A breath of fresh air: The effect of public smoking bans on Indigenous youth.

In general, past studies have estimated the average effect of public smoking bans on youth, ignoring differences across sub-populations. We extend the literature by considering Indigenous youth, who are a vulnerable and previously unexamined group (however, our analysis excludes First Nations youth who live on reserve). We also consider previously unexamined outcomes among youth: self-assessed health and subjective well-being. Our difference-in-differences estimates from Canada indicate that public bans reduced youth smoking and second-hand exposure in public places, on average. There was no displacement on the extensive margin, but the bans increased the number of people who smoke in the homes of youth, conditional on the presence of smokers in the household. Beyond average effects, however, we find that public bans reduced second-hand exposure in the homes of Indigenous youth (particularly Métis youth), on the extensive and intensive margins. The same youth experienced concurrent improvements in self-assessed health and life satisfaction. We conclude that public bans mitigate disparities in health and well-being between Indigenous and non-Indigenous youth, but the extent varies across Indigenous sub-populations, even within a particular country.

Rural-Urban Differences in the Decline of Adolescent Cigarette Smoking.

OBJECTIVES: To examine change over time in cigarette smoking among rural and urban adolescents and to test whether rates of change differ by rural versus urban residence. METHODS: We used the 2008 through 2010 and 2014 through 2016 US National Survey of Drug Use and Health to estimate prevalence and adjusted odds of current cigarette smoking among rural and urban adolescents aged 12 to 17 years in each period. To test for rural-urban differences in the change between periods, we included an interaction between residence and time. RESULTS: Between 2008 to 2010 and 2014 to 2016, cigarette smoking rates declined for rural and urban adolescents; however, rural reductions lagged behind urban reductions. Controlling for socioeconomic characteristics, rural versus urban odds of cigarette smoking did not differ in 2008 through 2010; however, in 2014 through 2016, rural youths had 50% higher odds of smoking than did their urban peers. CONCLUSIONS: Differential reductions in rural youth cigarette smoking have widened the rural-urban gap in current smoking rates for adolescents. Public Health Implications. To continue gains in adolescent cigarette abstinence and reduce rural-urban disparities, prevention efforts should target rural adolescents.

The effects of recent minimum wage increases on self-reported health in the United States.

Minimum wage policy continues to receive considerable popular and legislative attention in the United States. Despite a fast-growing empirical literature on the relationship between the minimum wage and health, previous studies generally use data from the 1990s to 2014. In this study, we estimate the impact of recent changes in state-level minimum wages on the self-reported health of adults in the post-Great Recession era. Using data from the Behavioral Risk Factor Surveillance System and a difference-in-differences design, we exploit more than 150 state-level increases in the minimum wage between 2011 and 2019. Our results indicate that a higher minimum wage increases men's physical and mental health burdens but has an ambiguous effect on a more general measure of health. Among women, the minimum wage improves general health and reduces their physical and mental health burdens. Compared to past studies, our work indicates that the relationship between the minimum wage and health has changed over time. It also illustrates the need for policymakers to consider the broader consequences of minimum wage policy, including health effects and gender differences therein.

Racial/Ethnic Differences in Light of 100% Smoke-free State Laws: Evidence from Adults in the United States.

This study estimates racial/ethnic differences in the association between 100% smoke-free state laws and smoking, as well as self-reported health, to facilitate policy aimed at reducing disparities. Data pertain to adults aged 18 years and older, obtained from the public-use Behavioral Risk Factor Surveillance System (2002-2014). The authors exploit variation in the timing of 100% smoke-free state laws using a difference-in-differences model. Examining heterogeneity across racial/ethnic minority groups, the authors consider the association between smoke-free laws and the probability of being: a daily smoker (versus occasional); an occasional smoker (versus former); and at the top of the self-reported health scale (versus the bottom). The authors find that 100% smoke-free state laws were not correlated with smoking among women. Moreover, racial/ethnic minority men who smoked occasionally were less likely to quit than white men, and results suggest that smoke-free laws did not reduce these disparities. However, there is evidence that smoke-free laws reduced the probability of being a daily smoker for Asian and Hispanic/Latinx men, but not the probability of quitting or being at the top of the self-reported health scale. More generally, smoke-free laws were not associated with self-reported health, except that there may have been an improvement among nonsmoking American Indian/Alaska Native women. These findings underscore the importance of looking beyond average effects to consider how 100% smoke-free state laws impact racial/ethnic minorities. There is evidence that they reduced smoking and improved self-reported health for some groups, but a suite of tobacco control policies is necessary to reduce racial/ethnic disparities more broadly.

Predicting 30-Day Readmissions: Evidence From a Small Rural Psychiatric Hospital.

To improve quality of care and patient outcomes, and to reduce costs, hospitals in the United States are trying to mitigate readmissions that are potentially avoidable. By identifying high-risk patients, hospitals may be able to proactively adapt treatment and discharge planning to reduce the likelihood of readmission. Our objective in this study was to derive and validate a predictive model of 30-day readmissions for a small rural psychiatric hospital in the northeast. However, this model can be adapted by other rural psychiatric hospitals-a context that has been understudied in the literature. Our sample consisted of 1912 adult inpatients (1281 in the derivation cohort and 631 in the validation cohort), who were admitted between August 1, 2014, and July 31, 2016. We used deidentified data from the hospital's electronic medical record, including physician orders and discharge summaries. These data were merged with community-level variables that reflected the availability of care in the patients' zip codes. We first considered the correlates of 30-day readmission in a regression framework. We found that the probability of readmission increased with the number of previous admissions (vs. no readmissions). Moreover, the probability of readmission was much higher for patients with a depressive disorder (vs. no depressive disorder), with another mood disorder (vs. no other mood disorder), and/or with a psychotic disorder (vs. no psychotic disorder). We used these associations to derive a predictive model, in which we used the regression coefficients to construct a score for each patient. We then estimated the predicted probability of 30-day readmission on the basis of that score. After validating the model, we discuss the implications for clinical practice and the limitations of our approach.

The Effectiveness of the Expanded Food and Nutrition Education Program (EFNEP) on Diet Quality as Measured by the Healthy Eating Index.

The objective of the study was to assess the relationship between participation in the Expanded Food and Nutrition Education Program (EFNEP) and food-related behavior change, as measured by the Healthy Eating Index (HEI)-2005, using a single-state, case study approach. Pre-EFNEP and post-EFNEP participation HEI scores as well as demographic, geographic, socioeconomic, and program participation characteristics from fiscal years 2013-2016 were analyzed using summary statistics and Ordinary Least Squares regressions. HEI scores were adjusted for age, sex, race, rural/urban residence, county, highest grade achieved, income, number of children, public assistance programs, and number of hours in EFNEP in the analysis. The total HEI score and several HEI subscores improved from pre-EFNEP to post-EFNEP at the 5% significance level or better. Sodium and total grains scores decreased post-EFNEP: P = .003 and P = .05, respectively. Participation in Women, Infants, and Children or the Supplemental Nutrition Assistance Program had no effect on HEI scores or changes in scores post-EFNEP. Spending less than 7 hours in the program was associated with a smaller improvement in total HEI score (P = .05) and an increased intake of sodium (P = .03), compared with spending 7 to 16 hours in the program. Overall, EFNEP participation was associated with improvements in diet quality.

The social complexities of disability: Discrimination, belonging and life satisfaction among Canadian youth.

Although disability has been on the psychological agenda for some time, there is limited empirical evidence on the life satisfaction of youth with a disability, especially the effect of discrimination and factors that might mitigate it. We address this critical gap by examining the complex social experiences of youth with a disability and the culminating effect on life satisfaction. We ask three questions: (1) Is having a disability associated with lower life satisfaction? (2) Do youth with a disability experience discrimination and, if so, how does this affect life satisfaction? (3) Can a sense of belonging mitigate the negative effect of discrimination? We address these questions using microdata from the Canadian Community Health Survey, which is nationally representative. Our sample consists of 11,997 adolescents, of whom 2193 have a disability. We find that life satisfaction is lower among youth with a disability. Moreover, many experience disability-related discrimination, which has a negative effect on life satisfaction. However, this is mitigated by a sense of belonging to the community. Specifically, youth with a disability do not report lower life satisfaction when high belonging is present, even if they experience discrimination. This is true for boys and girls. We conclude that belonging, even if it is not disability-related, is protective of well-being. This has important implications for policy whereby organizations that cultivate a sense of belonging may alleviate the harm sustained by youth who experience discrimination as a result of their disability.

Income and the mental health of Canadian mothers: Evidence from the Universal Child Care Benefit.

The Universal Child Care Benefit, introduced in 2006, was an income transfer for Canadian families with young children. I exploit this exogenous increase in income to answer the following questions: (1) Is there a relationship between income and mental health among Canadian mothers? (2) Is it corroborated by other measures of well-being (i.e. stress, life satisfaction)? (3) Is the effect different for lone mothers compared to those in two-parent families? I answer these questions using a difference-in-differences model and microdata from the Canadian Community Health Survey, 2003 to 2008. The estimating sample includes 26,886 mothers, 6273 of whom are lone parents. I find the income transfer improved mental health and life satisfaction regardless of family structure, albeit not necessarily for a given individual. Rather, average scores were higher for mothers with young children after implementation of the Universal Child Care Benefit. For example, they were more likely to report 'excellent' mental health and less likely to be in each of the other categories. The transfer also reduced stress among lone mothers with young children. Specifically, they were less likely to be 'quite a bit' or 'extremely' stressed on a daily basis, and more likely to be 'not at all' or 'not very' stressed. I argue that assumptions of the model are plausible and show that results are consistent across several robustness checks.