Melinda Sandler Morrill

Measuring inappropriate medical diagnosis and treatment in survey data: The case of ADHD among school-age children

We exploit the discontinuity in age when children start kindergarten generated by state eligibility laws to examine whether relative age is a significant determinant of ADHD diagnosis and treatment. Using a regression discontinuity model and exact dates of birth, we find that children born just after the cutoff, who are relatively old-for-grade, have a significantly lower incidence of ADHD diagnosis and treatment compared with similar children born just before the cutoff date, who are relatively young-for-grade. Since ADHD is an underlying neurological problem where incidence rates should not change dramatically from one birth date to the next, these results suggest that age relative to peers in class, and the resulting differences in behavior, directly affects a childs probability of being diagnosed with and treated for ADHD.

The effects of maternal employment on the health of school-age children ☆

The effects of maternal employment on childrens health are theoretically ambiguous and challenging to identify. There are trade-offs between income and time, and a mothers decision to work reflects, in part, her childrens health and her underlying preferences. I utilize exogenous variation in each childs youngest siblings eligibility for kindergarten as an instrument. Using the restricted-access National Health Interview Survey (1985-2004), I identify the effects on overnight hospitalizations, asthma episodes, and injuries/poisonings for children ages 7-17. Maternal employment increases the probability of each adverse health event by nearly 200 percent. These effects are robust and do not reflect a non-representative local effect.

Booms, Busts, and Divorce

Abstract For almost a century, anecdotes have suggested that divorce rates decline during recessions. However, until very recently there has been surprisingly little formal empirical evidence on whether such a link exists, let alone its magnitude if it does. Moreover, the anticipated direction of the effect is ambiguous theoretically. Although previous studies have concluded that individual job loss destabilizes marriages, macroeconomic conditions may affect divorce probabilities even for those not directly experiencing a job shock. We add to the few existing contemporaneous studies of the effects of macroeconomic shocks on divorce by conducting an empirical analysis of the relationship between state-level unemployment rates and state-level divorce rates using vital statistics data on divorces in the United States from 1976-2009. We find a significant and robust negative relationship between the unemployment and divorce rates, whereby a one percentage point rise in the unemployment rate is associated with a decrease of 0.043 divorces per one thousand people, or about a one percent fall in the divorce rate. The result that divorce is pro-cyclical is robust to a host of alternative empirical specifications, to disaggregating by state characteristics and time period, to expanding the unemployment series back to 1970, and to using alternative measures of local economic conditions.

Dads and Daughters: The Changing Impact of Fathers on Women's Occupational Choices

We examine whether womens rising labor force participation led to increased intergenerational transmission of occupation from fathers to daughters. We develop a model where fathers invest in human capital that is specific to their own occupations. Our model generates an empirical test where we compare the trends in the probabilities that women work in their fathers versus their father-in-laws occupation. Using data from birth cohorts born between 1909 and 1977, our results indicate that the estimated difference in these trends accounts for at least 13-20 percent of the total increase in the probability that a woman enters her fathers occupation.

What Effects Do Macroeconomic Conditions Have on Families' Time Together?

We examine family time together using data from the 2003-2010 American Time Use Survey combined with Bureau of Labor Statistics data on state-level unemployment rates. Couple time together is U-shaped; while fathers spend more time engaging in enriching childcare activities without a spouse present as the unemployment rate rises. Patterns are similar for dual-earner couples, but appear concentrated among demographic groups most affected by recessions. We also find that mothers are less likely to work standard hours and more likely to work on weekends as employment crises deepen, which is consistent with both sets of results for family time together.

The effect of college education on mortality

We exploit exogenous variation in years of completed college induced by draft-avoidance behavior during the Vietnam War to examine the impact of college on adult mortality. Our estimates imply that increasing college attainment from the level of the state at the 25th percentile of the education distribution to that of the state at the 75th percentile would decrease cumulative mortality for cohorts in our sample by 8 to 10 percent relative to the mean. Most of the reduction in mortality is from deaths due to cancer and heart disease. We also explore potential mechanisms, including differential earnings and health insurance.

Retiree Health Plans in the Public Sector

While retiree health plans are a dying benefit in the private sector, all US states and many local governments extend health insurance coverage to their retired employees. This book is the first to thoroughly examine public sector health insurance plans. Retiree Health Plans in the Public Sector provides a detailed description of the current plans offered and compares how they vary across states.

A New Paradigm: A Joint Test of Structural and Correlation Parameters in Instrumental Variables Regression When Perfect Exogeneity is Violated

Currently, the commonly employed instrumental variables strategy relies on the knife-edge assumption of perfect exogeneity for valid inference. To make reliable inferences on the structural parameters under violations of exogeneity one must know the true correlation between the structural error and the instruments. The main innovation in this paper is to identify an appropriate test in this context: a joint null hypothesis of the structural parameters with the correlation between the instruments and the structural error term. We introduce a new endogeneity accounted test by combining the structural parameter inference while correcting the bias associated with non-exogeneity of the instrument. To address inference under violations of exogeneity, significant contributions have been made in the recent literature by assuming some degree of non-exogeneity. A key advantage of our approach over that of the previous literature is that we do not need to make any assumptions about the degree of violation of exogeneity either as possible values or prior distributions. In particular, our method is not a form of sensitivity analysis. Since our test statistic is continuous and monotonic in correlation, one can conduct inference for the structural parameters by a simple grid search over correlation values. We can make accurate inferences on the structural parameters because of a feature of the grid search over correlation values. One can also build joint confidence intervals for the structural parameters and the correlation parameter by inverting the test statistic. In the inversion, the null values of these parameters are used. We also propose a new way of testing exclusion restrictions, even in the just identified case.

The Effects of Retiree Health Insurance Plan Characteristics on Retirees' Choice and Employers' Costs

To moderate the rate of growth of retiree health insurance costs, employers can modify plans and move retirees into less expensive plans. We examine policy modifications implemented by the North Carolina State Health Plan. We investigate whether incentives produce the desired plan elections and whether these changes, along with cost shifting, produce the expected reductions in cost growth. Using individual-level administrative data, along with aggregated data on expenditures for retirees, we estimate the effects of the introduction and subsequent repeal of a Comprehensive Wellness Initiative for non-Medicare eligible retirees, as well as increases in coinsurance and copayments and the introduction of a premium for all retirees. Over a third of non-Medicare retirees shifted into the least generous plan between June 2009 and December 2012. The level effects on annual costs and unfunded accrued liabilities were relatively modest, but growth rates were diminished. Increases in the retiree premiums reduced the states projected costs.

Golden Years or Financial Fears? How Plans Change after Retirement Seminars

Many organizations provide retirement planning seminars as a benefit to their employees, to help them make moreinformed retirement plans. This study examines 85 preretirement planning seminars conducted by five companies in 2008 and 2009 to determine whether participants improved their financial knowledge and learned important facts about retirement programs—and whether, on the basis of this potential change in knowledge, they adjusted their retirement plans. Using surveys conducted before and after the seminars, we find that financial literacy and knowledge of retirement program parameters were significantly higher after the seminar. Employees with the largest increases in knowledge were most likely to change their planned retirement age and planned age of claiming Social Security benefits.