage. Conclusions: Food insecurity plays a more important role in shaping patterns of psychological distress for people with disabilities, explaining more of the association between income and psychological distress among those with than without disabilities. Improving food security may reduce mental health disparities.

Economic downturns, like the one caused by the COVID-19 pandemic, can change retirement plans by prompting early retirement or inducing workers to remain in the labor force longer. These changes in the timing and circumstances of later-life labor force transitions can have significant impacts on the income sources available to those making the transition—and thus the likelihood of experiencing poverty—but prior studies do not examine these outcomes. Using the Current Population Survey March ASEC from 2018-2021, this study examines older adults’ (age 50 or over) labor force transitions during the COVID-19 pandemic. We contribute to prior literature by focusing specifically on trends, and the economic consequences of two types of labor force exits: retirement or non-retirement. Our main analysis estimates associations between labor force transitions and entries into poverty and describes changes in income during labor force transition years. We find that transitioning out of the labor force for any reason is significantly associated with substantial reductions in total income and a higher likelihood of entering poverty. However, these associations did not change much throughout the pandemic. We also find that COVID-19 Economic Impact Payments and Unemployment Insurance were important protections against earnings losses in 2020-21, but especially for those who transitioned out of the labor force. This study also sheds light on the fluidity of retirement and labor force participation in later life.

In this profile, we use the 2015 and 2020 American Community Survey (ACS) 5-Year IPUMS data to examine the prevalence of older adult household heads living with an adult roommate or living with a sibling. We also assess the age of the youngest roommate in the household as well as the marital status and race/ethnicity of the older adult household head in these two living arrangements. We define older adults as those who are 50 years or older. In our analysis, living with an adult roommate and living with a sibling are not treated as mutually exclusive categories (see Figure 1 for more information). This is an update to our previous profile on living with a roommate or sibling in later-life (Wu, 2018).

Despite substantial government funding and public support for the arts in the United States, quantitative evidence of the benefits of arts participation is rarely addressed in debates over cultural policy. Advocates in recent decades have relied heavily—and sometimes successfully—on economic impact studies, the validity of which has been repeatedly questioned by economists. Meanwhile, America is in the midst of social, political, and economic stratification and has not yet agreed on tools to bridge those divides. Qualitative studies and anecdotal evidence indicate that one outcome of arts participation is prosocial attitudes, suggesting that the proliferation of the arts may be a tool to overcome differences across constituencies in the U.S. This research study uses data from the Current Population Survey and American Time Use Survey to quantify the association between participating in arts activities and participating in civic activities such as volunteering and voting, which are considered crucial to a healthy democracy. The findings include a positive, moderate association between participating in both types of activities, despite methodological limitations. Any amount of arts participation in the prior year is associated with a 4 percentage point increase in the likelihood of engaging in civic activities on any given day, the equivalent of nearly 15 additional days with some civic activity across a year. The study also found that for every additional type of arts activity an individual engaged in during the prior year, they spent an average of 9% more time on civic activities on any given day. In addition to these findings, this paper makes recommendations for future research on the relationship between civic and arts participation, policy implications should a causal association be found, and lays an empirical foundation for the arts as a tool for the promotion of democracy.

The retirement village (RV) sector is booming and expanding its market as the world's ageing population has grown in recent years, notably in industrialised and developing countries. RV refers to a high-quality housing facility for retirees wanting to continue living independently in a safe and comfortable environment during post-retirement. In response to the demands of a sustainable development, sustainability of RV has been one of the critical focuses in existing literatures. Thus, this paper aims to advance the notion of Maslow hierarchical needs theory into the setting of retirement villages. The proposed framework of this paper offers a structured and thorough understanding of aged elderly requirements and aspirations; starting with the most fundamental of aged requirements and progressing to the highest desire of having a high quality of life during their golden years, which presents unique prospects for making a theoretical contribution to the requirements of the ageing population and improving RV sustainability.

We analyze the association between spouses' earnings taking account of non-linearities along both spouses' distribution of earnings. We also document the non-linearity of the relationships between earnings and labor force participation, earnings and couple formation , and earnings and number of children. Using simulations, we then analyze how changes in spouses' rank-dependence structure, labor force participation and couple formation contribute to the upsurge in inequality in the U.S between 1967 and 2018. We find that an increased tendency towards positive sorting contributed substantially to the rise in inequality only among dual-earner couples, while it contributed little to overall inequality across households. Temporal and distributional heterogeneity are important, as earnings association had a more substantial role in the bottom of the earnings distribution and in recent years. The decline in couple formation contributed substantially to the rise in inequality, while the increase in female labor force participation and the fertility decline had equalizing effects.

We document how lifetime utility varies by demographic groups in the US and how these differences have evolved since the start of the 21st century. Using the equivalent variation as our measure of welfare we find that the standard deviation in cross-sectional well-being between demographic groups is comparable to the standard deviation of relative annual income in prime earning years and double the standard deviation of relative consumption. Our metric includes consumption, leisure, and mortality risk. The results are primarily driven by differences in consumption and life expectancy. Controlling for other demographics, welfare is increasing in educational attainment and is higher for women and those of Asian descent. This qualitative ordering is robust to classifying a broad measure of home production and child care as work and various definitions of real consumption. Finally, we show that changes in mortality rates associated with 'deaths of despair' disproportionately lower the welfare of less educated Whites.

This paper examines the identification and estimation of the structural function in fuzzy regression discontinuity (RD) designs with a continuous treatment variable. Under a dual monotonicity condition, we show that the nonlinear and nonseparable structural function can be nonparametrically identified at the RD cutoff. The dual monotonicity condition requires that the structural function and the treatment choice be strictly increasing in the unobserved causal factor. This condition is satisfied by standard parametric models used in practice. The identification result contrasts with the local average treatment effect literature, where only a certain weighted average of the structural function is identified. We propose a three-step semiparametric estimation procedure and derive the asymptotic distribution of the estimator. The semi-parametric estimator achieves the same convergence rate as in the case of a binary treatment variable. As an application of the method, we estimate the causal effect of sleep time on health status by the discontinuity in natural light timing at time-zone boundaries.

This study reviews tends in available public opinion data on vaccines, which mainly cover 2001-2021. Four general findings emerge. First, Americans have been progressively hearing more information about vaccines over the past two decades. Second, attitudes regarding vaccines' utility, safety, and appropriateness of requirements have mostly declined during this same period. Third, trends in reported vaccination behavior differ from trends in attitudes, and also vary across different vaccine types. The pattern of these differences suggests a strong influence of public policies on vaccine behavior. Finally, an analysis of trends among Democrats and Republicans suggests that vaccine attitudes and behavior were mostly apolitical up until around 2008 or so. But since then-and clearly prior to the politicization of the COVID-19 pandemic-the parties have increasingly diverged on vaccines. While Republicans have continued to become more vaccine skeptical, Democrats have actually reversed the overall trend and become more vaccine supportive.

This dissertation consists of two chapters that investigate the impact of women empowerment on the survival outcomes of children in India. Chapter 1 Taking cognizance of the lack of representation of women in politics, the Indian government in 1993, enacted the 73rd constitutional amendment which led to a sudden increase in the representation of women in the local governments. Exploiting the exogenous variation in the timing of implementation of the 73rd amendment across the states, I study the spillover effects of this mandated empowerment of women on the health outcomes of children by using nationally representative survey data and employing a difference-in-difference estimation strategy. In this study, I find evidence of a positive impact of mandated women empowerment on the survival outcomes of higher birth order children. I also find evidence of increased birth spacing as the possible mechanism through which the increased representation of women in the local government leads to the improvement in the survival outcomes of children. Findings also suggests that the reservation at all levels of the local government is not equally effective and is mainly driven by the increased representation of women at the village level. Chapter 2 In this paper, I investigate the impact of the change in the gender composition of politicians due to the improved electoral performance of women in state-level elections in India on the survival outcomes of children. Early childhood mortality in India has been a matter of concern as it is among the countries which report high neonatal and infant mortality. The lack of decent healthcare facilities coupled with the cultural and social norms which dictate the preference for boy children have led to inferior health outcomes for the higher birth-order children, especially girl children. In this paper, I postulate that an improvement in the representation of women in a male-dominated decision-making position leads to better healthcare infrastructure and policies and a reduction in bias against women stemming from social and cultural norms and thus improves the early childhood mortality outcomes of children. I use a health survey data consisting of information about the reproductive history of mothers who gave birth in the period 1990-to 2015 and combine it with the data on the electoral performance of women in state legislative assembly elections conducted within the period 1989-to 2014 to examine the impact of a change in the gender composition of politicians at the district level on the neonatal and infant survival outcomes of the children born within each election-cycle in the respective districts. To correct for the endogeneity concerns arising out of the unobserved voter preferences, I exploit the quasi-randomness of women’s victories in close men-women elections using a regression discontinuity design. In contrast to previous research, I find that a change in the gender composition of politicians at the district level does not have an overall impact on the survival outcomes of children. Contrary to previous research, the findings also suggest that only girl children of higher birth order experience an improved neonatal survival probability relative to boys. The two papers improves our understanding of the spillover effects of women empowerment and highlights the role women empowerment plays in determining health of children

In this paper, I compare the children of inter-ethnic marriages to study the impact of having a Hispanic last name. While men born to Hispanic father-White mothers earn less than those born to White father-Hispanic mothers, the gap could be explained entirely by educational differences. I also study the effect of identifying as Hispanic on earnings. I find that men that identify as Hispanic earn significantly less than those that do not, even after controlling for educational differences.

Air pollution exposure disparities by race/ethnicity and socioeconomic status have been analyzed using data aggregated at various spatial scales. Our research question is this: To what extent does the spatial scale of data aggregation impact the estimated exposure disparities? We compared disparities calculated using data spatially aggregated at five administrative scales (state, county, census tract, census block group, census block) in the contiguous United States in 2010. Specifically, for each of the five spatial scales, we calculated national and intraurban disparities in exposure to fine particles (PM2.5) and nitrogen dioxide (NO2) by race/ethnicity and socioeconomic characteristics using census demographic data and an empirical statistical air pollution model aggregated at that scale. We found, for both pollutants, that national disparity estimates based on state and county scale data often substantially underestimated those estimated using tract and finer scales; in contrast, national disparity estimates were generally consistent using tract, block group, and block scale data. Similarly, intraurban disparity estimates based on tract and finer scale data were generally well correlated for both pollutants across urban areas, although in some cases intraurban disparity estimates were substantially different, with tract scale data more frequently leading to underestimates of disparities compared to finer scale analyses.

Gender has been identified as a social determinant of health, particularly as it relates to healthcare access for women of color. Yet, few analyses focus on the unique barriers that impact Latinx women’s access to healthcare, which demonstrates a significant gap in the literature given the heterogeneity of the Latinx population. The purpose of this study is to (1) describe how sociodemographic characteristics impact access to healthcare for Latinx women and (2) examine whether intersecting factors, particularly nativity and nationality, influence barriers to healthcare for Latinx women in the United States (US).

The COVID-19 pandemic has led to significant disruptions in all aspects of societies. Amidst the COVID-19 pandemic, systemic inequities and implicit biases have become more visible, as many pieces of evidence reveal that the US population is disproportionately harmed physically, socially, emotionally, economically, and educationally. This chapter aims to summarize relevant studies that reveal, analyze, and discuss the long-standing inequity issues in the US that have been emerging during the COVID-19 pandemic from three different perspectives: (1) inequity in COVID-19 testing rates, confirmed cases, and mortality, (2) inequity in stay-at-home compliance and short-/long-term recovery, and (3) inequity in vaccination tendency, vaccine allocation, and vaccination rate. The observed inequities from these three perspectives can be attributed mainly to the disparity of demographics and socioeconomic status of the population. Such a disparity may further widen the gap between advantaged and disadvantaged groups and cause unequal economic and health consequences that disproportionately affect vulnerable groups. By summarizing the analytical approaches, experimental settings, and statistical findings, we provide evidence that unravels the role of demographic and socioeconomic status in observed inequities during the COVID-19 pandemic. In addition, we discuss the strategies that can be adopted to reduce the inequity induced by future epidemics.

Stay-at-home fathers challenge norms related to masculinity and gendered divisions of parenting roles. We conduct a content analysis of 94 print news articles about at-home fathers published 1987–2016 in the United States, identifying key themes and comparing results with our earlier research on news depictions of at-home mothers. We also analyze national trends in fathers staying home using Current Population Survey data to understand contexts in which articles were published. Articles were family-centric and disproportionately focused on economic elites, emphasizing their “choice” to stay home, but economic reasons for fathers staying home were described more commonly than in portrayals of mothers. Stigmatization experiences were pervasive in articles, appearing more commonly when staying home was reported as discretionary, but less commonly when staying home resulted from involuntary unemployment in recent periods. Portrayals reflect, reinforce, contribute to, and challenge father-as-provider norms, mirroring changes in masculinity norms over time and revealing cultural ambivalence toward at-home fathers.

A soil-water-balance (SWB) model was developed for Long Island, New York, to estimate the potential amount of annual groundwater recharge to the Long Island aquifer system from 1900 to 2019. The SWB model program is a computer code based on a modified Thornthwaite-Mather SWB approach and uses spatially and temporally distributed meteorological, land-cover, and soil properties as input to compute potential daily groundwater recharge. Simulated outputs indicate that island-wide potential groundwater recharge trends, as a percentage of precipitation, have increased approximately 3 percent during the 120-year period. The simulated results account for both climatic and land-cover changes that have occurred during the period. A change from undeveloped (forested land cover) to low- and medium-density residential land cover or land use increased potential groundwater recharge because of a decrease in evapotranspiration. During the 30-year period from 1900 to 1930, the simulated potential average groundwater recharge rate on Long Island was estimated to be 18.50 inches per year (in/yr), or a total of 1,243 million gallons per day, during the 30-year period from 1985 to 2015, the simulated potential average groundwater recharge rate estimate increased to 20.73 in/yr (a total of around 1,393 million gallons per day). During the 1900–2019 simulation period, the potential average annual groundwater recharge rate was about 19.24 in/yr. The data for that period included values for a 3-year meteorological drought from 1963 to 1965, where the mean precipitation was about 26.5 percent lower than the long-term average of 46.7 in/yr, and the potential groundwater recharge rate was about 12.3 in/yr. During a 3-year wet period from 1982 to 1984, where mean precipitation was about 19.6 percent higher than the long-term average, the estimated potential groundwater recharge rate was about 26.8 in/yr.

The Community Rating System (CRS) was established to encourage community to voluntarily conduct higher standard floodplain management. Participating communities are rewarded with flood insurance discounts based on CRS points earned through CRS eligible activities. This paper examines an overlooked question by previous research: whether there is spillover effect of the CRS program regarding flood damage reduction, as well as the potential mechanism of this spillover effect. Results indicate that there is a lagged, short-term spillover effect. For non-CRS communities, having a CRS neighbor leads to about $0.5 million reduction in annual flood damage a few years after the treatment. This impact is possibly because of community's learning from their CRS neighbors by investing more on flood risk mitigation activities.

We use linked survey and administrative data to document and decompose the striking differences across demographic groups in both economic and health impacts of the first year of the COVID-19 pandemic in the United States. The impacts of the pandemic on all-cause mortality and on employment were concentrated in the same racial, ethnic, and education groups, with non-White individuals and those without a college degree experiencing higher excess all-cause mortality as well as a greater employment loss. Observable differences in living arrangements and the nature of work-which likely affected exposure to the virus and to economic contractions-can explain 15 percent of the Hispanic-White difference in excess mortality, almost one-quarter of the non-Hispanic Black-White difference, and almost half of the difference between those with and without a Bachelor's degree; they can also explain 35 to 40 percent of the differences in economic damages between these groups. These findings underscore the importance of non-medical factors in contributing to the disparate impacts of public health shocks.

This study focuses on age and digital exposure as factors driving individuals to be (1) employees or entrepreneurs, (2) full-time or part-time, or (3) opportunity or necessity entrepreneurs. It extends occupational choice models, relying on a utility maximization framework, to entrepreneur types incorporating age and digital exposure effects. Using 132 months of Current Population Survey data and multilevel modelling with individuals’ fixed effects and metropolitan area random effects, the study finds that (1) workers with low- and high- digital exposure are more likely to become entrepreneurs than peers with medium digital exposure, mirroring digitization’s “push” and “pull” mechanisms on entrepreneurship; (2) age strengthens digitization’s “pull” mechanism to be entrepreneurs (versus employees) and opportunity (versus necessity) entrepreneurs; (3) digital exposure has a weak marginal potential to increase workers’ odds to be part-time (versus full-time) entrepreneurs. The study also notes the importance of location and concludes with discussion and implications.