Adolescent Depression and Adult Earnings: the Roles of Direct and Indirect Effects
Abstract: Youth with depression earn less as adults, but we understand little about the pathways of effects that lead to this gap. I use data from a nationally representative survey of youth to estimate the direct and indirect effects of adolescent depression on adult earnings with a mediation analysis framework. I use several identification strategies to address issues of omitted variables bias. I find that more than half of the total effect of adolescent depression on earnings is mediated by educational attainment, while the rest of the effect is mediated by adult depression. The direct effect of adolescent depression on earnings is not robust to identification strategy. Results highlight the large economic benefits that could still be achieved by better treating adolescent depression or targeting gaps in mediating variables.
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Works in Progress
The Cost Savings of Tiered Care Coordination: Evidence from North Carolina
With Jeremy Bray
Abstract: This paper estimates the effect of Tiered Care Coordination (TCC) on the cost of care for system-involved youth with behavioral health needs. We use a difference-in-differences approach and a two-part model to estimate the effect of TCC on the probability of receiving a service and expenditures conditional on receiving a service. Estimation results find that referring youth involved with social services to TCC leads to average monthly savings of $2,824, or $33,888 annually. Descriptive evidence suggests that these savings are driven primarily by avoided inpatient claims. We also find that youth with a more serious and expensive service history are responsible for the largest savings, but there is evidence that TCC also lowers the cost of care for youth with a more modest service history. These results provide important insight on the benefits of interventions that successfully coordinate services for system-involved youth with behavioral health needs.
Adolescent Mental Health and Adult Labor Market Outcomes: A Scoping Review
With Jeremy Bray
Background and Aims: Mental illness and substance use are frequently comorbid among adolescents and present long-term economic consequences. The aims of this scoping review are to summarize the peer-reviewed literature on the association between adolescent mental illness, substance use, and their comorbidity and adult labor market outcomes, and discuss ways future research can better accomplish policy aims. Methods: A systematic scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methods. Studies were included if they use individual-level data to conduct empirical analyses on the effects of adolescent mental illness, substance use, or their comorbidities on adult labor market outcomes. Study heterogeneity prevented meta-analysis, so a narrative review is given. Results: Thirty-two studies from seven countries met the inclusion criteria. No study evaluated the relationship between comorbid adolescent mental illness and substance use and adult labor market outcomes. Instead, studies focused on either adolescent mental illness or substance use. Adolescent depression and attention deficit hyperactivity disorder (ADHD) are strongly associated with lower average earnings and rates of employment in adulthood. There is strong evidence that adolescent marijuana use is associated with poor labor market outcomes and conflicting evidence on the effects of alcohol use. The mechanisms driving these relationships are contested and studies seldom estimate mediated effects. Conclusions: There is a surprising lack of research on the association between adolescent comorbidities and adult labor market outcomes. Addressing this gap in the literature may improve estimates of long-term economic costs and lead to more accurate policy recommendations.
The Cost Savings of High Fidelity Wraparound in North Carolina
With Jeremy Bray
The Cost Savings of Eviction Mediation: Evidence from Guilford County
With the Center for Housing and Community Studies
Treatment Effects in a Poisson Fixed Effect DID Model: a Statistical Package
Developing an Interactive Energy Dashboard for UNCG
With the UNCG Green Fund