Copyright (c) 2009 University of Pennsylvania All rights reserved. http://repository.upenn.edu/psc_working_papers Recent documents in PSC Working Paper Series en-us Tue, 28 Jul 2009 15:00:20 PDT 3600 http://repository.upenn.edu/psc_working_papers/13 http://repository.upenn.edu/psc_working_papers/13 Mon, 27 Jul 2009 08:59:41 PDT Life expectancy in the United States fares poorly in international comparisons, primarily because of high mortality rates above age 50. Its low ranking is often blamed on a poor performance by the health care system rather than on behavioral or social factors. This paper presents evidence on the relative performance of the US health care system using death avoidance as the sole criterion. We find that, by standards of OECD countries, the US does well in terms of screening for cancer, survival rates from cancer, survival rates after heart attacks and strokes, and medication of individuals with high levels of blood pressure or cholesterol. We consider in greater depth mortality from prostate cancer and breast cancer, diseases for which effective methods of identification and treatment have been developed and where behavioral factors do not play a dominant role. We show that the US has had significantly faster declines in mortality from these two diseases than comparison countries. We conclude that the low longevity ranking of the United States is not likely to be a result of a poorly functioning health care system. Samuel H. Preston http://repository.upenn.edu/psc_working_papers/12 http://repository.upenn.edu/psc_working_papers/12 Tue, 28 Apr 2009 08:32:44 PDT In 1900 only six percent of unwed females engaged in premarital sex. Now, three quarters do. The sexual revolution is studied here using an equilibrium matching model, where the costs of premarital sex fall over time due to technological improvement in contraceptives. Individuals differ in their desire for sex. Given this, people tend to circulate in social groups where prospective partners share their views on premarital sex. To the extent that a society's customs and more reflect the aggregation of decentralization decision making by its members, shifts in the economic environment may induce changes in what is perceived as culture. Jeremy Greenwood http://repository.upenn.edu/psc_working_papers/11 http://repository.upenn.edu/psc_working_papers/11 Wed, 25 Mar 2009 09:18:32 PDT Life expectancy in the United States fares poorly in international comparisons. Its low ranking is often blamed on a poor performance by the health care system rather than on behavioral factors. This paper compares mortality trends from prostate cancer in the United States to those in other developed countries. Prostate cancer is chosen because it can be detected at an early stage, because effective treatments are available, and because it is less heavily influenced by behavioral factors than most other chronic diseases. We find that, after the introduction of the PSA screening test for prostate cancer, mortality from the disease declined significantly faster in the United States than in the set of comparison countries. Trends in incidence and survival rates support the interpretation that the US health care system has worked very effectively to reduce mortality from this important disease. A brief consideration of breast cancer suggests that similar processes may have been at work among women. Samuel Preston http://repository.upenn.edu/psc_working_papers/10 http://repository.upenn.edu/psc_working_papers/10 Fri, 23 May 2008 07:39:34 PDT Since World War II there has been: (i) a rise in the fraction of time that married households allocate to market work, (ii) an increase in the rate of divorce, and (iii) a decline in the rate of marriage. It is argued here that labor-saving technological progress in the household sector can explain these facts. This makes it more feasible for singles to maintain their own home, and for married women to work. To address this question, a search model of marriage and divorce, which incorporates household production, is developed. An extension looks back at the prewar era. Jeremy Greenwood http://repository.upenn.edu/psc_working_papers/9 http://repository.upenn.edu/psc_working_papers/9 Mon, 25 Jun 2007 14:50:29 PDT The sexual networks connecting members of a population have important consequences for the spread of sexually transmitted diseases including HIV. However, very few datasets currently exist that allow an investigation of the structure of sexual networks, particularly in sub-Saharan Africa where HIV epidemics have become generalized. In this paper, we describe the context and methods of the Likoma Network Study (LNS), a survey of complete sexual networks we conducted in Likoma island (Malawi) between October 2005 and March 2006. We start by reviewing theoretical arguments and empirical studies emphasizing the importance of network structures for the epidemiology of sexually and transmitted diseases. We describe the island setting of this study, and argue that the choice of an island as research site addresses the possible sources of bias in the collection of complete network data. We then describe in detail our empirical strategy for the identification of sexual networks, as well as for the collection of biomarker data (HIV infection). Finally, we provide initial results relating to the socioeconomic context of the island, the size and composition of sexual networks, the prevalence of HIV in the study population, the quality of the sexual network data, the determinants of successful contact tracing during the LNS, and basic measures of network connectivity. Stephane Helleringer http://repository.upenn.edu/psc_working_papers/8 http://repository.upenn.edu/psc_working_papers/8 Thu, 10 May 2007 15:36:18 PDT We document key facts about marriage and divorce, comparing trends through the past 150 years and outcomes across demographic groups and countries. While divorce rates have risen over the past 150 years, they have been falling for the past quarter century. Marriage rates have also been falling, but more strikingly, the importance of marriage at different points in the life cycle has changed, reflecting rising age at first marriage, rising divorce followed by high remarriage rates, and a combination of increased longevity with a declining age gap between husbands and wives. Cohabitation has also become increasingly important, emerging as a widely used step on the path to marriage. Out-of-wedlock fertility has also risen, consistent with declining "shotgun marriages". Compared with other countries, marriage maintains a central role in American life. We present evidence on some of the driving forces causing these changes in the marriage market: the rise of the birth control pill and women's control over their own fertility; sharp changes in wage structure, including a rise in inequality and partial closing of the gender wage gap; dramatic changes in home production technologies; and the emergence of the internet as a new matching technology. We note that recent changes in family forms demand a reassessment of theories of the family and argue that consumption complementarities may be an increasingly important component of marriage. Finally, we discuss the welfare implications of these changes. Betsey Stevenson http://repository.upenn.edu/psc_working_papers/7 http://repository.upenn.edu/psc_working_papers/7 Thu, 10 May 2007 15:07:14 PDT Divorce law changes made in the 1970s affected marital formation, dissolution, and bargaining within marriage. By altering the terms of the marital contract these legal changes impacted the incentives for women to enter and remain in the labor force. Whereas earlier work had suggested that the impact of unilateral divorce on female employment depended critically on laws governing property division, I show that these results are not robust to alternative specifications and controls. I find instead that unilateral divorce led to an increase in both married and unmarried female labor force participation, regardless of the underlying property laws. Betsey Stevenson http://repository.upenn.edu/psc_working_papers/6 http://repository.upenn.edu/psc_working_papers/6 Thu, 10 May 2007 14:36:34 PDT This article has since been published, please cite this published version: Clark, Shelly, Michelle Poulin, and Hans-Peter Kohler. 2009 "Marital Aspirations, Sexual Behaviors, and HIV/AIDS in Rural Malawi." Journal of Marriage and Family 71(2):396 - 416. Available online at: http://www3.interscience.wiley.com/journal/122328396/abstract Using both qualitative and quantitative data from young men and women in rural Malawi, this paper takes an in-depth look at how youths in an AIDS-afflicted sub-Saharan country - Malawi - attempt to achieve the dual goals of avoiding HIV/AIDS and finding a suitable spouse. For youths in Malawi facing AIDS epidemics, we show that the process leading to marriage, with its concurrent rapid changes in sexual partnerships and sexual behaviors, is integrally related to HIV/AIDS risks. In addition, concerns about HIV/AIDS appear to be influencing adolescents' marital aspirations with respect to the timing of marriage as well as the selection of spousal partners. Many youths are clearly failing to find safe pathways into marriage, indicating a strong need for far greater research and policy attention on the dynamic relationship between HIV risks and the marital process. Shelley Clark http://repository.upenn.edu/psc_working_papers/5 http://repository.upenn.edu/psc_working_papers/5 Thu, 05 Apr 2007 06:34:30 PDT This article focuses on decomposition of changes in life expectancy by cause of death. We propose an alternative to Arriaga's (1984) method for performing such decompositions. We apply our method to changes in life expectancy in the United States between 1970 and 2000 and compare results to those produced using Arriaga's formulation. The major difference between the approaches pertains to diseases prominent at older ages such as cardiovascular disease. For applications where causes of death are the central focus, our technique appears to have a modest advantage because of its conceptual clarity and attractive byproducts in the form of cause-deleted life tables. Hiram Beltrán-Sánchez http://repository.upenn.edu/psc_working_papers/4 http://repository.upenn.edu/psc_working_papers/4 Mon, 04 Dec 2006 12:53:07 PST Early childhood nutrition is thought to have important effects on education, broadly defined to include various forms of learning. We advance beyond previous literature on the effect of early childhood nutrition on education in developing countries by using unique longitudinal data begun during a nutritional experiment during early childhood with educational outcomes measured in adulthood. Estimating an intent-to-treat model capturing the effect of exposure to the intervention from birth to 36 months, our results indicate significantly positive, and fairly substantial, effects of the randomized nutrition intervention a quarter century after it ended: increased grade attainment by women (1.2 grades) via increased likelihood of completing primary school and some secondary school; speedier grade progression by women; a one-quarter SD increase in a test of reading comprehension with positive effects found for both women and men; and a one-quarter SD increase on nonverbal cognitive tests scores. There is little evidence of heterogeneous impacts with the exception being that exposure to the intervention had a larger effect on grade attainment and reading comprehension scores for females in wealthier households. The findings are robust to an array of alternative estimators of the standard errors and controls for sample attrition. John A. Maluccio