Affiliates' Research in Medical Journals, Fall 2023
Many NBER-affiliated researchers publish some of their health-related findings in journals that preclude pre-publication distribution, and thus do not post them as NBER Working Papers. This is a partial listing of recent papers in this category by NBER affiliates.
Air Pollution and Suicide in Rural and Urban America: Evidence from Wildfire Smoke
Molitor D, Mullins JT, White C. PNAS 120(38), September 2023.
Air pollution poses well-established risks to physical health, and has also been linked to impaired cognitive functioning, aggressive behavior, lost productivity, anxiety, depression, and suicide. This paper studies how air pollution from drifting wildfire smoke affects suicide risk in the United States and how the effects differ across sociodemographic groups and between urban and rural areas. Data, from 2007 to 2019, include all deaths by suicide and satellite-based measures of wildfire smoke and ambient fine particulate matter (PM2.5) concentrations. Year-over-year fluctuations in county-level monthly smoke exposure are related to fluctuations in suicide rates, with comparisons across local areas and demographic groups that differ considerably in their baseline suicide risk. Results showed no evidence that smoke pollution increases suicide risk among residents of any urban counties. By contrast, in rural counties, an additional day of smoke increases monthly mean PM2.5 by 0.41 μg/m3 and suicide deaths by 0.11 per million residents, such that a 1-μg/m3 (13 percent) increase in monthly wildfire-derived fine particulate matter leads to 0.27 additional suicide deaths per million residents (a 2.0 percent increase). These effects are concentrated among demographic groups with both high baseline suicide risk and high exposure to outdoor air: men, working-age adults, non-Hispanic Whites, and adults with no college education. To benchmark the magnitude of the effects, eliminating PM2.5 from rural counties is estimated to reduce the monthly suicide rate by 2.1 deaths per million, equivalent to 59 percent of the urban-rural gap in monthly suicide rates. Considering only suicide as an outcome underestimates the overall burden of air pollution on mental health, and considering only short-term exposure to transient smoke does not capture longer-term effects. This study provides large-scale evidence that air pollution elevates the risk of suicide, disproportionately so among rural populations.
Home Visits with a Registered Nurse Did Not Affect Prenatal Care in a Low-Income Pregnant Population
Gourevitch RA, Zera C, Martin MW, Zhou RA, Bates MA, Baicker K, McConnell M. Health Affairs 42(8), August 2023, pp. 1152–1161.
Prenatal nurse home visiting programs are intended to improve maternal and neonatal health outcomes and decrease racial disparities by increasing the use and quality of prenatal care and facilitating healthy behaviors during pregnancy. This randomized controlled trial of 5,670 Medicaid-eligible pregnant people in South Carolina examined the effects of receiving visits on the intensity of prenatal care use, receipt of guideline-based prenatal care services, other health care use, and gestational weight gain. There were no statistically significant differences in these outcomes between the control group and those receiving visits when adjusting for multiple hypothesis testing, including among subgroups of non-Hispanic Black participants and socially vulnerable participants (< age 18, < high school education, or with an indication of mental health needs). The outcomes measured have likely been shaped by structural, institutional, and social determinants of health, which nurse home visitors might not be able to affect. Structural forces shaping access to services during pregnancy may have made it difficult for visiting nurses to affect these outcomes; for example, they may have hesitated to refer clients to needed specialists or to social supports such as transportation if they were difficult to access. Compared with the broader Medicaid population, trial participants had more health and social risk factors, more engagement with prenatal care, and similar pregnancy outcomes. Results suggest that delivering intensive nurse home visiting programs to the general Medicaid population might not be an efficient method to improve prenatal care for those who need the most support during pregnancy. More evidence is needed to understand what kind of interventions can reach populations that are not already well connected to clinical care.
Health Care Staff Turnover and Quality of Care at Nursing Homes
Shen K, McGarry BE, Gandhi AD. JAMA Internal Medicine, October 2023.
Changes in Cannabis-Attributable Hospitalizations following Nonmedical Cannabis Legalization in Canada
Myran DT, Gaudreault A, Konikoff L, Talarico R, Pacula RL. JAMA Network Open 6(10), October 5, 2023.
Comparative Safety of Robotic-Assisted vs Laparoscopic Cholecystectomy
Kalata S, Thumma JR, Norton EC, Dimick JB, Sheetz KH. JAMA Surgery, September 2023.
Declines in Wealth among US Older Adults at Risk of Dementia
Li J, Skinner JS, McGarry K, Nicholas LH, Wang SP, Bollens-Lund E, Kelley AS. JAMA Neurology, September 2023.
Organization of Cancer Specialists in US Physician Practices and Health Systems
Nguyen CA, Beaulieu ND, Wright AA, Cutler DM, Keating NL, Landrum MB. Journal of Clinical Oncology 41(26), September 2023, pp. 4226–4235.
Volume of Care for Primary Care Physicians in Integrated vs Independent Practices through the COVID-19 Pandemic
Cuellar A, Jena AB. JAMA Health Forum 4(9), September 2023.
Impact of Medicaid Expansion on Inclusion of Medications for Opioid Use Disorder in Homeless Adults’ Treatment Plans
Swartz N, Odayappan S, Chatterjee A, Cutler DM. Journal of Substance Use & Addiction Treatment, September 2023.
How to Interpret Studies on the Impact of Legalizing Cannabis
Manthey J, Armstrong MJ, Hayer T, Myran DT, Pacula RL, Queirolo R, Rehm J, Wirth M, Zobel F. Addiction 118(11), August 2023, pp. 2242–2243.
Is Exposure to Pharmaceutical Direct-to-Consumer Advertising for Heart Disease and Diabetes Associated with Physical Activity and Dietary Behavior?
Niederdeppe J, Avery RJ, Liu J, Mann C, Sood N, Eisenberg MD. Social Science & Medicine, August 2023.
The Impacts of the 340B Program on Health Care Quality for Low-Income Patients
Smith K, Padmanabhan P, Chen A, Glied S, Desai S. Health Services Research 58(5), July 2023, pp. 1089–1097.
State Public Insurance Coverage Policies and Postpartum Care among Immigrants
Steenland MW, Fabi RE, Bellerose M, Desir A, White MS, Wherry LR. JAMA 330(3), July 2023, pp. 238–246.
Specialist Use among Privately Insured Children with Disabilities
Chien AT, Wisk LE, Beaulieu N, Houtrow AJ, Van Cleave J, Fu C, Cutler DM, Landrum MB. Health Services Research 58(6), November 2023.
Ecological Risk and Protective Factors for Food Insufficiency in Los Angeles County during the COVID-19 Pandemic
de la Haye K, Saw H-W, Miller S, Bruine de Bruin W, Wilson JP, Weber K, Frazzini A, Livings M, Babboni M, Kapteyn A. Public Health Nutrition 26(10), July 2023, pp. 1944–1955.
Regular Cannabis Use during the First Year of the Pandemic: Studying Trajectories Rather Than Prevalence
Lee JO, Lee WJ, Kritikos AF, Jin H, Leventhal AM, Pedersen ER, Cho J, Davis JP, Kapteyn A, Wilson JP, Pacula RL. American Journal of Preventive Medicine 64(6), June 2023, pp. 888−892.
Impact of Recreational Cannabis Legalization on Opioid Prescribing and Opioid-Related Hospital Visits in Colorado: An Observational Study
Buttorff C, Wang GS, Wilks A, Tung G, Kress A, Schwam D, Pacula RL. Journal of General Internal Medicine 38, June 2023, pp. 2726–2733.
Role of Parents’ Perceived Risk and Responsibility in Deciding on Children’s COVID-19 Vaccination
Liu Y, Bruine de Bruin W, Kapteyn A, Szilagyi P. Pediatrics 151(5), May 2023.
Racial and Ethnic Segregation in Primary Care and Association of Practice Composition with Quality of Care
Ding D, Zhu B, Glied S. Medical Care, 61(4), April 2023, pp. 216–221.