Research
Research
Working Papers
"The Long Tail of Childhood Health." (Job Market Paper).
Abstract: This paper provides a comprehensive accounting of how childhood health shapes economic outcomes across the full life cycle. Using uniquely detailed data from the Health and Retirement Study with linkages to Social Security Administration earnings records, I trace a chain of disadvantage that begins with health in childhood and persists throughout the prime working years and into old age. I find that poorer childhood health is associated with lower educational attainment and substantially worse adult health at midlife. In the labor market, childhood health is associated with substantial gaps in earnings and employment, with the largest differences occurring between ages 50 and 55, when poorer childhood health is associated with a 7.5 percentage point reduction in employment and a reduction of $6,000 in earnings. Poorer childhood health is also associated with larger year-to-year swings in earnings and a higher share of years with sharp earnings drops, indicating greater career earnings instability. These labor market deficits translate to substantial gaps in wealth accumulation from age 51 onward. My findings are robust to the use of alternative, condition-based measures of childhood health. While a causal test finds no evidence of a link between the introduction of the measles vaccine and later-life outcomes, my analysis of condition-based measures suggests that the relevant pathway for childhood health runs through persistent health deficits rather than acute childhood illnesses like measles.
“Compounding Disadvantage: Childhood Health and Black-White Economic Inequality over the Life Course.” Submitted for review.
Abstract: Childhood health has consistently been shown to predict later labor market and human capital outcomes, and many of the structural barriers that drive racial economic disparities also produce disparities in child health. Using data from the Health and Retirement Study linked to Social Security Administration earnings records, I ask whether childhood health compounds racial economic inequality across the life course. I find that poorer childhood health is associated with disproportionately large reductions in earnings and employment for Black respondents compared to White respondents. In Oaxaca-Blinder decompositions, up to 2.4% of the earnings gap and 12.2% of the employment gap can be attributed to childhood health, with contributions increasing with age in a manner consistent with cumulative disadvantage. Conversely, childhood health has little role in shaping Black wealth accumulation or Black-White wealth gaps, suggesting childhood health acts primarily through labor market-specific mechanisms to produce cumulative racial disadvantage.
“Sources of Health Insurance Coverage and Employment Survival Among Newly Disabled Workers.” (with Nicole Maestas and Kathleen J. Mullen)
Abstract: We use prospective longitudinal data on newly disabled older workers from the Health and Retirement Study to examine the effect of employer sponsorship of health insurance (ESHI) on post-onset employment and disability insurance claiming. We compare outcomes of workers with ESHI and no access to another coverage source immediately prior to onset with outcomes of two comparison groups: individuals with ESHI who also have access to an alternative coverage source, those who are covered by coverage source other than ESHI prior to onset. We find limited evidence of “employment lock” only when restricting to newly disabled older workers. We find no evidence that ESHI impedes application for Social Security Disability Insurance, but ESHI is associated with higher rates of disability receipt for newly disabled older workers.
Publications
Anna Sinaiko, Marai Hayes, Jon Kingsdale, Alon Peltz, and Alison A. Galbraith. (2022). “Understanding Consumer Experiences and Insurance Outcomes Following Plan Disenrollment in the Nongroup Insurance Market”, Medical Care Research and Review, Vol. 79, No.1, 36-45.