Daniel Dench, Wenhui Li, Theodore Joyce, H. Minkoff, G. V. Van Wye
We describe how the COVID-19 pandemic affected reproductive choices in New York City, the most acutely impacted area of the United States. We contrast changes in New York City with reproductive outcomes in the rest of the US. We find that births to New York City residents fell 8.4% more between March, 2020 and February 2021 than that would have been expected given trends leading up to the pandemic. Births to US-born residents of New York City fell 5.5% over the same year, triple the observed decline in the rest of the US. Births to foreign-born New York City residents fell 11.4%, twice the decline observed in the rest of the US. Reported induced abortions to New York City residents fell precipitously whereas induced abortions nation-wide rose slightly. The acute downturn and robust recovery in births in New York City maps closely with the spike in mortality and its equally rapid decline three months later. We conclude that the fear and uncertainty in the early months of the pandemic is the best explanation for the sudden, but brief drop in births in New York City.
{"title":"Fertility in the Heart of the COVID-19 Storm","authors":"Daniel Dench, Wenhui Li, Theodore Joyce, H. Minkoff, G. V. Van Wye","doi":"10.3386/w31070","DOIUrl":"https://doi.org/10.3386/w31070","url":null,"abstract":"We describe how the COVID-19 pandemic affected reproductive choices in New York City, the most acutely impacted area of the United States. We contrast changes in New York City with reproductive outcomes in the rest of the US. We find that births to New York City residents fell 8.4% more between March, 2020 and February 2021 than that would have been expected given trends leading up to the pandemic. Births to US-born residents of New York City fell 5.5% over the same year, triple the observed decline in the rest of the US. Births to foreign-born New York City residents fell 11.4%, twice the decline observed in the rest of the US. Reported induced abortions to New York City residents fell precipitously whereas induced abortions nation-wide rose slightly. The acute downturn and robust recovery in births in New York City maps closely with the spike in mortality and its equally rapid decline three months later. We conclude that the fear and uncertainty in the early months of the pandemic is the best explanation for the sudden, but brief drop in births in New York City.","PeriodicalId":84011,"journal":{"name":"Working paper series (National Bureau of Economic Research)","volume":"81 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85547761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We study how the societal disruptions of the COVID-19 pandemic impacted diagnosis of a prevalent childhood mental health condition, Attention Deficit Hyperactivity Disorder (ADHD). Using both nationwide private health insurance claims and a single state’s comprehensive electronic health records, we compare children exposed to the pandemic to same aged children prior to the pandemic. We find the pandemic reduced new ADHD diagnoses by 8.6% among boys and 11.0% among girls nationwide through February 2021. We further show that higher levels of in-person schooling in Fall 2020 dampened the decline for girls but had no moderating effect for boys.
{"title":"Societal Disruptions and Child Mental Health: Evidence from ADHD Diagnosis During the Covid-19 Pandemic","authors":"Seth Freedman, Kelli Marquardt, Dario Salcedo, Coady Wing","doi":"10.21033/wp-2023-04","DOIUrl":"https://doi.org/10.21033/wp-2023-04","url":null,"abstract":"We study how the societal disruptions of the COVID-19 pandemic impacted diagnosis of a prevalent childhood mental health condition, Attention Deficit Hyperactivity Disorder (ADHD). Using both nationwide private health insurance claims and a single state’s comprehensive electronic health records, we compare children exposed to the pandemic to same aged children prior to the pandemic. We find the pandemic reduced new ADHD diagnoses by 8.6% among boys and 11.0% among girls nationwide through February 2021. We further show that higher levels of in-person schooling in Fall 2020 dampened the decline for girls but had no moderating effect for boys.","PeriodicalId":84011,"journal":{"name":"Working paper series (National Bureau of Economic Research)","volume":"68 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80327967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Wallace, Paul Goldsmith-Pinkham, Jason C. Schwartz
Political affiliation has emerged as a potential risk factor for COVID-19, amid evidence that Republican-leaning counties have had higher COVID-19 death rates than Democrat-leaning counties and evidence of a link between political party affiliation and vaccination views. This study constructs an individual-level dataset with political affiliation and excess death rates during the COVID-19 pandemic via a linkage of 2017 voter registration in Ohio and Florida to mortality data from 2018 to 2021. We estimate substantially higher excess death rates for registered Republicans when compared to registered Democrats, with almost all of the difference concentrated in the period after vaccines were widely available in our study states. Overall, the excess death rate for Republicans was 5.4 percentage points (pp), or 76%, higher than the excess death rate for Democrats. Post-vaccines, the excess death rate gap between Republicans and Democrats widened from 1.6 pp (22% of the Democrat excess death rate) to 10.4 pp (153% of the Democrat excess death rate). The gap in excess death rates between Republicans and Democrats is concentrated in counties with low vaccination rates and only materializes after vaccines became widely available.
{"title":"Excess Death Rates for Republicans and Democrats During the COVID-19 Pandemic","authors":"J. Wallace, Paul Goldsmith-Pinkham, Jason C. Schwartz","doi":"10.3386/w30512","DOIUrl":"https://doi.org/10.3386/w30512","url":null,"abstract":"Political affiliation has emerged as a potential risk factor for COVID-19, amid evidence that Republican-leaning counties have had higher COVID-19 death rates than Democrat-leaning counties and evidence of a link between political party affiliation and vaccination views. This study constructs an individual-level dataset with political affiliation and excess death rates during the COVID-19 pandemic via a linkage of 2017 voter registration in Ohio and Florida to mortality data from 2018 to 2021. We estimate substantially higher excess death rates for registered Republicans when compared to registered Democrats, with almost all of the difference concentrated in the period after vaccines were widely available in our study states. Overall, the excess death rate for Republicans was 5.4 percentage points (pp), or 76%, higher than the excess death rate for Democrats. Post-vaccines, the excess death rate gap between Republicans and Democrats widened from 1.6 pp (22% of the Democrat excess death rate) to 10.4 pp (153% of the Democrat excess death rate). The gap in excess death rates between Republicans and Democrats is concentrated in counties with low vaccination rates and only materializes after vaccines became widely available.","PeriodicalId":84011,"journal":{"name":"Working paper series (National Bureau of Economic Research)","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78816405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Brownstein, J. Cantor, B. Rader, K. Simon, C. Whaley
Safe and effective vaccines have vastly reduced the lethality of the COVID-19 pandemic worldwide, but disparities exist in vaccine take-up. Although the out-of-pocket price is set to zero in the U.S., time (information gathering, signing up, transportation and waiting) and misinformation costs still apply. To understand the extent to which geographic access impacts COVID-19 vaccination take-up rates and COVID-19 health outcomes, we leverage exogenous, pre-existing variation in locations of retail pharmacies participating the U.S. federal government's vaccine distribution program through which over 40% of US vaccine doses were administered. We use unique data on nearly all COVID-19 vaccine administrations in 2021. We find that the presence of a participating retail pharmacy vaccination site in a county leads to an approximately 26% increase in the per-capita number of doses administered, possibly indicating that proximity and familiarity play a substantial role in vaccine take-up decisions. Increases in county-level per capita participating retail pharmacies lead to an increase in COVID-19 vaccination rates and a decline in the number of new COVID-19 cases, hospitalizations, and deaths, with substantial heterogeneity based on county rurality, political leanings, income, and race composition. The relationship we estimate suggests that averting one COVID-19 case, hospitalization, and death requires approximately 25, 200, and 1,500 county-level vaccine total doses, respectively. These results imply a 9,500% to 22,500% economic return on the full costs of COVID-19 vaccination. Overall, our findings add to understanding vaccine take-up decisions for the design of COVID era and other public health interventions.
{"title":"If You Build it, Will They Vaccinate? The Impact of COVID-19 Vaccine Sites on Vaccination Rates and Outcomes","authors":"J. Brownstein, J. Cantor, B. Rader, K. Simon, C. Whaley","doi":"10.3386/w30429","DOIUrl":"https://doi.org/10.3386/w30429","url":null,"abstract":"Safe and effective vaccines have vastly reduced the lethality of the COVID-19 pandemic worldwide, but disparities exist in vaccine take-up. Although the out-of-pocket price is set to zero in the U.S., time (information gathering, signing up, transportation and waiting) and misinformation costs still apply. To understand the extent to which geographic access impacts COVID-19 vaccination take-up rates and COVID-19 health outcomes, we leverage exogenous, pre-existing variation in locations of retail pharmacies participating the U.S. federal government's vaccine distribution program through which over 40% of US vaccine doses were administered. We use unique data on nearly all COVID-19 vaccine administrations in 2021. We find that the presence of a participating retail pharmacy vaccination site in a county leads to an approximately 26% increase in the per-capita number of doses administered, possibly indicating that proximity and familiarity play a substantial role in vaccine take-up decisions. Increases in county-level per capita participating retail pharmacies lead to an increase in COVID-19 vaccination rates and a decline in the number of new COVID-19 cases, hospitalizations, and deaths, with substantial heterogeneity based on county rurality, political leanings, income, and race composition. The relationship we estimate suggests that averting one COVID-19 case, hospitalization, and death requires approximately 25, 200, and 1,500 county-level vaccine total doses, respectively. These results imply a 9,500% to 22,500% economic return on the full costs of COVID-19 vaccination. Overall, our findings add to understanding vaccine take-up decisions for the design of COVID era and other public health interventions.","PeriodicalId":84011,"journal":{"name":"Working paper series (National Bureau of Economic Research)","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86017683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Many medical decisions during the pandemic were made without the support of causal evidence obtained in clinical trials. We study the case of nebulized ibuprofen (NaIHS), a drug that was extensively used on COVID-19 patients in Argentina amidst wild claims about its effectiveness and without regulatory approval. We study data on 5,146 patients hospitalized in 11 health centers spread over 4 provinces, of which a total of 1,019 (19.8%) received the treatment. We find a large, negative and statistically significant correlation between NaIHS treatment and mortality using inverse probability weighting estimators. We consider several threats to identification, including the selection of "low" risks into NaIHS, spillovers affecting patients in the control group, and differences in the quality of care in centers that use NaIHS. While the negative correlation appears to be, broadly, robust, our results are best interpreted as emphasizing the benefits of running a randomized controlled trial and the challenges of incorporating information produced in other, less rigorous circumstances.
{"title":"Causal Inference During a Pandemic: Evidence on the Effectiveness of Nebulized Ibuprofen as an Unproven Treatment for COVID-19 in Argentina","authors":"Sebastian Calonico, R. Tella, J. L. del Valle","doi":"10.3386/w30084","DOIUrl":"https://doi.org/10.3386/w30084","url":null,"abstract":"Many medical decisions during the pandemic were made without the support of causal evidence obtained in clinical trials. We study the case of nebulized ibuprofen (NaIHS), a drug that was extensively used on COVID-19 patients in Argentina amidst wild claims about its effectiveness and without regulatory approval. We study data on 5,146 patients hospitalized in 11 health centers spread over 4 provinces, of which a total of 1,019 (19.8%) received the treatment. We find a large, negative and statistically significant correlation between NaIHS treatment and mortality using inverse probability weighting estimators. We consider several threats to identification, including the selection of \"low\" risks into NaIHS, spillovers affecting patients in the control group, and differences in the quality of care in centers that use NaIHS. While the negative correlation appears to be, broadly, robust, our results are best interpreted as emphasizing the benefits of running a randomized controlled trial and the challenges of incorporating information produced in other, less rigorous circumstances.","PeriodicalId":84011,"journal":{"name":"Working paper series (National Bureau of Economic Research)","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87841516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This paper analyzes a simple model of infectious disease where the incentives for individuals to reduce risks through endogenous social distancing take straightforward cost-benefit form. Since disease is transmitted through social interactions, the threat of spread of infection poses a collective action problem. Policy interventions such as lockdowns, testing, and mask-wearing serve, in part, as substitutes for social distancing. Provision of a vaccination is the only intervention that unambiguously reduces both the peak infection level and the herd immunity level of infection. Adoption of vaccination remains limited in a decentralized equilibrium, with resulting reproductive rate of disease Rt > 1 at the conclusion of vaccination. Vaccine mandates yield increases in vaccination rates and corresponding reductions in future infection rates but do not increase expected payoffs to individuals.
{"title":"A Simple Model of Social Distancing and Vaccination","authors":"Christopher Avery","doi":"10.3386/w29463","DOIUrl":"https://doi.org/10.3386/w29463","url":null,"abstract":"This paper analyzes a simple model of infectious disease where the incentives for individuals to reduce risks through endogenous social distancing take straightforward cost-benefit form. Since disease is transmitted through social interactions, the threat of spread of infection poses a collective action problem. Policy interventions such as lockdowns, testing, and mask-wearing serve, in part, as substitutes for social distancing. Provision of a vaccination is the only intervention that unambiguously reduces both the peak infection level and the herd immunity level of infection. Adoption of vaccination remains limited in a decentralized equilibrium, with resulting reproductive rate of disease Rt > 1 at the conclusion of vaccination. Vaccine mandates yield increases in vaccination rates and corresponding reductions in future infection rates but do not increase expected payoffs to individuals.","PeriodicalId":84011,"journal":{"name":"Working paper series (National Bureau of Economic Research)","volume":"50 1-2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72481345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This paper uses the initial phase of the COVID-19 pandemic to examine how macroprudential frameworks developed over the past decade performed during a period of heightened financial and economic stress. It discusses a new measure of the macroprudential stance that better captures the intensity of different policies across countries and time. Then it shows that macroprudential policy has been used countercyclically—with stances tightened during the 2010’s and eased in response to COVID-19 by more than previous risk-off periods. Countries that tightened macroprudential policy more aggressively before COVID, as well as those that eased more during the pandemic, experienced less financial and economic stress. Countries’ ability to use macroprudential policy, however, was significantly constrained by the extent of existing “policy space”, i.e., by how aggressively policy was tightened before COVID-19. The use of macroprudential tools was not significantly affected by the space available to use other policy tools (such as fiscal policy, monetary policy, FX intervention, and capital flow management measures), and the use of other tools was not significantly affected by the space available to use macroprudential policy. This suggests that although macroprudential tools are being used countercyclically and should therefore help stabilize economies and financial markets, there appears to be an opportunity to better integrate the use of macroprudential tools with other policies in the future.
{"title":"Macroprudential Policy during COVID-19: The Role of Policy Space","authors":"Katharina Bergant, Kristin Forbes","doi":"10.3386/w29346","DOIUrl":"https://doi.org/10.3386/w29346","url":null,"abstract":"This paper uses the initial phase of the COVID-19 pandemic to examine how macroprudential frameworks developed over the past decade performed during a period of heightened financial and economic stress. It discusses a new measure of the macroprudential stance that better captures the intensity of different policies across countries and time. Then it shows that macroprudential policy has been used countercyclically—with stances tightened during the 2010’s and eased in response to COVID-19 by more than previous risk-off periods. Countries that tightened macroprudential policy more aggressively before COVID, as well as those that eased more during the pandemic, experienced less financial and economic stress. Countries’ ability to use macroprudential policy, however, was significantly constrained by the extent of existing “policy space”, i.e., by how aggressively policy was tightened before COVID-19. The use of macroprudential tools was not significantly affected by the space available to use other policy tools (such as fiscal policy, monetary policy, FX intervention, and capital flow management measures), and the use of other tools was not significantly affected by the space available to use macroprudential policy. This suggests that although macroprudential tools are being used countercyclically and should therefore help stabilize economies and financial markets, there appears to be an opportunity to better integrate the use of macroprudential tools with other policies in the future.","PeriodicalId":84011,"journal":{"name":"Working paper series (National Bureau of Economic Research)","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77704196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Official statistics on deaths in India during the COVID pandemic are either incomplete or are reported with a delay. To overcome this shortcoming, we estimate excess deaths in India using the household roster from a large panel data set, the Consumer Pyramids Household Survey, which reports attrition from death. We address the problem that the exact timing of death is not reported in two ways, via a moving average and differencing monthly deaths. We estimate roughly 4.5 million (95% CI: 2.8M to 6.2M) excess deaths over 16 months during the pandemic in India. While we cannot demonstrate causality between COVID and excess deaths, the pattern of excess deaths is consistent with COVID-associated mortality. Excess deaths peaked roughly during the two COVID waves in India;the age structure of excess deaths is right skewed relative to baseline, consistent with COVID infection fatality rates;and excess deaths are positively correlated with reported infections. Finally, we find that the incidence of excess deaths was disproportionately among the highest tercile of income-earners and was negatively associated with district-level mobility.
{"title":"Using Household Rosters from Survey Data to Estimate All-cause Mortality during COVID in India","authors":"A. Malani, Sabareesh Ramachandran","doi":"10.3386/w29192","DOIUrl":"https://doi.org/10.3386/w29192","url":null,"abstract":"Official statistics on deaths in India during the COVID pandemic are either incomplete or are reported with a delay. To overcome this shortcoming, we estimate excess deaths in India using the household roster from a large panel data set, the Consumer Pyramids Household Survey, which reports attrition from death. We address the problem that the exact timing of death is not reported in two ways, via a moving average and differencing monthly deaths. We estimate roughly 4.5 million (95% CI: 2.8M to 6.2M) excess deaths over 16 months during the pandemic in India. While we cannot demonstrate causality between COVID and excess deaths, the pattern of excess deaths is consistent with COVID-associated mortality. Excess deaths peaked roughly during the two COVID waves in India;the age structure of excess deaths is right skewed relative to baseline, consistent with COVID infection fatality rates;and excess deaths are positively correlated with reported infections. Finally, we find that the incidence of excess deaths was disproportionately among the highest tercile of income-earners and was negatively associated with district-level mobility.","PeriodicalId":84011,"journal":{"name":"Working paper series (National Bureau of Economic Research)","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84326483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Supply chains for many agricultural products have an hour-glass shape;in between a sizable number of farmers and consumers is a smaller number of processors. The concentrated nature of the meat processing sectors in the United States implies that disruption of the processing capacity of any one plant, from accident, weather, or as recently witnessed – worker illnesses from a pandemic – has the potential to lead to system-wide disruptions. We explore the extent to which a less concentrated meat processing sector would be less vulnerable to the risks of temporary plant shutdowns. We calibrate an economic model to match the actual horizontal structure of the U.S. beef packing sector and conduct counter-factual simulations. With Cournot competition among heterogeneous packing plants, the model determines how industry output and producer and consumer welfare vary with the odds of exogenous plant shutdowns under different horizontal structures. We find that increasing odds of shutdown results in a widening of the farm-to-retail price spread even as packer profits fall, regardless of the structure. Results indicate that the extent to which a more diffuse packing sector performs better in ensuring a given level of output, and thus food security, depends on the exogenous risk of shutdown and the level of output desired;no horizontal structure dominates. These results illustrate the consequences of policies and industry efforts aimed at increasing the resilience of the food supply chain and highlight that there are no easy solutions to improving the short-run resilience by changing the horizontal concentration of meat packing.
{"title":"Concentration and Resilience in the U.S. Meat Supply Chains","authors":"M. Ma, J. Lusk","doi":"10.3386/w29103","DOIUrl":"https://doi.org/10.3386/w29103","url":null,"abstract":"Supply chains for many agricultural products have an hour-glass shape;in between a sizable number of farmers and consumers is a smaller number of processors. The concentrated nature of the meat processing sectors in the United States implies that disruption of the processing capacity of any one plant, from accident, weather, or as recently witnessed – worker illnesses from a pandemic – has the potential to lead to system-wide disruptions. We explore the extent to which a less concentrated meat processing sector would be less vulnerable to the risks of temporary plant shutdowns. We calibrate an economic model to match the actual horizontal structure of the U.S. beef packing sector and conduct counter-factual simulations. With Cournot competition among heterogeneous packing plants, the model determines how industry output and producer and consumer welfare vary with the odds of exogenous plant shutdowns under different horizontal structures. We find that increasing odds of shutdown results in a widening of the farm-to-retail price spread even as packer profits fall, regardless of the structure. Results indicate that the extent to which a more diffuse packing sector performs better in ensuring a given level of output, and thus food security, depends on the exogenous risk of shutdown and the level of output desired;no horizontal structure dominates. These results illustrate the consequences of policies and industry efforts aimed at increasing the resilience of the food supply chain and highlight that there are no easy solutions to improving the short-run resilience by changing the horizontal concentration of meat packing.","PeriodicalId":84011,"journal":{"name":"Working paper series (National Bureau of Economic Research)","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81399015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vadim Elenev, L. Quintero, A. Rebucci, Emilia Simeonova
Local policies can have substantial spillovers both across geographies and markets. Little is known about the impact of public health regulations across administrative borders. We estimate U.S. county level direct and spillover effects of Stay-at-Home-Orders (SHOs) aimed at containing the spread of COVID-19 on mobility and social interaction measures. We propose a modified difference-in-difference regression design, based on contiguous-county triplets. This approach compares treated counties, which adopted the SHO, and neighbors, to the neighbor's neighbors, which we term hinterland, counties. We find that mobility in neighboring counties declined by a third to a half as much as in the treated locations. These spillover effects are concentrated in neighbors that share media markets with treated counties. Using directional mobility data, we decompose the spillover decline in mobility into reductions in external visits coming from the treated county and an even stronger voluntary decline in the neighbor county's own traffic. Together, our results provide strong evidence that SHOs operate through information sharing and illustrate the quantitative importance of voluntary social distancing. The finding that the estimated spillovers are in the same direction as the direct effects casts doubt on the prevailing narrative that a more nationally coordinated policy response would have accomplished a greater reduction in mobility and contacts.
{"title":"Direct and Spillover Effects from Staggered Adoption of Health Policies: Evidence from COVID-19 Stay-at-Home Orders","authors":"Vadim Elenev, L. Quintero, A. Rebucci, Emilia Simeonova","doi":"10.3386/w29088","DOIUrl":"https://doi.org/10.3386/w29088","url":null,"abstract":"Local policies can have substantial spillovers both across geographies and markets. Little is known about the impact of public health regulations across administrative borders. We estimate U.S. county level direct and spillover effects of Stay-at-Home-Orders (SHOs) aimed at containing the spread of COVID-19 on mobility and social interaction measures. We propose a modified difference-in-difference regression design, based on contiguous-county triplets. This approach compares treated counties, which adopted the SHO, and neighbors, to the neighbor's neighbors, which we term hinterland, counties. We find that mobility in neighboring counties declined by a third to a half as much as in the treated locations. These spillover effects are concentrated in neighbors that share media markets with treated counties. Using directional mobility data, we decompose the spillover decline in mobility into reductions in external visits coming from the treated county and an even stronger voluntary decline in the neighbor county's own traffic. Together, our results provide strong evidence that SHOs operate through information sharing and illustrate the quantitative importance of voluntary social distancing. The finding that the estimated spillovers are in the same direction as the direct effects casts doubt on the prevailing narrative that a more nationally coordinated policy response would have accomplished a greater reduction in mobility and contacts.","PeriodicalId":84011,"journal":{"name":"Working paper series (National Bureau of Economic Research)","volume":"108 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80546518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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