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Objective: Cardiometabolic disease is the leading cause of mortality in the United States. Cardiometabolic function during adolescence predicts future cardiometabolic disease, yet few studies have examined early determinants of cardiometabolic function. Informed by evidence of sex differences in the prevalence and severity of cardiometabolic disorders and evidence of sexual dimorphism in the stress response, we examined sex differences in the association between living in poverty and cardiometabolic function during adolescence, a precursor of later cardiometabolic disorders. Methods: We linked data from 10 415 adolescents aged 12-19 in the National Health and Nutrition Examination Survey (1999-2012) with US Census–tract data on area-level poverty (percentage of the population living in poverty, grouped into quartiles). We parameterized cardiometabolic dysfunction by summing the z scores of 6 cardiometabolic biomarkers, grouped into quintiles. Hierarchical ordinal models estimated associations. Results: Compared with residents in low-poverty areas, residents in high-poverty areas had elevated odds of cardiometabolic dysfunction (highest quartile of poverty odds ratio [OR] = 1.27; 95% confidence interval [CI], 1.08-1.50). This association was more pronounced among boys than girls (highest quartile of poverty for boys: OR = 1.36; 95% CI, 1.10-1.70; highest quartile of poverty for girls: OR = 1.17; 95% CI, 0.94-1.47). Conclusion: Our study supports the existence of sex-specific associations. These results highlight the potential for community-based programs, such as housing assistance, to improve population health.

The U.S. incarceration rate rose dramatically over the past 45 years, increasing the number of marriages and cohabiting unions disrupted by a jail or prison stay. But as some have pointed out, not all unions dissolve as a result of incarceration, and there seems to be racial–ethnic variation in this tendency, with Blacks displaying higher rates of dissolution than Whites and Hispanics. Yet it is unclear what explains racial–ethnic differences in union dissolution among the incarcerated. Drawing on the National Longitudinal Survey of Youth 1997 (NLSY97), we examine why racial–ethnic differences in union dissolution exist among a sample of individuals who had a marital or a cohabiting union interrupted by an incarceration spell. In doing so, we draw on social exchange theory and structural and cultural theories to suggest that racial–ethnic disparities in union dissolution are explained by differential exposure to protective relationship characteristics. The results of Cox hazard models reveal that Blacks have significantly higher hazards of union dissolution than do Whites and Hispanics. These results also indicate that being married, having a child together, having full‐time employment, a longer union duration, and a shorter incarceration spell may protect against dissolution and that these factors account, in part, for the greater risk of dissolution among Blacks relative to Whites and Hispanics.

This paper assesses if voting for democracy affects long-term electoral participation. We study the effects of participating in Chile's 1988 plebiscite, which determined whether democracy would be reinstated after a 15-year long military dictatorship. Taking advantage of individual-level voting data for upwards of 13 million Chileans, we implement an age-based RD design comparing long run registration and turnout rates across marginally eligible and ineligible individuals. We find that Plebiscite eligibility (participation) significantly increased electoral turnout three decades later, reaching 1.8 (3.3) percentage points in the 2017 Presidential election. These effects are robust to different specifications and distinctive to the 1988 referendum. We discuss potential mechanisms concluding that the scale of initial mobilization explains the estimated effects. We find that plebiscite eligibility induced a sizable share of less educated voters to register to vote compared to eligibles in other upstream elections. Since less educated voters tended to support Chile's governing left-wing coalition, we argue that the plebiscite contributed to the emergence of one party rule the twenty years following democratization.

Michel Boudreaux, Health Policy and Management, and Anuj Gangopadhyaya, Urban Institute

Wade Jacobsen, Criminology and Criminal Justice

Utilization of cost-effective essential preventive health services increased after the implementation of the Affordable Care Act’s (ACA) provision that non-grandfathered private insurers provide cost-effective preventive services without cost sharing in 2010. Little is known, however, whether this change is also observed among Asians in the US. We examined patterns of preventive services utilization among Asian subgroups relative to non-Latino whites (whites) after the implementation of the ACA’s preventive services provisions. Using 2013–2016 Medical Expenditure Panel Survey data, we examined utilization trends in preventive services among Asian Indians, Chinese, Filipinos, and other Asians relative to whites. We also ran logistic regression models to estimate the likelihood of having received each of the seven essential preventive services (routine checkups, flu vaccinations, cholesterol screenings, blood pressure checkups, Papanicolaou “pap” tests, mammograms, and colorectal cancer screenings). Compared to whites, Asians had higher rates of utilization of routine checkups, cholesterol screenings, and flu vaccinations, but they had lower utilization rates of blood pressure checkups, pap tests, and mammograms. The patterns of preventive services utilization differed across the Asian subgroups. All Asian subgroups, except for Filipinos, were less likely to have pap tests or mammograms than whites. Moreover, we observed a decreasing trend in having pap tests, mammograms, or colorectal cancer screenings among all Asian subgroups between 2013 and 2016. Our findings suggest that there are low cancer screening rates across Asian subgroups. This indicates the need for programs tailored to specific Asian subgroups to improve cancer screening.

Gang membership is believed to impede success in the legitimate economic market while simultaneously supporting success in the illegal market. We extend the study of the economic effects of gang membership by using a within-and between-individual analytic design, decomposing gang membership into multiple statuses (i.e., entering a gang,continuously in a gang, leaving a gang, and inactive gang membership), examining legal and illegal earnings simultaneously, and accounting for factors endogenous to gang membership that may contribute to economic achievement.By using panel data from 1,213 individuals who participated in the Pathways to Desistance Study to conduct a multi level path analysis, we find that active gang membership status is unrelated to legal earnings. Alternatively,entering a gang is associated with increased illegal earnings, attributable to changes in delinquent peers and drug use, whereas leaving a gang has a direct relationship with decreased illegal earnings. Our results indicate that the positive economic effect of gang membership (i.e., illegal earnings and total earnings) is short-lived and that, on balance,the sum of the gang membership experience does not “pay”in terms of overall earnings.

From education to health to criminal justice, government regulation and policy decisions have important effects on social and individual experiences. New data science tools applied to data created by government agencies have the potential to enhance these meaningful decisions. However, certain institutional barriers limit the realization of this potential. First, we need to provide systematic training of government employees in data analytics. Second we need a careful rethinking of the rules and technical systems that protect data in order to expand access to linked individual-level data across agencies and jurisdictions, while maintaining privacy. Here, we describe a program that has been run for the last three years by the University of Maryland, New York University, and the University of Chicago, with partners such as Ohio State University, Indiana University/Purdue University, Indianapolis, and the University of Missouri. The program—which trains government employees on how to perform applied data analysis with confidential individual-level data generated through administrative processes, and extensive project-focused work—provides both online and onsite training components. Training takes place in a secure environment. The aim is to help agencies tackle important policy problems by using modern computational and data analysis methods and tools. We have found that this program accelerates the technical and analytical development of public sector employees. As such, it demonstrates the potential value of working with individual-level data across agency and jurisdictional lines. We plan to build on this initial success by creating a larger community of academic institutions, government agencies, and foundations that can work together to increase the capacity of governments to make more efficient and effective decisions.

Children exposed to "Sesame Street" were more likely to be enrolled in the correct grade level for their age at middle and high school

Montgomery County Executive, Maryland Governor disagree on Thin Blue Line Flag