New IPR Research: December 2022
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This month’s new research from IPR faculty explores Black girl space, when citizens engage in corruption, and the gun spike during the pandemic. It also examines the link between drug development for older patients and productivity growth, price and quality care in the U.S. hospital market, and how tap water avoidance is connected to food insecurity.
Poverty, Race, & Inequality
Exploring Black Girl Space
The development of Black girls and Black girl space, or a space designed for Black girls, have been understudied in academic research. In the Journal of Research on Adolescence, IPR developmental psychologist Onnie Rogers and her co-author examine the meaning and potential of spaces that intentionally serve Black girls in an effort to counter the racist and sexist cultural norms that threaten Black girls’ identities and sense of wellbeing. The researchers used data from a larger longitudinal study of Black girls attending a predominantly Black all-girls school, a Black girl space, that offers workshops and mentorships from Black women and programming directed toward the Black girls. They analyzed open-ended interviews conducted in 2018 with 17 Black high school girls to understand how they made sense of their school. The researchers asked the girls whether they liked school, the relationship between students and teachers, and the importance of having a school like theirs exist. In the interviews, the girls discussed relational challenges they experienced at school but also how they felt known in their school by being surrounded by so many other Black girls and women. They also talked about their frustration with a school policy banning cell phones when their school’s technology didn’t always work and problems with the structure of the school and general lack of funding. The findings show how Black girls were able to see the school as a place of resistance to tell counternarratives about being a Black girl, but they also recognized how the physical space posed barriers and reinforced inequalities, such as few extracurriculars and academic resources. The researchers argue that when cultivating Black girl space, experiencing connection with other Black girls matters, but so does the physical space, policies, and funding structures that regulate it. Listening to the voices of Black girls is crucial for developmental science research to value and learn from their experiences.
Politics, Institutions, & Public Policy
When Do Citizens Engage in Corruption?
One in four citizens across the globe report paying a bribe in the past year to obtain public services. Yet, even in countries where corruption is prevalent, few people always give bribes. In a working paper, political scientist and IPR associate Jordan Gans-Morse and his colleagues ask what prompts citizens to bribe. The researchers conducted an experiment in Ukraine, a nation that prior to Russia’s February 2022 invasion was engaged in a longstanding struggle to root out corruption, recruiting 3,060 respondents through Facebook. They presented participants with two scenarios in which a citizen seeks a service from a public servant, one to receive a driver's license and the other to be treated at a healthcare clinic. Respondents were asked to gauge how likely these citizens would be to bribe the officials, and how likely they themselves would be to offer a bribe. Among other factors, red tape, urgency of needing public services, and access to substitute service providers influenced the decision to bribe. Additionally, citizens were much more willing to make a bribe when those around them were also participating in bribery. These findings imply that understanding more about the demand side of bribery can inform policy efforts and offer insights into the types of institutional reforms most likely to reduce corruption.
Understanding the Spike in Gun Purchases During the COVID-19 Pandemic
In 2020, a record-breaking 17 million Americans purchased one or more firearms. In a working paper, IPR political scientist James Druckman and his colleagues, including former IPR graduate research assistant Matthew Lacombe, study motivations behind this spike in gun purchases. Between April and July 2021, they surveyed 7,699 gun owners—both gun owners who purchased a gun for the first time during the pandemic and those who owned a gun before March 2020. The survey asked whether the participants or someone in their household had purchased a gun, why they purchased one, if they had experienced an economic hardship, if anyone in their household was diagnosed with COVID-19, and about demographic information, such as their racial group and party affiliation. The survey also asked whether gun owners believe in conspiracy theories, such as that Donald Trump won the 2020 election, and if they trusted institutions, such as the CDC or FDA. The researchers find that first-time gun owners were more likely to hold conspiracy beliefs and were less likely to trust government institutions than pre-existing gun owners. First-time buyers were also more likely to report they purchased a gun because of threats. The results reveal that recent gun owners are more likely to hold extreme views than pre-existing gun owners. Consequently, it could be that gun owners as a group will become more extreme than in the past. The researchers suggest that future research should consider how threatening events could change the composition of other political groups. Druckman is the Payson S. Wild Professor of Political Science.
Performance Measurement & Rewards
Examining the Link Between Drug Development for Older Patients and Productivity Growth
More businesses are investing in intangible capital like software, intellectual property, and research and development (R&D). However, labor productivity and output growth have been slower than the rise in intangible investments. In AEA Papers and Proceedings, professor of finance and IPR associate Janice Eberly, Efraim Benmelech, Joshua Krieger, and Dimitris Papanikolaou investigate the impact of increasing investment in medical R&D on output and productivity growth. First, they show pharmaceutical companies are responsible for an increase in R&D spending in the U.S. economy, with an increase from 3% of overall R&D spending in the 1970s to 10% today. Then, the researchers find more spending targeted toward developing treatments for older patients. They estimate about one-third of total R&D investments are specifically focused on patients ages 65 and over. The research suggests that increased life expectancy and better quality of life for older patients may improve welfare but have less influence on productivity and output growth. The researchers also note that shifting pharmaceutical research and development toward keeping workers in the workforce longer may help retain the knowledge and skills of older people, improving labor productivity and output. Eberly is the James R. and Helen D. Russell Professor of Finance.
Prices and Quality of Care in the U.S. Hospital Market
Rising prices in the U.S. hospital market could stem from multiple factors, including the clustering of healthcare providers, hospital consolidation, or the willingness of patients to pay for quality of care. In the Journal of Health Economics, IPR associates healthcare economist Craig Garthwaite and strategy professor Amanda Starc and Christopher Ody investigate the relationship between hospital prices and quality. They look at the quality investments hospitals make and their effects on revenue. The researchers examined over 2,200 general acute care hospitals that filed Medicare’s Hospital Cost reports for 2012, using demographic data from the American Community Survey (ACS) and the 2010 Census to estimate the share of patients at each hospital with private insurance, public insurance, or who were uninsured. The authors measured quality as a combination of factors, including emergency wait time, technology adoption, and a composite of Medicare Hospital Compare scores that integrates outcome measures, process measures, and patient experience scores. The study finds that hospitals with a higher share of potential patients who are privately insured perform better on quality measures, which implies that hospitals are investing in quality if they are more likely to serve privately insured patients, who pay higher prices than Medicare. These results suggest that changes to Medicare reimbursement policies will affect hospitals’ decisions about quality, and that there may be a quality tradeoff if policies such as Medicare for All or broader public options are adopted. Garthwaite is the Herman Smith Research Professor in Hospital and Health Services Management.
Social Disparities & Health
Tap Water Avoidance is Connected to Food Insecurity
Food insecurity is a large and growing problem in the United States, and water insecurity may be an overlooked factor that contributes to the lack of reliable access to food. In the Journal of the Academy of Nutrition and Dietetics, Asher Rosinger of Penn State University, assistant research professor Hilary Bethancourt, and IPR anthropologist Sera Young investigate how tap water avoidance, a proxy for water insecurity, is associated with food insecurity in the U.S. Using the National Health and Nutrition Survey (NHANES), a nationally representative sample of the U.S. population, they examined a survey of 31,390 U.S. adults in 2005–06 and 2017–18. The survey asked participants questions about their household food security in the prior year, how often individuals drank tap water, and about their demographic background. The researchers find that adults who avoided tap water had a 21% higher chance of food insecurity compared to those who drank tap water, and the probability of food insecurity doubled from the 2005–06 survey to the 2017–18 survey. They also find that food insecurity decreased across tap water drinkers and avoiders as income rose, but it was higher among tap water avoiders at all income levels. The study highlights how water insecurity and food insecurity—both public health problems—are connected and can occur in the United States, a high-income country. The researchers argue that future research is necessary to understand why people avoid tap water and how water insecurity relates to food insecurity.
Photo credits: Unsplash
Published: December 13, 2022.