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"Pepper, John"
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Partial Identification Methods for Evaluating Food Assistance Programs: A Case Study of the Causal Impact of Snap on Food Insecurity
We illustrate how partial identification methods can be used to provide credible inferences on the causal impacts of food assistance programs, focusing on the impact that the Supplemental Nutrition Assistance Program (SNAP, formerly known as the Food Stamp Program) has on food insecurity among households with children. Recent research applies these methods to address two key issues confounding identification: missing counterfactuals and nonrandomly misclassified treatment status. In this paper, we illustrate and extend the recent literature by using data from the Survey of Income and Program Participation (SIPP) to study the robustness of prior conclusions. The SIPP confers important advantages: the detailed information about income and eligibility allows us to apply a modified discontinuity design to sharpen inferences, and the panel nature allows us to reduce uncertainty about true participation status. We find that SNAP reduces the prevalence of food insecurity in households with children by at least six percentage points.
Journal Article
HOW DO RIGHT-TO-CARRY LAWS AFFECT CRIME RATES? COPING WITH AMBIGUITY USING BOUNDED-VARIATION ASSUMPTIONS
Despite dozens of studies, research on crime has struggled to reach consensus about the impact of right-to-carry (RTC) gun laws. With this in mind, we formalize and apply a class of bounded-variation assumptions that flexibly restrict the degree to which outcomes may vary across time and space. Using these assumptions, we present empirical analysis of the effect of RTC laws on violent and property crimes in Virginia, Maryland, and Illinois. Imposing specific assumptions that we believe worthy of consideration, we find that RTC laws increase some crimes, decrease other crimes, and have effects that vary over time for others.
Journal Article
Durable Continuous-Flow Mechanical Circulatory Support
The prevalence of heart failure in the UK is 1 in 35 people aged from 65 to 74 and 1 in 15 people aged from 75 to 84 [...]
Journal Article
Identifying the Effects of SNAP (Food Stamps) on Child Health Outcomes When Participation Is Endogenous and Misreported
The literature assessing the efficacy of the Supplemental Nutrition Assistance Program (SNAP), formerly known as the Food Stamp Program, has long puzzled over positive associations between SNAP receipt and various undesirable health outcomes such as food insecurity. Assessing the causal impacts of SNAP, however, is hampered by two key identification problems: endogenous selection into participation and extensive systematic underreporting of participation status. Using data from the National Health and Nutrition Examination Survey (NHANES), we extend partial identification bounding methods to account for these two identification problems in a single unifying framework. Specifically, we derive informative bounds on the average treatment effect (ATE) of SNAP on child food insecurity, poor general health, obesity, and anemia across a range of different assumptions used to address the selection and classification error problems. In particular, to address the selection problem, we apply relatively weak nonparametric assumptions on the latent outcomes, selected treatments, and observed covariates. To address the classification error problem, we formalize a new approach that uses auxiliary administrative data on the size of the SNAP caseload to restrict the magnitudes and patterns of SNAP reporting errors. Layering successively stronger assumptions, an objective of our analysis is to make transparent how the strength of the conclusions varies with the strength of the identifying assumptions. Under the weakest restrictions, there is substantial ambiguity; we cannot rule out the possibility that SNAP increases or decreases poor health. Under stronger but plausible assumptions used to address the selection and classification error problems, we find that commonly cited relationships between SNAP and poor health outcomes provide a misleading picture about the true impacts of the program. Our tightest bounds identify favorable impacts of SNAP on child health.
Journal Article
The Economics of Food Insecurity in the United States
Food insecurity is experienced by millions of Americans and has increased dramatically in recent years. Due to its prevalence and many demonstrated negative health consequences, food insecurity is one of the most important nutrition-related public health issues in the U. S. In this article, we address three questions where economic insights and models have made important contributions: What are the determinants of food insecurity?; What are the causal effects of food insecurity on health outcomes?; and What is the impact of food assistance programs on food insecurity? We conclude with a discussion of the policy implications of the answers to these questions and future research opportunities in this research venue.
Journal Article
Bilateral versus Single Internal-Thoracic-Artery Grafts at 10 Years
In a randomized trial, 3102 patients undergoing CABG were assigned to receive bilateral or single internal-thoracic-artery grafts. There was no significant between-group difference in all-cause mortality at 10 years.
Journal Article
Identifying the Effects of WIC on Food Insecurity Among Infants and Children
The Women, Infants, and Children (WIC) Program is considered a crucial component of the social safety net in the United States, yet there is limited supporting evidence on the effects of WIC on the nutritional well-being and food security of infants and young children. Using data from the National Health and Nutrition Examination Survey, we apply recently developed partial identification methods to jointly account for unobserved counterfactual outcomes and systematic underreporting of WIC participation. Under nonparametric assumptions, we find that WIC reduces the prevalence of child food insecurity by at least 3.6 percentage points (20%).
Journal Article
Reconstructing the Supplemental Nutrition Assistance Program to More Effectively Alleviate Food Insecurity in the United States
Although the central objective of the Supplemental Nutrition Assistance Program (SNAP) is to reduce food insecurity in the United States, the majority of SNAP households are food insecure. Higher benefits may lead these households to food security. To evaluate this possibility, we use a question from the Current Population Survey that asks respondents how much additional money they would need to be food secure. Food insecure SNAP households report needing an average of about $42 per week to become food secure. Under a set of assumptions about the measurement of benefits and behavioral responses, we find that an increase in weekly benefits of $42 for SNAP households would lead to a 62 percent decline in food insecurity at a cost of about $27 billion.
Journal Article
Saphenous vein grafts in contemporary coronary artery bypass graft surgery
Myocardial ischaemia resulting from obstructive coronary artery disease is a major cause of morbidity and mortality in the developed world. Coronary artery bypass graft (CABG) surgery is the gold-standard treatment in many patients with complex multivessel coronary artery disease or left main disease. Despite substantial improvements in the outcome of patients undergoing CABG surgery in the past decade, graft patency remains the ‘Achilles’ heel’ of this procedure. Whereas the use of the left internal mammary artery as a conduit is associated with the highest 10-year patency rate (>90%), saphenous vein grafts — the most commonly used conduit in CABG surgery — fail in 40−50% of treated patients by 10 years after surgery. Vein graft disease (VGD) and failure result from complex pathophysiological processes that can lead to complete occlusion of the graft, affecting long-term clinical outcomes. Optimal harvesting techniques, intraoperative preservation strategies and intraoperative patency control have important roles in the prevention of VGD. In addition, several studies published in the past decade have reported similar mid-term patency rates between vein grafts and arterial grafts when veins are used as a composite graft based on the internal mammary artery. In this Review, we present the latest evidence on the utilization of saphenous vein grafts for CABG surgery and provide an overview of the current practices for the prevention of VGD and vein graft failure.Although saphenous vein grafts (SVGs) are the most commonly used conduit in coronary artery bypass graft surgery, vein graft failure (VGF) occurs in almost half of all patients with SVGs by 10 years after surgery. In this Review, Caliskan and colleagues discuss approaches to prevent saphenous VGF, including optimal harvesting techniques and intraoperative preservation strategies.
Journal Article