Charles Courtemanche

Applied Microeconomics - Health Economics

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WORKING PAPERS:

Rising Cigarette Prices and Rising Obesity: Coincidence or Unintended Consequence?
Economists have begun to debate if the U.S. anti-smoking campaign, which led to a sharp rise in cigarette prices, has had the unintended consequence of contributing to the nation's rise in obesity. This is possible since smoking may reduce weight by suppressing one's appetite and increasing one's metabolism. I find that the sensitivity to specification seen in the literature disappears after including additional survey waves and accounting for secular state trends in body weight, and that the marginal effect of contemporaneous cigarette prices on weight is indistinguishable from zero. I next show that a rise in cigarette prices is actually associated with a reduction in body mass index and obesity in the long run. Finally, I provide evidence that indirect effects on exercise and food consumption may explain the counterintuitive result. I hypothesize that people who quit smoking experience a renewed interest in their health, increased confidence in their self-control, and a replenished stock of willpower, causing them to make healthier decisions in other areas as well.

Working Yourself to Death? The Relationship Between Work Hours and Obesity? (under review)
Work hours may affect obesity if reduced leisure time decreases exercise and causes substitution from meals prepared at home to fast food and pre-prepared processed food. Additional work by adults may also impact child weight by reducing parental supervision. I find that a rise in work hours increases one's weight and, to a lesser extent, the weight of one's spouse. Mothers', but not fathers', work hours affect child weight. My estimates imply that increases in labor force participation account for 6% and 10% of the growth in adult and childhood obesity in recent decades.

A Silver Lining? The Connection Between Gasoline Prices and Obesity (under review)
A causal relationship between gasoline prices and obesity is possible through mechanisms of increased exercise and decreased eating in restaurants. Using a fixed effects model with a variety of robustness checks, I find empirical support for this theory. My estimates imply that an additional $1 in real gasoline prices would reduce the prevalence of overweight and obesity in the U.S. by 7% and 9% after seven years, and that 8% of the rise in obesity between 1979 and 2004 can be attributed to falling real gasoline prices during this period. I also provide evidence that rising gas prices are associated with both an increase in walking or bicycling and a reduction in the frequency with which people eat at restaurants.

Tax Incentives and the Decision to Purchase Long-Term Care Insurance (with Daifeng He) (revise and resubmit requested by the Journal of Public Economics)
This paper studies the impact of the tax incentive prescribed in the Health Insurance Portability and Accountability Act of 1996 (HIPAA) on people’s long-term care (LTC) insurance purchasing behavior. Using data from the Health and Retirement Study, we find that the tax incentive in HIPAA increased the take-up rate of private LTC insurance by 3.2 percentage points, or 25%, for those eligible. Nonetheless, we calculate that even an above-the-line tax deduction would not increase the overall coverage rate of seniors beyond 13%. We therefore conclude that tax incentives alone are unlikely to expand the market substantially. We also present, to our knowledge, the first estimate of the price elasticity of demand for LTC insurance of around -3.6, suggesting that demand is highly elastic, at least at the current low ownership rate.

Does Wal-Mart Reduce Social Capital? (with Art Carden and Jeremy Meiners; revised and resubmitted to Public Choice)
Social capital has attracted increasing attention in recent years. We use county-level and individual survey data to study how Wal-Mart affects social capital. Estimates using several proxies for social capital—such as club membership, religious activity, time with friends, and other measures—do not support the thesis that “Wal-Mart destroys communities” by reducing social capital. We measure exposure to Wal-Mart two ways: Wal-Marts per 10,000 residents and Wal-Marts per 10,000 residents aggregated over years since 1979 to capture a more cumulative “Wal-Mart Effect.” We find that coefficients on Wal-Mart’s presence are statistically insignificant in most specifications.

Wal-Mart and Values: Painting the Town Red? (with Art Carden and Jeremy Meiners; under review)
This essay explores the relationship between commerce and culture in the context of the recent debate over the social effect of Wal-Mart. In spite of much public debate, little is known about how Wal-Mart affects values. Using data collected from multiple sources, we show there is little evidence that Wal-Mart makes communities more conservative or more progressive.

Risky Business? Wal-Mart and Risky Health Behaviors (with Art Carden)
We test the hypothesis that Wal-Mart’s low prices may lead to an increase in risky health behaviors. We find that Wal-Mart is associated with increases in smoking and drinking but with reductions in obesity. Wal-Mart appears to reduce exercise but also the consumption of unhealthy foods.


WORK IN PROGRESS:

Healthier Habits for Everyone? The Spillover Effects of Smoking Cessation

Three Birds with One Stone? The Effect of Alcohol Taxes on Cigarette Smoking and Obesity

Is Insurance Bad for Your Health? Moral Hazard and Risky Health Behaviors

Does Increasing the Minimum Wage Build Social Capital? (with Art Carden)

Stupor Wal-Mart? Wal-Mart's Presence and Leisure Activities (with Art Carden)


Contact Information:
Email: cjcourte@artsci.wustl.edu
Phone: (314) 368-0230, Fax: (314) 935-4156
Campus Box 1208, Department of Economics, Washington University in St. Louis, St. Louis, MO 63130

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