M. Melinda Pitts
Federal Reserve Bank of Atlanta
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Featured researches published by M. Melinda Pitts.
American Journal of Health Promotion | 2008
Brian S. Armour; M. Melinda Pitts; Chung-Won Lee
Purpose. To quantify the association between food insecurity and smoking among low-income families. Design and Setting. A retrospective study using data from the 2001 Panel Study of Income Dynamics (PSID), a longitudinal study of a representative sample of U.S. men, women, and children and the family units in which they reside. Subjects. Low-income families. Measures. Family income was linked with U.S. poverty thresholds to identify 2099 families living near or below 200% of the federal poverty level. Food insecurity (i.e., having insufficient funds to purchase enough food to maintain an active and healthy lifestyle) was calculated from the 18-core-item food security module of the U.S. Department of Agriculture. Current smoking status was determined. Results. Smoking prevalence was higher among low-income families who were food insecure compared with low-income families who were food secure (43.6% vs. 31.9%; p < .01). Multivariate analysis revealed that smoking was associated with an increase in food insecurity of approximately six percentage points (p < .01). Conclusions. Given our finding that families near the federal poverty level spend a large share of their income on cigarettes, perhaps it would be prudent for food-assistance and tobacco-control programs to work together to help low-income people quit smoking.
Education Economics | 2006
Julie L. Hotchkiss; Robert E. Moore; M. Melinda Pitts
This paper applies a standard treatment effects model to determine that participation in Freshman Learning Communities (FLCs) improves academic performance and retention. Not controlling for individual self-selection into FLC participation leads one to incorrectly conclude that the impact is the same across race and gender groups. Accurately assessing the impact of any educational program is essential in determining what resources institutions should devote to it.
Applied Economics | 2005
Julie L. Hotchkiss; M. Melinda Pitts
Using the Health and Retirement Survey from the USA, this paper finds a 16% selectivity-corrected wage penalty among women who engage in intermittent labour market activity. This penalty is experienced at a low level of intermittent activity, but appears to not play an important role in a womans decision to undertake such activity. In addition, employer preferences appear to play a larger role than human capital atrophy in the determination of the wage penalty.
The American Journal of Managed Care | 2003
Brian S. Armour; Carol Friedman; M. Melinda Pitts; Jennifer Wike; Linda Alley; Jeff Etchason
OBJECTIVE To estimate the effect of physician bonus eligibility on colorectal cancer (CRC) screening, controlling for patient and primary care physician characteristics. STUDY DESIGN Retrospective study using managed care plan claims data from 2000 and 2001. METHODS Data on 50-year-old commercially insured patients in a managed care health plan were linked to enrollment and provider files. The data included information on 6749 patients (3058 in 2000 and 3691 in 2001). Multivariate logistic regression models were used to assess the association between CRC screening receipt and physician bonus eligibility. RESULTS From 2000 to 2001, CRC screening use increased from 23.4% to 26.4% (P < .01). Results from the multivariate logistic regression analysis revealed that the probability that a patient received a CRC screening was approximately 3 percentage points higher in the bonus year, 2001 (P < .01). CONCLUSIONS Bonuses targeted at individual physicians were associated with increased use of CRC screening tests. However, more research is needed to examine the effect of performance-based incentives on resource use and the quality of medical care. Specifically, there is a need to determine whether explicit financial incentives are effective in reducing racial disparities in the quality of patient care. This has particular relevance for CRC screening given that black patients are less likely to be screened, they have higher CRC incidence and mortality rates compared with other racial groups, and screening has been shown to be more cost effective in this population.
The American Economic Review | 2007
Julie L. Hotchkiss; M. Melinda Pitts
Using the Health and Retirement Survey and standard wage decomposition techniques, this paper finds that the difference in intermittent labor force participation between men and women accounts for 47 percent of the contribution to the wage gap of differences in observed characteristics. Not controlling for intermittent behavior results in too much importance being placed on gender differences in job characteristics.
The American Economic Review | 2003
Julie L. Hotchkiss; M. Melinda Pitts
A common explanation offered for the observed wage differential between men and women is that women are less attached to the labor market; they exhibit a greater degree of labor-market intermittency than do men. There are several theories that explain this link between intermittency and lower wages, including differences in human-capital attainment, atrophy of skills during absences, and preferences of employers (see e.g., Solomon W. Polachek and W. Stanley Siebert, 1993; Joyce P. Jacobsen and Laurence M. Levin, 1995; James W. Albrecht et al., 2000). The goal of this paper is to explore in greater depth the role past labormarket intermittency plays in the determination of a woman’s current wage and at what level of intermittent activity women can expect to have that activity affect her wage. Previous methods employed to measure the penalty associated with intermittent activity have either classified workers as intermittent if they have at least one spell of absence from the labor market (Jacobsen and Levin, 1995) or have relied on the percentage of time out of the labor force to classify intermittent workers (Elaine J. Sorenson, 1993). However, if employers perceive intermittent behavior as a signal, then both the frequency of intermittent spells and the duration of the spells should be taken into account. We contribute to this literature by creating an intermittency index that captures both of these factors. We also statistically determine at what level of intermittency a woman will incur a penalty for absence from the labor force. This index is used to determine the magnitude of the penalty associated with intermittent participation in the labor force. The analysis is limited to women as intermittent behavior is more prevalent for women and to avoid potential confounding factors associated with gender discrimination.
Archive | 2003
M. Melinda Pitts
This paper controls for the selection bias associated with occupational choice and the labor force participation decision in estimating the wage penalty for working in female-dominated occupations. Using data from the May 1979 and the April 1993 supplements to the Current Population Survey, the author finds that women working in female-dominated occupations have similar or higher expected wages in their chosen occupation compared to nonfemale-dominated occupations. This result indicates that there is efficient matching between occupations and skills for women in the labor force and refutes the theories of occupational segregation or crowding as determinants of the gender wage differential.
Public Finance Review | 2004
Brian S. Armour; M. Melinda Pitts
This paper extends the literature on net marginal tax rates created by the Social Security program by including variations in both the probability of being eligible to receive benefits and income-related life expectancy. The previous literature has found that women incur a lower net marginal tax rate because they have longer life expectancies. The results presented in this paper indicate that including variations in eligibility for benefits partially reverses this result by increasing net marginal Social Security tax rates for older women. In addition, the existing literature has shown that low-income households pay lower net marginal tax rates because the benefit formula is progressive. Including variations in life expectancy reduces, but does not eliminate, this result. This implies that differential mortality increases the net marginal Social Security tax rates incurred by low-income households. These results are important from a policy standpoint given the gender differences in poverty among the population over age sixty-five and the current debate on the future of the Social Security system.
Archive | 2004
Julie L. Hotchkiss; M. Melinda Pitts; John C. Robertson
This paper uses unique employer-employee matched administrative data files to determine that firm and industry employment dynamics play significant roles in the earnings gains of workers who change jobs and in different ways across the business cycle. Among the more notable results is the finding that job-changers who leave a firm that is shutting down experience a greater earnings loss than job-changers who leave a firm that is merely contracting. In addition, the earnings loss from changing industries where firm-specific human capital is likely to be important has the potential of creating a much greater barrier to labor mobility during recessionary times than during an expansion.
Disease Management & Health Outcomes | 2003
Brian S. Armour; M. Melinda Pitts
Patients with health insurance do not make the most cost conscious healthcare decisions since they bear only a fraction of the total cost of medical care. Managed care advocates point to financial incentives as a way to reduce wasteful resource use. However, physicians with managed care contracts feel financial pressures designed to reduce waste may also limit medically necessary services and adversely impact the quality of patient care. In light of a growing public and professional distrust of the motives behind offering financial incentives, the economic theory of agency is used to illustrate how financial contracts designed to reduce wasteful resource use influence physician behavior.A review of the literature was conducted to determine the effects of financial incentives on resource use, cost and the quality of medical care. The method used to undertake this literature review followed the approach set forth in the Cochrane Collaboration handbook. This review revealed that much of the empirical evidence on the effect of managed care on physician behavior compared the experiences of traditional indemnity plan enrollees with health maintenance organization enrollees.Published studies are outdated and are influenced by statistical problems including both patient and physician selection bias. With respect to the newer types of managed care organizations, there is a paucity of information on the effects of financial incentives on physician behavior. Despite the lack of empirical evidence, the perception remains that managed care financial incentives are perverse in that they induce physicians to take actions that compromise quality of care. To evaluate the legitimacy of these concerns, research on how physician contractual arrangements influence the cost and quality of care in the newer types of plans is needed. In the absence of such research, political rhetoric bent by anecdotal evidence will continue to influence public policy and undermine managed care.