I study how the deregulation of radio content in the U.S. transformed local politics and public health outcomes. The 1987 repeal of the FCC’s Fairness Doctrine removed requirements for broadcasters to air contrasting viewpoints on political issues and triggered the expansion of conservative talk radio. I find that quasi-exogenous exposure to growth in conservative talk radio raised Republican vote shares across presidential, Senate, and House elections, and also increased “deaths of despair” (alcohol-, overdose- and suicide-related mortality). These effects emerge in the early 1990s and persist decades later, underscoring how partisan media ecosystems can reshape both politics and public health.

How important are churches to local economic outcomes? Exploiting two plausibly exogenous shocks to church access and attendance, we study the causal effect of churches on a variety of economic and social outcomes. Using data from the Southern Baptist Convention (SBC), we study: (1) unexpected pastor deaths, which precipitate church closures, and (2) SBC pastor convictions for sex crimes, which also alter local congregations and attendance. Across multiple data sources, we find that churches exert large positive effects on economic activity and wellbeing, and that these effects are partly due to the church's role in facilitating social connectedness.

School-based health centers (SBHCs) aim to improve child and adolescent health by providing health care at schools. SBHCs have become increasingly widespread in recent decades, with over 2,500 SBHCs serving more than 6 million students throughout the United States. While existing research finds that SBHCs are positively correlated with health care use and educational outcomes, differences between students at schools with and without SBHCs may confound these estimates. Moreover, while a large literature shows that childhood health has lasting impacts on later adult health, human capital, and economic outcomes, little is known about the impacts of SBHCs on students’ long-run trajectories. This project aims to fill this gap by measuring the causal effects of SBHCs on students’ health care utilization and their behavioral, educational, and economic outcomes using a differences-in-differences approach that exploits the staggered openings of SBHCs across schools compared to matched control schools. Using the near-universe of psychotropic prescriptions written spanning 13 years linked to over 1,800 SBHC openings, we find that SBHC openings lead to persistent increases in youth antidepressant and antipsychotic medication use. We will further examine broader impacts on youth health care utilization, leveraging Medicaid claims data covering the entire US, as well as administrative records on all public-school students in Texas linked with information on the opening of 54 SBHCs. These data will allow us to further estimate effects on a range of student outcomes, including attendance, disciplinary actions, high school graduation, college enrollment/graduation, and adult employment and earnings. We will also assess heterogeneity by student characteristics such as race/ethnicity, socioeconomic status, and by SBHC characteristics such as service offerings and staffing patterns. Overall, the findings will help policymakers, schools, health care providers, and parents understand the impacts of SBHCs on youth, thereby helping inform discussions about further expanding such centers across the US.

Using a thirteen-year universe of U.S. outpatient prescription claims covering more than one hundred million psychotropic prescriptions, we disentangle the opposing roles of on-the-job learning and medical-school vintage in shaping physician quality. Cross-sectional estimates show that older doctors prescribe guideline-deviant “red-flag” doses much more frequently than younger colleagues, a pattern that might be read as deterioration with age. Tracking fixed cohorts over time reveals the opposite life-cycle: within a cohort, red-flag rates decline steadily and variance shrinks, consistent with learning-by-doing and selection. The raw age gradient therefore hides a powerful cohort effect. Physicians who trained more recently begin their careers with substantially safer prescribing habits, while earlier cohorts carry forward higher baseline propensities to deviate from guidelines. An event study around the 2011 FDA revision that discouraged high-dose citalopram confirms both forces: doctors of every age promptly cut high-dose prescriptions after the announcement, yet older cohorts persistently remain above younger ones. Together, the results imply that the apparent disadvantage of experience in the cross-section is driven by outdated training rather than ageing per se; meanwhile, within-doctor learning continues throughout the career. Policy efforts to improve prescribing quality will therefore be most productive when they combine reforms in medical education for future cohorts with targeted continuing-education or decision-support tools that help earlier cohorts update long-held prescribing habits.

This paper estimates the effects of fatal school shootings on youth psychotropic drug use over the subsequent 5.5 years. Using an event study approach that compares trends in drugs prescribed by providers practicing close to a school shooting relative to those practicing slightly farther away, we find that fatal school shootings lead to large increases in youth psychotropic drug use that persist for years after the event. These effects are driven primarily by increases in prescriptions for antidepressants and antipsychotics and are observed both among youth who were previously taking psychotropic medication and those who were not.