The role of social status in life expectancy is a burgeoning topic of interest in health research. Isolating the impact of "pure status" on longevity is empirically challenging as an individual's ranking within the social hierarchy is related to other SES measures (e.g. education, income) which are correlated with health. Previous work is based either on animal studies (e.g. Sapolksy's work on baboons) or studies of humans in unique non-experimental settings (e.g. British Civil Servants: Academy Awards and Nobel Prize winners). We use the precise rules for induction into the Baseball Hall of Fame to examine the impact of status attainment (or non-attainment) on life expectancy. The Baseball Hall of Fame provides a compelling context since the selection rule for induction by the Baseball Writers Association of America (BBWAA) is perfectly observed - a BBWAA vote share of 75 percent or more. We explore whether this discontinuous rule for assigning status leads to differential exposure to stress depending on proximity to the cut-off. We obtain BBWAA voting data from the Baseball Hall of Fame website (www.baseballhalloffame.org). For each player born prior to 1946 (n=597) we use complete voting histories to construct a series of variables used in our analysis. From membership lists on the Hall of Fame website we construct indicators denoting whether a player was inducted by the BBWAA or the Committee on Baseball Veterans. From two other websites (www.baseball-reference.com, www.baseball-almanac.com) we obtain player characteristics including exact dates of birth/death, height/weight, ethnicity and education. Finally, we categorize cause of death using obituaries found through Lexis-Nexis, and a book on the necrology of baseball players. We estimate the impact of Hall of Fame induction and the number of narrow losses (vote share>50%) on life expectancy, controlling for each player's maximum vote share, the number of ballot appearances, and demographic characteristics. We use several parametric (Tobit MLE, Buckley-James) and non-parametric (Kaplan-Meier survivor analysis) methods to correct for right censoring in the life durations of players who are still alive. The effect of induction on longevity depends both on the definition of the reference group and the ease of induction. BBWAA inductees do not live longer, on average, than players who were not inducted. However, they do live 10 percent longer than players who narrowly missed induction through the BBWAA. This results from the reduced life expectancies of players who narrowly missed induction relative to non-inductees with lower BBWAA vote shares. Life expectancy falls by 3 percent for each ballot with a vote share over 50 percent but below the 75 percent threshold required for induction. Hall of Fame induction through the Veteran's Committee increases life expectancy, with the largest effect among players who never received a BBWAA ballot share above 10 percent. The effect sizes of the Hall of Fame variables are much larger in magnitude than the effects of BMI, year of birth, and educational attainment (i.e., college matriculation). Our results suggest that the anxiety induced by non-attainment or delayed attainment of status can lead to premature death - with heart attacks being the predominant cause of death - and that there are health benefits of status attained through 'luck' rather than through performance.

We report on a large randomized controlled trial of hospital insurance for above-poverty-line Indian households. Households were assigned to free insurance, sale of insurance, sale plus cash transfer, or control. To estimate spillovers, the fraction of households offered insurance varied across villages. The opportunity to purchase insurance led to 59.91% uptake and access to free insurance to 78.71% uptake. Access increased insurance utilization. Positive spillover effects on utilization suggest learning from peers. Many beneficiaries were unable to use insurance, demonstrating hurdles to expanding access via insurance. Across a range of health measures, we estimate no significant impacts on health.

We report on a large randomized controlled trial of hospital insurance for above-poverty-line Indian households. Households were assigned to free insurance, sale of insurance, sale plus cash transfer, or control. To estimate spillovers, the fraction of households offered insurance varied across villages. The opportunity to purchase insurance led to 59.91% uptake and access to free insurance to 78.71% uptake. Access increased insurance utilization. Positive spillover effects on utilization suggest learning from peers. Many beneficiaries were unable to use insurance, demonstrating hurdles to expanding access via insurance. Across a range of health measures, we estimate no significant impacts on health.

Objective: To identify factors related to an HMO's performance on the standardized HEDIS and CAHPS measures and factors related to improvement in those measures over time. Study Design: Longitudinal analysis of a four year panel of HEDIS and CAHPS data (calendar year 1998-2001). All plans reporting to NCQA, regardless of their decision to allow the data to be publicly available, were included. All plans that reported data in at least one year of the panel were included. Data Sources: Data were obtained from a variety of sources including the National Committee for Quality Assurance (NCQA), Interstudy, the Area Resource File, the U.S. Office of Personnel Management, and the U.S. Department of Labor. Methods: Multivariate growth models were estimated on market demographic and competition variables, as well as health plan characteristics and decisions regarding data collection and reporting. Principal Findings: Our estimates don't support the hypothesis that greater competition is associated with better performance on the six HEDIS measures examined. HMO penetration is positively related to HEDIS performance for four of the six measures. Health plan characteristics such as plan profit status, model type, reporting method and decision to allow the data to be made publicly available are all significantly related to better HEDIS performance. The growth parameters indicate that the relationship between the covariates and HEDIS performance is stable over time.