County Unemployment Rates Research Articles

Bank Concentration and Local Labor Markets

I use a quasi-experimental design supplied by bank anti-trust policy to inspect how bank concentration impacts local labor market outcomes. The regulator applies a cutoff rule when dealing with bank mergers such that markets directly below this regulatory cutoff see an increase in bank concentration, while ones directly above this cutoff do not. Markets that are just below the cutoff see an increase in their deposit-HHI as well as a decrease in their small business lending. A rise in county-level deposit-HHI of 142 points leads to a rise in the county's unemployment rate of 0.284 percentage points, a decline in employment of 0.5 percent, and a decline in average wages of 1 percent. The decline in employment is concentrated in tradable and bank dependent industries, suggesting that the employment effect is due to lower small business lending by banks. These employment effects are also concentrated in black neighborhoods, which also see a larger small business lending and entrepreneurship declines relative to other areas in the markets that receive the positive concentration shock. This paper is the first to show that local labor market conditions respond to changes in local bank concentration, and also that lower small business lending and entrepreneurship in black areas lead to disproportionately larger negative employment effects for these areas.

Did Medicaid slow declines in access to health care during the great recession?

ObjectiveWe examine whether broadened access to Medicaid helped insulate households from declines in health coverage and health care access linked to the 2007‐2009 Great Recession.Data Source2004‐2010 Behavioral Risk Factor Surveillance System (BRFSS).Study DesignFlexible difference‐in‐difference regressions were used to compare the impact of county‐level unemployment on health care access in states with generous Medicaid eligibility guidelines versus states with restrictive guidelines.Data Collection/Extraction MethodsNonelderly adults (aged 19‐64) in the BRFSS were linked to county unemployment rates from the Bureau of Labor Statistics’ Local Area Unemployment Statistics Program. We created a Medicaid generosity index by simulating the share of a nationally representative sample of adults that would be eligible for Medicaid under each state's 2007 Medicaid guidelines using data from the 2007 Current Population Survey's Annual Social and Economic Supplement.Principal FindingsA percentage point (PPT) increase in the county unemployment rate was associated with a 1.3 PPT (95% CI: 0.9‐1.6, P < .01) increase in the likelihood of being uninsured and a 0.86 PPT (95% CI: 0.6‐1.1, P < .01) increase in unmet medical needs due to cost in states with restrictive Medicaid eligibility guidelines. Conversely, a one PPT increase in unemployment was associated with only a 0.64 PPT (P < .01) increase in uninsurance among states with the most generous eligibility guidelines. Among states in the fourth quartile of generosity (ie, most generous), rises in county‐level unemployment were associated with a 0.68 PPT (P < .10) increase in unmet medical needs due to cost—a 21% smaller decrease relative to states with the most restrictive Medicaid eligibility guidelines.ConclusionsIncreased access to Medicaid during the Great Recession mitigated the effects of increased unemployment on the rate of unmet medical need, particularly for adults with limited income.

Association between county jail incarceration and cause-specific county mortality in the USA, 1987–2017: a retrospective, longitudinal study

BackgroundMass incarceration has collateral consequences for community health, which are reflected in county-level health indicators, including county mortality rates. County jail incarceration rates are associated with all-cause mortality rates in the USA. We assessed the causes of death that drive the relationship between county-level jail incarceration and mortality.MethodsIn this retrospective, longitudinal study, we assessed the association between county-level jail incarceration rates and county-level cause-specific mortality using county jail incarceration data (1987–2017) for 1094 counties in the USA obtained from the Vera Institute of Justice and cause-specific mortality data for individuals younger than 75 years in the total county population (1988–2018) obtained from the US National Vital Statistics System. We fitted quasi-Poisson models for nine common causes of death (cerebrovascular disease, chronic lower respiratory disease, diabetes, heart disease, infectious disease, malignant neoplasm, substance use, suicide, and unintentional injury) with county fixed effects, controlling for all unmeasured stable county characteristics and measured time-varying confounders (county median age, county poverty rate, county percentage of Black residents, county crime rate, county unemployment rate, and state incarceration rate). We lagged county jail incarceration rates by 1 year to assess the short-term, by 5 years to assess the medium-term, and by 10 years to assess the long-term associations of jail incarceration with premature mortality.FindingsA 1 per 1000 within-county increase in jail incarceration rate was associated with a 6·5% increase in mortality from infectious diseases (risk ratio 1·065, 95% CI 1·061–1·070), a 4·9% increase in mortality from chronic lower respiratory disease (1·049, 1·045–1·052), a 2·6% increase in mortality induced from substance use (1·026, 1·020–1·032), a 2·5% increase in suicide mortality (1·025, 1·020–1·029), and smaller increases in mortality from heart disease (1·021, 1·019–1·023), unintentional injury (1·015, 1·011–1·018), malignant neoplasm (1·014, 1·013–1·016), diabetes (1·013, 1·009–1·018), and cerebrovascular disease (1·010, 1·007–1·013) after 1 year. Associations between jail incarceration and cause-specific mortality rates weakened as time lags increased, but to a greater extent for causes of death with generally shorter latency periods (infectious disease and suicide) than for those with generally longer latency periods (heart disease, malignant neoplasm, and cerebrovascular disease).InterpretationJail incarceration rates are potential drivers of many causes of death in US counties. Jail incarceration can be harmful not only to the health of individuals who are incarcerated, but also to public health more broadly. Our findings suggest important points of intervention, including disinvestment from carceral systems and investment in social and public health services, such as community-based treatment of substance-use disorders.

The Effects of Shortening Potential Benefit Duration: Evidence from Regional Cut-Offs and a Policy Reform

We quantify labour market effects of changes in the potential benefit duration (PBD) in Poland. Individual workers' PBD depends on the county unemployment rate relative to the national average - 12 months of PBD above a cut-off of 125 per cent and 6 months below. This cut-off shifted from 125 to 150 per cent in a 2009 reform. We utilize i) the natural experiment of the reform, and ii) the sharp discontinuity generated by the cut-offs to estimate effects of shortening the PBD. Our administrative data cover unemployment spells for prime age workers during the years 2006-2018. A one-month shorter PBD decreases average benefit duration by 0.5 months and average unemployment duration by 0.4 months. The PBD reduction by six months increased the job finding rate within the first 9 months by 6 percentage points. Using the stock of unemployed per county, we find evidence for positive aggregate employment effects.ment duration by 0.4 months. The PBD reduction by six months increased the job finding rate within the first 9 months by 6 percentage points. Using the stock of unemployed per county, we find evidence for positive market-level employment effects.

Organizational Factors Associated With Retention of Direct Care Workers: A Comparison of Nursing Homes and Assisted Living Facilities

Low retention of direct care workers (DCWs), either certified nursing assistants in nursing homes (NHs) or personal care assistants in assisted living (AL), continues to be an unresolved problem. While numerous studies have examined predictors of DCW retention in NHs, little attention has been paid to differences between settings of long-term care. This study compares the predictors of DCW retention rates across both settings. The 2017 Ohio Biennial Survey of Long-Term Care Facilities provides facility-level information from NHs and ALs (NHs = 739; ALs = 465). We compare the factors that predict retention rates of DCWs utilizing regression analysis. The factors are structural, financial, resident conditions, staffing, and management characteristics, as well as retention strategies. Average DCW retention rates were 66% and 61% in ALs and NHs, respectively. Not-for-profit status was significantly associated with higher retention rates across settings. While the percent of residents with dementia and less administrator turnover were associated with significantly higher DCW retention in NHs, these were not significant for ALs. However, in the AL context, a higher county unemployment rate and DCWs' participation in resident care planning meetings were positively related to DCW retention after controlling for all other covariates, while DCW cross-training was negatively associated. Retention strategies for DCWs may need to differ by setting, as a result of differing working environments, resources, and regulations.

A Quantile Regression Approach to Examine Changes in County Unemployment Rates in Indiana during the Great Recession

We take a closer look at changes in county unemployment rates in Indiana during the Great Recession and evaluate how local population and the mix of sectoral employment influence these patterns. Using a quantile regression approach, we specifically observe the impacts on counties on both tails of the changes in unemployment distribution. We find the impact of sectoral composition of a county’s workforce depends on its geographical classification. Overall, greater reliance on pro-cyclical industries, most notably manufacturing, magnifies the increases in unemployment during the recession. This effect is further amplified for MSA counties. In contrast, counter-cyclical industries, education in particular, insulates the counties in the top 10th percentile of the distribution of changes in unemployment rates, and a stronger insulation effect is observed for MSA counties. At the bottom 10th percentile, education marginally amplifies changes in unemployment rates for MSA counties, whereas it insulates non-MSA counties from the same distribution.

Broadband speed and unemployment rates: Data and measurement issues

We examine the effects of broadband speed on county unemployment rates in the U.S. state of Tennessee. We merge the older National Broadband Map dataset and the newer FCC dataset in lengthening our broadband access data over the period 2011–2015. Extending the dataset improves the precision of the estimates. Our panel regressions control for potential selection bias and reverse causality and show that broadband speed matters: unemployment rates are about 0.26 percentage points lower in counties with high speeds compared to counties with low speeds. Ultra-high speed broadband also appears to reduce unemployment rates; however, we are unable to distinguish between the effects of high and ultra-high speed broadband. We document beneficial effects of the early adoption of high speed broadband on unemployment rates. Better quality broadband appears to have a disproportionately greater effect in rural areas.

Abstract 3: Association of Medicaid Expansion with Cardiovascular Mortality - A Quasi-experimental Analysis

Background: Medicaid expansion under the Affordable Care Act (ACA) led to one of the largest gains in health insurance coverage for non-elderly adults in the US. However, its impact on health outcomes is unclear. We aimed to study whether trends in cardiovascular mortality for middle-aged adults differed between states that did and did not expand Medicaid. Methods: Using the CDC Wide-ranging Online Data for Epidemiologic Research mortality database, we obtained county-level, age-adjusted, cardiovascular mortality rates for all individuals 45 to 64 years of age from 2010 to 2016 for all states except Massachusetts and Wisconsin (due to non-ACA related Medicaid expansion in these two states). We used a differences-in-differences (DID) approach to measure differences in cardiovascular morality rates between states, based on Medicaid expansion status, before and after expansion. The DID estimator was adjusted for percentage of residents who were female, African-American, Hispanic, percentage of residents living in poverty, county unemployment rate, median household income, number of primary care providers per 100,000 residents, number of cardiologists per 100,000 residents, metropolitan vs. non-metropolitan county classification, and percentage of low-income residents with health insurance in 2010. Results: A total of 1960 counties were included. As of 2016, 29 states and DC had expanded Medicaid eligibility, while 19 states had not. Compared with counties in non-expansion states, counties in expansion states had a greater increase in health insurance coverage for low-income residents [19.8% (SD = 5.5) vs. 13.5% (SD = 3.9); p &lt;0.001]. Pre-expansion there were no significant differences in trends in mortality rates. Counties in expansion states had a significantly smaller increase in cardiovascular mortality rates [141.9 (95% CI 135.6, 148.3) to 142.0 (95% CI 135.5, 148.6) deaths per 100,000 residents per year] compared to counties in non-expansion states [176.1 (95% CI 169.3, 182.8) to 180.6 (95% CI 173.2, 188.0) deaths per 100,000 residents per year]. After accounting for differences in demographic and economic variables, counties in expansion states had 4.0 (95% CI 2.1, 6.0) fewer deaths per 100,000 residents per year from cardiovascular causes after expansion, compared to if they had followed the same trends as counties in non-expansion states. This effect was more prominent in non-metropolitan counties and in counties in the top 50 th percentile for residents living in poverty. Conclusion: Counties in Medicaid expansion states had a significantly smaller increase in cardiovascular mortality rates among non-elderly adults compared with counties in non-expansion states. Our findings suggest that Medicaid expansion was associated with a beneficial effect on cardiovascular mortality and may be an important consideration for states debating expansion of Medicaid eligibility.

Is NY's Supply-side Experiment Working? A Preliminary Analysis using County Unemployment Rates

The State of New York recently enacted business tax reforms. The first legislative act launched the START-UP NY program in 2014. It created tax free enterprise zones throughout the state to incentivize business incubation within, or relocation of existing firms to, the State of New York. In that same year, the state lowered its corporate tax rate state-wide from 7.1% to 6.5% in 2016. We use a difference-in-differences (DID) methodology, evaluated using county-level data, to empirically test whether New York’s recent business tax reforms significantly reduce unemployment, beyond what would exist in the absence of the reforms. We fail to find significant evidence that START-UP NY affects unemployment during the period studied, 2014-2017. We do, however, find evidence suggesting that New York lowering its corporate tax rates in 2016 is associated with a large reduction in unemployment (by approximately 90,000 jobs) in 2016 and a smaller reduction (by approximately 25,000 jobs) in 2017.

Macroeconomic conditions and opioid abuse

We examine how deaths and emergency department (ED) visits related to use of opioid analgesics (opioids) and other drugs vary with macroeconomic conditions. As the county unemployment rate increases by one percentage point, the opioid death rate per 100,000 rises by 0.19 (3.6%) and the opioid overdose ED visit rate per 100,000 increases by 0.95 (7.0%). Macroeconomic shocks also increase the overall drug death rate, but this increase is driven by rising opioid deaths. Our findings hold when performing a state-level analysis, rather than county-level; are primarily driven by adverse events among whites; and are stable across time periods.

The impact of income on reunification among families with children in out-of-home care

Income appears to be associated with faster time to family reunification. The observed connection between income and reunification, however, may be causal in nature or the relationship may be an issue of selection, in that other underlying factors explain both income and family safety and stability. We examine the causal role that the source of income plays in reunification. We use administrative data on primary caregivers of children placed in out-of-home care in Washington State from 2000 through 2007 (N=15,159) matched with public economic support and employment data linked by the Washington State Department of Social and Health Services (DSHS) Integrated Client Database (ICDB). Using instrumental variable analysis, we estimated the effect of the amount of earnings and the amount of cash benefits on reunification. We used county unemployment rates and county food stamp participation rates as instruments. We find modest and inconsistent results that suggest higher earnings are associated with lower likelihood of reunification. We find no consistent evidence linking cash assistance to reunification.

The Great Recession and America's Geography of Unemployment.

The Great Recession of 2007-2009 was the most severe and lengthy economic crisis in the U.S. since the Great Depression. The impacts on the population were multi-dimensional, but operated largely through local labor markets. To examine differences in recession-related changes in county unemployment rates and assess how population and place characteristics shaped these patterns. We calculate and decompose Theil Indexes to describe recession-related changes in the distribution of unemployment rates between counties and states. We use exploratory spatial statistics to identify geographic clusters of counties that experienced similar changes in unemployment. We use spatial regression to evaluate associations between county-level recession impacts on unemployment and demographic composition, industrial structure, and state context. The recession was associated with increased inequality between county labor markets within states, but declining between-state differences. Counties that experienced disproportionate recession-related increases in unemployment were spatially clustered and characterized by large shares of historically disadvantaged racial and ethnic minority populations, low educational attainment, and heavy reliance on pro-cyclical industries. Associations between these sources of vulnerability were partially explained by unobserved state-level factors. The local consequences of macroeconomic trends are associated with county population characteristics, as well as the structural contexts and policy environments in which they are embedded. The recession placed upward pressure on within-state inequality between local labor market conditions. To present new estimates of the recession's impact on local labor markets, quantify how heterogeneous impacts affected the distribution of unemployment prevalence, and identify county characteristics associated with disproportionately large recession-related increases in unemployment.

The Great Recession of 2007-2009 and Public Insurance Coverage for Children in Alabama: Enrollment and Claims Data from 1999-2011.

This study examined the impact of the Great Recession of 2007-2009 on public health insurance enrollment and expenditures in Alabama. Our analysis was designed to provide a framework for other states to conduct similar analyses to better understand the relationship between macroeconomic conditions and public health insurance costs. We analyzed enrollment and claims data from Medicaid and the Children's Health Insurance Program (CHIP) in Alabama from 1999 through 2011. We examined the relationship between county-level unemployment rates and enrollment in Medicaid and CHIP, as well as total county-level expenditures in the two programs. We used linear regressions with county fixed effects to estimate the impact of unemployment changes on enrollment and expenditures after controlling for population and programmatic changes in eligibility and cost sharing. A one-percentage-point increase in a county's unemployment rate was associated with a 4.3% increase in Medicaid enrollment, a 0.9% increase in CHIP enrollment, and an overall increase in public health insurance enrollment of 3.7%. Each percentage-point increase in unemployment was associated with a 6.2% increase in total public health insurance expenditures on children, with Medicaid spending rising by 7.5% and CHIP spending rising by 1.8%. In response to the 6.4 percentage-point increase in the state's unemployment rate during the Great Recession, combined enrollment of children in Alabama's public health insurance programs increased by 24% and total expenditures rose by 40%. Recessions have a substantial impact on the number of children enrolled in CHIP and Medicaid, and a disproportionate impact on program spending. Programs should be aware of the likely magnitudes of the effects in their budget planning.

Perceived Local Job Prospects and School Connectedness in a Struggling Rural Economy: A Life-Course Perspective

Late in first decade of the 2000s, the closing of pulp and paper mills in the rural northeastern United States contributed to economic decline in the region and to rising concerns about population decline due to out-migration among local emerging adults in search of occupational or educational opportunities. In this context, and drawing on a life-course framework, the present study used four waves of panel data from the population of 7th- and 11th-grade public school students in a rural northeastern U.S. county to explore whether the county unemployment rate was related to perceived local job prospects; school connectedness was related to subsequent perceived job prospects; and the effects of county unemployment and school connectedness on perceived local job prospects varied by age cohort. Initially, changes in respondents’ perceptions about local job prospects paralleled shifts in local unemployment similarly for both cohorts; yet after the older cohort respondents had completed high school, their perceived local job prospects fell sharply, while perceptions among the younger cohort respondents, who were still in high school, remained stable. Among the older cohort respondents only, school connectedness was associated with subsequent positive perceptions about local job prospects net of relevant controls. Same-age cohort comparisons, evaluated when each cohort was in 12th-grade, showed no differences in the short-term effects of school connectedness on perceived local job prospects, despite variations in the age-linked timing of the most dramatic rise in unemployment during the study. The results highlight the lasting importance of school connectedness for teens raised in struggling rural economies.

Embracing Comprehensive Mental Health and Social Services Programs to Serve Children Under California's Mental Health Services Act.

Authorized under California's Mental Health Services Act (MHSA) of 2004, full service partnership (FSP) programs address social welfare and other human service needs of seriously mentally ill adults and children who are especially socially and economically vulnerable or who are untreated or insufficiently treated. Because FSP enrollment should reflect greater individual and community distress, we investigated whether counties' enrollment of children into FSPs came from mental health system caseloads with higher crisis use, assessed trauma and substance abuse problems; and from counties which had more foster care placement, more child poverty, lower median household incomes and more unemployment. We addressed these questions in 36 counties over 34 quarters after MHSA's onset. Results indicated greater FSP enrollment for children was associated with higher county unemployment and foster care placement rates and with mental health systems which had increasing children's crisis rates over the study period. These findings suggest that underservice and community adversity prompt officials to adopt and make greater use of children's FSP programming, in keeping with MHSA's intensions.

Physician responses to rising local unemployment rates: Healthcare provision to Medicare and privately insured patients

Prior studies suggest that hospital care is countercyclical among Medicare beneficiaries, and if anything, procyclical among the non-elderly. In this paper, we provide the first physician-level analysis of changes in healthcare provision to Medicare and privately insured patients across the business cycle. Using Florida discharge data aggregated to the physician level, we find that as county unemployment rates increase, physicians treat fewer privately insured patients in both inpatient and outpatient settings. In contrast, physicians who are more exposed to income losses during recessions provide more care to Medicare patients as the unemployment rate rises. Further analysis suggests that easing capacity constraints may contribute to this rise in Medicare volume; however, even in areas that are not capacity constrained, care provided to Medicare patients remains countercyclical among physicians with a large share of privately insured patients. This pattern is consistent with demand inducement in response to a negative income shock.

Risk of starting to smoke tobacco cigarettes in the United States: Estimates for foreign-born vs. U.S.-born young people, 2002–2009

lected from the American Community Survey and the Area Health Resources Files. Methadone dosage rates were measured by percentage of patients receiving dosages below 40, 60 and 80mg/day. Results: County density and median income were positively associated with methadone program income; median county income formed a positive relationship with expenditures per patient, after controlling for program income and total patients. Patient methadone dosage levels were significantly related to a county’s unemployment rate and median income. High county population density is associated with lower methadone dosages. However, increased county unemployment rates and program incomewere found tobe associatedwith increased rates of patients receiving higher dosages, controlling for total number of clients. Conclusions: Area-level attributes and program resources are important determinants of variation in program treatment practices. The significant relationship between these factors and concentrated racial and ethnic populations may be significant contributors in predicting the likelihood of patients receiving recommended dosage levels. Future studies should define causal pathways and specify the effects of area-level characteristics on program resources and treatment. Financial support: KL2 T81, R01DA030459.

Unemployment and substance outcomes in the United States 2002–2010

BackgroundThe economic shock of 2008–2009 provided an opportunity to study the robustness of observed statistical associations between unemployment and problematic substance use. MethodsData from 405,000 non-institutionalized adult participants in the 2002 to 2010 U.S. National Survey on Drug Use and Health were used to compare substance outcomes among unemployed and employed persons. Association of unemployment with substance outcomes was examined for the years 2002–2004, 2005–2007, 2008, and 2009–2010, corresponding to periods prior to and after the economic downturn of 2008. Multivariate logistic regression models adjusted for age, sex, race/ethnicity, education, urban/rural residence, current DSM-IV Major Depression, and local county unemployment rates. ResultsHigher rates of past month tobacco and illicit drug use, heavy alcohol use, and past-year drug or alcohol abuse/dependence were found among the unemployed. Markedly increased unemployment in 2009–2010 did not moderate the association between substance outcomes and employment. This association was not confounded by sex, age group, or race/ethnicity for tobacco and illicit drugs, although it varied for alcohol outcomes among 18–25 year-olds. Results based on retrospective data regarding marijuana use in the period prior to unemployment suggest its use was associated with future job loss. ConclusionsEmployment status was strongly and robustly associated with problematic use of substances. Prevention and treatment interventions are warranted for a group whose employment and resulting insurance status may impair access to much needed health care.

Income Packaging and Economic Disconnection: Do Sources of Support Differ from Other Low-Income Women?

Income packaging, or piecing together cash and non-cash resources from a variety of sources, is a common financial survival strategy among low-income women. This strategy is particularly important for economically disconnected women, who lack both employment income and public cash assistance receipt. Using data from the confidential Census Bureau versions of the Survey of Income and Program Participation, this study compares the use of public and private supports between disconnected and connected low-income women, controlling for differences in state welfare rules and county unemployment rates. Findings from bivariate comparisons and multilevel logistic regressions indicate that disconnected women utilize public non-cash supports at similar rates to connected women, but rely more heavily on private sources. Conclusions focus on the policy implications for outreach and program development.

Associations between U.S. Adult Obesity and State and County Economic Conditions in the Recession.

This study examines the association between state and county unemployment rates and individuals’ body weight status during the latest recession in the U.S. We used the U.S. Behavioral Risk Factor Surveillance System (BRFSS) data in 2007, 2009 and 2011, which were collected from 722,692 American adults aged 18 or older. Overweight and obesity were defined as body mass index (BMI) ≥25, and ≥30, respectively. Multivariate linear and logistic regressions were applied to assess the association between BMI, risks of overweight and obesity, and state and county unemployment rates. State unemployment rates were negatively associated with individual BMI across years, while county unemployment rates were significantly positively associated with BMI and obesity rates in all years (p < 0.05). However, the scale of the positive relationship was reduced in 2009 and 2011. Stratified analyses were conducted among adults with employment and without employment. The unemployed group’s body weight status was not related to state- and county-level economic conditions in most times. In the pooled analyses with all three years’ data, the relationship between unemployment rates and body weight status were consistently reduced after the recession of 2008–2009. Our results indicated that macroeconomic conditions at different levels can have different associations with individuals’ obesity risk across time.