The Dynamic Relationship between Temperature and Morbidity

Forthcoming -- Journal of the Association of Environmental and Resource Economists

This paper examines the relationship between temperature and hospital usage with a focus on the role of behavioral responses to weather. I use high-frequency data on the near universe of hospital and emergency department (ED) visits in California between 2005-2014 to estimate the effects of temperature on hospital usage patterns. Focusing on emergency department usage, I find that a day with mean temperature under 40F leads to a 6.1% decrease in ED visits on the day of the event, but that total net ED visits increase by up to 17.0% above the daily mean in the weeks that follow. Additionally, I find that a day over 80F is associated with a same-day increase in ED visits of 3.5%, and a total net increase of 5.1%. For both cold and hot temperatures, I argue that behavioral responses – rather than purely biological mechanisms – are responsible for many of the observed patterns. Importantly, I argue that behavioral responses to environmental conditions have the potential to be either protective (as is commonly assumed) or damaging to health.


Working Papers and Works in Progress


Can Paid Sick Leave Mandates Decrease Leave-Taking? 

With Jenna Stearns (UC Davis)
R&R -- Labour Economics

Since 2006, several cities and states have implemented paid sick leave mandates that require employers to provide workers with access to paid sick leave. These mandates have substantially expanded access to paid leave, especially within low-skill occupations including retail and food services. We examine the effects of the two largest paid sick leave mandates in Connecticut (2011) and Washington, D.C. (2008) on leave-taking behavior and public health. After these policies are implemented, there are significant decreases in aggregate personal illness leave-taking rates, relative to control groups, for both those directly affected and those not directly affected by the policy. This suggests such policies provide large public health externalities by allowing sick workers to stay home rather than coming to work (and infecting their customers and coworkers). We are using data on consumer drug expenditures to explore this mechanism. 


Measuring The Social and Externality Benefits of Influenza Vaccination

Upcoming Presentations: All-California Labor Econ Conference (Sept 2017)
Vaccination represents a canonical example of externalities in economics, yet there are few estimates of their magnitudes. I provide evidence on the social and externality benefits of influenza vaccination in two settings. First, using pre-existing differences in state-level vaccination rates interacted with exogenous variation in vaccine quality, I provide causal estimates of the impacts of aggregate vaccination rates on mortality and work absences in the United States. Scaled nationally, I find that a one percentage point increase in the vaccination rate results in 985 fewer deaths and 7.5 million fewer work hours lost due to illness each year. The mortality effects are concentrated among individuals 75 and older, but 35-85% of the benefits are driven by the vaccination of people under 75, suggesting a considerable externality effect. Second, I examine a setting in which vaccination is targeted at a group with high externality benefits: influenza vaccination mandates for health care workers. I estimate that these mandates lead to a 17% decrease in hospital admissions with an influenza diagnosis. For both the general population and the population of health care workers, I calculate the monetary benefit per vaccination and find that these benefits are large in comparison to the costs of vaccine administration.


THE Impacts of Reduced Access to Abortion and Family Planning SERVIces: Evidence from Texas

With Stefanie Fischer (Cal Poly SLO) and Heather Royer (UCSB)
NBER Working Paper No. 23634, IZA Discussion Paper No. 10920

Between 2011 and 2014, Texas enacted three pieces of legislation that significantly reduced funding for family planning services and increased restrictions on abortion clinic operations. Together this legislation creates cross-county variation in access to abortion and family planning services, which we leverage to understand the impact of family planning and abortion clinic access on abortions, births, and contraceptive purchases. In-state abortions fell 20% and births rose 3% in counties that no longer had an abortion provider within 50 miles. Births increased 1% and contraceptive purchases rose 8% in counties without a publicly-funded family planning clinic within 25 miles.



With  Jamie Mullins (UMass Amherst)



Corey White and Max Zhang. 2011. “Using Vehicle-to-Grid Technology for Frequency Regulation and Peak-Load Reduction”. Journal of Power Sources 196, 3972-3980. Link