John V. Pepper’s research while affiliated with University of Richmond and other places

Objectives To analyze relative differences in oral health care utilization, oral health, and other population characteristics of older Americans with respect to self-reported chronic conditions in the health and retirement study. Methods Differences in estimated percentages of those with specific chronic conditions by selected attributes were tested for statistical significance with standardized normal Z tests and logistic regressions. All estimates were based on weighted data from 1992 to 2016 Early Release RAND HRS Longitudinal file. SE estimates for the percentages accounted for the complex sample design of the survey. Results We establish that the strength of the associations between regular use of dental care and the absence of a chronic condition is similar in magnitude to having a college education, living in a high-income family, never smoking, not having certain functional limitations, and being under 65 years of age. Discussion These cross-sectional findings establish the relative strength of relationships between dental care use, oral health status, and other population characteristics and eight diagnosed conditions. Further work beyond the scope of this paper is needed to confirm these results as either attributes of those with the disease or causal risk factors for the onset of the condition.

Past research suggests there are systematic associations between oral health and chronic illness among older adults. Although causality has not yet been credibly established, periodontitis has been found to be associated with higher risk of both heart disease and stroke. We advance this literature by estimating the direct association between dental care use and systemic health using multiple waves of the 1992 to 2016 Health and Retirement Study. Through the inclusion of individual fixed effects in our regression models, we account for unobservable time-invariant characteristics of individuals that might otherwise bias estimates of the association between dental care use and health. We find statistically significant negative associations between dental care use and the number of health conditions, self-reported overall health, the incidence of heart disease, and the incidence of stroke. In particular, the use of dental care within the past 2 y is associated with a 2.7% reduction in the likelihood of being diagnosed with a heart condition and a reduction in the likelihood of a stroke diagnosis of between 5.3% and 11.6%. We also find large positive correlations between edentulism and the measures of chronic illness. Associations from models estimated separately for men and women are qualitatively similar to one another. These findings provide additional motivation for the consideration of a Medicare dental benefit.

We reevaluate the causal impacts of prenatal participation in the Women, Infants, and Children (WIC) supplemental nutrition program on birth outcomes by simultaneously accounting for self‐selection into WIC and systematic underreporting of program participation. Combining survey data from the Early Childhood Longitudinal Study‐Birth Cohort with administrative data from the USDA, we extend partial identification methods to reflect institutional details of the WIC program and validate WIC program participation for a mixture of positive and negative responses. Our preferred estimates imply that WIC increases the prevalence of normal birth weight by at least 4.8% and normal gestation duration by at least 3.7%. ( JEL C14, C21, I12, I31, I38)

Introduction This study describes the characteristics of, services received by, and labor market outcomes of applicants with visual impairments to three state vocational rehabilitation programs. Our objective is to both document cross-state variation in vocational rehabilitation clientele and services and provide new insights on the longitudinal labor market outcomes of clients with visual impairments (i.e., blindness or low vision). This analysis is a first step in assessing the returns to vocational rehabilitation services for this population. Methods We first created a unique longitudinal data set by matching administrative records on applicants who are visually impaired in state fiscal year 2007 from three vocational rehabilitation agencies to 8 years of employment data from state Unemployment Insurance programs. Using these data, we examined cross-state variation in the descriptive statistics for important client explanatory variables and vocational rehabilitation service categories. We then compared the long-term labor market outcomes of clients receiving services (treated) to untreated individuals. Results We documented two important findings. First, there were substantial differences in client characteristics, services provided, and costs across the three states. Second, the long-run labor market analysis was consistent with vocational rehabilitation services having no employment effect but a positive earnings effect. Discussion Labor market results indicate vocational rehabilitation services provided persistent earnings benefits. Yet the substantial cross-state heterogeneity suggests these labor market results might not be generalizable and should be interpreted with caution. We explain what was missing from this analysis and why the results should not be thought of as causal. Implications for Practitioners This article gives practitioners a sense of a unique new data set on vocational rehabilitation and labor market variables for applicants with visual impairments. We highlight the importance of cross-state variation and linking vocational rehabilitation data to long-term employment measures. The question of how best to inform the efficacy of different vocational rehabilitation strategies for clients with visual impairments is left for future researchers to consider.

The process of “transitioning” to adulthood for youth with disabilities has long been recognized to be an important but understudied public policy concern. This paper evaluates the labor market effects of Virginia's school-to-work vocational evaluation program, PERT. Using a unique panel data set containing more than a decade of labor market and service information, we provide the first-ever assessment of the long-term employment impacts of a transitioning program for youth with disabilities. Overall, the estimated effects are substantial: PERT has an estimated median quarterly rate of return of nearly 30%.