Essays on Health, Family, and Work Choices
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This dissertation investigates how changes in policies, technology, and lifestyles affect individual's decisions about their health, well-being, and life choices. The dissertation primarily focuses on two questions within this topic: i) the effects of greater affordability of assisted reproductive technology (ART) on women's marriage and fertility timing decisions and ii) the effects of time spent working on individual's obesity and health status and the mechanisms contributing to these effects. In two chapters, I examine whether greater affordability of ART has impacted women's fertility and marriage choices. ART consists of medical technologies that help women and couples with fertility problems conceive a child using such methods as in-vitro fertilization (IVF). Since the percentage of women facing infertility increases greatly with age, by making it affordable for women to delay family formation and then use ART to start families later if they face infertility, greater affordability of ART could induce women to delay marriage and childbearing. To formally identify channels through which greater affordability of ART might impact women's decisions about timing of family, I develop theoretical models of greater affordability of ART and women's allocation of time on work and family investment over the life course. To test the implications of the models, I utilize empirical strategies exploiting variation in the mandated insurance coverage of ART across U.S. states and over time. In the first chapter, I use linear probability models and the 1977-2010 Current Population Survey to examine the likelihood that women of different ages with and without mandated insurance coverage of ART have ever been married in order to compute marriage rates between age groups, the differences in the likelihoods of having ever been married between one age group and the next. Results show that greater access to ART is associated with marital delay for white (but not for black) women. In the second chapter, to estimate a more precise analysis and examine channels for the effects on marriage, I perform survival and competing risks analyses using the 1986-2009 Panel Study of Income Dynamics to examine the effects of the mandates on the hazards of transitioning to first marriage and first birth for single and childless women, respectively. The findings of this research suggest that the mandates are associated with delayed marriage and childbearing at younger ages and speeded transition to marriage and motherhood after age 30, but only for college graduate women, consistent with the theoretical framework's prediction that women with steeper wage trajectories should be more influenced by the mandates to delay family formation. For the full sample of women, the mandates appear to be associated with speeded transition to marriage after age 25 and motherhood within marriage after age 30, but not with delay at younger ages. This research builds on the literature examining changes in women's marriage and fertility timing and on the literature investigating the effects of ART insurance mandates. This research is valuable for understanding the impacts of technology and policy as well as the factors impacting women's marriage and fertility timing. In the third chapter, I investigate mechanisms for the positive relationship between time spent working and Body Mass Index (BMI). BMI might increase and health status might decline with more hours spent working since as leisure time declines, the opportunity cost of time rises, and it becomes more costly to undertake health-producing activities and receive medical care. Additionally, more time spent working would increase the incidence of detrimental effects of the workplace such as job-related stress, which would have a negative effect on health. This chapter uses the 2006, 2007, and 2008 American Time Use Surveys (ATUS) linked with Eating and Health module data to identify channels through which time spent working could affect BMI. While other datasets provide information on individuals' market work time, the ATUS also provides insight into individuals' non-market work activities. Linked with the Eating and Health module, it permits inference to be drawn about individuals' time use in a variety of activities as well as measures relating to eating and health, including BMI. Making use of this data, in this chapter I first replicate the results of other papers by estimating the effect of working time on BMI and find that increased working time is associated with a positive and significant effect on own BMI for both men and women. Then, to investigate the channels through which working time may impact BMI, I next estimate a series of equations to determine whether a variety of potential mediators significantly change the estimated effect of time spent working on own BMI. A number of the tested channels appear to mediate the effect of hours worked on BMI with strong significant effects found for exercise, active time, and screen time, and marginally significant effects found for secondary eating and food preparation. No significant effects were found for primary eating, secondary drinking, grocery shopping, purchasing prepared food, sleeping, housework, commuting, or own medical care. These results suggest the main channels through which working hours could be related to BMI are related to physical activity. These findings suggest plausible mechanisms for the association between time spent working and obesity. This work contributes to the literature by using time use data to examine the effect of time spent working on BMI as well as by modeling the channels through which time use affects weight and health outcomes. While previous work has explored the effect of working time on BMI, this paper considers the effect of working time on various measures of time use to get a fuller picture of how work time affects lifestyle choices that affect weight and health. This is valuable because recent research has found that there is a growing disparity in working hours between Americans and those in other industrialized countries, and the full consequences of increasing working hours are not explored in the literature and can have significant implications for labor and tax policy. Further, to prescribe effective policy interventions, it is necessary to know the channels through which any effects are arising. This work contributes to the literature by investigating the potential eating, health investment, and physical activity channels driving the positive relationship between working time and BMI to obtain a fuller picture of how work time affects lifestyle choices that affect weight and health. This is valuable because as Americans transition to more sedentary jobs, the full consequences of increased work hours in those jobs are not explored in the literature and can have significant implications for labor and tax policy. Accordingly, the paper provides insights useful for designing effective policy interventions aiming to reduce obesity prevalence. This research has examined questions related to individuals' health and life choices with relevant policy implications. Recent decades have seen significant changes in the roles of and opportunities for women and associated changes in lifestyle and the family, and this dissertation explores the effects of these changes. The findings of this research suggest that women have responded to lower prices of infertility treatment with higher educated women delaying marriage and child bearing, and it could be the case that these invest more time when younger in education and work. In addition, the research suggests that increased time spent working may be associated with an increase in BMI driven by allocating less time to physical activity. These results suggest that changes in technology and lifestyle over recent decades have had real effects on individuals' life choices and health.
- Economics