Mind-Body Problems

Kevin Lewis

May 22, 2024

The changing relationship between bodyweight and longevity in high- and low-income countries
Joanna Kopinska et al.
Economics & Human Biology, August 2024

Standard measures of bodyweight (overweight and obese, for example) fail to reflect differences across populations and technological progress over time. This paper builds on the pioneering work of Waaler (1984) and Fogel (1994) to empirically estimate how the relationship between body mass index (BMI) and longevity varies across high-, middle-, and low-income countries. Importantly, we show that these differences are so profound that the share of national populations above mortality-minimizing bodyweight is not clearly greater in countries with higher overweight and obesity rates (as traditionally defined) -- and in fact, relative to current standards, a larger share of low-income countries’ populations can be unhealthily heavy.

Human Capital Spillovers and Health: Does Living Around College Graduates Lengthen Life?
Jacob Bor et al.
NBER Working Paper, April 2024

Equally educated people are healthier if they live in more educated places. Every 10 percent point increase in an area’s share of adults with a college degree is associated with a decline in all-cause mortality by 7%, controlling for individual education, demographics, and area characteristics. Area human capital is also associated with lower disease prevalence and improvements in self-reported health. The association between area education and health increased greatly between 1990 and 2010. Spatial sorting does not drive these externalities; there is little evidence that sicker people move disproportionately into less educated areas. Differences in health-related amenities, ranging from hospital quality to pollution, explain no more than 17% of the area human capital spillovers on health. Over half of the correlation between area human capital and health is a result of the correlation between area human capital and smoking and obesity. More educated areas have stricter regulations regarding smoking and more negative beliefs about smoking. These have translated over time into a population that smokes noticeably less and that is less obese, leading to increasing divergence in health outcomes by area education.

The Opioid Crisis and Firm Skill Demand: Evidence from Job Posting Data
Bokyung Kim, Minseog Kim & Geunyong Park
Stanford Working Paper, May 2024

While growing evidence suggests that the opioid crisis has reduced employment levels, little is known about how the crisis has affected job skill requirements -- tools that employers use to screen job candidates. Using data on the near universe of US job vacancies, this paper studies the impact of the opioid crisis on employers' job skill requirements. Specifically, we investigate the effect of the reformulation of OxyContin, which represents one of the most substantial reductions in the availability of abusable prescription opioids. Prior studies have documented that the reformulation resulted in a large transition from prescription opioids to more dangerous illicit opioids. Using a difference-in-differences event study design that exploits firm-level variation in exposure to reformulation, we show that this transition toward illicit opioids has reduced employment at the firm level. Furthermore, we find that firms have increased requirements for cognitive and computer skills in response to this crisis. Finally, we find that the reformulation has resulted in reductions in local store sales, firm revenue, and firm capital stock, highlighting how the opioid crisis may impact firms' hiring decisions by affecting various aspects of firms' constraints and considerations. Our findings emphasize the distributional consequences of this crisis: less-skilled workers may experience a disproportionate impact from the increased skill requirements, even among workers without a history of opioid use disorders.

Impact of Neighborhood Social Cohesion and Rodent Sightings on Mental Health among Residents of New York City During the COVID-19 Pandemic
Isabel Inez Curro, Chloe Teasdale & Elizabeth Kelvin
Journal of Urban Health, April 2024, Pages 308–317

Common mental disorders such as depression and anxiety are prevalent globally, and rates are especially high in New York City (NYC) since the COVID-19 pandemic. Neighborhood social and physical environments have been found to influence mental health. We investigated the impact of neighborhood social cohesion and neighborhood rodent sightings (as an indicator of neighborhood cleanliness) on nonspecific serious psychological distress (NSPD) status using 2020 NYC Community Health Survey data from 8781 NYC residents. Multivariable logistic regression was used to evaluate the relationships among social cohesion, rodent sightings, and NSPD adjusted for confounders and complex sampling and weighted to the NYC population. Effect measure modification of rodent sightings on the effect of social cohesion on NSPD was evaluated on the multiplicative scale by adding the interaction term to the multivariable model and, if significant, stratifying on the effect modifier, and on the additive scale using the relative excess risk due to interaction (RERI). Social cohesion was found to decrease the odds of NSPD, and rodent sightings were found to increase the odds of NSPD. We found significant evidence of effect measure modification on the multiplicative scale. In the stratified models, there was a protective effect of social cohesion against NSPD among those not reporting rodent sightings, but no effect among those reporting rodent sightings. Our findings suggest that both neighborhood social cohesion and rodent sightings impact the mental health of New Yorkers and that rodent infestations may diminish the benefit of neighborhood social cohesion.

Associations between Rat Infestations and Mental Health Vary by Gender, Race, and Income in Chicago
Maureen Murray et al.
Journal of Urban Health, April 2024, Pages 318–326

Rats are an understudied stressor for people in urban environments around the world but the effects may not be distributed equally among residents. In this study, we examined associations between residential rat sightings and mental health in Chicago, where rat complaints are the highest of any American city. We examined how this relationship varied by frequency of rat sightings, race, ethnicity, income, home ownership, and gender and explored potential psychosocial pathways (e.g., feelings about the home) between rat sightings and mental distress. We conducted a randomized household survey along an income gradient in 2021 and asked about depressive symptoms in the past week (i.e., Center for Epidemiologic Studies Depression scale), frequency of rat sightings in/around the home, perceptions of rats, neighborhood conditions, and socio-demographic characteristics. We used logistic regression to assess relationships among these variables for our entire sample and for specific demographics using stratified models. Respondents (n = 589; 409 complete cases) who saw rats in/around the home daily/almost daily had 5.5 times higher odds of reporting high depressive symptoms relative to respondents who saw rats less frequently after accounting for socio-demographics and neighborhood conditions. This relationship was significant for men and respondents with lower incomes or race or ethnicity other than white. Our results show that rat infestations should be considered a threat to mental health among urban residents. Increased mental health support for residents living in rat-infested housing may improve public health in cities.

Shifting Cohort Patterns in the Use of Drugs with Elevated Overdose Risk in the United States
Kira England et al.
Social Problems, forthcoming

Rising drug overdose rates are a major social problem, but understanding of trends in the use of high-risk drugs is limited. The increasingly addictive potential of high-risk drugs, broader social changes, and the importance of peers and social contexts in shaping use may create conditions in which some cohorts have elevated use further into adulthood than others. We use an age-period-cohort model that defines cohort effects as the differential influences of social events for individuals of different ages. We analyze data from the 1979–2018 National Survey on Drug Use and Health to study past-year (mis)use of prescription analgesics, heroin, cocaine, and methamphetamine. Pre-1990 cohorts had either consistently lower than average odds or decreasing odds of use as they aged. The 1990s cohorts had higher than average odds of use, which increased as they aged. Early-2000s cohorts had increasing odds of use with age, despite low odds in adolescence. High-risk drug use appears to be an important cohort differentiating mechanism, with implications for policy and theories of deviance and stratification. The typical focus on period trends obscures the elevated odds of high-risk drug use in certain cohorts, whose members are entering the ages when overdose is most likely and consequences become most pronounced.

Racial differences in physical activity engagement, barriers, and enjoyment during weight loss
Francesca Knudsen et al.
Health Psychology, forthcoming

Method: Adults (N = 290) enrolled in an 18-month BWL [behavioral weight loss] program from 2014 to 2016 completed accelerometer-based measurements of moderate-to-vigorous PA [physical activity] and self-reported measures of PA barriers and enjoyment at months 0, 6, 12, and 18.

Results: Black participants had significantly fewer minutes of PA than White participants at baseline, 6, 12, and 18 months. Black participants reported fewer barriers to PA than White participants at 0 and 6 months but not at 12 or 18 months. They also reported higher PA enjoyment than White participants at 0 and 6 months but not at 12 or 18 months. Furthermore, whereas White participants had a significant reduction in PA barriers and an increase in PA behavior overtime, Black participants did not. There was no interaction between race and time on PA enjoyment.

Do E-Cigarette Retail Licensure Laws Reduce Tobacco Use?
Charles Courtemanche et al.
NBER Working Paper, May 2024

E-cigarette licensure laws (ELLs) require retailers to obtain a state license to sell e-cigarettes over the counter. This study is the first to comprehensively explore the effect of ELL adoption on youth and adult tobacco product use. Using data from the State Youth Risk Behavior Survey (YRBS) and a difference-in-differences approach, we find no evidence that ELL adoption reduces overall youth ENDS use. The precision of our estimates allows us to rule out, with 95 percent confidence, ELL-induced prior-month youth ENDS use declines of more than 3.4 percent. The pattern of null findings persists when we examine ELLs that impose (1) higher penalties for retailer non-compliance, (2) higher renewable licensure fees, and (3) criminal as compared to civil penalties. However, we do uncover evidence that adoption of ELLs with higher penalties associated with a modest reduction in ENDS use among Black teens. We conclude that ELLs have only limited success in curbing access to ENDS.

Unemployment insurance and opioid prescriptions during the Great Recession
Xiaohui Guo & Lizhong Peng
Southern Economic Journal, forthcoming

This is the first U.S. study on the causal relationship between unemployment insurance (UI) expansions during the Great Recession and the use of prescribed opioids. Using annual county-level prescription data from 2006 to 2013 and plausibly exogenous variation in state and federal policies, we estimate that a one standard deviation increase in UI generosity ($10,800) reduces per-capita prescription opioid use by 1.9%. We supplement our main analysis with a border discontinuity design and find a similar effect. We also find no evidence of pre-trends in the outcome. Finally, additional analyses suggest that increased health care utilization after exposure to higher UI generosity could be a plausible explanation for the declines in opioid prescriptions.

US exceptionalism? International trends in midlife mortality
Jennifer Beam Dowd et al.
International Journal of Epidemiology, April 2024

Methods: We document trends in midlife mortality in the USA, UK and a group of 13 high-income countries in Western Europe, Australia, Canada and Japan, as well as seven CEE [Central and Eastern European] countries from 1990 to 2019. We use annual mortality data from the World Health Organization Mortality Database to analyse sex- and age-specific (25–44, 45–54 and 55–64 years) age-standardized death rates across 15 major cause-of-death categories.

Results: US midlife mortality rates have worsened since 1990 for several causes of death including drug-related, alcohol-related, suicide, metabolic diseases, nervous system diseases, respiratory diseases and infectious/parasitic diseases. Deaths due to homicide, transport accidents and cardiovascular diseases have declined since 1990 but saw recent increases or stalling of improvements. Midlife mortality also increased in the UK for people aged 45–54 year and in Canada, Poland and Sweden among for those aged 25–44 years.


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