Above: We show that Americans become significantly less likely to die at a given than their international peers upon Medicare eligibility at age 65. Focusing on the years 2000 through 2019, we plot the percentage difference in mortality rates between the US and those peers, where the peers are determined via synthetic control.
\nLink to working paper
\nMedicare was created to bring older Americans the “healing miracle of modern medicine.” Nonetheless, even six decades after its creation, the degree to which Medicare improves health and survival remains uncertain. Researchers have extensively studied the short-term impacts around the eligibility threshold of age 65, but the long-term effects that accrue slowly are not known. We address this open question by leveraging the fact that near-universal health-insurance coverage begins at age 65 in the United States---and only in the United States. Specifically, we estimate the impact of Medicare on mortality over long horizons using a synthetic-control approach, which generates a counterfactual from a blend of other countries that closely matches age-specific mortality rates in the United States up to age 65. Our results, illustrated by a sudden and persistent departure of the United States from that counterfactual at age 65, indicate that Medicare has extended life expectancy at age 65 throughout its history by about eight months on average. Critically, a similar impact is still seen today. The constituent causes of death point decisively toward medical care as the central mechanism. Gains arise almost solely from reductions in deaths considered amenable to timely and effective treatment. Our results imply that Medicare recoups a substantial portion of its trillion-dollar annual bill through previously unknown extensions in longevity. We conclude that lowering the age of Medicare eligibility would generate benefits exceeding the net costs to Americans.
","pages":[{"url":"/about/","relativePath":"about.md","relativeDir":"","base":"about.md","name":"about","frontmatter":{"title":"About","subtitle":null,"seo":{"type":"stackbit_page_meta","title":"About","description":"Sam Arenberg, About","extra":[{"name":"og:type","value":"website","keyName":"property"},{"name":"og:title","value":"About Me","keyName":"property"},{"name":"og:description","value":"This is the about me page","keyName":"property"},{"name":"og:image","value":"images/about.jpg","keyName":"property","relativeUrl":true},{"name":"twitter:card","value":"summary_large_image"},{"name":"twitter:title","value":"About Me"},{"name":"twitter:description","value":"This is the about me page"},{"name":"twitter:image","value":"images/about.jpg","relativeUrl":true}]},"template":"page"},"html":"Dr. Arenberg is an economist from Birmingham, Alabama. In 2022, he completed a PhD in Economics from The University of Texas at Austin. For the 2022-23 academic year, he was a postdoctoral fellow in Aging and Health at the National Bureau of Economic Research. He is now an Assistant Professor at the University of Houston, one of the university’s inaugural Presidential Frontier Faculty members. He holds a joint appointment between the Department of Economics and the Hobby School of Public Affairs.
\nHis current research is focused on life expectancy in the United States and why it lags behind peer countries. His latest work, with Nicholas Reynolds and Sam Stripling, raises the possibility that US ails may be rooted in adverse childhood events long ago that are now manifesting in adulthood. Much of his other work, with Seth Neller, is focused on such connections between childhood circumstances and adulthood wellbeing. Dr. Arenberg also studies the extent to which governments can impact population health through their delivery of healthcare.
\nDr. Arenberg’s CV can be viewed here. His office hours are by appointment for the fall semester, and he can be contacted directly at sarenberg@uh.edu. For media inquiries or for part-time undergraduate work opportunities, however, contact his research manager, Andrew Wallace, at abwallac@uh.edu.
"},{"url":"/research/a-taxonomy-of-recent-changes-in-american-mortality/","relativePath":"research/a-taxonomy-of-recent-changes-in-american-mortality.md","relativeDir":"research","base":"a-taxonomy-of-recent-changes-in-american-mortality.md","name":"a-taxonomy-of-recent-changes-in-american-mortality","frontmatter":{"title":"A Taxonomy of Recent Changes in American Mortality","type":"In-Progress","date":"2025-11-13T22:41:41.159Z","thumb_img_path":"/images/taxonomy_graph_s-min.png","content_img_path":"/images/taxonomy_graph_l-min.png","excerpt":"This paper argues that three patterns—as opposed to one, two, or many—are causing the United States to be such an outlier in terms of life expectancy among rich countries in the 21st Century. Each pattern has distinctive properties, and one—which appears to be most influential—has only recently been recognized.","seo":{"title":"","description":"","robots":["all"],"extra":[{"name":"","value":"","keyName":"name"}],"type":"stackbit_page_meta"},"template":"post"},"html":"Above: I show age-specific mortality rates over a long time horizon in order to illustrate three distinct patterns driving poor longevity in the United States in the 21st Century: (1) a well documented rise in deaths of despair; (2) a newly recognized cohort phenomenon; and (3) a slowdown that is most pronounced at elderly ages.
\nWorking paper coming soon
\nLife expectancy in the United States has stopped increasing, and it stopped increasing several years before the pandemic set in. Much has been written about the underlying problems, such as the opioid epidemic, but a full accounting of the departure from past trends and from other rich countries is incomplete. By simply plotting single-age mortality rates over a long period of time, I conclude that there are three distinct patterns unfolding in the 21st Century. In my view, the literature has not fully recognized all of them, leading researchers to conflate or mischaracterize the patterns that have been observed. The first pattern I identify, which is well understood, is the opioid epidemic and the “deaths of despair” that have tracked with it. The second, which has only recently been noticed but that I show weighs heavily on life expectancy, is an adverse cohort phenomenon with more mysterious roots. The third is a slowdown in progress that is most apparent at elderly ages. These results suggest that further research specifically into the cohort phenomenon could reap large returns, but acknowledging that there are three separate matters to address—each with distinct properties (but overlap in their affected populations)—could catalyze the ongoing search for causes more broadly.
"},{"url":"/research/ashes-to-ashes/","relativePath":"research/ashes-to-ashes.md","relativeDir":"research","base":"ashes-to-ashes.md","name":"ashes-to-ashes","frontmatter":{"title":"Ashes to Ashes: The Lifelong Consequences of Early-life Exposure to Wildfires","type":"Working","subtitle":"with Seth Neller","date":"2021-09-03T05:00:00.000Z","thumb_img_path":"/images/wildfires_graph_s.png","thumb_img_alt":"Wildfires","content_img_path":"/images/wildfires_graph_l.png","content_img_alt":"Wildfires","excerpt":"This paper assesses the impact of in utero and early childhood wildfire exposure on lifelong outcomes, including longevity, disability, human capital accumulation, and economic achievement in adulthood.","coauthors":"with Seth Neller","seo":{"type":"stackbit_page_meta","title":"Ashes to Ashes","description":"This paper assesses the impact of in utero and early childhood wildfire exposure on lifelong outcomes, including longevity, disability, human capital accumulation, and economic achievement in adulthood.","extra":[{"name":"og:type","value":"article","keyName":"property"},{"name":"og:title","value":"Ashes to Ashes","keyName":"property"},{"name":"og:description","value":"This paper assesses the impact of in utero and early childhood wildfire exposure on lifelong outcomes","keyName":"property"},{"name":"og:image","value":"images/wildfire.jpg","keyName":"property","relativeUrl":true},{"name":"twitter:card","value":"summary_large_image"},{"name":"twitter:title","value":"Ashes to Ashes"},{"name":"twitter:description","value":"This paper assesses the impact of in utero and early childhood wildfire exposure on lifelong outcomes"},{"name":"twitter:image","value":"images/wildfire.jpg","relativeUrl":true}]},"template":"post"},"html":"Above: We plot the estimated impact of an additional month of wildfire-smoke exposure in early life on the likelihood of dying by age 55 (deaths per 1,000).
\nLink to working paper
\nThis paper assesses the impact of in utero and early childhood wildfire exposure on lifelong outcomes, including longevity, disability, human capital accumulation, and economic achievement in mid-to-late adulthood. To do so, we link pollution exposure from mid-20th century California wildfires to four decades of birth cohorts (born 1930-1969). These cohorts are in turn linked to administrative birth and death records from the Social Security Administration and restricted Decennial Census and American Community Survey data to evaluate their long-term outcomes. To the best of our knowledge, this is the first paper to causally assess both the long-run effects of wildfire exposure as well as the effects of air pollution over the entire lifespan when the exposure occurs in utero or during the first years of life.
\nDisclaimer: Any views expressed are those of the authors and not those of the U.S. Census Bureau. The Census Bureau's Disclosure Review Board and Disclosure Avoidance Officers have reviewed this information product for unauthorized disclosure of confidential information and have approved the disclosure avoidance practices applied to this release. This research was performed at a Federal Statistical Research Data Center under FSRDC Project Number 2603. (CBDRB-FY21-P2272-R9133)
"},{"url":"/research/can-job-opportunities-account-for-the-mortality-gaps-by-educational-attainment-in-the-united-states/","relativePath":"research/can-job-opportunities-account-for-the-mortality-gaps-by-educational-attainment-in-the-united-states.md","relativeDir":"research","base":"can-job-opportunities-account-for-the-mortality-gaps-by-educational-attainment-in-the-united-states.md","name":"can-job-opportunities-account-for-the-mortality-gaps-by-educational-attainment-in-the-united-states","frontmatter":{"title":"Can Job Opportunities Account for the Mortality Gaps by Educational Attainment in the United States?","type":"Working","date":"2025-03-29T00:59:02.393Z","thumb_img_path":"/images/rsf_graph_s.png","content_img_path":"/images/rsf_graph_l.png","excerpt":"This paper was invited to an issue of The Russell Sage Foundation Journal of the Social Sciences edited by Anne Case, Andrew Cherlin, and Angus Deaton entitled \"Moving Beyond Deaths of Despair: Rethinking Rising Morbidity and Mortality among Americans without a College Degree.\" Our article considers the role of labor markets.","coauthors":"with Sam Stripling","journal":"","seo":{"title":"","description":"","robots":["all"],"extra":[{"name":"","value":"","keyName":"name"}],"type":"stackbit_page_meta"},"template":"post"},"html":"Above: We show midlife mortality rates for men without a four-year college degree working in (i) white-collar industries and (ii) blue-collar industries, namely manufacturing, construction, transportation, and utilities.
\nWorking paper currently embargoed
\nUsing a novel single-source mortality file that covers a broad swath of the US population, this paper sheds light on the large and increasing mortality advantage that Americans with a four-year college degree hold over their less educated peers. We focus on a popular explanation for the division between them: their jobs. From data immune to many of the measurement issues that complicate the interpretation of mortality studies, we first show mortality rates over time by granular levels of education, including the first estimates of mortality by college major. We then plot mortality rates for specific blue-collar industries to see if this storied notion of a working class is driving the poor health of low and moderately educated Americans. Finally, we estimate mortality gaps that are conditional on industry, occupation, income, and other labor market outcomes to test whether their jobs can explain the growing chasm.
\nDisclaimer: Any views expressed are those of the authors and not those of the U.S. Census Bureau. The Census Bureau has reviewed this data product to ensure appropriate access, use, and disclosure avoidance protection of the confidential source data used to produce this product. This research was performed at a Federal Statistical Research Data Center under FSRDC Project Number 2603. (CBDRB-FY25-P2603-R11872/12193)
"},{"url":"/research/candidate-origins-of-the-recent-stagnation-in-midlife-mortality-in-the-united-states/","relativePath":"research/candidate-origins-of-the-recent-stagnation-in-midlife-mortality-in-the-united-states.md","relativeDir":"research","base":"candidate-origins-of-the-recent-stagnation-in-midlife-mortality-in-the-united-states.md","name":"candidate-origins-of-the-recent-stagnation-in-midlife-mortality-in-the-united-states","frontmatter":{"title":"Candidate Origins of the Recent Stagnation in Midlife Mortality in the United States","type":"Working","subtitle":"with Nicholas Reynolds and Sam Stripling","date":"2025-04-29T03:44:52.868Z","thumb_img_path":"/images/origins_graph_s.png","content_img_path":"/images/origins_graph_l.png","excerpt":"The recent and ongoing stagnation in midlife mortality in the United States is among the country's most urgent health crises, yet its primary causes are unknown. This paper posits that the explanation could lie in another concerning trend that unfolded nearly 80 years ago.","coauthors":"with Nicholas Reynolds and Sam Stripling","seo":{"title":"","description":"","robots":["all"],"extra":[{"name":"","value":"","keyName":"name"}],"type":"stackbit_page_meta"},"template":"post"},"html":"Above: We present adulthood and childhood mortality rates side-by-side for cohorts born in the middle of the 20th Century. The dashed vertical lines reveal that the cohorts driving the stagnation in midlife mortality today drove a similar stagnation in early-life mortality decades earlier, inviting the possibility that current ails reflect “scars” from childhood.
\nLink to working paper
\nThis paper offers a new explanation for the alarming trend in midlife mortality observed in the United States since 2000, when death rates among working-age Americans stalled after decades of unprecedented progress. The explanation hinges on a striking parallel with a pattern that emerged just before 1950, in which death rates among children also stalled, ending a period of similarly historic gains. We will show that sustained reductions in both midlife and early-life mortality rates ceased abruptly with the same birth cohort. The implication, backed by empirical and theoretical literature connecting adulthood health to childhood circumstances, is that the recent stagnation may not be a new phenomenon, but the second manifestation of an older one. Supporting this hypothesis, we will find similar trends in midlife mortality in, and only in, peer countries where there was also a stagnation in early-life mortality decades prior, namely in other Anglo countries. We will also demonstrate that the slowdown in childhood has the capacity to be, not just a cause, but the primary cause of the slowdown in adulthood.
"},{"url":"/research/chronicling-the-loss-of-public-health-insurance-evidence-from-the-tenncare-disenrollees/","relativePath":"research/chronicling-the-loss-of-public-health-insurance-evidence-from-the-tenncare-disenrollees.md","relativeDir":"research","base":"chronicling-the-loss-of-public-health-insurance-evidence-from-the-tenncare-disenrollees.md","name":"chronicling-the-loss-of-public-health-insurance-evidence-from-the-tenncare-disenrollees","frontmatter":{"title":"Chronicling the Loss of Public Health Insurance: Evidence from the TennCare Disenrollees","type":"Working","date":"2025-03-29T00:27:00.000Z","thumb_img_path":"/images/tenncare_graph_s.png","content_img_path":"/images/tenncare_graph_l.png","excerpt":"Although the “TennCare disenrollment”—the largest disenrollment from public health insurance in US history at the time—has been studied many times, never has the exact set of disenrollees been identified and traced over a long period of time, as we do in this paper by linking administrative enrollment records from CMS to large household surveys from the Census Bureau.","coauthors":"with Sam Stripling","journal":"","seo":{"title":"","description":"","robots":["all"],"extra":[{"name":"","value":"","keyName":"name"}],"type":"stackbit_page_meta"},"template":"post"},"html":"Above: We first illustrate the sudden cut to Medicaid eligibility among working-age adults in Tennessee in the middle of 2005. We then plot the fraction of (i) the “TennCare disenrollees” who remained uninsured many years after losing eligibility and (ii) adults enrolled in Medicaid in 2005 in states where similar waivers for eligibility remained intact.
\nWorking paper temporarily unavailable
\n\nAmid the largest rollback of Medicaid in generations, we study what was, at that time, the largest cut in US history, when the State of Tennessee suddenly and swiftly cut from its Medicaid rolls nearly four percent of the state’s working-age population. Although the “TennCare disenrollment” has been studied in the past, never has the set of disenrollees been identified and tracked over a long period of time, as we do in this paper by linking administrative enrollment records to large household surveys and to complete death records. We first show that nearly half of the approximately 170,000 TennCare disenrollees were still uninsured several years after the disenrollment. This is true despite 40,000 disenrollees getting back onto Medicaid rolls immediately through alternative bases of eligibility and despite 2,000 disenrollees aging onto Medicare each year. Although many disenrollees obtained insurance through an employer, we do not find increases in labor force participation or employment among the disenrolled. We do find, however, evidence that employees increased hours worked, ostensibly to qualify for health insurance with their employer. We also consider the health outcomes of the disenrollees, namely rates of disability and mortality. We find no evidence of an increase in either, whether soon or long after disenrollment, which puts our estimates more in the line with the experimental than the quasi-experimental literature on Medicaid and health. We caution that mortality effects are particularly difficult to detect, generally requiring large sample sizes, and we close by emphasizing that our “template” can be applied to study other changes in access to Medicaid, such as the cuts now underway for millions of low-income Americans.
\nDisclaimer: Any views expressed are those of the authors and not those of the U.S. Census Bureau. The Census Bureau has reviewed this data product to ensure appropriate access, use, and disclosure avoidance protection of the confidential source data used to produce this product. This research was performed at a Federal Statistical Research Data Center under FSRDC Project Number 2603. (CBDRB-FY21-P2603-R09240, CBDRB-FY25-P2603-R11872/12193)
"},{"url":"/research/from-classroom-to-labor-market-the-divergent-paths-of-black-and-white-americans/","relativePath":"research/from-classroom-to-labor-market-the-divergent-paths-of-black-and-white-americans.md","relativeDir":"research","base":"from-classroom-to-labor-market-the-divergent-paths-of-black-and-white-americans.md","name":"from-classroom-to-labor-market-the-divergent-paths-of-black-and-white-americans","frontmatter":{"title":"The Distinct Trajectories of Black and White Students with Identical Achievement","type":"Working","subtitle":"with Seth Neller and Anjali Verma","date":"2021-09-03T04:45:12.250Z","thumb_img_path":"/images/bwmobile_graph_s.png","content_img_path":"/images/bwmobile_graph_l.png","excerpt":"This paper examines the longstanding Black-white achievement gap in new detail afforded by longitudinal, administrative data from the State of Texas. The focus is on comparing Black and white students with the same scores on the same tests in terms of their participation in gifted programs, their degree attainment, and even their subsequent earnings.","coauthors":"with Seth Neller and Anjali Verma","seo":{"title":"","description":"","robots":["all"],"extra":[{"name":"","value":"","keyName":"name"}],"type":"stackbit_page_meta"},"template":"post"},"html":"Above: We first show just how different the test scores of Black and white students are: In the top one percent of all test takers in Texas public schools, for example, white students outnumber Black students fifty-to-one; in the lowest achieving percentile, Black students outnumber white students instead three-to-one. We then show that, for any given level of achievement, Black students are (i) much less likely than their white counterparts to be enrolled consistently in gifted programs; (ii) much more likely to attempt a college degree of any kind, particularly at the lower end of the test-score distribution, although less likely (not pictured) to complete those degrees; and (iii) earning significantly less, even at the very top of the test-score distribution, where the gap is close to $20,000 annually.
\nLink to working paper
\nWe bring new data to the longstanding achievement gap between Black and white children in the United States. Constructing a panel of nearly half a million children tracked from kindergarten through age 30, we first highlight the stark differences in test scores between Black and white students, particularly at the extremes. In the lowest achieving one percent of all test takers, for example, Black students outnumber white students three-to-one. In the top one percent, white students outnumber Black students fifty-to-one. We then compare the outcomes of students with the same test scores, which provides useful context for other racial disparities in the United States. We show, for example, that Black students with high levels of achievement are substantially less likely than white students with the same scores to be in gifted programs. At the same time, Black students with low test scores are substantially less likely to be in special education programs. We show that Black students with low test scores, and only Black students with low test scores, are more likely than their white counterparts to drop out of high school. Across the distribution of achievement, Black students, relative to white students with the same achievement, are nonetheless more likely to enroll in college. However, they are still significantly less likely to complete a college degree of any kind. We also show that Black students, at any given level of achievement, which is often regarded as a level of skill, earn substantially lower wages than their white counterparts, nearly $10,000 less annually, a gap that bears almost exclusively on Black men. None of these disparities conditional on test scores, can be fully explained, or even mostly explained, by schools: Substantial differences exist between Black and white students who obtained the same scores while attending the same schools.
\nDisclaimer: The conclusions of this research do not necessarily reflect the opinion or official position of the Texas Education Research Center, the Texas Education Agency, the Texas Higher Education Coordinating Board, the Texas Workforce Commission, or the State of Texas.
"},{"url":"/research/geographic-variation-in-life-expectancy-in-the-united-states/","relativePath":"research/geographic-variation-in-life-expectancy-in-the-united-states.md","relativeDir":"research","base":"geographic-variation-in-life-expectancy-in-the-united-states.md","name":"geographic-variation-in-life-expectancy-in-the-united-states","frontmatter":{"title":"The First Estimates of Life Expectancy by County of Birth in the United States: Implications for Geographic Inequality","type":"In-Progress","subtitle":"","date":"2021-09-10T05:00:00.000Z","thumb_img_path":"/images/pobmort_graph_s.png","thumb_img_alt":"","content_img_path":"/images/pobmort_graph_l.png","content_img_alt":"","excerpt":"Life expectancy in the United States varies widely by geography. These well documented and oft discussed disparities, however, are based on where people die. This paper provides the first county-level estimates of life expectancy based on where the deceased were born, a location with outsized impact on health that no one chooses for themselves.","seo":{"type":"stackbit_page_meta","title":"The First Estimates of Life Expectancy by County of Birth in the United States","description":"Life expectancy in the United States varies widely by geography","extra":[{"name":"og:type","value":"article","keyName":"property"},{"name":"og:title","value":"Geographic Variation in Life Expectancy in the United States","keyName":"property"},{"name":"og:description","value":"Life expectancy in the United States varies widely by geography","keyName":"property"},{"name":"og:image","value":"images/research2.jpg","keyName":"property","relativeUrl":true},{"name":"twitter:card","value":"summary_large_image"},{"name":"twitter:title","value":"Geographic Variation in Life Expectancy in the United States"},{"name":"twitter:description","value":"Life expectancy in the United States varies widely by geography"},{"name":"twitter:image","value":"images/research2.jpg","relativeUrl":true}]},"template":"post"},"html":"Above: I compare two versions of life expectancy at age 65, one that defines counties by people who reside there (as is standard) and one that defines counties instead by people who were born there (a novel measure). By birth, counties are much more similar to one another.
\nWorking paper coming soon
\nLife expectancy in the United States varies widely by geography: The gap between the top and bottom-ranking counties is over twenty years (Dwyer-Lindgren et al., 2017). These disparities are often viewed as maps of deprivation, but they are based on where people die, a location that reflects deprivation as well as sorting. This paper provides the first county-level estimates of life expectancy based instead on where people were born. The results show that counties are much more similar when defined by who is born there rather than who dies there. As I show, this is driven partially by the locations chosen by immigrants, who are generally much healthier than the native-born population, but more so by the \"health-selective\" migration of the native-born population, which is highly mobile over the life course. As I show, nearly three quarters of Americans over the age of 65 live in a county distinct from the one in which they were born. Examining the observable characteristics of the parents of this demographic (by linking death certificates and new Census data to old Census data), I also show that those who migrate internally come from families of higher socioeconomic status. Life expectancy in origin and destination counties are only weakly positively correlated, but, again, such movements are so common that they significantly alter the landscape of longevity in the United States.
\nDisclaimer: Any views expressed are those of the authors and not those of the U.S. Census Bureau. The Census Bureau's Disclosure Review Board and Disclosure Avoidance Officers have reviewed this information product for unauthorized disclosure of confidential information and have approved the disclosure avoidance practices applied to this release. This research was performed at a Federal Statistical Research Data Center under FSRDC Project Number 2603. (CBDRB-FY21-P2603-R9186)
"},{"url":"/","relativePath":"index.md","relativeDir":"","base":"index.md","name":"index","frontmatter":{"title":"Home","hide_title":true,"sections":[{"type":"section_hero","title":"","section_id":"hero","content":"Dr. Arenberg is an Assistant Professor at the University of Houston with a joint appointment between the Department of Economics and the Hobby School of Public Affairs. He conducts research in the fields of population health and economic demography."},{"type":"section_posts","title":"Latest Research","section_id":"recent-posts","posts_number":4,"actions":[{"type":"action","label":"View All Research","url":"/research","style":"button"}]}],"seo":{"type":"stackbit_page_meta","title":"Sam Arenberg, Economist","description":"Samuel Arenberg, Home","extra":[{"name":"og:type","value":"website","keyName":"property"},{"name":"og:title","value":"Sam Arenberg, Economist","keyName":"property"},{"name":"og:description","value":"Dr. Arenberg is an Assistant Professor at the University of Houston with a joint appointment between the Department of Economics and the Hobby School of Public Affairs. He conducts research in the fields of health economics and economic demography with a focus on the determinants of mortality.","keyName":"property"},{"name":"og:image","value":"images/arenberg_profile_chalkboard.jpg","keyName":"property","relativeUrl":true},{"name":"twitter:card","value":"summary_large_image"},{"name":"twitter:title","value":"Sam Arenberg, Economist"},{"name":"twitter:description","value":"Dr. Arenberg is an Assistant Professor at the University of Houston with a joint appointment between the Department of Economics and the Hobby School of Public Affairs. He conducts research in the fields of population health and economic demography."},{"name":"twitter:image","value":"images/arenberg_profile_chalkboard.jpg","relativeUrl":true}]},"template":"advanced"},"html":""},{"url":"/research/heritable-fertility-is-not-sufficient-for-positive-long-term-population-growth-research-note-published/","relativePath":"research/heritable-fertility-is-not-sufficient-for-positive-long-term-population-growth-research-note-published.md","relativeDir":"research","base":"heritable-fertility-is-not-sufficient-for-positive-long-term-population-growth-research-note-published.md","name":"heritable-fertility-is-not-sufficient-for-positive-long-term-population-growth-research-note-published","frontmatter":{"title":"Intergenerational Transmission Is Not Sufficient for Positive Long-Term Population Growth","type":"Publication","subtitle":"with the Population Wellbeing Initiative","date":"2022-12-02T03:19:51.512Z","thumb_img_path":"/images/fertherit_graph_s.png","thumb_img_alt":"Pervasive fertility decline in India","content_img_path":"/images/fertherit_graph_l.png","content_img_alt":"Pervasive fertility decline in India","excerpt":"We show that heritable fertility, despite claims to the contrary from a recent literature inspired by mathematical biology, is not sufficient for positive long-term population growth, for empirical and theoretical reasons.","coauthors":"with the Population Wellbeing Initiative","journal":"Demography (2022)","seo":{"type":"stackbit_page_meta","title":"Intergenerational Transmission Is Not Sufficient for Positive Long-Term Population Growth","description":"Intergenerational Transmission Is Not Sufficient for Positive Long-Term Population Growth","extra":[{"name":"og:type","value":"article","keyName":"property"},{"name":"og:title","value":"","keyName":"property"},{"name":"og:description","value":"","keyName":"property"},{"name":"og:image","value":"","keyName":"property","relativeUrl":true},{"name":"twitter:card","value":""},{"name":"twitter:title","value":""},{"name":"twitter:description","value":""},{"name":"twitter:image","value":"","relativeUrl":true}]},"template":"post"},"html":"Above: We divide mothers in India into 16 large sub-populations according to sector, religion, education, and geography (North versus South India). Even the groups with the highest levels of fertility have declining levels of fertility.
\nDemography, Vol. 59, No. 6, December 2022
\nLink to working paper
\nAll leading long-term global population projections agree on continuing fertility decline, resulting in a rate of population size growth that will continue to decline toward zero and would eventually turn negative. However, scholarly and popular arguments have suggested that because fertility transmits intergenerationally (i.e., higher fertility parents tend to have higher fertility children) and is heterogeneous within a population, long-term population growth must eventually be positive, as high-fertility groups come to dominate the population. In this research note, we show that intergenerational transmission of fertility is not sufficient for positive long-term population growth, for empirical and theoretical reasons. First, because transmission is imperfect, the combination of transmission rates and fertility rates may be quantitatively insufficient for long-term population growth: higher fertility parents may nevertheless produce too few children who retain higher fertility preferences. Second, today even higher fertility subpopulations show declining fertility rates, which may eventually fall below replacement (and in some populations already are). Therefore, although different models of fertility transmission across generations reach different conclusions, depopulation is likely under any model if, in the future, even higher fertility subpopulations prefer and achieve below-replacement fertility. These results highlight the plausibility of long-term global depopulation and the importance of understanding the possible consequences of depopulation.
"},{"url":"/research/","relativePath":"research/index.md","relativeDir":"research","base":"index.md","name":"index","frontmatter":{"title":"Research","hide_title":false,"subtitle":" ","seo":{"type":"stackbit_page_meta","title":"Research","description":"This is the Research page","extra":[{"name":"og:type","value":"website","keyName":"property"},{"name":"og:title","value":"Research","keyName":"property"},{"name":"og:description","value":"This is the Research page","keyName":"property"},{"name":"og:image","value":"images/1.jpg","keyName":"property","relativeUrl":true},{"name":"twitter:card","value":"summary_large_image"},{"name":"twitter:title","value":"Research"},{"name":"twitter:description","value":"This is the Research page"},{"name":"twitter:image","value":"images/1.jpg","relativeUrl":true}]},"template":"blog"},"html":"Research
"},{"url":"/research/the-impact-of-medicare-on-mortality/","relativePath":"research/the-impact-of-medicare-on-mortality.md","relativeDir":"research","base":"the-impact-of-medicare-on-mortality.md","name":"the-impact-of-medicare-on-mortality","frontmatter":{"title":"The Impact of Medicare on Mortality","type":"Working","subtitle":"with Seth Neller","date":"2026-07-01T20:19:14.629Z","thumb_img_path":"/images/medicare_graph_s.png","content_img_path":"/images/medicare_graph_l.png","excerpt":"This paper shows that Medicare has, throughout its existence, increased the life expectancy of older Americans. The longevity gains are valuable enough to offset a substantial portion of the program's costs.","coauthors":"with Seth Neller","seo":{"title":"","description":"","robots":["all"],"extra":[{"name":"","value":"","keyName":"name"}],"type":"stackbit_page_meta"},"template":"post"},"html":"Above: We show that Americans become significantly less likely to die at a given than their international peers upon Medicare eligibility at age 65. Focusing on the years 2000 through 2019, we plot the percentage difference in mortality rates between the US and those peers, where the peers are determined via synthetic control.
\nLink to working paper
\nMedicare was created to bring older Americans the “healing miracle of modern medicine.” Nonetheless, even six decades after its creation, the degree to which Medicare improves health and survival remains uncertain. Researchers have extensively studied the short-term impacts around the eligibility threshold of age 65, but the long-term effects that accrue slowly are not known. We address this open question by leveraging the fact that near-universal health-insurance coverage begins at age 65 in the United States---and only in the United States. Specifically, we estimate the impact of Medicare on mortality over long horizons using a synthetic-control approach, which generates a counterfactual from a blend of other countries that closely matches age-specific mortality rates in the United States up to age 65. Our results, illustrated by a sudden and persistent departure of the United States from that counterfactual at age 65, indicate that Medicare has extended life expectancy at age 65 throughout its history by about eight months on average. Critically, a similar impact is still seen today. The constituent causes of death point decisively toward medical care as the central mechanism. Gains arise almost solely from reductions in deaths considered amenable to timely and effective treatment. Our results imply that Medicare recoups a substantial portion of its trillion-dollar annual bill through previously unknown extensions in longevity. We conclude that lowering the age of Medicare eligibility would generate benefits exceeding the net costs to Americans.
"},{"url":"/research/the-impact-of-youth-medicaid-eligibility-on-adult-incarceration/","relativePath":"research/the-impact-of-youth-medicaid-eligibility-on-adult-incarceration.md","relativeDir":"research","base":"the-impact-of-youth-medicaid-eligibility-on-adult-incarceration.md","name":"the-impact-of-youth-medicaid-eligibility-on-adult-incarceration","frontmatter":{"title":"The Impact of Youth Medicaid Eligibility on Adult Incarceration","type":"Publication","subtitle":"with Seth Neller and Sam Stripling","date":"2024-01-01T06:00:00.000Z","thumb_img_path":"/images/medinc_graph_s.png","thumb_img_alt":"Medicaid and incarceration","content_img_path":"/images/medinc_graph_l.png","content_img_alt":"Medicaid and incarceration","excerpt":"This paper shows that an expansion of public health insurance to children from low-income families reduced the probability of those children going to prison as adults.","coauthors":"with Seth Neller and Sam Stripling","journal":"American Economic Journal: Applied Economics (2024)","seo":{"type":"stackbit_page_meta","title":"The Impact of Youth Medicaid Eligibility on Adult Incarceration","description":"The Impact of Youth Medicaid Eligibility on Adult Incarceration","extra":[{"name":"og:type","value":"article","keyName":"property"},{"name":"og:title","value":"","keyName":"property"},{"name":"og:description","value":"","keyName":"property"},{"name":"og:image","value":"","keyName":"property","relativeUrl":true},{"name":"twitter:card","value":""},{"name":"twitter:title","value":""},{"name":"twitter:description","value":""},{"name":"twitter:image","value":"","relativeUrl":true}]},"template":"post"},"html":"Above: We show that adult incarceration falls sharply beginning with the cohort born on October 1, 1983, which coincides with the first cohort eligible for a large expansion of youth Medicaid eligibility.
\nAmerican Economic Journal: Applied Economics, Vol. 16, No.1, January 2024
\nCited by the 2024 Economic Report of the President
\nCited by the 2025 Economic Report of the President
\nAwarded IPUMS Best Graduate Student Research Using Health Surveys
\nLink to working paper
\nThis paper identifies an important spillover associated with public health insurance: reduced incarceration. In 1990, Congress passed legislation that increased Medicaid eligibility for individuals born after September 30, 1983. We show that Black children born just after the cutoff are 5 percent less likely to be incarcerated by age 28, driven primarily by a decrease in incarcerations connected to financially motivated offenses. Children of other races, who experienced almost no gain in Medicaid coverage as a result of the policy, demonstrate no such decline. We find that reduced incarceration in adulthood substantially offsets the initial costs of expanding eligibility.
"},{"url":"/research/the-signature-of-a-mid-century-cohort-malaise/","relativePath":"research/the-signature-of-a-mid-century-cohort-malaise.md","relativeDir":"research","base":"the-signature-of-a-mid-century-cohort-malaise.md","name":"the-signature-of-a-mid-century-cohort-malaise","frontmatter":{"title":"The Signature of a Mid-century Cohort Malaise","type":"Working","date":"2025-11-12T22:58:59.487Z","thumb_img_path":"/images/pervasive_graph_s.png","content_img_path":"/images/pervasive_graph_l.png","excerpt":"This paper lays out several key facts about the cessation of progress in adult mortality rates for successive birth cohorts in the United States. We document (i) the sharp timing of the “cohort malaise,” (ii) its uniqueness among wealthy countries, and (iii) its ubiquity within the US, which together form a distinctive “signature.”","coauthors":"with Nicholas Reynolds and Sam Stripling","seo":{"title":"","description":"","robots":["all"],"extra":[{"name":"","value":"","keyName":"name"}],"type":"stackbit_page_meta"},"template":"post"},"html":"Above: We first plot mortality rates for Americans nearing retirement ages by their month of birth, highlighting the sharpness of their departure from the trend set by previous cohorts. We show additionally how pervasive that departure is: We see it (i) among Black Americans just as we see it among White Americans; (ii) for both men and women; and (iii) in dense urban areas as well as rural parts of the country.
\nLink to working paper
\nThe high and rising rates of adult mortality in the United States relative to peer nations is now widely recognized as one of the most serious public health concerns facing the country. Researchers from multiple disciplines have posited many theories in efforts to explain the problem, yet a consensus explanation remains elusive. We depict the unprecedented stagnation in adult mortality as a “cohort malaise.” We first show that progress in adult mortality stops abruptly with Americans born in the summer of 1947, with no such trend break in other countries. We then look for differential severity by race, sex, and geography within the United States. What we find instead is remarkable pervasiveness, with the cohort break in mortality appearing across all of these demographics. Our conclusion is that successful theories of the malaise, now responsible for over a million excess deaths relative to trend, will demonstrate a distinctive “signature”: sudden cohort-by-cohort changes in the United States around the summer of 1947 that span race, sex, and geography.
\nDisclaimer: Any views expressed are those of the authors and not those of the U.S. Census Bureau. The Census Bureau has reviewed this data product to ensure appropriate access, use, and disclosure avoidance protection of the confidential source data used to produce this product. This research was performed at a Federal Statistical Research Data Center under FSRDC Project Number 2603. (CBDRB-FY25-P2603-R12039/12193/12447)
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