The effect of combat deployments on veteran opioid abuse.

Grim national statistics about the U.S. opioid crisis are increasingly well known to the American public. Far less well known is that U.S. servicemembers are at ground zero of the epidemic, with veterans facing an overdose death rate of up to twice that of civilians. Exploiting a quasi-experiment in overseas deployment assignment, this study estimates the causal impact of combat exposure among the deployed in the Global War on Terrorism on opioid abuse. We find that exposure to war theater substantially increased the risk of prescription painkiller abuse and illicit heroin use among active duty servicemen. The magnitudes of our estimates imply lower-bound combat exposure-induced healthcare costs of $1.04 billion per year for prescription painkiller abuse and $470 million per year for heroin use.

The Impact of Education on Health Outcomes and Behaviors in a Middle-Income, Low-Education Country.

Although the impact of education on health is important for public policy everywhere, the overwhelming majority of research identifying the health returns to education has focused on developed countries. We use data from multiple waves of nationally-representative Health and Tobacco Surveys in Turkey, and exploit an education reform that increased the mandatory years of schooling from 5 to 8 years in 1997. Using exposure to the reform as an instrument for completing at least eight years of schooling, we examine the impact of education on health indicators and smoking among young adults. We find that extending schooling on this margin impacts men and women differently. Our results indicate that while a one-year of extra schooling increases the likelihood of being obese among males by 9.9 percentage points, the same increase in schooling improves the probability of women being in the healthy weight range by 15.5 percentage points. Consistent with this result, an extra year of education increases women's propensity to self-evaluate their health as excellent by 4.3 percentage points. Additional analyses reveal that education makes men (but not women) more likely to spend time on computers, using the internet, and to spend time on social media, suggesting that differential time allocation between men and women, triggered by enhanced education, may be a mechanism behind the differential results between the sexes. Education has no impact on smoking for men or women regardless of the measure of smoking.

Can natural gas save lives? Evidence from the deployment of a fuel delivery system in a developing country.

There has been a widespread displacement of coal by natural gas as space heating and cooking technology in Turkey in the last two decades, triggered by the deployment of natural gas networks. We examine the impact of this development on mortality among adults and the elderly by exploiting the variation in the timing of the deployment and the intensity of expansion of gas networks across provinces using data from 2001 to 2016. The results indicate that the expansion of natural gas has caused significant reductions in mortality among both adults and the elderly. These findings are supported by our auxiliary analysis, which demonstrates that the expansion of natural gas networks might have led to a significant improvement in air quality. Furthermore, we show that the mortality gains are primarily driven by reductions in cardio-respiratory deaths, which are more likely to be due to conditions caused or exacerbated by air pollution.

Combat exposure and migraine headache: evidence from exogenous deployment assignment.

Migraine headache is a growing problem for U.S. servicemembers deployed to Iraq and Afghanistan and has been linked to substantial negative socioeconomic consequences. However, there has been no comprehensive examination of the relationship between combat exposure and migraine headache or its stress-related triggers. Analyzing data drawn from the National Longitudinal Study of Adolescent Health, we use exogenous variation in deployment assignment to estimate the effect of combat exposure on migraine headache. We find that those deployed to a combat zone with enemy firefight are at substantially increased risk for migraine headache relative to those deployed to non-combat zones outside the United States or to combat zones without enemy firefight. We find that combat-induced sleep disorders, stress-related psychological problems, and physical injuries in combat explain approximately 40-45 percent of the relationship between combat exposure and migraine headache.

The psychological costs of war: military combat and mental health.

We exploit plausibly exogenous variation in overseas deployment assignment to estimate the effect of combat exposure on psychological well-being. Controlling for pre-deployment mental health, we find that active-duty soldiers deployed to combat zones are more likely to suffer from post-traumatic stress disorder (PTSD) than their counterparts deployed outside the United States in non-combat zones. Among those deployed to combat zones, those deployed to locales where they engage in enemy firefight or witness allied or civilian deaths are at an increased risk for suicidal ideation and PTSD relative to their active-duty counterparts deployed to combat zones without enemy firefight.