Johanna Catherine Maclean

Do alcohol consumers exercise more? Findings from a national survey.

Purpose. Investigate the relationship between alcohol consumption and physical activity because understanding whether there are common determinants of health behaviors is critical in designing programs to change risky activities. Design. Cross-sectional analysis. Setting. United States. Subjects. A sample of adults representative of the U.S. population (N = 230,856) from the 2005 Behavioral Risk Factor Surveillance System. Measures. Several measures of drinking and exercise were analyzed. Specifications included numerous health, health behavior, socioeconomic, and demographic control variables. Results. For women, current drinkers exercise 7.2 more minutes per week than abstainers. Ten extra drinks per month are associated with 2.2 extra minutes per week of physical activity. When compared with current abstainers, light, moderate, and heavy drinkers exercise 5.7, 10.1, and 19.9 more minutes per week. Drinking is associated with a 10.1 percentage point increase in the probability of exercising vigorously. Ten extra drinks per month are associated with a 2.0 percentage point increase in the probability of engaging in vigorous physical activity. Light, moderate, and heavy drinking are associated with 9.0, 14.3, and 13.7 percentage point increases in the probability of exercising vigorously. The estimation results for men are similar to those for women. Conclusions. Our results strongly suggest that alcohol consumption and physical activity are positively correlated. The association persists at heavy drinking levels.

Alcohol consumption and body weight

The number of Americans who are overweight or obese has reached epidemic proportions. Elevated weight is associated with health problems and increased medical expenditures. This paper analyzes Waves 1 and 2 of the National Epidemiological Survey of Alcohol and Related Conditions to investigate the role of alcohol consumption in weight gain. Alcohol is not only an addictive substance but also a high-calorie beverage that can interfere with metabolic function and cognitive processes. Because men and women differ in the type and amount of alcohol they consume, in the biological effects they experience as a result of alcohol consumption, and in the consequences they face as a result of obesity, we expect our results to differ by gender. We use first-difference models of body mass index (BMI) and alcohol consumption (frequency and intensity) to control for time-invariant unobservable factors that may influence changes in both alcohol use and weight status. Increasing frequency and intensity of alcohol use is associated with statistically significant yet quantitatively small weight gain for men but not for women. Moreover, the first-difference results are much smaller in magnitude and sometimes different in sign compared with the benchmark pooled cross-sectional estimates.

The health effects of leaving school in a bad economy

This study investigates the lasting health effects of leaving school in a bad economy. Three empirical patterns motivate this study: Leaving school in a bad economy has persistent and negative career effects, career and health outcomes are correlated, and fluctuations in contemporaneous economic conditions affect health in the short-run. I draw data from the National Longitudinal Survey of Youth 1979 Age 40 Health Supplement. Members of my sample left school between 1976 and 1992. I find that men who left school when the school-leaving state unemployment rate was high have worse health at age 40 than otherwise similar men, while leaving school in a bad economy lowers depressive symptoms at age 40 among women. A 1 percentage point increase in the school-leaving state unemployment rate leads to a 0.5% to 18% reduction in the measured health outcomes among men and a 6% improvement in depressive symptoms among women.

Drinkers and Bettors: Investigating the Complementarity of Alcohol Consumption and Problem Gambling

Regulated gambling is a multi-billion dollar industry in the United States with greater than 100% increases in revenue over the past decade. Along with this rise in gambling popularity and gaming options comes an increased risk of addiction and the associated social costs. This paper focuses on the effect of alcohol use on gambling-related problems. Variables correlated with both alcohol use and gambling may be difficult to observe, and the inability to include these items in empirical models may bias coefficient estimates. After addressing the endogeneity of alcohol use when appropriate, we find strong evidence that problematic gambling and alcohol consumption are complementary activities.

From Pubs to Scrubs: Alcohol Misuse and Health Care Use

OBJECTIVE To analyze the relationships between alcohol misuse and two types of acute health care use-hospital admissions and emergency room (ER) episodes. DATA SOURCES/STUDY SETTING The first (2001/2002) and second (2004/2005) waves of the National Epidemiological Survey of Alcohol and Related Conditions (NESARC). STUDY DESIGN Longitudinal study using a group of adults (18-60 years in Wave 1, N=23,079). Gender-stratified regression analysis adjusted for a range of covariates associated with health care use. First-difference methods corrected for potential omitted variable bias. DATA COLLECTION The target population of the NESARC was the civilian noninstitutionalized population aged 18 and older residing in the United States and the District of Columbia. The survey response rate was 81 percent in Wave 1 (N=43,093) and 65 percent in Wave 2 (N=34,653). PRINCIPAL FINDINGS Frequent drinking to intoxication was positively associated with hospital admissions for both men and women and increased the likelihood of using ER services for women. Alcohol dependence and/or abuse was related to higher use of ER services for both genders and increased hospitalizations for men. CONCLUSIONS These findings provide updated and nationally representative estimates of the relationships between alcohol misuse and health care use, and they underscore the potential implications of alcohol misuse on health care expenditures.

Reporting error in weight and its implications for bias in economic models

Most research on the economic consequences of obesity uses data on self-reported weight, which contains reporting error that has the potential to bias coefficient estimates in economic models. The purpose of this paper is to measure the extent and characteristics of reporting error in weight, and to examine its impact on regression coefficients in models of the healthcare consequences of obesity. We analyze data from the National Health and Nutrition Examination Survey (NHANES) for 2003-2010, which includes both self-reports and measurements of weight and height. We find that reporting error in weight is non-classical: underweight respondents tend to overreport, and overweight and obese respondents tend to underreport, their weight, with underreporting increasing in measured weight. This error results in roughly 1 out of 7 obese individuals being misclassified as non-obese. Reporting error is also correlated with other common regressors in economic models, such as education. Although it is a common misconception that reporting error always causes attenuation bias, comparisons of models that use self-reported and measured weight confirm that reporting error can cause upward bias in coefficient estimates. For example, use of self-reports leads to overestimates of the probability that an obese man uses a prescription drug, has a healthcare visit, or has a hospital admission. These findings underscore that models of the consequences of obesity should use measurements of weight, when available, and that social science datasets should measure weight rather than simply ask subjects to report their weight.

Does Having a Dysfunctional Personality Hurt Your Career? Axis II Personality Disorders and Labor Market Outcomes

Despite recent interest in how psychiatric disorders affect work outcomes, little is known about the role of personality disorders (PDs), which are poorly understood yet prevalent (15%) and impairing. We used nationally representative data for 12,457 men and 16,061 women to examine associations of PDs with any employment, full-time employment, chronic unemployment, being fired or laid off, and having trouble with a boss or co-worker. Antisocial, paranoid, and obsessive-compulsive PDs demonstrated the broadest patterns of associations with adverse outcomes. Findings suggest that PDs may have implications for the productivity of co-workers as well as that of the disordered employees themselves.

The morning after: alcohol misuse and employment problems

Using a rich, recent and nationally representative longitudinal survey specifically designed to examine alcohol use and associated problems, we investigate the effects of alcohol misuse on a series of understudied and perhaps less common employment problems. Such problems include being fired or laid off from a job, sustained unemployment and conflicts with a supervisor and/or co-worker. After controlling for time-invariant omitted variables via fixed effects estimation, we find evidence that three measures of alcohol misuse are significantly related to employment problems. The results offer new information on the potential adverse labour market effects of alcohol misuse and shed light on potential mechanisms through which alcohol misuse may impact intensive labour supply and/or wages.

Cigarette Taxes and Older Adult Smoking: Evidence from the Health and Retirement Study

In this study, we use the Health and Retirement Study to test whether older adult smokers, defined as those 50 years and older, respond to cigarette tax increases. Our preferred specifications show that older adult smokers respond modestly to tax increases: a

Personality disorders and body weight

1.00 (131.6%) tax increase leads to a 3.8-5.2% reduction in cigarettes smoked per day (implied tax elasticity = -0.03 to -0.04). We identify heterogeneity in tax elasticity across demographic groups as defined by sex, race/ethnicity, education, and marital status and by smoking intensity and level of addictive stock. These findings have implications for public health policy implementation in an aging population.