Essays in Labor Economics and Child Welfare

Abstract

This dissertation consists of three papers on topics in labor economics and child welfare. Chapter 1 studies the rise of the nursing profession. In the early 20th century, hospitals founded training schools for nurses to meet the growing demand for medical care. Training schools increased overall nurse supply and soon became the primary pathway for young women to receive a professional nursing credential. I estimate how the availability of nurse training affected labor market outcomes. Using linked census records and training school openings as a source of variation, I show that white women who were geographically close to an opening in adolescence were more likely to become trained nurses. Effects are largest for women from well-off families, as proxied using father's occupation. Availability of nurse training caused women to substitute away from other occupations and had little effect on labor force participation or occupation-based measures of income. Furthermore, by their thirties, women who were geographically close to an opening were less likely to become physicians. These results paint a mixed picture: Nurse training provided new opportunities for women in the workforce, reinforcing existing gender segregation in medicine. Over the course of the 20th century, nursing would grow to become the largest majority-female occupation in the United States. Chapter 2 studies state vaccination policy and child vaccination rates (co-authored with Samantha Gold). Vaccination rates have fallen below the threshold for herd immunity in many states, prompting concerns over exposure to infectious disease outbreaks. In this paper, we estimate how state efforts to enforce vaccination requirements for children in school have affected vaccination rates. In the past decade, several states have repealed non-medical vaccine exemptions. Using a staggered difference-in-differences design, we estimate that state repeal raised kindergarten vaccination rates by 2 to 4 percentage points, with little substitution toward medical exemptions. We next examine whether school immunization audits further increased vaccination rates in California. Immunization audits were conducted starting in 2021 in schools with vaccine non-compliance rates of greater than 10 percent. Using a regression discontinuity design, we find no evidence of improved vaccine compliance in later years among schools at the audit threshold. Our results suggest that amidst growing vaccine hesitancy, state repeal of non-medical exemptions is particularly effective at keeping vaccination rates high. Furthermore, state policy has resulted in diverging vaccination rates between Democratic and Republican states. Based on our event study estimates, two-thirds of the gap in vaccination rates between Democratic and Republican states is driven by state exemption policy. Chapter 3 studies the economics of foster care (previously published in the Journal of Economic Perspectives and co-authored with Joseph J. Doyle Jr., Max Gross, and Brian A. Jacob). Foster care provides substitute living arrangements to protect maltreated children. The practice is remarkably common: it is estimated that 5 percent of children in the United States are placed in foster care at some point during childhood. This paper describes the main tradeoffs in child welfare policy and provides background on policy and practice most in need of rigorous evidence. Trends include efforts to prevent foster care on the demand side and to improve foster home recruitment on the supply side. With increasing data availability and a growing interest in evidence-based practices, there are opportunities for economic research to inform policies that protect vulnerable children.