Category: Law
Opioid deaths are not mainly about prescription opioids
A recent study of opioid-related deaths in Massachusetts underlines this crucial point, finding that prescription analgesics were detected without heroin or fentanyl in less than 17 percent of the cases. Furthermore, decedents had prescriptions for the opioids that showed up in toxicology tests just 1.3 percent of the time.
Alexander Walley, an associate professor of medicine at Boston University, and five other researchers looked at nearly 3,000 opioid-related deaths with complete toxicology reports from 2013 through 2015. “In Massachusetts, prescribed opioids do not appear to be the major proximal cause of opioid-related overdose deaths,” Walley et al. write in the journal Public Health Reports. “Prescription opioids were detected in postmortem toxicology reports of fewer than half of the decedents; when opioids were prescribed at the time of death, they were commonly not detected in postmortem toxicology reports….The major proximal contributors to opioid-related overdose deaths in Massachusetts during the study period were illicitly made fentanyl and heroin.”
The study confirms that the link between opioid prescriptions and opioid-related deaths is far less straightforward than it is usually portrayed. “Commonly the medication that people are prescribed is not the one that’s present when they die,” Walley told Pain News Network. “And vice versa: The people who died with a prescription opioid like oxycodone in their toxicology screen often don’t have a prescription for it.”
That is by Jacob Sullum at Reason, via Arnold Kling.
Imperfect optimization
Paul Ohm, a former prosecutor in the Justice Department’s computer crime and intellectual property section, said the laws governing child sexual abuse imagery were among the “fiercest criminal laws” on the books.
“Just the simple act of shipping the images from one A.I. researcher to another is going to implicate you in all kinds of federal crimes,” he said.
A Coasean solution for New Delhi?
If the late Ronald Coase could be called upon to advise the Delhi government, he would persuade chief minister Arvind Kejriwal to pay farmers in Punjab and Haryana to stop burning crop residue.
In recent times, air quality in Delhi has remained poor throughout the year for various reasons, including the rapid loss of green cover, construction of homes and infrastructure projects, and vehicular as well as industrial pollution. But for a few weeks every November, it gets almost impossible to breathe. The last straw has been the crop residue burning (CRB) by farmers in Punjab and Haryana, which causes a heavy smog to settle over Delhi…
The good news is that these [health] costs—avoidable by Delhi residents if CRB were eliminated—are about 10 times the cost that would be incurred by farmers in adopting substitutes to crop burning. Where policymakers see costs, Coase saw potential for gains from trade.
Here is more from Shruti Rajagopalan.
The racial integration of the Korean War
The racial integration of the US Army during the Korean War (1950-1953) is one of the largest and swiftest desegregation episodes in American history. This paper argues that racial integration improved white survival rates at the expense of blacks, and resulted in less anti-black prejudice among white veterans decades after the war. Using a novel military casualty file, I construct a wartime similarity index to measure the extent of racial integration across military units and time. Using exogenous changes in racial integration, I show that integrated whites were 3% more likely to survive their injuries than segregated whites, whereas integrated blacks were 2% were less likely to survive their injuries than segregated blacks. Given that blacks were initially confined to noncombat support roles, the results reflect a convergence in hazardous combat assignments. To explore the long-term effects of racial integration, I link individual soldiers to post-war social security and cemetery data using an unsupervised learning algorithm. With these matched samples, I show that a standard deviation change in the wartime racial integration caused white veterans to live in more racially diverse neighborhoods and marry non-white spouses. In aggregate, these results are some of the first and only examples of large-scale interracial contact reducing prejudice on a long-term basis.
That is from the job market paper from Daniel Indacochea of the University of Toronto.
Rent control is also not great for labor market outcomes
I had never thought of this before:
This paper, using a novel data set on rent stabilization in New York City, takes a first step in investigating the policy’s unintended consequences on tenant labor market outcomes, while also exploring the impact of policy awareness on those outcomes. Recognizing the potential endogeneity of living in a rent-stabilized unit, this paper uses three decades of housing vacancy data to construct an instrumental variable leveraging variation in the availability of rent-stabilized units across New York boroughs over time. The sorted effects method in Chernozhukov, Fern´andez-Val, and Luo (2018) is also applied to investigate heterogeneous effects beyond their averages. The main results demonstrate that rent-stabilized tenants are more likely to be unemployed compared with tenants in private market-rate units. These effects are particularly salient among white and high-skilled tenants.
That is from the job market paper of Hanchen Jiang of Johns Hopkins University.
Facial recognition isn’t just about China and airports
The child labor activist, who works for Indian NGO Bachpan Bachao Andolan, had launched a pilot program 15 months prior to match a police database containing photos of all of India’s missing children with another one comprising shots of all the minors living in the country’s child care institutions.
He had just found out the results. “We were able to match 10,561 missing children with those living in institutions,” he told CNN. “They are currently in the process of being reunited with their families.” Most of them were victims of trafficking, forced to work in the fields, in garment factories or in brothels, according to Ribhu.
This momentous undertaking was made possible by facial recognition technology provided by New Delhi’s police. “There are over 300,000 missing children in India and over 100,000 living in institutions,” he explained. “We couldn’t possibly have matched them all manually.”
Locating thousands of missing children is just one of the challenges faced by India’s overstretched police force in a nation of 1.37 billion people.
In spite of these practical benefits, I still do not favor facial recognition systems at the macro level. India seems to be planning a big one:
…India’s government now has a much more ambitious plan. It wants to construct one of the world’s largest facial recognition systems. The project envisions a future in which police from across the country’s 29 states and seven union territories would have access to a single, centralized database.
Here is the full article with much more detail about the plans.
Of course it has other uses too
Shachihata, a company that sells personal seals, has developed a stamp that allows victims to mark their attackers with invisible ink, which can be detected under ultraviolet light. A trial run of 500 anti-groping stamps, priced at ¥2,500 ($23), sold out within 30 minutes.
Here is more from The Economist, via Hugo.
Harvard sentences to ponder
We show that Harvard encourages applications from many students who effectively have no chance of being admitted, and that this is particularly true for African Americans.
Here is the whole abstract, by Peter Arcidiacono, Josh Kinsler, and Tyler Ransom:
Over the past 20 years, elite colleges in the US have seen dramatic increases in applications. We provide context for part of this trend using detailed data on Harvard University that was unsealed as part of the SFFA v. Harvard lawsuit. We show that Harvard encourages applications from many students who effectively have no chance of being admitted, and that this is particularly true for African Americans. African American applications soared beginning with the Class of 2009, with the increase driven by those with lower SAT scores. Yet there was little change in the share of admits who were African American. We show that this change in applicant behavior resulted in substantial convergence in the overall admissions rates across races yet no change in the large cross-race differences in admissions rates for high-SAT applicants.
And from the paper’s conclusion:
If the goal of recruiting African Americans is not simply to increase the diversity of matriculants, but also to achieve racial balance in the admit pool and/or racial balance in admit rates, then the policy could be deemed a success. As an example, admit rates for African American applicants were twice as large as admit rates for Asian American applicants in 2000, but by 2017 were approximately the same. Why Harvard might careabout the racial distribution of admit rates and applicants is not obvious. What is clear is that each year there are a significant number of African American high school students who have a potentially false impression about their chances of being admitted to Harvard.
Here is the full paper. And here is a recent paper by Howell, Hurwitz, and Smith, with related results.
The effect of district attourneys on criminal justice outcomes
In the United States, elected district attorneys’ offices prosecute over 85% of all felony cases, but we know little about their effect on local criminal justice outcomes. Using a newly-collected dataset of district attorney elections, I show that Republican district attorneys lead to a 18-21% increase in new prison admissions in the two years following their election, while nonwhite district attorneys lead to a 10% decline. In both cases, there are no significant effects on local crime or arrest rates. These results show that the identity of the local district attorney is an important determinant of incarceration rates.
Here is the paper, by Sam Krumholz, on the job market this year from UCSD, that is not his job market paper, here is his full portfolio, public economics and law and economics, to me one of the more interesting candidates this year.
Opioids and labor market participation
The onset of the opioid crisis coincided with the beginning of nearly 15 years of declining labor force participation in the US. Furthermore, the areas most affected by the crisis have generally experienced the worst deteriorations in labor market conditions. Despite these time series and cross-sectional correlations, there is little agreement on the causal effect of opioids on labor market outcomes. I provide new evidence on this question by leveraging a natural experiment which sharply decreased the supply of hydrocodone, one of the most commonly prescribed opioids in the US. I identify the causal impact of this decrease by exploiting pre-existing variation in the extent to which different types of opioids were prescribed across geographies to compare areas more and less exposed to the treatment over time. I find that areas with larger reductions in opioid prescribing experienced relative improvements in employment-to-population ratios, driven primarily by an increase in labor force participation. The regression estimates indicate that a 10 percent decrease in hydrocodone prescriptions increased the employment-to-population ratio by about 0.7 percent. These findings suggest that policies which reduce opioid misuse may also have positive spillovers on the labor market.
That is from a job market paper by David Beheshti at the University of Texas at Austin.
Economists and non-economists on elasticity
From a recent paper by Joanna Venator and Jason Fletcher:
In this paper, we estimate the impacts of abortion clinic closures on access to clinics in terms of distance and congestion, abortion rates, and birth rates. Legislation regulating abortion providers enacted in Wisconsin in 2011-2013 ultimately led to the closure of two of five abortion clinics in Wisconsin, increasing the average distance to the nearest clinic to 55 miles and distance to some counties to over 100 miles. We use a difference-in-differences design to estimate the effect of change in distance to the nearest clinic on birth and abortion rates, using within-county variation across time in distance to identify the effect. We find that a hundred-mile increase in distance to the nearest clinic is associated with 25 percent fewer abortions and 4 percent more births. We see no significant effect of increased congestion at remaining clinics on abortion rates. We find significant racial disparities in who is most affected by abortion clinic closures, with increases in distance increasing birth rates significantly more for Black, Asian, and Hispanic women. Our results suggest that even small numbers of clinic closures can result in significant restrictions to abortion access of similar magnitude to those seen in Texas when a greater number of clinics closed their doors.
There are (at least) two possible responses to such results, and that is without even getting into one’s underlying view of the ethics of abortion. One is to say that a great deprivation has occurred because many fewer women end up having abortions. Another response is to infer that the marginal value of the abortions could not have been so high to begin with, if the number drops off so readily.
The same issue comes up with Obamacare. If the price of health insurance goes up, quite a large number of people decide to go without coverage. Is the size of that number a measure of the human tragedy resulting from the price increase? Or is it a measure of how little those people actually value health insurance? Or somehow both?
I have yet to meet a person who can think through these issues rationally and absorb what is interesting and valid in each of those two perspectives.
Release Bad News on a Friday
Politicians have long known to release bad news on a Friday and it appears that pharmaceutical firms may do likewise.
Safety alerts are announcements made by health regulators warning patients and doctors about new drug-related side effects. However, not all safety alerts are equally effective. We provide evidence that the day of the week on which the safety alerts are announced explains differences in safety alert impact. Specifically, we show that safety alerts announced on Fridays are less broadly diffused: they are shared 34% less on social media, mentioned in 23% to 66% fewer news articles, and are 12% to 51% less likely to receive any news coverage at all. As a consequence of this, we propose Friday alerts are less effective in reducing drug-related side effects. We find that moving a Friday alert to any other weekday would reduce all drug-related side effects by 9% to 12%, serious drug-related complications by 6% to 15%, and drug-related deaths by 22% to 36%. This problem is particularly important because Friday was the most frequent weekday for safety alert announcements from 1999 to 2016. We show that this greater prevalence of Friday alerts might not be random: firms that lobbied the U.S. Food and Drug Administration in the past are 49% to 56% more likely to have safety alerts announced on Fridays.
From The Friday Effect in Management Science by Diestre, Barber and Santalo.
Hat tip: Kevin Lewis.
The impact of the Affordable Care Act
The Impact of the Affordable Care Act: Evidence from California’s Hospital Sector
(with Mark Duggan and Atul Gupta) R&R, AEJ: Economic PolicyThe Affordable Care Act (ACA) authorized the largest expansion of public health insurance in the U.S. since the mid-1960s. We exploit ACA-induced changes in the discontinuity in coverage at age 65 using a regression discontinuity based design to examine effects of the expansion on health insurance coverage, hospital use, and patient health. We then link these changes to effects on hospital finances. We show that a substantial share of the federally-funded Medicaid expansion substituted for existing locally-funded safety net programs. Despite this offset, the expansion produced a substantial increase in hospital revenue and profitability, with larger gains for government hospitals. On the benefits side, we do not detect significant improvements in patient health, although the expansion led to substantially greater hospital and emergency room use, and a reallocation of care from public to private and better-quality hospitals.
The Long-Term Effects of California’s 2004 Paid Family Leave Act on Women’s Careers
It is not obviously a winner policy, at least not from the point of view of boosting women’s labor market opportunities. In fact it seems to harm them:
This paper uses IRS tax data to evaluate the short- and long-term effects of California’s 2004 Paid Family Leave Act (PFLA) on women’s careers. Our research design exploits the increased availability of paid leave for women giving birth in the third quarter of 2004 (just after PFLA was implemented). These mothers were 18 percentage points more likely to use paid leave but otherwise identical to multiple comparison groups in pre-birth demographic, marital, and work characteristics. We find little evidence that PFLA increased women’s employment, wage earnings, or attachment to employers. For new mothers, taking up PFLA reduced employment by 7 percent and lowered annual wages by 8 percent six to ten years after giving birth. Overall, PFLA tended to reduce the number of children born and, by decreasing mothers’ time at work, increase time spent with children.
That is from a new NBER working paper by Martha J. Bailey, Tanya S. Byker, Elena Patel, and Shanthi Ramnath. And are you wondering why the number of children falls as a response? Because the mother ends up staying home with them? Or do mothers invest more in child quality, thereby lower quantity, as in a Becker model? In any case a good question.
The Mexican drug war and its intensification
Event study estimates suggest that cartel presence increases substantially after 2010 in municipalities well suited to grow opium poppy. Homicide rates increase along with the number of active cartels per municipality, with higher increases when a second, third, fourth and fifth cartel become active in the territory. These results suggest that some of the increase in violence that Mexico experienced in the last fifteen years could be attribute to criminal groups fighting for market shares of heroin and not only to changes in government enforcement.
That is from a recent job market paper by Fernanda Sobrino of Princeton University.