Living Donor Decision-Making and the Complex Interplay of Finances and Other Motivators, Barriers, and Facilitators.

INTRODUCTION: The decision to become a living donor requires consideration of a complex, interactive array of factors that could be targeted for clinical, policy, and educational interventions. Our objective was to assess how financial barriers interact with motivators, other barriers, and facilitators during this process. METHODS: Data were obtained from a public survey assessing motivators, barriers, and facilitators of living donation. We used multivariable logistic regression and consensus k-means clustering to assess interactions between financial concerns and other considerations in the decision-making process. RESULTS: Among 1592 respondents, the average age was 43; 74% were female and 14% and 6% identified as Hispanic and Black, respectively. Among employed respondents (72%), 40% indicated that they would not be able to donate without lost wage reimbursement. Stronger agreement with worries about expenses and dependent care challenges was associated with not being able to donate without lost wage reimbursement (OR = 1.2, 95% CI = 1.0-1.3; OR = 1.2, 95% CI = 1.1-1.3, respectively). Four respondent clusters were identified. Cluster 1 had strong motivators and facilitators with minimal barriers. Cluster 2 had barriers related to health concerns, nervousness, and dependent care. Clusters 3 and 4 had financial barriers. Cluster 3 also had anxiety related to surgery and dependent care. CONCLUSIONS: Financial barriers interact primarily with health and dependent care concerns when considering living organ donation. Targeted interventions to reduce financial barriers and improve provider communication regarding donation-related risks are needed.

Sound the Alarm: The Sonographer Shortage Is Echoing Across Healthcare.

OBJECTIVES: The growth in ultrasound usage necessitates concurrent growth in the number of sonographers. Despite the increasing importance of ultrasound, there is a shortage of sonographers in the United States that has never been specifically quantified. This study examines recent trends in the number of ultrasound exams, sonography graduates, open sonographer positions, and wages. METHODS: This retrospective study uses public databases and surveys including the Medical Expenditure Panel Survey (MEPS), Bureau of Labor Statistics (BLS), Integrated Postsecondary Education Data System (IPEDS), and Zippia, a human resources platform to determine metrics. These metrics include the number of ultrasound exams conducted in the United States (excluding inpatient setting), number of sonographers and sonographer wages, sonography graduates, and open sonographer positions. RESULTS: Ultrasound exams in the United States from 2011 to 2021 increased from 38.6 million to 59.8 million (+55.1%,) while the number of sonographers (2011-2021) increased from 54,760 to 78,640 (+43.6%). There was a significant difference between supply and demand of sonographers with the number of sonography graduates (2011-2021) increasing from 4,386 to 5,393 (+23.0%) while the number of open sonographer positions (2012-2021) increased from 18,462 to 25,162 (+36.3%). CONCLUSIONS: From 2011 to 2021, the increase in the number of ultrasound exams has significantly outpaced the increase in the number of sonographers. Furthermore, the increase in demand for sonographers has grown significantly faster than the supply, leading to a shortage and consequent strain on the healthcare system. To address the shortage, the number of sonography school openings should be increased, and the attendant challenges addressed.

Food prices and the wages of the poor: A cost-effective addition to high-frequency food security monitoring.

The affordability of nutritious food for "all people, at all times" is a critically important dimension of food security. Yet surprisingly, timely high-frequency indicators of food affordability are rarely collected in any systematic fashion despite price volatility emerging as major source of food insecurity in the 21st Century. The 2008 global food crisis prompted international agencies to invest heavily in monitoring domestic food prices in low and middle income countries (LMICs). However, food price monitoring is not sufficient for measuring changes in diet affordability; for that, one must also measure changes either in income or in an income proxy. We propose using the wages of unskilled workers as a cheap and sufficiently accurate income proxy, especially for the urban and rural non-farm poor. We first outline alternative measures of "food wage" indices, defined as wages deflated either by consumer food price indices or novel healthy diet cost indices. We then discuss the conceptual strengths and limitations of food wages. Finally, we examine patterns and trends in different types of real food wage series during well-known food price crises in Ethiopia (2008, 2011 and 2022), Sri Lanka (2022) and Myanmar (2022). In all these instances, food wages declined by 20-30%, often in the space of a few months. In Myanmar, the decline in real wages during 2022 closely matches declines in household disposable income. We strongly advocate tracking the wages of the poor as a timely, accurate and cost-effective means of monitoring food affordability for important segments of the world's poor.

Occupations and careers within organizations: Do organizations facilitate unequal wage growth?

Recent research suggests that occupations and organizations intersect during the formation of wage inequality. Using administrative data from the Netherlands, I investigate whether workers who are employed in different occupations experience unequal wage growth when staying in an organization. Results reveal that workers in professional and managerial positions realize larger wage growth than workers who work initially in lower-status occupations. After six years of staying at the same organization, predicted wage growth rates vary between 5.44% for production workers and 10.18% for technical professionals. The findings indicate that occupations compound present and future wage advantages at the organizational level. I test whether occupational sorting across organizations with differing pay quality mediates part of the occupation-based heterogeneity in wage growth. The results show that occupational sorting is marked but that sorting explains only up to around 8% of inequality in firm-internal wage growth between different occupational classes in the Dutch labor market.

Wage Disparities across Immigrant Generations: Education, Segregation, or Unequal Pay?

Immigrants and their native-born children often face considerable wage penalties relative to natives, but less is known about whether this inequality arises through differences in educational qualifications, segregation across occupations and establishments, or unequal pay for the same work. Using linked employer-employee data from Norway, the authors ask whether immigrant-native wage disparities 1) reflect differences in detailed educational qualifications, labor market segregation, or within-job pay differences; 2) differ by immigrant generation; and 3) vary across different segments of the labor market. They find that immigrant-native wage disparities primarily reflect sorting into lower-paying jobs, and that wage disadvantages are considerably reduced across immigrant generations. When doing the same work for the same employer, immigrant-background workers, especially children of immigrants, earn similar wages to natives. Sorting into jobs seems more meritocratic for university graduates, for professionals, and in the public sector, but within-job pay differences are strikingly similar across market segments.

Class, gender and the work of working-class women amid turbulent times.

The article focuses on the work of working-class women (WCW) amid turbulent times. Its timespan is just prior to and during the Covid-19 pandemic in the UK. The women's work, and the key skills involved, are fundamental to everyday lives, but both have been under-valued and under-rewarded. The pandemic shone a fresh light on the societal importance of this work and highlighted how its under-valuation and the women's systemic low pay and inferior working conditions have serious ramifications not only for individual workers and their families but for the provision of key services. The article centres WCW, at the intersection of classed and gendered disadvantage, to ask about inequalities in work experiences. Analysing nationally representative samples of thousands of workers in the UK prior to and as Covid-19 rolled out, we compare WCW with other workers. We show that the women faced both persistent and new inequalities at work: enduring low earnings, pandemic-led risks to jobs and paid hours, little opportunity to work from home or flexibly, and stressful key working roles. We reveal the heavily classed nature of some of these findings, show that others were more strongly gendered, while still others were classed and gendered outcomes that require intersectional analyses of the women's working lives.

Minimum Wages around Birth and Child Health.

This paper studies the effects of minimum wages in Indonesia around the time of birth on child height-for-age Z scores (HAZ) up to five years of age. Using variations in annual fluctuations in real minimum wages in different Indonesian provinces, it finds that children exposed to increases in minimum wages in their birth years have higher HAZ in the first five years of their lives. The estimated impacts are based on difference-in-differences models with biological-mother fixed effects and year-of-birth fixed effects and are robust to inclusion of multiple time-varying factors. The impacts are prominent particularly among male children.

Inflation and wage growth since the pandemic.

Following the worst of the COVID-19 pandemic, inflation surged to levels last seen in the 1980s. Motivated by vast differences in pandemic support across countries, we investigate the subsequent response of inflation and its feedback to wages. We exploit the differences in pandemic support to identify the effect that these programs had on inflation and the passthrough to wages. Our empirical approach focuses on a novel dynamic difference-in-differences method based on local projections. Our estimates suggest that an increase of 5 percentage points in direct transfers (relative to trend) translates into about a peak 3 percentage points boost to inflation and wage growth. Moreover, higher inflation accentuates the role of inflation expectations on wage-setting dynamics.

Public universities and human capital development in the United States.

Public colleges and universities play an important role in the formation of human capital through the attraction, training, and often local-regional retention of students. Much of the existing research on the subject examines one stage in this process, one type of institution, and/or one type of regional environment. While such studies can generate important insights, taking too narrow a perspective on one or more of these elements can lead to distortions about the impact of institutions of higher learning on the regions they serve. This paper adds to the literature by (1) widening the temporal frame of analysis to include the student's journey from hometown to campus and then to additional locations 10 years after graduation, and (2) by deepening the cross-sectional view of a region's layered institutions to include the many different types of public higher education and the variety of human capital they support. Data from 64 institutions spread across 10 labor market regions under the State University of New York show how institution type corresponds to (1) the geography of populations served, (2) the nature of skills and training supplied, and (3) local/regional retention a decade later. The empirical study also identifies the extent to which factors such as regional variation, degree level, and students' program of study associate with human capital development (e.g., wages, retention) and therefore contributes to a more nuanced understanding of the broader relationship between institutions of higher learning and local/regional human capital formation.

Did Minimum Wage Policy Changes Impact Home Health Workforce?

The shortage of home health aides has been exacerbated in recent years partially because of low wages. Minimum wage (MW) policy changes may alleviate this workforce shortage. This study examined the effects of MW policies on wages and employment of home health aides. We performed a county-level longitudinal analysis using 2012 to 2018 national data. The study cohort included 2,496 counties and focused on all workers in the home health industry. Outcome variables included wages and the employment of home health aides. Key variables of interest included the consumer price index adjusted state MW and a set of variables that captured the effect of the Fair Labor Standards Act (FLSA) extension. This study found that home health aides' hourly wages were $1.00 higher (p = .011) in states that increased their MWs from below $8 to above $10. The FLSA extension was associated with $1.15 higher wages in states with higher MWs (i.e., state MW above $10 in 2014). The FLSA extension was associated with higher employment of home health aides in less-competitive markets, rather than high- or average-competitive markets. This study suggests that state MW increases combined with the FLSA extension may help maintain the current home health workforce and improve their wages.

Association of Low Hourly Wages in Middle Age With Faster Memory Decline in Older Age: Evidence From the Health and Retirement Study.

Little research has investigated the long-term relationship between low wages and memory decline, despite the growing share of low-wage workers in the US labor market. Here, we examined whether cumulative exposure to low wages over 12 years in midlife is associated with memory decline in later life. Using 1992-2016 data from the Health and Retirement Study, we analyzed data from 2,879 individuals born in 1936-1941 using confounder-adjusted linear mixed-effects models. Low-wage work was defined as an hourly wage lower than two-thirds of the federal median wage for the corresponding year and was categorized into "never," "intermittent," and "sustained" based on wages earned from 1992 to 2004. Memory function was measured at each study visit from 2004 to 2016 via a memory composite score. The confounder-adjusted annual rate of memory decline among "never" low-wage earners was -0.12 standard units (95% confidence interval: -0.13, -0.10). Compared with this, memory decline among workers with sustained earning of low midlife wages was significantly faster (ßtime×sustained = -0.014, 95% confidence interval: -0.02, -0.01), corresponding to an annual rate of -0.13 standard units for this group. Sustained low-wage earning in midlife was significantly associated with a downward trajectory of memory performance in older age. Enhancing social policies to protect low-wage workers may be especially beneficial for their cognitive health.

The rare disease neurofibromatosis 1 as a source of hereditary economic inequality: Evidence from Finland.

PURPOSE: This study investigated whether individuals with neurofibromatosis 1 (NF1) fare worse than individuals without NF1 in terms of economic well-being. NF1 is relatively common in the population and provides an informative case of a rare hereditary disease. METHODS: We examined a subset of 692 individuals with verified NF1 from the Finnish total population-based NF1 cohort and compared that with 7407 control individuals matched for age, sex, and municipality during 1997-2014. Economic well-being was operationalized with annual work earnings and total income, including social income transfers. RESULTS: NF1 significantly worsened economic well-being. Low education, increased morbidity, and reduced labor market participation partly explained the effect of NF1. Yet, NF1 was independently associated with lower income even after adjusting for these factors. Furthermore, NF1 had a larger negative effect on income from work than it had on total income, which indicated that the Finnish social security system partly compensated the labor market losses suffered by individuals with NF1. NF1 had a larger impact on economic inequality for men than for women. CONCLUSION: NF1 contributes to economic inequality. A hereditary disease may convey worse economic well-being over several generations.

Adverse working conditions and immigrants' physical health and depression outcomes: a longitudinal study in Greece.

PURPOSE: Τhe study examines whether adverse working conditions for immigrants in Greece bear an association with deteriorated physical health and increased levels of depression during 2018 and 2019. METHODS: A panel dataset resulted from the collaboration with centers providing free Greek language courses to immigrant population groups. Random Effects models assess the determinants of physical health and depression. RESULTS: Findings indicate that workers with no written contract of employment, receiving hourly wages lower than the national hourly minimum wages, and experiencing insults and/or threats in their present job experience worse physical health and increased levels of depression. Moreover, the study found that the inexistence of workplace contracts, underpayment, and verbal abuse in the workplace may coexist. An increased risk of underpayment and verbal abuse reveals itself when workers do not have a contract of employment and vice versa. CONCLUSION: Immigrant workers without a job contract might experience a high degree of workplace precariousness and exclusion from health benefits and insurance. Immigrant workers receiving a wage lower than the corresponding minimum potentially do not secure a living income, resulting in unmet needs and low investments in health. Workplace abuse might correspond with vulnerability related to humiliating treatment. These conditions can negatively impact workers' physical health and foster depression. Policies should promote written employment contracts and ensure a mechanism for workers to register violations of fair practices.

Intergenerationally penalized? The long-term wage consequences of parental joblessness.

Studies of intergenerational stratification and mobility have long called for investigation of the joint role of mothers and fathers in affecting labor market outcomes of children. However, long-term effects of parental joblessness-where no co-residing parent is employed at a given time-are not well understood. Using longitudinal data (covering 9942 person-year observations from 2281 children) from the Household, Income, and Labour Dynamics in Australia (HILDA) Survey, this study investigates the long-term association between parental joblessness and children's wages during early adulthood. It examines whether these associations are mediated by family income during childhood and adolescence, educational attainment, and subsequent employment inactivity of the child, and whether exposure at earlier ages is associated with more detrimental effects. Multilevel mixed-effects models regressing hourly wages in early adulthood (observed over 2008-2018) on the proportion of time spent living in a household where no parent is employed (observed over 2001-2007) reveal two major findings. First, exposure to parental joblessness during childhood and adolescence is correlated with adverse wage outcomes during early adulthood in addition to previously documented employment penalties, with similar estimates across age groups. Second, mediation analyses indicate that household income, children's educational attainment, and children's own inactivity reduce the magnitude of this wage penalty, but do not completely offset it.

First Digits' Shannon Entropy.

Related to the letters of an alphabet, entropy means the average number of binary digits required for the transmission of one character. Checking tables of statistical data, one finds that, in the first position of the numbers, the digits 1 to 9 occur with different frequencies. Correspondingly, from these probabilities, a value for the Shannon entropy H can be determined as well. Although in many cases, the Newcomb-Benford Law applies, distributions have been found where the 1 in the first position occurs up to more than 40 times as frequently as the 9. In this case, the probability of the occurrence of a particular first digit can be derived from a power function with a negative exponent p > 1. While the entropy of the first digits following an NB distribution amounts to H = 2.88, for other data distributions (diameters of craters on Venus or the weight of fragments of crushed minerals), entropy values of 2.76 and 2.04 bits per digit have been found.

The Differential Impact of COVID-19 on Labour Market Outcomes of Immigrants in Canada.

Based on Canadian Labour Force Survey data, we estimate the differential effect of the COVID-19 pandemic on seven labour market outcomes, and separate between recent and established immigrants relative to domestic-born Canadians. We also use Recentered Influence Function (RIF) unconditional quantile regressions to estimate the differential effects across the distribution of outcomes. We find that the pandemic had an adverse effect on the labour market outcomes for all workers, and that the adverse effects were generally larger for immigrants and especially recent immigrants as well as for immigrants at the bottom of the outcome distributions. The adverse effects were generally larger at the earliest waves of the pandemic, and for recent immigrants who were female, less educated, and those with child responsibilities, and for jobs at greater risk of contact with the pandemic.

Sur la base des données de l'Enquête sur la population active du Canada, nous estimons l'effet différentiel de la pandémie de COVID-19 sur sept résultats sur le marché du travail, séparément pour les immigrants récents et établis par rapport aux Canadiens nés au pays. Nous utilisons également des régressions quantiles inconditionnelles de la fonction d'influence recentrée (RIF) pour estimer les effets différentiels sur la distribution des résultats. Nous constatons que la pandémie a eu un effet négatif sur les résultats du marché du travail pour tous les travailleurs, les effets négatifs étaient généralement plus importants pour les immigrants et en particulier les immigrants récents ainsi que pour les immigrants au bas de la distribution des résultats. Les effets néfastes étaient généralement plus importants pour les premières vagues de la pandémie et pour les immigrants récents qui étaient des femmes, moins instruits, ceux qui avaient des responsabilités envers les enfants et pour les emplois les plus à risque d'être en contact avec la pandémie.

Job Mobility and Wealth Inequality.

The extent to which employees change jobs, known as the job mobility rate, has been steadily declining in the US for decades. This decline is understood to have a negative impact on both productivity and wages, and econometric studies fail to support any single cause brought forward. This decline coincides with decreases in household savings, increases in household debt and wage stagnation. We propose that the decline could be the consequence of a complex interaction between mobility, savings, wages and debt, such that if changing jobs incurs costs which are paid out of savings, or incurs debt in the absence of sufficient savings, a negative feedback loop is generated. People are further restricted in making moves by their debt obligations and inability to save, which in turn depresses wages further. To explore this hypothesis, we developed a stylized model in which agents chose their employment situation based on their opportunities and preferences for work and where there are costs to changing jobs and the possibility of borrowing to meet those costs. We indeed found evidence of a negative feedback loop involving changes, wages, savings and debt, as well as evidence that this dynamic results in a level of wealth inequality on the same scale as we see today in the US.

The redistributive effects of pandemics: Evidence on the Spanish flu.

Which are the effects of pandemics on the returns to factors of production? Are these effects persistent over time? These questions have received renewed interest after the out-burst of deaths caused by Covid-19. The Spanish Flu is the closest pandemic to Covid-19. In this paper, we analyze the impact of the Spanish Flu on the returns to labor and capital in Spain. Spain is an ideal country to perform this exercise. First, the "excess death rate" was one of the largest in Western Europe and it varied substantially across regions. Second, Spain was transitioning towards industrialization, with regions in different stages of development. Third, Spain was developed enough to have reliable data. We identify the effect of the Spanish Flu by exploiting within-country variation in "excess death rate". Our main result is that the effect of the Spanish Flu on daily real wages was large, negative, and broadly short-lived. The effects are heterogeneous across occupations and regions. The negative effects are exacerbated in (i) occupations producing non-essential goods like shoemakers and (ii) more urbanized provinces. Quantitatively, relative to pre-1918, the decline for the average region ranges from null to around 30 percent. In addition, we fail to find significant negative effects of the flu on returns to capital. Whereas the results for dividends are imprecisely estimated (we cannot reject a null effect), the effect on real estate prices (houses and land), driven by the post-1918 recovery, is positive. Experts on inequality have argued that pandemics have equalizing effects especially in a Malthusian setting, due to real wage increases. Our findings suggest that, at least, for a developing economy like Spain in the early 20th century, this result does not apply. Indeed, we document that the flu pandemic was conducive to a (short-run) reduction in real wages. In addition, we interpret our heterogeneous results as suggestive evidence that pandemics represent a demand shock.

The K-Shaped Recovery: Examining the Diverging Fortunes of Workers in the Recovery from the COVID-19 Pandemic Using Business and Household Survey Microdata.

This paper examines employment patterns by wage group over the course of the coronavirus pandemic in the United States using microdata from two well-known data sources from the U.S. Bureau of Labor Statistics: the Current Employment Statistics and the Current Population Survey. We find establishments paying the lowest average wages and the lowest wage workers had the steepest decline in employment and experienced the most persistent losses. We disentangle the extent to which the effect observed for low wage workers is due to these workers being concentrated within a few low wage sectors of the economy versus the pandemic affecting low wage workers in a number of sectors across the economy. Our results indicate that the experience of low wage workers is not entirely due to these workers being concentrated in low wage sectors - for many sectors, the lowest wage quintiles in that sector also has had the worst employment outcomes. From April 2020 to May 2021, between 23% and 46% of the decline in employment among the lowest wage establishments was due to within-industry changes. Another important finding is that even for those who remain employed during the pandemic, the probability of becoming part-time for economic reasons increased, especially for low-wage workers. Supplementary Information: The online version contains supplementary material available at 10.1007/s10888-021-09506-6.

The effects of Medicaid expansion on labor market outcomes: Evidence from border counties.

This paper provides new empirical evidence on the employment and earning effects of the recent Medicaid expansion. Unlike most existing studies that use a conventional state and year fixed effects approach, our main identification strategy is based on the comparison of employment and wages in contiguous county-pairs in neighboring states (i.e., border counties) with different Medicaid expansion status. Using the 2008-2016 Quarterly Census of Employment and Wages, we estimate a set of distributed lag models in order to examine the dynamic effects of Medicaid expansion. Results from our preferred specification suggest a statistically significant decrease in total employment of 1.2% 1 year after the expansion of Medicaid. This translates into a 37% decrease in employment among newly eligible Medicaid enrollees under the strong assumption that Medicaid coverage did not crowd out private insurance coverage. We also find that this disemployment effect is transitory: 2 years after the Medicaid expansion employment returns to preexpansion levels. We do not find any statistically significant effect of the Medicaid expansion on wages at any point.