Recreational Marijuana Legalization and Workplace Injuries Among Younger Workers.

This case-control study uses state-by-year workplace injury data to assess recreational marijuana legalization adoption and workplace injuries among younger workers aged 20 to 34 years.

Welfare Reform and the Quality of Young Children's Home Environments.

This study investigates the effects of welfare reform-a major policy shift in the United States that increased low-income mothers' employment and reliance on earnings instead of cash assistance-on the quality of the home environments mothers provide for their preschool-age children. Using empirical methods designed to identify plausibly causal effects, we estimate the effects of welfare reform on validated survey and observational measures of maternal behaviors that support children's cognitive skills and emotional adjustment and the material goods that parents purchase to stimulate their children's skill development. The results suggest that welfare reform did not affect the amount of time and material resources mothers devoted to cognitively stimulating activities with their young children. However, it significantly decreased emotional support provision scores, by approximately 0.3-0.4 standard deviations. The effects appear to be stronger for mothers with lower human capital. The findings provide evidence that welfare reform came at a cost to children in the form of lower quality parenting. They also underscore the importance of considering quality, and not just quantity, in assessing the effects of maternal work-incentive policies on parenting and children's home environments.

Have recreational marijuana laws undermined public health progress on adult tobacco use?

Public health experts caution that legalization of recreational marijuana may normalize smoking and undermine the decades-long achievements of tobacco control policy. However, very little is known about the impact of recreational marijuana laws (RMLs) on adult tobacco use. Using newly available data from the Population Assessment of Tobacco and Health (PATH) and dynamic difference-in-differences and discrete-time hazard approaches, we find that RML adoption increases prior-month marijuana use among adults ages 18-and-older by 2-percentage-points, driven by an increase in marijuana initiation among prior non-users. However, this increase in adult marijuana use does not extend to tobacco use. Rather, we find that RML adoption is associated with a lagged reduction in electronic nicotine delivery systems (ENDS) use, consistent with the hypothesis that ENDS and marijuana are substitutes. Moreover, auxiliary analyses from the National Survey on Drug Use and Health (NSDUH) show that RML adoption is associated with a reduction in adult cigarette smoking. We conclude that RMLs may generate tobacco-related health benefits.

Mental Distress Among Female Individuals of Reproductive Age and Reported Barriers to Legal Abortion Following the US Supreme Court Decision to Overturn Roe v Wade.

This case-control study investigates the association of the US Supreme Court decision to overturn Roe v Wade with mental distress among female individuals of reproductive age.

Effects of Welfare Reform on Positive Health and Social Behaviors of Adolescents.

This paper explores a missing link in the literature on welfare reform in the U.S.-the effects on positive health and social behaviors of adolescents, who represent the next generation of potential welfare recipients. Previous research on welfare reform and adolescents has focused almost exclusively on negative behaviors and found that welfare reform led to decreases in high school dropout and teenage fertility among girls, but increases in delinquent behaviors and substance use, particularly among boys. Using nationally representative data on American high school students in 1991-2006 and a quasi-experimental research design, we estimated the effects of welfare reform implementation on eating breakfast, regular fruit/vegetable consumption, regular exercise, adequate sleep, time spent on homework, completion of assignments, participation in community activities or volunteering, participation in school athletics, participation in other school activities, and religious service attendance. We found no robust evidence that welfare reform affected any of these adolescent behaviors. In concert with the past research on welfare reform in the U.S. and adolescents, the findings do not support the implicit assumption underlying welfare reform that strong maternal work incentives would increase responsible behavior in the next generation and suggest that welfare reform had overall adverse effects on boys, who have been falling behind girls in terms of high school completion for decades.

Intended and unintended effects of e-cigarette taxes on youth tobacco use.

Over the past decade, rising youth use of e-cigarettes and other electronic nicotine delivery systems (ENDS) has contributed to aggressive regulation by state and local governments. Between 2010 and mid-2019, ten states and two large counties adopted ENDS taxes. We use two large national surveys (Monitoring the Future and the Youth Risk Behavior Surveillance System) to estimate the impact of ENDS taxes on youth tobacco use. We find that ENDS taxes reduce youth ENDS consumption, with estimated ENDS tax elasticities of -0.06 to -0.21. However, we estimate sizable positive cigarette cross-tax effects, suggesting economic substitution between cigarettes and ENDS for youth. These substitution effects are particularly large for frequent cigarette smoking. We conclude that the unintended effects of ENDS taxation may considerably undercut or even outweigh any public health gains.

Novel transthyretin gene mutation in familial amyloid neuropathy in India: Case.

Familial amyloid polyneuropathy (PN), also known as amyloid transthyretin (TTR)-PN is an autosomal dominant adult-onset fatal disease, if not treated. It occurs due to mutations in (TTR) gene which leads to a faulty TTR protein which folds up to form amyloid and gets deposited mainly on nerves and causes length-dependent PN and autonomic dysfunction. We report a case of a 45-year-old female who presented with symptoms of painful peripheral neuropathy for 5 months, a history of deafness for 5 years, and cardiac pacemaker implantation 2 years ago for complete heart block. She denied any symptoms of autonomic dysfunction. Her brother with similar symptoms died of cardiac arrest at the age of 50 years. Clinical examination was suggestive of symmetrical sensorimotor PN. The nerve conduction study was suggestive of axonal sensorimotor PN. Abdominal fat biopsy was negative for amyloid. Sural nerve biopsy was suggestive of amyloid neuropathy. Genetic analysis showed c. 165G > T mutation encoding amino acid p. Lys55Asn on exon-4 of TTR gene. This mutation has not been reported from India.

Résumé La polyneuropathie amyloïde familiale (NP), également connue sous le nom de transthyrétine amyloïde (TTR) -PN, est une maladie mortelle autosomique dominante de l'adulte, si elle n'est pas traitée. Il se produit en raison de mutations du gène (TTR) qui conduisent à une protéine TTR défectueuse qui se replie pour former de l'amyloïde et se dépose principalement sur les nerfs et provoque une PN dépendante de la longueur et un dysfonctionnement autonome. Nous rapportons le cas d'une femme de 45 ans qui présentait des symptômes de neuropathie périphérique douloureuse depuis 5 mois, des antécédents de surdité depuis 5 ans et l'implantation d'un stimulateur cardiaque il y a 2 ans pour un bloc cardiaque complet. Elle a nié tout symptôme de dysfonctionnement autonome. Son frère présentant des symptômes similaires est décédé d'un arrêt cardiaque à l'âge de 50 ans. L'examen clinique évoquait une NP sensorimotrice symétrique. L'étude de la conduction nerveuse était évocatrice d'une NP sensorimotrice axonale. La biopsie de la graisse abdominale était négative pour l'amyloïde. La biopsie du nerf sural était évocatrice d'une neuropathie amyloïde. L'analyse génétique a montré c. Mutation 165G > T codant pour l'acide aminé p. Lys55Asn sur l'exon-4 du gène TTR. Cette mutation n'a pas été signalée en Inde. Mots clés: Neuropathie amyloïde familiale, tests génétiques, biopsie nerveuse, amylose à transthyrétine.

Acute Onset Flaccid Paraplegia with Monocular Diminution of Vision in a Case of Chikungunya Infection.

Chikungunya is a common tropical viral infection in India. The majority of patients have limited systemic manifestations. Neurological manifestations of chikungunya may be due to direct viral infection or immune mediated. We present a case of a 45-year-old male who presented with acute onset paraplegia with diminution of vision in the right eye. A detailed evaluation revealed a diagnosis of chikungunya myeloradiculitis with viral keratitis. The patient was treated with steroids followed by intravenous immunoglobulin and had a good recovery.

Political violence, risk aversion, and population health: Evidence from the US Capitol riot.

This study is the first to explore the impact of the January 6, 2021 Capitol riot on risk avoidance behavior and the spread of COVID-19. First, using anonymized smartphone data from SafeGraph, Inc., and an event-study approach, we document a substantial increase on January 6 in non-resident smartphone pings at the sites of the protest: the Ellipse, the National Mall, and the US Capitol Building. Then, using data from the same source and a synthetic control approach, we find that the Capitol riot led to an increase in stay-at-home behavior among District of Columbia residents, consistent with risk avoidance behavior and post-riot policies designed to limit large in-person gatherings. Finally, while we find no evidence that the Capitol riot substantially increased the spread of COVID-19 in the District of Columbia, we do find that counties with the highest inflows of out-of-town protesters experienced a 0.004 to 0.010 increase in the rate of daily cumulative COVID-19 case growth during the month following the event. These findings are exacerbated in counties without COVID-19 mitigation policies in place. Supplementary Information: The online version contains supplementary material available at 10.1007/s00148-022-00914-0.

The limits of reopening policy to alter economic behavior: New evidence from Texas.

In the midst of mass COVID-19 vaccination distribution efforts in the U.S. Texas became the first state to abolish its mask mandate and fully lift capacity constraints for all businesses, effective on March 10, 2021. Proponents claimed that the reopening would generate short-run employment growth and signal a return to normal while opponents argued that it would cause a resurgence of COVID-19 and kill Texans. This study finds that each side was largely incorrect. First, using daily anonymized smartphone data - and synthetic control and difference-in-differences approaches - we find no evidence that the Texas reopening led to substantial changes in mobility, including foot traffic at a wide set of business establishments. Second, we find no evidence that the Texas reopening affected the rate of new COVID-19 cases or deaths during the five weeks following the reopening. Our null results persist across more urbanized and less urbanized counties, as well as across counties that supported Donald Trump and Joe Biden in the 2020 presidential election. Finally, we find no evidence that the Texas reopening impacted short-run employment, including in industries most affected by the reopening. Together, these findings underscore the persistence of late-pandemic era private behavior and stickiness in individuals' risk-related beliefs, and suggest that reopening policies may have impacts that are more muted than policymakers expect. Supplementary information: The online version contains supplementary material available at 10.1007/s11166-022-09379-8.

Lead in drinking water and birth outcomes: A tale of two water treatment plants.

The recent lead-in-water crisis in Newark has renewed concerns about the crisis being a widespread problem in the nation. Using data on the exact home addresses of pregnant women residing in the city combined with information on the spatial boundary separating areas within the city serviced by two water treatment plants, we exploit an exogenous change in water chemistry that resulted in lead leaching into the tap water of one plant's service area, but not the other's, to identify a causal effect of prenatal lead exposure on fetal health. We find robust evidence of adverse health impacts, which has important policy implications in light of the substantial number of lead water pipes that remain in use as part of our aging infrastructure and the cost-benefit calculus of lead abatement interventions.

Effects of welfare reform on household food insecurity across generations.

This study estimates the effects of welfare reform in the 1990s, which permanently restructured and contracted the cash assistance system in the U.S., on food insecurity-a fundamental form of material hardship-of the next generation of households. An implicit goal underlying welfare reform was the disruption of an assumed intergenerational transmission of disadvantage; however, little is known about the effects of welfare reform on the well-being of the next generation of adults. Using intergenerational data from the Panel Study of Income Dynamics and a variation on a difference-in-differences framework, this study exploits 3 sources of variation in childhood exposure to welfare reform: (1) risk of exposure across birth cohorts; (2) variation of exposure within cohorts because different states implemented welfare reform in different years; and (3) variation between individuals with the same exposure who were more likely and less likely to rely on welfare. We found that exposure to welfare reform led to decreases in food insecurity of the next generation of households, by about 10% for a 5-year increase in exposure, with stronger effects for individuals exposed for longer durations during childhood, individuals exposed in early childhood (0-5 years), and women. We also found smaller favorable effects for individuals whose mothers had less than a high school education, indicating that in terms of food insecurity, welfare reform led to relative disadvantages among the most disadvantaged and thus could be exacerbating socioeconomic and health inequalities.

JUE Insight: Were urban cowboys enough to control COVID-19? Local shelter-in-place orders and coronavirus case growth.

One of the most common policy prescriptions to reduce the spread of COVID-19 has been to legally enforce social distancing through shelter-in-place orders (SIPOs). This study examines the role of localized urban SIPO policy in curbing COVID-19 cases. Specifically, we explore (i) the comparative effectiveness of county-level SIPOs in urbanized as compared to non-urbanized areas, (ii) the mechanisms through which SIPO adoption in urban counties yields COVID-related health benefits, and (iii) whether late adoption of a statewide SIPO yields health benefits beyond those achieved from early adopting counties. We exploit the unique laboratory of Texas, a state in which the early adoption of local SIPOs by densely populated counties covered almost two-thirds of the state's population prior to adoption of a statewide SIPO on April 2, 2020. Using an event study framework, we document that countywide SIPO adoption is associated with an 8 percent increase in the percent of residents who remain at home full-time and between a 13 to 19 percent decrease in foot-traffic at venues that may contribute to the spread of COVID-19 such as restaurants, bars, hotels, and entertainment venues. These social distancing effects are largest in urbanized and densely populated counties. Then, we find that in early adopting urban counties, COVID-19 case growth fell by 21 to 26 percentage points two-and-a-half weeks following adoption of a SIPO, a result robust to controls for county-level heterogeneity in COVID-19 outbreak timing, coronavirus testing, the age distribution, and political preferences. We find that approximately 90 percent of the curbed growth in COVID-19 cases in Texas came from the early adoption of SIPOs by urbanized counties, suggesting that the later statewide shelter-in-place mandate yielded relatively few health benefits.

Risk avoidance, offsetting community effects, and COVID-19: Evidence from an indoor political rally.

The Centers for Disease Control and Prevention (CDC) deem large indoor gatherings without social distancing the "highest risk" activity for COVID-19 contagion. On June 20, 2020, President Donald J. Trump held his first mass campaign rally following the US coronavirus outbreak at the indoor Bank of Oklahoma arena. In the weeks following the event, numerous high-profile national news outlets reported that the Trump rally was "more than likely" the cause of a coronavirus surge in Tulsa County based on time series data. This study is the first to rigorously explore the impacts of this event on social distancing and COVID-19 spread. First, using data from SafeGraph Inc, we show that while non-resident visits to census block groups hosting the Trump event grew by approximately 25 percent, there was no decline in net stay-at-home behavior in Tulsa County, reflecting important offsetting behavioral effects. Then, using data on COVID-19 cases from the CDC and a synthetic control design, we find little evidence that COVID-19 grew more rapidly in Tulsa County, its border counties, or in the state of Oklahoma than each's estimated counterfactual during the five-week post-treatment period we observe. Difference-in-differences estimates further provide no evidence that COVID-19 rates grew faster in counties that drew relatively larger shares of residents to the event. We conclude that offsetting risk-related behavioral responses to the rally-including voluntary closures of restaurants and bars in downtown Tulsa, increases in stay-at-home behavior, displacement of usual activities of weekend inflows, and smaller-than-expected crowd attendance-may be important mechanisms. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11166-021-09359-4.

INTERGENERATIONAL EFFECTS OF WELFARE REFORM: ADOLESCENT DELINQUENT AND RISKY BEHAVIORS.

This study investigates effects of welfare reform in the United States on the next generation. Most previous studies of effects of welfare reform on adolescents focused on high-school dropout of girls or fertility; little is known about how welfare reform has affected other teenage behaviors or boys. We use a difference-in-difference-in-differences framework to identify gender-specific effects of welfare reform on skipping school, fighting, damaging property, stealing, hurting others, smoking, alcohol, marijuana, and other illicit drugs. Welfare reform led to increases in delinquent behaviors of boys as well as increases in substance use of boys and girls, with substantially larger effects for boys.

Association Between Statewide COVID-19 Lottery Announcements and Vaccinations.

This case-control study assesses if announcements of cash drawings in 19 states were associated with increased vaccine uptake by comparing vaccination trends in states that announced drawings with states that did not using a difference-in-differences framework.

The contagion externality of a superspreading event: The Sturgis Motorcycle Rally and COVID-19.

Large in-person gatherings of travelers who do not socially distance are classified as the "highest risk" for COVID-19 spread by the Centers for Disease Control and Prevention (CDC). From August 7-16, 2020, nearly 500,000 motorcycle enthusiasts converged on Sturgis, South Dakota for its annual rally in an environment without mask-wearing requirements or other mitigating policies. This study is the first to explore this event's public health impacts. First, using anonymized cell phone data, we document that foot traffic at restaurants/bars, retail establishments, and entertainment venues rose substantially at event locations. Stay-at-home behavior among local residents fell. Second, using a synthetic control approach, we find that the COVID-19 case rate increased substantially in Meade County and in the state of South Dakota in the month following the Rally. Finally, using a difference-in-differences model to assess nationwide spread, we find that following the Sturgis event, counties outside of South Dakota that contributed the highest inflows of rally attendees experienced a 6.4-12.5% increase in COVID-19 cases relative to counties without inflows. Our findings highlight that local policy decisions assessing the tradeoff between local economic benefits and COVID-19 health costs will not be socially optimal in the presence of large contagion externalities.

WHEN DO SHELTER-IN-PLACE ORDERS FIGHT COVID-19 BEST? POLICY HETEROGENEITY ACROSS STATES AND ADOPTION TIME.

This study explores the impact of Shelter-in-Place Orders (SIPOs) on health, with attention to heterogeneity in their impacts. First, using daily state-level social distancing data, we document that adoption of a SIPO was associated with a 9%-10% increase in the rate at which state residents remained in their homes full-time. Using daily state-level coronavirus case data, we find that approximately 3 weeks following the adoption of a SIPO, cumulative COVID-19 cases fell by approximately 53.5%. However, this average effect masks important heterogeneity across states-early adopters and high population density states appear to reap larger benefits from their SIPOs. (JEL H75, I12, I18).

Association of e-cigarette advertising with e-cigarette and cigarette use among US adults.

AIMS: To estimate the association of e-cigarette advertisement exposure with e-cigarette and cigarette use behavior among US adults. DESIGN: Data from the 2013-14 National Adult Tobacco Survey (NATS) were linked to Kantar Media and National Consumer Study data to construct measures of e-cigarette advertisements on TV and in magazines. The relationship between advertisement measures and outcomes was estimated using logistic and Poisson regressions, controlling for socio-demographics, state cigarette taxes and state and year fixed-effects. SETTING: United States. PARTICIPANTS/CASES: A total of 98 746 adults aged ≥ 18 years who responded to the 2013-14 NATS. MEASUREMENTS: The independent variables of interest were the number of e-cigarette advertisements in magazines to which an adult was exposed in the past 6 months and the number of e-cigarette advertisements on TV to which an adult was exposed in the past 6 months. Outcomes were awareness of e-cigarettes, ever e-cigarette use, current e-cigarette use, current cigarette use and number of cigarettes smoked per month. FINDINGS: Exposure to one additional e-cigarette advertisement on TV was associated with a 0.18, 0.13 and 0.03 percentage point increase, respectively, in awareness, ever use and current use of e-cigarettes among all adults (P < 0.05). This exposure also was associated with a 0.11 percentage point increase in current cigarette use among all adults and an increase in cigarette consumption of 2.24 cigarettes per month among adults aged ≥ 45 (P < 0.05). CONCLUSIONS: Exposure to e-cigarette advertising appears to be positively associated with the use of e-cigarettes and cigarettes among adults of all ages, and with increased cigarette consumption among older adults.

Atypical Multiple Sclerosis with Antibody to MOG.

CASE PRESENTATION: We report a case of a young female who had magnetic resonance imaging (MRI) brain lesions typical of multiple sclerosis (MS) with cerebrospinal fluid (CSF) oligoclonal bands (OCBs) and definite multiple sclerosis based on revised McDonald criteria; however, she also had atypical features of mild pleocytosis, brainstem and cerebellar peduncle involvement apart from opticospinal (OS) involvement. She also turned out to be positive for anti-myelin oligodendrocyte glycoprotein (MOG) antibody; hence, she was diagnosed with atypical multiple sclerosis. This case highlights when to suspect atypical MS and its management approach. DISCUSSION: Typical MS cases are largely anti-MOG-negative. In a study of 50 Japanese cases, with anti-aquaporin 4 (AQP4)-immunoglobulin (IgG)-negative OSMS, just 2 were MOG-IgG-positive, but they had some features atypical for MS, such as bilateral optic neuritis, longitudinally extensive transverse myelitis, or moderate pleocytosis. In another study, antibodies to MOG were found in about 5% (5/104) of preselected adult patients with MS. Patients with MS with antibodies to MOG showed typical MS lesions on brain MRI with concomitant severe brainstem and spinal cord involvement and had a severe disease course with high relapse rates. CONCLUSION: In conclusion, any patient showing typical MS lesions on brain MRI with OCB present in CSF but has atypical features like mild pleocytosis with brainstem, cerebellar, or OS involvement should also be tested for autoantibodies to MOG, and if positive, then he/she would require aggressive treatment approach in the form of plasma exchange, if resistant to pulse steroid therapy, followed by either rituximab or natalizumab rather than trying other disease modifying therapies (DMTs).