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· 2017
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 response to these policies, abortions to Texas residents fell 20.5% and births rose 2.6% in counties that no longer had an abortion provider within 50 miles. Changes in the family planning market induced a 1.5% increase in births for counties that no longer had a publicly funded family planning clinic within 25 miles. Meanwhile, responses of retail purchases of condoms and emergency contraceptives to both abortion and family planning service changes were minimal.
· 2015
The Man You Love is Marrying Your Bestfriend.. Anna Crows worst nightmare has come true. Her best friend and the love of her life is getting married. to another woman. Anna never told Brian Walker how she felt, but recalls a moment seven years ago when he'd asked her out and wonders what life would have been like had she said 'yes'. But the morning of the wedding, Brian drops a bombshell on her. He wishes she'd said 'yes' as well. But it's too late. Nothing can change the past. All Anna can do now is to have one last good cry and move on. So, she cries to herself, but to her surprise, she's not alone. Someone hears her. A mystical stranger. Soon, Anna is offered a chance to go back in time seven years for twelve hours. Anna is given the chance to change history and win Brian's heart. Does she dare? Can one night in the past truly change their futures forever? Can Anna get Brian to fall in love in just one night? How often is a girl given the chance to change the past? How often do we get to go back and start again? Anna's got one chance. One night. One night in the middle of time.
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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.
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Rapidly growing health-care costs have fueled interest in using financial incentives to improve health behaviors. Most of the research on financial incentives outside of clinical studies has been observational, limiting our ability to make causal inferences on their effectiveness. The few carefully-designed studies have generally found little lasting effect on behavior after the incentive program ended. We report on a large field experiment with employees of a Fortune 500 company which offered incentives for using the company gym. In addition to understanding the effects of incentives alone, we investigate a novel approach to generate lasting behavior change using self-funded commitment contracts. At the end of incentive period, half of the incentive group were offered the opportunity to create a self-funded commitment contract to motivate their own behavior. Workers responded strongly during the incentive period, doubling their rate of use of the company gym. After the incentive period ended, we find that those offered incentives only continued to attend at higher rates, but the effect was quite modest in magnitude. The availability of a commitment contract, however, substantially improved the long-run effects of the incentive program both during the commitment period and well beyond, offering a promising new approach to increasing the long-run effect of incentive programs.
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Fewer births occur on major US holidays than would otherwise be expected. We use California data to study the nature and health implications of this birth date manipulation. We document 18% fewer births on the day of and just after a holiday. Cesarean sections account for roughly half of the decline. Using insights from the tax bunching and test score manipulation literature, we show that "missing” holiday births are displaced to a window of time 11 days before the holiday through 16 days after the holiday. Delivery type does not change over this window, consistent with a pure retiming of births rather than an increase in the use of procedures such as cesarean sections. Despite the change in timing, we find little evidence of any adverse health consequences for babies born around a holiday. Even among high-risk pregnancies, which are more likely to be retimed, we find a minimal impact of holiday-related birth timing manipulation on infant health. Finally, while some of the retiming seems to be driven by patients' preferences, provider incentives appear to play a crucial role in holiday-related birth retiming. At Kaiser Permanente hospitals, where systemwide financial incentives discourage providers from electively timing births, the dip in births on holidays is less than for hospitals overall. This suggests that holiday retiming occurs more frequently among providers who face less of a disincentive to electively schedule births.
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The rise of childhood obesity in less developed countries is often overlooked. We study the impact of body weight report cards in Mexico. The report cards increased parental knowledge and shifted parental attitudes about children's weight. We observe no meaningful changes in parental behaviors or children's body mass index. Interestingly, parents of children in the most obese classrooms were less likely to report that their obese child weighed too much relative to those in the least obese classrooms. As obesity rates increase, reference points for appropriate body weights may rise, making it more difficult to lower obesity rates.
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The use of incentives to encourage healthy behaviors is increasingly widespread, but we have little evidence about how best to structure these programs. We explore how different incentive designs affect behavior on the extensive and intensive margins through an experiment offering incentives to employees of a Fortune 500 company to use their workplace gym. Overall the likelihood of joining the gym was not strongly affected by the incentive design. Notably, front-loading incentives to encourage initial participation was not more effective than an incentive kept constant over time. For those who were already at least occasional users of the gym, however, we find more evidence that the design of incentives matters. For this group, front-loading incentives appears to be detrimental relative to a constant incentive, but a novel design that spreads out the incentive budget by turning incentives on and off over a longer period of time is effective.