Unhealthy Options
Researchers' degrees of flexibility: Revisiting COVID-19 policy evaluations
Joakim Weill et al.
Economic Inquiry, forthcoming
Abstract:
Empirical research involves multiple, seemingly-minor choices that can substantially impact a study's findings. While acknowledged, the importance of these "degrees of flexibility" on published estimates is not well understood. We examine the considerable literature focused on the impacts of early COVID-19 policies on social distancing to assess the role of researchers' degrees of flexibility on the estimated effects of mobility-reducing policies. We find that estimates reported in previous studies are not robust to minor changes in typically-unexplored dimensions of the degree of flexibility space, and usual robustness tests systematically fail to detect these issues.
Does Peer Review Penalize Scientific Risk Taking? Evidence from NIH Grant Renewals
Pierre Azoulay & Wesley Greenblatt
NBER Working Paper, February 2025
Abstract:
Scientific projects that carry a high degree of risk may be more likely to lead to breakthroughs yet also face challenges in winning the support necessary to be carried out. We analyze the determinants of renewal for more than 100,000 R01 grants from the National Institutes of Health between 1980 and 2015. We use four distinct proxies to measure risk taking: extreme tail outcomes, disruptiveness, pivoting from an investigator's prior work, and standing out from the crowd in one's field. After carefully controlling for investigator, grant, and institution characteristics, we measure the association between risk taking and grant renewal. Across each of these measures, we find that risky grants are renewed at markedly lower rates than less risky ones. We also provide evidence that the magnitude of the risk penalty is magnified for more novel areas of research and novice investigators, consistent with the academic community's perception that current scientific institutions do not motivate exploratory research adequately.
Springing forward and falling back on health: The effects of daylight saving time on acute myocardial infarction
Shinsuke Tanaka & Hideto Koizumi
Journal of Economic Behavior & Organization, December 2024
Abstract:
Daylight Saving Time (DST) is a common energy policy worldwide. We examine the effects of DST on the incidence of acute myocardial infarction (AMI) over three distinct time frames: short, medium, and long run. By exploiting the unique circumstances in Indiana, our findings highlight a substantial 27.2% increase in AMI admissions at the spring transition, which lasts for approximately two weeks, is not offset by counteractive reductions during the DST period, and occurs at each transition over the years studied, indicating little adaptation to time adjustments. Conversely, we find no similar effects at the autumn transitions. Together, these findings contribute to the ongoing policy debate by providing evidence of the short-term costs of time adjustments, without offering any discernible health benefits associated with the adoption of permanent DST.
Pharmaceutical Drug Regulation and Mortality: Evidence from E-cigarettes
Michael Pesko & Christian Saenz
Georgia State University Working Paper, January 2025
Abstract:
This study evaluates drug regulation in the United States by examining a product that was unexpectedly judicially exempted from drug regulation in 2010: e-cigarettes. We compare these effects to nicotine replacement therapy, which was not exempted. Our analysis shows that this exemption led to significant increases in e-cigarette innovation, as evidenced by patent applications. Leveraging differences in smoking rates across demographic groups prior to e-cigarette introduction, we find that from 2011 to 2019, e-cigarettes saved 677,000 life-years, or approximately 1/3 the estimated benefit of early HIV/AIDS drugs through year 2000, and increased social surplus by $8 billion annually. We demonstrate that reduced smoking is a key mechanism explaining this mortality reduction, with statistically significant smoking reductions proceeding mortality reductions by approximately 4 years.
Long-Run Effects of Childhood Exposure to Medical Marijuana Laws on Education and Labor Market Outcomes
Maorui Yang & Han Yu
Journal of Labor Research, December 2024, Pages 565-597
Abstract:
We investigate the long-run effects of medical marijuana laws (MMLs) on the educational attainment and labor market outcomes of individuals who experienced childhood exposure to these laws, utilizing data from the American Community Survey between 2000 and 2019. We apply the Borusyak et al. (2021) imputation estimator to address potential biases commonly encountered in a conventional difference-in-differences model with two-way fixed effects caused by staggered timings and heterogeneous effects in treatment. The results demonstrate a significant and negative impact of medical marijuana laws on various aspects of individuals' educational and occupational achievements. Specifically, we observe adverse effects on years of schooling, college attendance, employment, and income. Furthermore, our findings reveal the presence of heterogeneity in these effects based on gender and race. To further explore the mechanisms through which MMLs affect these individual outcomes, we explore several potential factors. Our results suggest that MMLs may affect long-term outcomes by increasing drug consumption and the propensity of experiencing alcohol use disorder among both children and adults.
Education and Dementia Risk
Silvia Barcellos et al.
NBER Working Paper, January 2025
Abstract:
There is little causal evidence on factors that can protect individuals against Alzheimer's Disease and Related Dementias (ADRD) risk. We study the causal effect of education on ADRD, exploiting a regression discontinuity generated by a compulsory schooling reform. ADRD was ascertained based on medical history, hospital records, and death registries, addressing concerns about selective sample attrition. We find that education reduces incidence of ADRD and may delay its onset. Using molecular genetic data, we show that the reform weakened the relationship between genetics and ADRD incidence, implying this genetic risk is not immutable and can be modified by social policy.
The No-Hunger Games: How GLP-1 Medication Adoption is Changing Consumer Food Purchases
Sylvia Hristakeva, Jura Liaukonyte & Leo Feler
Cornell Working Paper, January 2025
Abstract:
We examine how consumers modify their food purchasing behavior after adopting appetite-suppressing GLP-1 receptor agonists, such as Ozempic and Wegovy. Utilizing a unique dataset linking survey responses on medication adoption and timing with transaction data from a representative U.S. household panel, we document the prevalence, motivations, and demographic patterns of GLP-1 adoption, including off-label use. Households with at least one GLP-1 user reduce grocery spending by approximately 6% within six months of adoption, with higher-income households reducing spending by nearly 9%. These reductions are driven by significantly larger decreases in purchases of calorie-dense, processed items, including a 11% decline in savory snacks. In contrast, we observe directional increases in nutrient-dense purchases, such as yogurt and fresh produce. We also examine food-away-from-home spending at limited-service establishments, such as fast-food chains and coffee shops, finding reductions at breakfast and especially during dinner times. Our findings highlight the potential for GLP-1 medications to significantly reshape consumer food demand, a trend with increasingly important implications for the food industry as adoption continues to grow.
GLP-1 receptor agonists significantly impair taste function
Rafa Khan & Richard Doty
Physiology & Behavior, 15 March 2025
Abstract:
Over 10% of the US population are prescribed glucagon-like peptide-1 receptor agonists (GLP-1 RAs) to combat obesity. Although they decrease cravings for foods, their influence on chemosensory function is unknown. We employed state-of-the-art quantitative taste and smell tests to address this issue. The 53-item Waterless Empirical Taste Test (WETTR) and the 40-item University of Pennsylvania Smell Identification Test (UPSITR) were completed by 46 persons taking GLP-1 RAs and 46 controls matched on age, sex, smoking behavior, and COVID-19 infection histories. Data were analyzed using analyses of variance. The WETTR scores were significantly diminished in the GLP-1 RA group relative to controls [total means (95% CIs) = 28.61 (25.66,31.56) and 40.63 (38.35,42.91), p < 0.001, η2 = 0.37]. Eighty five percent of the GLP-1 subjects scored worse than their individually matched controls. All 5 WETTR subtest scores were similarly affected (ps < 0.001). Smell function, although slightly decreased on average, was not significantly impacted (p = 0.076). Women outperformed men on all tests. Remarkably, UPSITR and WETTR scores were higher, i.e., better, in those reporting nausea, diarrhoea, and other GLP-1-related side effects. This study demonstrates, for the first time, that GLP-1 RAs alter the function of a major sensory system, significantly depressing the perception of all five basic taste qualities. The physiologic basis of this effect is unknown but may involve GLP-1 receptors in the brainstem and afferent taste pathways, as well as vagus nerve-related processes.
Understanding the Role of Genetic Heterogeneity in Smoking Interventions: Experimental Evidence from the Lung Health Study
Shubhashrita Basu et al.
NBER Working Paper, February 2025
Abstract:
We examine whether genome-wide summary measures of genetic risk known as polygenic indices (PGIs) provide new insights into the efficacy of the Lung Health Study (LHS)-a large, randomized controlled trial (RCT) that evaluated the effect of a smoking cessation intervention program on cessation maintenance and lung function. Results indicate that the intervention was less successful for participants with higher PGIs for smoking initiation and intensity. Given the increasing availability and affordability of genomic data, we argue that in the context of RCTs, PGIs can further our understanding of heterogeneous treatment effects and the mechanisms that may be driving them.