Background: While much progress has been made in understanding the demographic determinants of mortality in the United States using individual survey data and aggregate tabulations, the lack of population-level register data is a barrier to further advances in mortality research. With the release of Social Security application (SS-5), claim, and death records, the National Archives and Records Administration (NARA) has created a new administrative data resource for researchers studying mortality. We introduce the Berkeley Unified Numident Mortality Database (BUNMD), a cleaned and harmonized version of these records. This publicly available dataset provides researchers access to over 49 million individual-level mortality records with demographic covariates and fine geographic detail, allowing for high-resolution mortality research. Objective: The purpose of this paper is to describe the BUNMD, discuss statistical methods for estimating mortality differentials based on this deaths-only dataset, and provide case studies illustrating the high-resolution mortality research possible with the BUNMD. Methods: We provide detailed information on our procedure for constructing the BUNMD dataset from the most informative parts of the publicly available Social Security Numident application, claim, and death records. Contribution: The BUNMD is now publicly available, and we anticipate these data will facilitate new avenues of research into the determinants of mortality disparities in the United States.

Purpose: Recent research has found a general pattern of health erosion in self-assessed pain and allostatic load among adults in the United States (US). It remains to be determined if self-reported health status, hereafter SRH, also follows this pattern. The aim of this study was to examine whether a general pattern of health erosion is found in SRH among adults in the United States (US). Methods: Data from the National Health Interview Survey 1997–2018 were used to study sex, educational attainment, and racial/ethnic patterns in SRH by age, period and cohort among adults in the US. The analytic sample consisted of respondents aged 18 years or older at the moment of interview with valid information in the age, sex, education, race/ethnicity and health status question (n = 669,501). Estimates for the percent population reporting poor/fair health were produced by age, period and cohort to study trends in health status by sex, educational attainment and race/ethnicity. All estimates were weighted to account for complex survey design. Results: No discernible pattern of health erosion, or improvement, is observed in the age, period or cohort analyses of the percent of the population reporting poor/fair SRH by sex, educational attainment or race/ethnicity. Conclusions: The analysis indicates that self-reported health does not follows the general pattern of health erosion found in self-assessed pain and allostatic load in the US. The percent of the population reporting poor/fair health status has remained relatively stable between 1997 and 2018. Further research is required to determine whether self-reported health is an appropriate metric to track population health in the US.

If mothers take care of children more than fathers, then after the onset of COVID-19 mothers’ employment is expected to drop more than that of fathers. This gender gap is likely to be larger where women are less concerned about the financial repercussions of opting out of the labor force, and therefore the gender gap in employment is likely to grow more where community property or homemaking provisions give more protection to homemakers in case of union dissolution. Difference-in-differences and dynamic study estimations applied to CPS data for 2019–2020 show that after the onset of COVID-19 the labor force participation of mothers of school-age children—but not of fathers–dropped more in states with marital property laws more generous to parental caregivers. These results stand in contrast to how these groups’ labor force participation changed after the Great Recession, compared to pre-recession levels.

This study examines the association between educational attainment, relative to that of an intimate partner, and all-cause mortality for men and women in different-sex relationships. Research suggests some health benefits for partnered adults that arise from economic benefits and improved access to health-promoting tools. One way these benefits could be gained is through the pairing of the highly educated. While high individual educational attainment lowers mortality risk, less is known about the risks of mortality associated with one’s education, relative to their partner’s education. Using National Health Interview Survey Linked Mortality Files (NHIS-LMF) for the years 1999–2014 with prospective mortality follow-up through December 2015 (N = 347,994), we document the association between relative educational attainment and mortality for men and women with different-sex partners in the United States. Fully adjusted Cox proportional hazard models revealed a higher risk of all-cause mortality for men and women who have more education than their partner, relative to those having the same education as their partner. For women only, having less education than their male partner was associated with a lower risk of all-cause mortality. A better understanding of relative status within different-sex partnerships provides insights into partnered adult’s mortality risks.

As we enter yet another phase of a pandemic that has highlighted the essential nature of early care and education (ECE) services, California’s ECE sector is experiencing dire staffing shortages (Center for the Study of Child Care Employment, 2022) due in part to the low wages of ECE providers. As of this writing, California has 7,200 fewer child care slots and 7,000 fewer child care jobs than in February 2020, before the onset of the pandemic (Assembly Budget Committee, 2022; BLS Beta Labs, 2022). Throughout the state, administrators cite compensation as a main barrier to recruiting and retaining staff (Kim et al., 2022). The low wages and lack of benefits for the California ECE workforce are increasingly recognized and decried (McLean et al., 2021; Gould et al., 2019; Whitebook et al., 2014). But ECE jobs are not just low wage, they are among the worst-paid jobs in the United States. Although early educators provide the foundation for quality ECE programs and are the backbone of the economy, the wages of child care workers rank in the bottom 2 percent of all occupations, averaging $11.65 per hour nationally (McLean et al., 2021). In the State of California, the ECE workforce is largely women of color (Powell, Kim, et al., 2022). For centuries, care work, the work of women, and the work of people of color have been undervalued in our country (Gould et al., 2021; Austin et al., 2019). This reality, coupled with insufficient public funding and a reliance on parents to shoulder most costs of ECE services, has debilitated the sector. The result is a system in which the vast majority of the workforce does not earn a living wage, with dire consequences for their well-being. Furthermore, this arrangement does not work well for families that struggle to find and afford the care they want and need for their children. This report draws on findings from the California Early Care and Education Workforce Study to report income and benefits of licensed family child care (FCC) providers and center-based directors, teachers, and assistant teachers. This study is the first comprehensive examination of California’s workforce in 15 years. Despite a growing understanding of the importance of early learning and development and the expansion of quality improvement initiatives during this time, little has been done to address the economic well-being of educators themselves. Early educators’ wages are still low. In fact, we estimate that teachers with bachelor’s degrees working in California child care centers saw a decline in actual wages of 1 to 2.5 percent between 2006 and 2022, despite a 35-percent increase in the minimum wage over the same period. To better understand variations and inequities in the system, we examine compensation by educator role and education level as well as program type and funding. We also provide findings by region, when sample sizes allow (see Appendix 2 for map of study regions).

Former immigrants are widely believed to pave the way for new immigrants and to influence their life decisions in host countries. The groups of immigrants are usually called immigrants enclaves or networks. These networks play several roles, such as reducing migration costs and uncertainty. Previous research finds that networks’ members can provide referrals so that new migrants can get new jobs easily (Munshi, 2003).

Housing is a key social determinant of health with implications for both physical and mental health. The measurement of healthy housing and studies characterizing the same in sub-Saharan Africa (SSA) are uncommon. This study described a methodological approach employed in the assessment and characterization of healthy housing in SSA using the Demographic and Health Survey (DHS) data for 15 countries and explored healthy housing determinants using a multiple survey-weighted logistic regression analysis. For all countries, we demonstrated that the healthy housing index developed using factor analysis reasonably satisfies both reliability and validity tests and can therefore be used to describe the distribution of healthy housing across different groups and in understanding the linkage with individual health outcomes. We infer from the results that unhealthy housing remains quite high in most SSA countries. Having a male head of the household was associated with decreased odds of healthy housing in Burkina Faso (OR = 0.80, CI = 0.68–0.95), Cameroon (OR = 0.65, CI = 0.57, 0.76), Malawi (OR = 0.70, CI = 0.64–0.78), and Senegal (OR = 0.62, CI = 0.51–0.74). Further, increasing household size was associated with reducing odds of healthy housing in Kenya (OR = 0.53, CI = 0.44–0.65), Namibia (OR = 0.34, CI = 0.24–0.48), Nigeria (OR = 0.57, CI = 0.46–0.71), and Uganda (OR = 0.79, CI = 0.67–0.94). Across all countries, household wealth was a strong determinant of healthy housing, with middle and rich households having higher odds of residing in healthy homes compared to poor households. Odds ratios ranged from 3.63 (CI = 2.96–4.44) for households in the middle wealth group in the DRC to 2812.2 (CI = 1634.8–4837.7) in Namibia’s wealthiest households. For other factors, the analysis also showed variation across countries. Our findings provide timely insights for the implementation of housing policies across SSA countries, drawing attention to aspects of housing that would promote occupant health and wellbeing. Beyond the contribution to the measurement of healthy housing in SSA, our paper highlights key policy and program issues that need further interrogation in the search for pathways to addressing the healthy housing deficit across most SSA countries. This has become critical amid the COVID-19 pandemic, where access to healthy housing is pivotal in its control.

Objectives/Hypothesis: This scoping review aims to map out existing disparities research within the subspecialty of laryngology in order to highlight gaps in knowledge and guide future research. Study Design: Scoping Review. Methods: We completed a scoping review of PubMed, Ovid Embase, and the Cochrane Library for primary research focused on evaluating the existence and impact of disparities in race/ethnicity, sex/gender, insurance status, education level, income, geography, and LGBTQ identity in the context of various laryngological conditions. Publications of any design and date, performed in the United States, and focusing on the adult population exclusively were included. Results: Of the 4,999 unique abstracts identified, 51 articles were ultimately included. The most frequently examined condition in relation to disparities was laryngeal cancer (27 of 51), followed by voice disorders (15 of 51), deglutitive disorders (eight of 51), and airway disorders (one of 51). Sources of inequity evaluated from most common to least common were race/ethnicity (43 of 51), sex/gender (39 of 51), insurance status (23 of 51), geography (23 of 51), income (21 of 51), and education level (16 of 51). No study examined the association of LGBTQ identity with inequity. Conclusions: This scoping review highlights the limited extent of disparities research in laryngology and establishes the need for further scholarship on the impact of disparities in laryngology care. The pathologies studied were, in decreasing order of frequency: laryngeal cancer, voice disorders, deglutitive disorders, and airway disorders. Race/ethnicity and sex/gender were the most common disparities examined, with no evaluation of LGBTQ-related care inequity.

The objective of this study was to describe how structural racism and sexism shape the employment trajectories of Black women in the US health care system. Using data from the American Community Survey, we found that Black women are more overrepresented than any other demographic group in health care and are heavily concentrated in some of its lowest-wage and most hazardous jobs. More than one in five Black women in the labor force (23 percent) are employed in the health care sector, and among this group, Black women have the highest probability of working in the long-term-care sector (37 percent) and in licensed practical nurse or aide occupations (42 percent). Our findings link Black women’s position in the labor force to the historical legacies of sexism and racism, dating back to the division of care work in slavery and domestic service. Our policy recommendations include raising wages across the low-wage end of the sector, providing accessible career ladders to allow workers in low-wage health care to advance, and addressing racism in the pipeline of health care professions.

My dissertation studies labor market structure and evaluates effects of policies relating to transportation improvements and immigration enforcement in different countries including Germany, the Untied States, and China. Specifically, I examine the nature and extent of labor market frictions, explore the causes and consequences, as well as study the role in policy evaluations. In the first chapter, I investigate one potential source of labor market frictions from limited labor mobility by examining how integrating labor markets through improved transportation infrastructure affects both wages and the allocation of workers across establishments. I take advantage of the expansion of the High-Speed Rail in Germany, which connected medium-sized districts located on existing rail lines, providing a natural experiment to study the effects of labor market integration. Using administrative panel data on establishments and workers linked to their employers, I estimate difference-in-differences and event-study models that compare newly connected districts to matched controls that were never connected. In theory, policies that improve labor mobility might raise wages both by facilitating more productive matches of workers to firms and by reducing the monopsony power that employers have vis-`a-vis workers. I find evidence of increased labor mobility for workers in treated districts, especially those that are more likely to commute. Worker wages increase significantly and I find that both reduced monopsony power and better match quality are possible mechanisms. I also test for establishment adjustments including entry, exit, size, and wage that are predicted by each mechanism. This study shows evidence of reduced labor market frictions from improved transportation. It also sheds light on the importance of policies that enhance workers’ ability to switch employers. In the second chapter, I explore the effects of LAWA on labor markets based on evidence that LAWA has significantly reduced the population of Hispanic noncitizens in Arizona. Specifically, I focus on the composition of the labor force and industry heterogeneity. I first show that a synthetic control has similar concurrent economic trends with Arizona, and verify that changes in employee composition are due to the replacement of Hispanic noncitizen workers by other subgroups and not by a change in overall employment. In response to LAWA, firms tend to reduce both the new hire rate and the separation rate. Several robustness checks are conducted to test the accuracy of the estimates and several mechanisms are considered that may drive the results. In the third chapter, we study the structure of labor markets and the effects on wages in China. A growing literature has emphasized the existence of monopsony power stemming from employer concentration within local labor markets, which deviates from the conventional view of labor markets as perfectly competitive. We use firm-level data from the Chinese Annual Survey of Industrial Firms to analyze how employer concentration affects wage behavior. We first verify that local employment concentration measured by the Herfindahl-Hirschman Index of firm employment decreases between 1998 and 2013, in contrast to the increasing trend found in developed countries. Then with OLS and IV models, we show a negative relationship between labor market concentration and wages both the at the market level and at the firm level, indicating the existence of imperfect labor market competition in China.

Introduction: The National Institutes of Health (NIH) Toolbox (NIHTB) provides computerized measures of cognition, emotion, sensation, and motor abilities across the lifespan. The ARMADA (Assessing Reliable Measurement in Alzheimer’s Disease and Cognitive Aging) study validated the NIHTB in individuals across the cognitive aging spectrum. This article reports the characteristics of our sample of participants. Methods: Participants were recruited across nine sites and classified clinically as cognitively normal (NC), with mild cognitive impairment (MCI), or with dementia of the Alzheimer’s type (DAT.) They completed the NIHTB at multiple time points and many had at least one Alzheimer’s biomarker previously obtained. Results: Groups differed with respect to dementia severity levels, as anticipated, but were well-matched across many demographic characteristics. Discussion: The ARMADA study demographics and baseline characteristics provide a suitable sample for validating the NIHTB across the cognitive aging spectrum. Other enriched samples (African American participants, Spanish NIHTB, 85+ years of age) will be reported elsewhere.

Children born in 2020 are estimated to experience two to seven more climate change-induced extreme events in their lifetimes than those born in 1960. Given children’s vulnerability to disasters and other environmental hazards, this dissertation argues that children and disaster research should examine the effects of child/adolescent exposure to cumulative disasters alongside chronic environmental stressors in the context of their families. This dissertation develops and validates a conceptual framework elucidating the pathways of cumulative environmental stress exposure on child/adolescent physical and mental health outcomes. The model is unique in that it incorporates conservation of resources, family stress, and allostatic load theories. Data for this research come from two studies conducted among highly disaster-exposed Gulf Coast families in the aftermath of the 2010 Deepwater Horizon oil spill: the Gulf Coast Population Impact (GCPI) study and Women and their Children’s Health (WaTCH) study. Qualitative analysis was first conducted on data from in-depth interviews and focus groups with stakeholders and caregivers in five communities highly impacted by the oil spill. These qualitative data provided insight for better understanding the effects of the oil spill on children and adolescents in the context of multiple disasters. Household data from WaTCH was used to develop a novel index using geospatial analysis and principal components analyses to assess xv cumulative, place-based environmental stress predicated on stressors in five environmental domains –social, technological, natural, built, and chemical. The composite novel index was then applied to a structural equation model to assess the direct relationship between cumulative, place-based environmental stress to child/adolescent psychological and physical health outcomes, as well as their indirect relationship mediated by cascading household-, family-, and individual level stressors. Findings show that while most children and adolescents demonstrate resilience, cumulative place-based environmental stress induces adverse outcomes when there are also household- and family-level stressors. It is therefore imperative to identify strategies and meaningful public health interventions that enhance children’s resilience in the era of accelerated climate change.

Against a backdrop of extreme racial health inequality, the 1918 influenza pandemic resulted in a striking reduction of non-White to White influenza and pneumonia mortality disparities in United States cities. We provide the most complete account to date of these reduced racial disparities, showing that they were unexpectedly uniform across cities. Linking data from multiple sources, we then examine potential explanations for this finding, including city-level sociodemographic factors such as segregation, implementation of nonpharmaceutical interventions, racial differences in exposure to the milder spring 1918 “herald wave,” and racial differences in early-life influenza exposures, resulting in differential immunological vulnerability to the 1918 flu. While we find little evidence for the first three explanations, we offer suggestive evidence that racial variation in childhood exposure to the 1889–1892 influenza pandemic may have shrunk racial disparities in 1918. We also highlight the possibility that differential behavioral responses to the herald wave may have protected non-White urban populations. By providing a comprehensive description and examination of racial inequality in mortality during the 1918 pandemic, we offer a framework for understanding disparities in infectious disease mortality that considers interactions between the natural histories of particular microbial agents and the social histories of those they infect.

We examine how lower-income households in the United States acquire automobiles. Although car ownership plays an important role in social and economic mobility in the U.S., transportation scholars know little about how households acquire cars. We use an online opt-in survey of adults from lower-income households to examine how and why they acquire cars, and the effects of these different pathways to car ownership on finances and quality of life. We identify five pathways to car ownership: buying a new car, buying a used car at a dealer, buying a used car from informal markets, receiving a car as a gift, and obtaining a car through a life-event (e.g., moving in with a car owner). The most common path is to acquire a used car from a dealer (38% of our sample), followed by acquiring a used car informally (24%), purchasing new (17%), receiving a car as a gift (15%), and via a move-in (5%). Respondents most often acquired a car for financial reasons and to increase accessibility. In contrast, the COVID-19 pandemic, life-events, and built environment factors played a smaller role. Respondents reported that acquiring a car had a positive effect on their lives. The overwhelming majority said the effect on their quality of life was positive and getting a car was worth it. However, almost half experienced some type of financial hardship related to owning and operating their car.

The presence of active or inactive (i.e., postproduction) oil and gas wells in neighborhoods may contribute to ongoing pollution. Racially discriminatory neighborhood security maps developed by the Home-Owners Loan Corporation (HOLC) in the 1930s may contribute to environmental exposure disparities. To determine whether receiving worse HOLC grades was associated with exposure to more oil and gas wells. We assessed exposure to oil and gas wells among HOLC-graded neighborhoods in 33 cities from 13 states where urban oil and gas wells were drilled and operated. Among the 17 cities for which 1940 census data were available, we used propensity score restriction and matching to compare well exposure neighborhoods that were similar on observed 1940 sociodemographic characteristics but that received different grades. Across all included cities, redlined D-graded neighborhoods had 12.2 ± 27.2 wells km−2, nearly twice the density in neighborhoods graded A (6.8 ± 8.9 wells km−2). In propensity score restricted and matched analyses, redlined neighborhoods had 2.0 (1.3, 2.7) more wells than comparable neighborhoods with a better grade. Our study adds to the evidence that structural racism in federal policy is associated with the disproportionate siting of oil and gas wells in marginalized neighborhoods.

Using Census data, this paper proposes an empirical approach to look at differences and changes in the composition of employment across NUTS-3 level regions of six European Union countries over the period 1981 – 2011. We focus on jobs (defined as specific occupations within specific sectors) as our unit of analysis. We rank all jobs based on their average educational level and divide these distributions into terciles. We accommodate the approach to compare regions to their national average and see how they evolve compared to the national trend. Our aim is to determine if regional employment structures converge over time and whether they are polarizing, upgrading or downgrading. Several hypotheses regarding possible underlying factors of structural changes are further discussed. Results show a high degree of heterogeneity in the different regions. This presents considerable challenges for policymakers, as they need to gear their efforts at regional, more localized level.

As genetic testing becomes increasingly incorporated into clinical practice to aid in both the diagnosis and risk assessment of genetic diseases, patients benefit from genetic counseling to support their understanding of test results either before and/or after genetic testing. Therefore, access to genetic testing and counseling is imperative for patient care. It is well established that health insurance coverage is a major determinant of access to health care in the United States as individuals without insurance are less likely to have a regular source of health care than their insured counterparts. Different health insurance plans and benefits also influence patients’ access to health care. Data on the association of health insurance and the uptake of genetic testing and/or counseling for cancer risk are limited. Using data from the National Health Interview Survey, we examined the uptake of genetic testing and/or counseling for breast/ovarian cancer risk by health insurance type. We found that only a small proportion of women undergo genetic testing and/or counseling for breast/ovarian cancer risk (2.3%), even among subgroups of women at risk due to family or personal history (6.5%). Women with health insurance were more likely to undergo genetic testing and/or counseling for breast/ovarian cancer risk, particularly those with military and private insurance plans, than those without health insurance after adjusting for various demographic, socioeconomic, and health risk covariates. Further investigations are needed to examine potential disparities in access and health inequities.

Rosen (1974, 1979) and Roback (1982) imply that wage differentials across locations between similar workers arise from the differences in local amenities and cost of living. If the valuation of amenities varies across individuals (or groups of individuals), this affects the geographical sorting of households (Bayer and Timmins, 2007; Bayer et al., 2009; Lee, 2010; Moretti, 2013; Couture et al., 2019; Baum-Snow and Hartley, 2020). As a result, although the free mobility assumption ensures that the indirect utility of each worker type within the same group should be equalized across areas, this does not imply that interregional wage differentials should be the same for all groups of workers. The first essay proposes an approach to measuring interarea wage differentials by matching individuals with similar demographic and education characteristics to adjust for the effects of differences in preferences for local amenities and cost of living on wages. Given that the preferences for amenities, housing, and local public goods vary across individuals, workers are disaggregated into highly detailed subgroups based on their observable demographic characteristics under the hypothesis that people in the same group share similar utility functions and have similar preferences. The results show that disaggregating workers can overcome measurement problems in estimating amenity and house price variables commonly found in previous literature and can also adjust for preference heterogeneity across worker types. The results confirm the theoretical prediction that a commonly used aggregate Mincer equation underestimates the compensating variation required by the average worker, suggesting that disaggregating workers into highly detailed subgroups can be an effective method of explaining differences in intercity real wage differentials. The second essay applies the method developed in the first essay to investigate the effects of potential monopsony power on interregional wage differentials for a particular occupation. Current research investigates the effect of monopsony on wages by constructing a concentration measure (Herfindahl-Hirschman Index, for example) or estimating labor supply elasticity for a particular occupation or in a specific region. However, the problem with conducting direct tests for lower wages for a particular occupation that is susceptible to monopsony is that living cost and amenities also cause wage differentials. Higher wages for a given category of worker in city A than in city B might not arise just from a lower degree of monopsony, but from a higher cost of living or lower amenities in city A, and thus workers are paid more as compensation. The potential effect of monopsony on wages cannot be identified separately without adjusting for the effect of local cost of living and amenity differences, and thus classical Mincer-type wage equations with monopsony measures added could be subject to substantial omitted variable biases. The second essay matches each potentially monopsonized occupation with comparable occupations that are less prone to monopsony. Then, the effect of interregional differences in monopsony power for a particular occupation on interregional relative wage differentials with respect to a similar occupation is analyzed using five proxy measures of monopsony power taken from previous literature. The third essay concerns measurement of intercity differences in housing cost. Intercity housing price indexes that rely on median house price, pooled hedonic regressions, or repeat sales adjust imperfectly for differences in housing characteristics. In addition, intercity house price indexes that rely on asset value are a biased measure of differences in the rental price of housing, because capitalization rates vary dramatically across cities. To mitigate these shortcomings, the third essay creates a Fisher Ideal intercity housing price index for rental rates and asset value using a twofold Blinder-Oaxaca decomposition. The original method introduced in the third essay improves upon current house price indexes by allowing implicit prices to vary across locations.

The trade war initiated by the Trump administration is the largest since the US imposed the Smoot-Hawley tariffs in the 1930s and was still raging when he left office. We analyze how the trade war impacted the 2020 US Presidential election. Our results highlight the political salience of the trade war: US trade war tariffs boosted Trump’s support but foreign retaliation hurt Trump. In particular, the pro-Trump effects of US trade war tariffs were crucial for Trump crossing the recount thresholds in Georgia and Wisconsin. Even more important politically, voters abandoned Trump in counties with large expansions of health insurance coverage since the Affordable Care Act, presumably fearing the roll-back of such expansion. Absent this anti-Trump effect, Trump would have been on the precipice of re-election by winning Georgia, Arizona, Nevada, and only losing Wisconsin by a few thousand votes. These effects of the trade war and health insurance coverage expansion cross political and racial lines, suggesting the mechanism operates through the impact on local economies rather than political polarization.