Pooled Time Series Research Articles

How climate volatility influences human rights

We explore how climate volatility influences human rights practices. We argue that climate volatility intensifies competition for material resources, increases citizens’ grievances against the state, and leads to more frequent repression as governments seek to respond to environmentally induced protests and local conflicts. We situate this argument in the existing literature’s emphasis on three mechanisms linking climate shocks and repression: resource shocks, mobilization shocks, and migration shocks. We assert that the climate volatility-human rights relationship is strongest in the context of civil conflict as rebel groups and governments place a higher priority on survival and material well-being rather than governance and public goods provision. Using a pooled time series dataset of 194 countries from 1946 to 2017, we estimate a panel vector autoregression (PVAR) model. Our analyses show that for countries experiencing armed conflicts, increased precipitation volatility significantly reduces human rights protections for multiple years. Indicators for the three mechanisms also show indirect relationships to repression through the precipitation variable, consistent with our theory. We illustrate our findings with case vignettes from Benin and Mali. Our results demonstrate that climate volatility alters states’ strategies for addressing internal security threats.

Consumption and expenditure of antidepressants and anxiolitycs in 14 European countries

Abstract Background Since the burden of depressive and anxiety disorders, assessing the use and spending of drugs commonly prescribed for treating such conditions is a valuable barometer of mental health assistance and healthcare services. The current research aims to evaluate the consumption of antidepressants and anxiolytics and the relative expenditure among 14 European countries (Austria, Czech Republic, Finland, Germany, Hungary, Italy, Latvia, Luxembourg, Norway, Portugal, Slovak Republic, Slovenia, Spain and Sweden). Methods A retrospective longitudinal study was assessed based on pooled time series analysis of secondary data over ten years (2012-2021). Defined Daily Doses (DDD) per 1,000 inhabitants and health expenditure per capita (current US$, computed on purchasing power parity) were considered. Linear and quadratic trends were calculated for defining relationships between the variables of interest. Results Prevailing patterns of consumption and spending show an increase in antidepressants and a decrease in anxiolytics. Noteworthy is the growth slope of antidepressant consumption in three selected countries, Portugal, Spain, and Sweden, by over two and a half times from 2012 to 2021. In addition, for a few countries, there is a pattern contrary to most countries for anxiolytics (Latvia, Spain) and discordant between consumption and expenditure for antidepressants (Austria, Hungary). Conclusions The widespread growth of antidepressant use deserves attention. As a public health issue, the prescription and use of antidepressants should be addressed by targeted policies for integrating multifaceted strategies. Key messages • Monitoring consumption and expenditure of antidepressant and anxiolytic drugs represents a valid tool for assessing the efficacy and availability of mental healthcare services among the population. • The growth in the consumption of antidepressants represents a relevant public health issue and deserves attention for the evaluation of an integrated approach of assistance.

What’s pension got to do with it? Mortality inequality at older ages

Abstract Background The potential role of social protection systems and welfare states for population health and mortality has attracted increased interest in recent decades but mostly focused on overall characteristics or clusters of countries. Moreover, often neglecting older people even though the great majority of all deaths in high-income countries occur at later ages. We focus on the key social protection scheme for old adults: the generosity of the level of pensions. We compare pensions based on previous work history to basic minimum pensions. Our study is novel both by linking pension system to remaining life expectancy at age 65(LE65+), but also by studying the association to variation in LE65+, since that gives a measure of inequality. We do so across countries and over time. Methods and Materials Our sources of data are from the Human Mortality Database and the Social Policy Indicator Database. Data for OECD countries are matched over a long period of time and analysed by pooled time-series regression analyses with fixed effects. Results Although the results indicate that the generosity of pensions based on both pervious work history and basic minimum income our results primarily show the importance of basic minimum income. Here the effect sizes are larger and especially for women than for men (0.149*** vs. 0,.0715***). Concerning the variation in LE (65+) we find that more generous basic pensions are associated with reduced variation for women -4.64e-05**. Conclusions We provide new insights in how pension policies potentially influence mortality among older persons especially by extending our analyses also to inequality in mortality. Our results points to the importance of basic pensions. The gendered division of labour is a plausible explanation for the findings and to have an adequate pension for all should be of primary concern for public health. Key messages • Adequate basic pension for all of importance for remaining life expectancy among older people. • Adequate basic pension for all of importance for reducing mortality inequality among women.

Economic convergence in the European Union at the regional level with particular attention to the impact of the COVID-19 pandemic – a spatio-temporal approach

The study presents an analysis of the impact of the COVID-19 pandemic on the economic convergence in the European Union (EU). It is widely known that every crisis can have a negative influence on the economic development of a country or region. This research analysed data for 233 EU regions on the NUTS-2 level in the years 2000-2020.analyzed To verify the occurrence of the convergence process, the spatio-temporal β-convergence models for pooled time series and cross-sectional data (TSCS) were estimated. Expandingthe convergence models with the dummy variables characterising two critical crises in the analysed period (the global financial crisis in 2007-2009 and the start of the COVID-19 pandemic in 2020) allowed us to verify their impact on the regional convergence processin the EU. The main aim of this research is to assess the influence of presented crises on the economic convergence between EU regions. Because regions cooperate, the spatial element of the β-convergence models was also included. The additional aspect of the study is the comparison of the differences in strength of the influence of the mentioned crises on economic convergence.

Patterns of Antidepressant and Anxiolytic Use and Spending in 14 European Countries (2012-2021): A Comprehensive Time Series Analysis.

The assessment of antidepressant and anxiolytic consumption and expenditures represents a reliable barometer of the burden of such mental health disorders and the effectiveness of relative healthcare services. The current analysis aims to evaluate trajectories of consumption and expenditures of antidepressant and anxiolytic drugs to define patterns of usage and spending across 14 European countries between 2012 and 2021. A retrospective longitudinal study was performed based on pooled time series secondary data analysis over 2012/2021. Defined Daily Doses (DDD) per 1000 inhabitants and health expenditure per capita were analysed. Linear and quadratic trends were computed to determine relationships between the variables of interest. Only 2 patterns of consumption/expenditure of antidepressants can be identified: consumption and expenditure both grow; consumption grows, and spending decreases. Consumption and expenditures registered 2 main patterns, decreasing in most European countries and increasing only in 2 cases. Prevailing patterns of consumption and spending show an increase in antidepressants and a decrease in anxiolytics. The variation in consumption of such drugs during this timeframe is attributable to several reasons, such as the epidemiological characteristics of mental disease, for instance, the prevalence and incidence of disorders, the accessibility of drugs and alternative treatments, like psychotherapy, different clinical practices and national guidelines. However, such analyses deserve attention for targeted policies and strategies for promoting mental health.

The effect of COVID-19 containment measures on fresh food market vendors in Uganda

PurposeThe coronavirus disease (COVID-19) pandemic continues to impact economic systems, with devastating consequences on livelihoods. Anecdotal evidence has predicted the adverse effects of COVID-19 on the livelihood of food system actors. Uganda experienced two lockdowns in March 2020 and June 2021 with varying government containment measures. During the first lockdown, fresh food market vending was deemed essential to meet urban food demand, and was consequently exempted from a total shutdown despite the ban on public and private transport. Thus, this study sought to examine the effect of COVID-19 containment measures on fresh food market vending businesses in Uganda.Design/methodology/approachUsing primary data collected from fresh food market vendors, this study applied a pooled time-series estimation to examine the effect of the first lockdown COVID-19 containment measures on fresh food vendors' welfare.FindingsThe study revealed that COVID-19 had a significant negative impact on the income of fresh food vendors, with female vendors being the most affected. COVID-19 containment measures reduced the diversity of buyers, individual customers and the number of commodities traded in causing a greater impact on vendors' income.Research limitations/implicationsThe unavailability of data for vendors who did not return to the market at the time of data collection limits the scope of the study. Additionally, the absence of data for the second lockdown limited the analysis to only March 2020 lockdown period.Originality/valueThe empirical analysis highlights how vulnerabilities of different gender categories could be exacerbated by crises. The study provides empirical evidence of various market distortions caused by the COVID-19 pandemic and the disproportionate impact on women and men market vendors which calls for the need to integrate women's perspectives in future planning for market systems as well as advocating for gender-sensitive recovery responses.

Regional economic growth and unemployment in the European Union – a spatio-temporal analysis at the NUTS-2 level (2013–2019)

The study aims to verify the relationship between the unemployment rate and economic growth in European Union (EU) regions. As the most important macroeconomic relationship, the significance of the dependence between the labour market situation and the output growth is widely known and considered. Analysis in this research was conducted using data for 229 EU regions on the NUTS-2 level in the years 2013–2019. In order to verify the relationship between the unemployment rate and the output growth, the spatio-temporal models for pooled time series and cross-sectional data (TSCS) were estimated. The Fitted Trend and Elasticity Method of verifying Okun’s law was used in the analysis, wherein the deterministic trend factor was enriched with the spatial element. Educational attainment as the additional explanatory variable was included in the models. The neighbourhood between regions was quantified based on two criteria: (1) common border criterion – related to the possibility of population migrations, and (2) similarity of the unemployment rate criterion – related to the imitation effect in the issue of introduced rules and regulations on the labour market by regional governments. One of the hypotheses verified in the investigation is the superiority of the economic neighbourhood over the geographical neighbourhood.

Economic Determinants of Changing Integration: A Study on India and Its Major Trading Partners

This article has investigated, first, the changing degree of integration the using Geweke Feedback method between the stock indices of India and its 13 major trading partners, and second, the relationship between trade and this changing integration. Geweke feedback helped to measure the contemporaneous feedback between stock markets of India and the sampled countries, and it also measured the lead of Indian stock market on other markets and vice versa. Geweke feedbacks have been measured between the stock market of India and those of the sampled countries for the whole sample period and every year during 1999–2020. It helps to reach the conclusion that the contemporaneous effect is very high between the Indian stock market and other stock markets. The Indian stock market leads stock markets of Asian countries, whereas European countries and USA lead the Indian stock market. The effect of trade and other economic variables, on these Geweke feedbacks have been assessed through pooled time series regression. Import of India and inflation differential are statistically significant to assess contemporaneous feedback. Export from sampled countries to India, inflation, and interest rate differential and trend are statistically significant to explain lead feedbacks.

Longitudinal Effects of Distress and Its Management During COVID-19 Lockdown in Spain.

Introduction: The COVID-19 pandemic that hit Spain during March 2020 forced the strict confinement of the population for 2 months. The objectives of this study were (a) to assess the magnitude and duration of the influence of confinement on people’s Distress, (b) to study the temporal sequence of stress, and (c) to show how different day-to-day activities and personal variables influence perceived Distress levels.Method: A daily registration was completed by 123 people, with ages ranging from 21 to 75 years old ( = 43, SD = 10 years), of which there were 40 men (32%) and 83 females (68%). During 45 days of lockdown, from March 19th to May 3rd, participants were asked to respond to a socio-demographic survey and make daily records comprising the MASQ-D30 and some day-to-day behaviors. Pooled time series was applied to establish what effect time had on the dependent variable.Results: Distress has a 14-day autoregressive function and gender, physical activity, sexual activity, listening to music, and teleworking also influence Distress. It has been hypothesized that the intercept presents variability at level 2 (individual), but it has not been significant. Interactions between Gender—Telecommuting, and Gender—Physical Activity were observed. Approximately 66% of the variance of Distress was explained (R2 = 0.663).Discussion: At the beginning of the lockdown, the average levels of Distress were well above the levels of the end (z = 3.301). The individuals in the sample have followed a very similar process in the development of Distress. During the lockdown, the “memory” of Distress was 2 weeks. Our results indicate that levels of Distress depend on activities during lockdown. Interactions exist between gender and some behavioral variables that barely influence Distress in men but decrease Distress in women. The importance of routine maintenance and gender differences must be considered to propose future interventions during confinement.

Does Financial Integration Increase Bank Efficiency? New Evidence From the Euro area: European Financial Integration

This paper aims to estimate the relationship between bank's cost and profit efficiency and financial integration, which we defined as five groups of competition, bank market ownership, financial liberalization, free capital flow, and the euro area control variables. A two-step quantitative research design was employed to accomplish purpose of the current paper for an unbalanced pooled time series dataset of 126 banks of the euro area banking system between 1999 and 2012 : Data Envelopment Analysis (DEA) and panel regression analysis (GMM regression model). The results suggest that concentration ratio, foreign ownership, domestic credit, and market integration are negatively related to bank's cost and profit efficiency while the coefficient of real credit growth and capital flow have a positive relationship to cost and profit efficiency score. Furthermore, empirical findings of bank market power, government budget deficit targeting, and public debt targeting are consistent in both cost and profit efficiency models. Therefore, the government budget deficit has a positive impact on cost efficiency without assurance of sound public finance policy which is important to ensure sustainable economic development within the euro area. criteria relating to government deficit needs to adjustment for the euro area adopted Member States because, by increasing the difference of actual from targeted value of government budget deficit; bank cost efficiency will be increased.

Addressing Health Disparities: The Health Department Nurse Lead Executive's Relationship to Improved Community Health.

The nurse-trained local health department (LHD) lead executive has been shown to be positively associated with LHD performance; however, no other research has explored whether this association translates to improved community health. To investigate the relationship between the type of LHD leadership-whether or not the lead executive is a nurse-and changes in health outcomes. This study used a multivariate panel time series design. Each model was estimated as a pooled time series and using time and unit fixed effects, with a 1-year lag used for all covariates and the main predictor. A national, county-level data set was compiled containing variables pertaining to the LHD, community demographics, and health outcomes for the years 2010-2018. The unit of analysis was the LHD. The data set was restricted to those counties with measurable mortality rates during at least 8 of the 9 time periods of the study, resulting in a total of 626 LHDs. The outcomes of interest were changes in 15- to 44-year-old all-cause mortality, infant mortality, and entry into prenatal care. In models with combined time and unit fixed effects, a significant relationship exists between a nurse-led LHD and reduced mortality in the 15- to 44-year-old Black population (-5.2%, P < .05) and a reduction in the Black-White mortality ratio (-6%, P < .05). In addition, there is a relationship between the nurse-led LHD and a reduction in the percentage of the population with late or no entry to prenatal care. The evidence presented here helps connect the known positive association between nurse lead executives and LHD performance to improvements in community health. It suggests that nurse leaders are associated with health improvements in line with addressing health inequities.

Multivocality and robust action dynamics in political discourse

How do politicians gain an upper hand in political discourse? Recent literature on framings in political discourse have re-directed attention from static models of issue ownership to more interactive models of strategic framing contests. This article proposes a robust action approach to the tactical horizon of political discourse dynamics, and tests hypotheses about the dual repertoires of local action: First, we test for the presence of exploratory local action, when discourse positions are altered in response to positions by others. Second, we show evidence for the presence of role claim behavior, when a multivocal dominant discourse position is taken, and suppresses participation from others. It is multivocality, rather the amount of speech that has a silencing effect. Using the case of economic policy discourse in Hungary in 1997, we show how the “GDP growth” discourse position silenced opposition positions on the right, mostly built from stigmatizing frames. Discourse positions beyond the one built around growth did not silence alternative framings, but elicited discourse shifts. We coded 8632 utterances over 100 days of discourse into a two-mode network of speech acts and statements and used a two-mode blockmodeling approach to identify positions and frames. We took a pooled time series approach to test hypotheses of local action dynamics. We found evidence for both exploratory local action and role claim, while controlling for observed and unobserved heterogeneity at the actor level.

Demand Elasticities of Canned Tuna at Point of Sale of a Large Retail Chain in Southern Philippines: Implications for Sustainability Policy

New variants of canned skipjack tuna have been developed by large manufacturers of canned tuna in the Philippines. This study analyzes the expenditure and price elasticities of canned tuna and determines the implications for sustainable fishery. An AIDS (almost ideal demand system) model incorporating an income group variable was used to estimate these elasticities. This study utilized a pooled time series data of 459 weekly point-of-sale observations from 2010–2012 of three store branches of a large supermarket chain in southern Philippines. The point-of-sale data suggest that canned tuna consumption is composed mostly of tuna in sauce with vegetables followed by tuna in oil and tuna in sauce without vegetables. For both high- and low-income groups, the expenditure elasticities have the expected positive signs – indicating that as the income of consumers’ increases, the quantity demanded for canned tuna in three product mediums also increases. For high-income consumers, consumption of tuna in sauce with and without vegetables is more responsive to income changes. The own-price elasticities of the three product mediums across high- and low-income store branches have negative signs – suggesting that as their own price increases, the quantity demanded for these products decreases. The cross-price elasticities suggest that tuna in sauce with vegetables is a substitute for tuna in oil and in sauce without vegetables for both income groups. Thus, promoting more use of vegetables through product development may lead to a lower volume of tuna meat used in canned tuna products, which contributes to addressing tuna resource sustainability

The Puzzle of Protest Policing Over Time: Historicizing Repression Research Using Temporal Moving Regressions

Research attempting to predict repression, including the policing of protest, has tended to rely on pooled time series data, which statistically produces coefficients that estimate the average relationship between each variable and the outcome across the entire pooled time period. When relationships are very stable, this statistical assumption, referred to as temporal homogeneity, is unproblematic. But, when enforced without testing, it threatens to artificially “stabilize” temporally heterogenous relationships. In terms of protest policing, this has resulted in relatively ahistorical empirical explanations of protest policing. This article imports modeling techniques from work on identifying historical periods to show how temporal moving regressions can be built to recognize and model temporal heterogeneity in the factors influencing protest policing. We present three important uses for these models: testing exhaustively for temporal heterogeneity in apparently stable findings; testing for temporal heterogeneity that may reconcile otherwise contradictory findings; and inductively combining orthogonal research lines. We demonstrate the utility of each in examinations of protest policing. More generally, we show the potential of temporal moving regressions for uncovering new insights and bringing greater historical sensitivity to research on protest and beyond.

Detecting voids in 3D printing using melt pool time series data

Powder Bed Fusion (PBF) has emerged as an important process in the additive manufacture of metals. However, PBF is sensitive to process parameters and careful management is required to ensure the high quality of parts produced. In PBF, a laser or electron beam is used to fuse powder to the part. It is recognised that the temperature of the melt pool is an important signal representing the health of the process. In this paper, Machine Learning (ML) methods on time-series data are used to monitor melt pool temperature to detect anomalies. In line with other ML research on time-series classification, Dynamic Time Warping and k-Nearest Neighbour classifiers are used. The presented process is effective in detecting voids in PBF. A strategy is then proposed to speed up classification time, an important consideration given the volume of data involved.

Don't Mention the War versus Escalating Commitment: Political Party Responses to Military Casualties

Abstract Do political parties change their position when military casualties increase? Several studies demonstrate that once military casualties increase, public support for sometimes even the government itself declines. With this potential backlash, once governing parties are faced with military casualties, do they (1) maintain that intervention was the “right thing” to do and even escalate their commitment by becoming even more pro-military or (2) try to avoid the blame and downplay the issue, i.e., “not mentioning the war”? And do the opposition parties become more negative or more positive about the military? To evaluate this, we measure the position on military issues in parties’ election manifestoes. Our dataset comprises 326 party policy changes in eleven Organisation for Economic Co-operation and Development (OECD) countries and focuses on post-Cold War military interventions. By using pooled time-series cross-sectional analysis, we find that opposition parties and governing parties respond differently. Generally, governing parties become more negative in their manifesto and opposition parties more positive. We also demonstrate important differences between party families and pre/post-9/11. Our analyses show that whether political parties change policy course once confronted with negative outcomes depends on their position in office, and also the direction in which they change policy depends on political ideology.

Impact of helmet laws on motorcycle crash mortality rates.

Helmets are effective in reducing traumatic brain injury. However, population effects of helmet laws have not been well described. This study assesses the impact of helmet laws on the motorcycle (MC) fatality rate in the United States from 1999 to 2015. Fatality Analysis Reporting System MC fatalities (aged ≥16 years), crash characteristics, and MC-related laws were collected by year for all 50 states from 1999 to 2015 to create a pooled time series. Generalized linear autoregressive modeling was applied to assess the relative contribution of helmet laws to the MC fatality rate while controlling for other major driver laws and crash characteristics. Universal helmet laws were associated with a 36% to 45% decline in the motorcycle crash mortality rate during the study period across all age cohorts (unstandardized regression coefficients are reported): 16 to 20 years, B = -0.45 (p < 0.05); 21 to 55 years, B = -0.42 (p < 0.001); 56 to 65 years, B = -0.38 (p < 0.04); and older than 65 years, B = -0.36 (p < 0.02). Partial helmet laws were associated with a 1% to 81% increase in the fatality rate compared with states with no helmet laws and a 22% to 45% increase compared with universal laws. Helmet usage did not attenuate the countervailing effect of weaker partial laws for 16 to 20 years (B = 0.01 [p < 0.001]). Other laws associated with a declining motorcycle crash mortality rate included the following: social host/overservice laws, 21 to 55 years (B = -0.38 [p < 0.001]); 56 to 65 years (B = -0.16 [p < 0.002]), and older than 65 years (B = -0.12 [p < 0.003]); laws reducing allowable blood alcohol content, 21 to 55 years (B = -4.9 [p < 0.02]); and laws limiting passengers for new drivers 16 to 20 years (B = -0.06 [p < 0.01]). During the period of the study, universal helmet laws were associated with a declining mortality rate, while partial helmet laws were associated with an increasing mortality rate. Other state driver laws were also associated with a declining rate. In addition to universal helmet laws, advocating for strict alcohol control legislation and reevaluation of licenses in older riders could also result in significant reduction in MC-related mortality. Prognostic and epidemiological, level III.

Businesses, Places, and Homicide: A Preliminary Empirical Examination

ABSTRACT This paper empirically examines the relations between homicide rates by age (adults 18 to 24 and adults 25 or older), the tattoo shop density, on-site and off-site alcohol outlets, and disadvantage. It offers an additional explanation for the relation between alcohol outlets and homicide besides alcohol availability and consumption being facilitators of such lethal violence, suggesting that these businesses are a proxy for attracting those most prone to violent behavior. The analysis estimated linear pooled cross-sectional time series models to test the relations between age-specific homicide rates and tattoo shop density, on-site alcohol density, off-site alcohol density, and a multidimensional measure of disadvantage. These relations were examined among 88 of the largest cities in the United States for the years 1998 to 2006 (city-years = 792). The findings showed positive relations between homicides rates involving young adults 18 to 24 years of age, off-site alcohol outlets, tattoo shops, controlling for disadvantage. Findings suggest business establishments that attract young adults increase the likelihood of lethal violence not solely because of the availability and consumption of alcohol, but by increasing the convergence in space and time of motivated offenders and suitable targets, with limited or absent capable guardianship.

Pooled Time Series Modeling Reveals Smoking Habit Memory Pattern.

Smoking is a habit that is hard to break because nicotine is highly addictive and smoking behavior is strongly linked to multiple daily activities and routines. Here, we explored the effect of gender, age, day of the week, and previous smoking on the number of cigarettes smoked on any given day. Data consisted of daily records of the number of cigarettes participants smoked over an average period of 84 days. The sample included smokers (36 men and 26 women), aged between 18 and 26 years, who smoked at least five cigarettes a day and had smoked for at least 2 years. A panel data analysis was performed by way of multilevel pooled time series modeling. Smoking on any given day was a function of the number of cigarettes smoked on the previous day, and 2, 7, 14, 21, 28, 35, 42, 49, and 56 days previously, and the day of the week. Neither gender nor age influenced this pattern, with no multilevel effects being detected, thus the behavior of all participants fitted the same smoking model. These novel findings show empirically that smoking behavior is governed by firmly established temporal dependence patterns and inform temporal parameters for the rational design of smoking cessation programs.

Social determinants of health and disparities in prenatal care utilization during the Great Recession period\xa02005-2010

BackgroundEarly, regular prenatal care utilization is an important strategy for improving maternal and infant health outcomes. The purpose of this study is to better understand contributing factors to disparate prenatal care utilization outcomes among women of different racial/ethnic and social status groups before, during, and after the Great Recession (December 2007–June 2009).MethodsData from 678,235 Washington (WA) and Florida (FL) birth certificates were linked to community and state characteristic data to carry out cross-sectional pooled time series analyses with institutional review board approval for human subjects’ research. Predictors of on-time as compared to late or non-entry to prenatal care utilization (late/no prenatal care utilization) were identified and compared among pregnant women. Also explored was a simulated triadic relationship among time (within recession-related periods), social characteristics, and prenatal care utilization by clustering individual predictors into three scenarios representing low, average, and high degrees of social disadvantage.ResultsIndividual and community indicators of need (e.g., maternal Medicaid enrollment, unemployment rate) increased during the Recession. Associations between late/no prenatal care utilization and individual-level characteristics (including disparate associations among race/ethnicity groups) did not shift greatly with young maternal age and having less than a high school education remaining the largest contributors to late/no prenatal care utilization. In contrast, individual maternal enrollment in a supplemental nutrition program for women, infants, and children (WIC) exhibited a protective association against late/no prenatal care utilization. The magnitude of association between community-level partisan voting patterns and expenditures on some maternal child health programs increased in non-beneficial directions. Simulated scenarios show a high combined impact on prenatal care utilization among women who have multiple disadvantages.ConclusionsOur findings provide a compelling picture of the important roles that individual characteristics—particularly low education and young age—play in late/no prenatal care utilization among pregnant women. Targeted outreach to individuals with high disadvantage characteristics, particularly those with multiple disadvantages, may help to increase first trimester entry to utilization of prenatal care. Finally, WIC may have played a valuable role in reducing late/no prenatal care utilization, and its effectiveness during the Great Recession as a policy-based approach to reducing late/no prenatal care utilization should be further explored.