Christopher S. Carpenter

Proximity of Fast-Food Restaurants to Schools and Adolescent Obesity

OBJECTIVES We examined the relationship between fast-food restaurants near schools and obesity among middle and high school students in California. METHODS We used geocoded data (obtained from the 2002-2005 California Healthy Kids Survey) on over 500,000 youths and multivariate regression models to estimate associations between adolescent obesity and proximity of fast-food restaurants to schools. RESULTS We found that students with fast-food restaurants near (within one half mile of) their schools (1) consumed fewer servings of fruits and vegetables, (2) consumed more servings of soda, and (3) were more likely to be overweight (odds ratio [OR] = 1.06; 95% confidence interval [CI] = 1.02, 1.10) or obese (OR = 1.07; 95% CI = 1.02, 1.12) than were youths whose schools were not near fast-food restaurants, after we controlled for student- and school-level characteristics. The result was unique to eating at fast-food restaurants (compared with other nearby establishments) and was not observed for another risky behavior (smoking). CONCLUSIONS Exposure to poor-quality food environments has important effects on adolescent eating patterns and overweight. Policy interventions limiting the proximity of fast-food restaurants to schools could help reduce adolescent obesity.

Disparities in Health Insurance Coverage, Access, and Outcomes for Individuals in Same-Sex Versus Different-Sex Relationships, 2000–2007

OBJECTIVES We used data from the Behavioral Risk Factor Surveillance System to compare health insurance coverage, access to care, and womens cancer screenings for individuals in same-sex versus different-sex relationships. METHODS We estimated logistic regression models by using data on 5265 individuals in same-sex relationships and 802,659 individuals in different-sex relationships. RESULTS Compared with women in different-sex relationships, women in same-sex relationships were significantly less likely to have health insurance coverage, were less likely to have had a checkup within the past year, were more likely to report unmet medical needs, and were less likely to have had a recent mammogram or Pap test. Compared with men in different-sex relationships, men in same-sex relationships were significantly less likely to have health insurance coverage and were more likely to report unmet medical needs, although they were more likely to have had a checkup in the past year. CONCLUSIONS In the largest and most recent nationally representative sample, we found important differences in health insurance coverage and access to care between individuals in same-sex relationships and those in different-sex relationships for both men and women.

Cigarette taxes and youth smoking: New evidence from national, state, and local Youth Risk Behavior Surveys

Several studies have examined the effects of state cigarette tax increases on youth substance use over the 1990s, with most--but not all--finding that higher taxes reduce youth consumption of tobacco. We advance the literature by using data from the 1991 to 2005 waves of the national Youth Risk Behavior Surveys (YRBS), providing information on over 100,000 high school age youths. We also are the first to make use of hundreds of independently fielded state and local versions of the YRBS, reflecting data from over 750,000 youths. Importantly, these data are to our knowledge the only sources of relevant information on youth smoking that were explicitly designed to be representative of the sampled state or locality. We estimate two-way fixed effects models of the effect of state cigarette taxes on youth smoking, controlling for survey demographics and area and year fixed effects. Our most consistent finding is that--contrary to some recent research--the large state tobacco tax increases of the past 15 years were associated with significant reductions in smoking participation and frequent smoking by youths. Our price elasticity estimates for smoking participation by high school youths are generally smaller than previous cross-sectional approaches but are similar to recent quasi-experimental estimates.

SELF-REPORTED SEXUAL ORIENTATION AND EARNINGS: EVIDENCE FROM CALIFORNIA

Researchers using the 1988–96 General Social Survey (GSS) have found that behaviorally gay/bisexual men earn 15–30% less, and behaviorally lesbian/bisexual women earn 20–30% more, than similar heterosexuals. This study uses confidential data on self-reported sexual orientation for 50,000 adults in California in 2001, providing more than five times as many respondents who identify themselves as sexual minorities as does the GSS. Previous approaches are extended by using more complete data on earnings, work effort, and job characteristics. Apart from the well-documented marriage premium, the author finds no statistically or economically significant independent effect of a gay or lesbian sexual orientation on earnings. There is some evidence that bisexual men and women earn less than heterosexuals. Analysis of more recent GSS data (including data from 1998–2000) suggests the findings of previous studies are somewhat sensitive to the time period considered.

GAY AND LESBIAN PARTNERSHIP: EVIDENCE FROM CALIFORNIA*

Much recent research on sexual minorities has used couples-based samples, which—by construction—provide no information on nonpartnered individuals. We present the first systematic empirical analysis of partnership and cohabitation among self-identified gay men and lesbians using two independent, large, population-wwbased data sources from California. These data indicate that 37%–46% of gay men and 51%–62% of lesbians aged 18–59 are in cohabiting partnerships (compared with 62% of heterosexual individuals in coresidential unions at comparable ages). Unlike previous research, we find that white and highly educated gay men and lesbians are more likely to be partnered, and we confirm that same-sex cohabiting partners in our data have demographic characteristics that are similar to California same-sex couples from Census 2000. We also present the first detailed analysis of officially registered domestic partnerships in California. We find that almost half of partnered lesbians are officially registered with the local or state government, while less than a quarter of partnered gay men are officially registered. We conclude with implications of our findings for couples-based research on gay men and lesbians, as well as recommendations for survey data collection.

Heavy Alcohol Use and Crime: Evidence from Underage Drunk-Driving Laws

This paper provides new evidence on the causal effect of alcohol use and crime. I use variation induced by the adoption of strict zero‐tolerance (ZT) drunk‐driving laws, which significantly reduced binge drinking by males aged 18–20 years but did not affect slightly older males aged 22–24 years. I use age‐specific arrest data for police agencies in metropolitan statistical areas to estimate the effect of ZT laws on crime, controlling for both year and police agency fixed effects. I find that ZT laws significantly increased the fraction of adult male arrests for driving under the influence attributable to 18–20‐year‐olds and decreased the fraction of nuisance and property crime arrests attributable to 18–20‐year‐olds, with no effects on violent crime. These results are validated by important null findings: ZT laws did not affect arrests in any crime category for males aged 22–24 years. These results suggest that heavy alcohol use causes the commission of property and nuisance crimes.

Sexual Orientation, Work, and Income in Canada

We provide the first evidence on sexual orientation and economic outcomes in Canada using confidential data that ask adults a direct question about their sexual orientation. Gay men have 12% lower personal incomes and lesbians have 15% higher personal incomes than otherwise similar heterosexual men and women, respectively. Different labour force patterns can account for some of the income differentials. We also document large differences in educational attainment, childrearing, and urbanicity that generally mirror patterns found in the US. Finally, we show that applying couples-based approaches common in this literature greatly overstates the magnitudes of gay/straight income gaps.

The Effects of State Parity Laws on the Use of Mental Health Care

Objective:We used a quasiexperimental research design to measure the effect of state parity laws on the use of mental health care in the past year. Methods:We pooled cross-sectional data from the 2001, 2002, and 2003 National Surveys on Drug Use and Health. Our sample included 83,531 adults 18 years of age or over with private health insurance stratified by the level of mental and emotional distress experienced in the worst month of the past year. We used a state and year-fixed effects approach to measure the effect of parity. Similar to a difference-in-difference analysis, the effect of parity was measured by comparing pre-/postchanges in mental health service use within states that switched active parity status to changes in service use within states that did not change parity status in the same calendar year. For each subgroup, we report predictions of the percentage point change in any mental health care use, prescription drug use, and outpatient care use resulting from parity laws. Results:Depending on the time window used to define active parity status, we found that parity increased the probability of using any mental health care in the past year by as much as 1.2 percentage points (P < 0.01) for the lower distress group and by as much as 1.8 percentage points (P < 0.05) in the middle distress group. We found no statistically significant changes in service use for the upper distress group. Whether measured differences were attributable to changes in the use of prescription drug or outpatient care also depended on the definition of active parity status. Conclusions:Overall, the results of this study suggest that state parity laws succeeded in expanding access to mental health care for those with relatively mild mental health problems.

Effects of venue‐specific state clean indoor air laws on smoking‐related outcomes

A large literature has documented relationships between state clean indoor air laws (SCIALs) and smoking-related outcomes in the United States. These laws vary within states over time and across venues such as schools, government buildings, and bars. Few studies, however, have evaluated whether the effects of SCIALs are plausibly concentrated among workers who should have been directly affected because they worked at locations covered by the venue-specific restrictions. We fill this gap in the literature using data on private sector workers, government employees, school workers, eating and drinking place workers, and bartenders from the 1992-2007 Tobacco Use Supplements to the Current Population Survey. Our quasi-experimental models indicate robust effects of SCIALs restricting smoking in bars: these laws significantly increased the presence of workplace smoking restrictions as reported by bartenders and reduced the fraction of bartenders who smoke. We do not, however, find that SCIALs in private workplaces, government workplaces, schools, or restaurants increased the presence of workplace smoking restrictions among groups of workers working in venues covered by these laws. This suggests that the smoking reductions associated with SCIALs in previous research are unlikely to have been directly caused by effects of workplace smoking restrictions on workers.

Exposure to the Above the Influence Antidrug Advertisements and Adolescent Marijuana Use in the United States, 2006–2008

OBJECTIVES We examined the relationship between exposure to the Above the Influence antidrug campaign in 210 US media markets and adolescent marijuana and alcohol use from 2006 to 2008. METHODS We analyzed monthly advertising exposure (targeted rating points) data from the Office of National Drug Control Policy and drug use data from the Monitoring the Future study. We estimated multivariate logistic regression models of marijuana use for students in grades 8, 10, and 12, with controls for individual, family, and media market characteristics and year and regional fixed effects. RESULTS For eighth-grade adolescent girls, greater exposure to antidrug advertisements was associated with lower rates of past-month marijuana use (adjusted odds ratio [AOR] = 0.67; 95% confidence interval [CI] = 0.52, 0.87) and lower rates of lifetime marijuana use (AOR = 0.76; 95% CI = 0.62, 0.93), but not alcohol use (AOR = 1.00; 95% CI = 0.84, 1.19). Associations were not significant for adolescent boys or for students in grades 10 and 12. CONCLUSIONS Antidrug advertising may be an effective way to dissuade eighth-grade adolescent girls from initiating marijuana use.