Research

Working papers

Political polarization in medicine (pdf)

Job market paper

Abstract: Political polarization is increasingly affecting policymaking across issues, but is it also influencing the decision-making of professionals? This paper studies the differences in medical practice between Republican and Democrat physicians over 1999-2019. It links physicians in Medicare claims data with their campaign contributions to identify their party alignment. In 1999, there were no partisan differences in medical expenditure per patient. Two decades later, Republican physicians now spend 13% more, particularly on elective procedures. We analyze four potential sources of this partisan difference: practice characteristics (i.e., specialization and location), patient composition, preferences for financial gain, and beliefs about treatments. We find the most evidence for differences in beliefs. Republican physicians perform more low-value care, which aligns with their beliefs in prior surveys. The timing of the divergence matches the politicization of medicine in Congress. These results suggest that the polarization of policies may lead to partisan differences in the behavior and beliefs of practitioners.Updated October 2024

Policy diffusion and polarization across U.S. states (pdf)

With Stefano DellaVigna

Revise and resubmit, Review of Economic Studies

Abstract: Economists have studied the impact of numerous state laws, from welfare rules to voting ID requirements. Yet for all this policy evaluation, what do we know about policy diffusion—how these policies spread from state to state? We present a series of facts based on a data set of over 700 U.S. state policies spanning the past 7 decades. First, for the introduction of new laws, state capacity seems to have a small role, in that larger and richer states are only slightly more likely to innovate policy. Second, the diffusion of policies from 1950 to 2000 is best predicted by proximity—a state is more likely to adopt a policy if nearby states have already done so—as well as similarity in demographics and voter policy preferences. Third, since 2000, political alignment is the strongest predictor of diffusion. Models of learning and correlated preferences can account for the earlier patterns, but the findings for the last two decades indicate a sharply increasing role of party control. We conclude that party polarization has emerged as a key factor recently for policy adoption, plausibly leading to a worse match between state policies and voter preferences.Updated March 2023

“Don’t you plan on voting?” The motives and effects of peer pressure in voter mobilization (pdf)

Revise and resubmit, Quarterly Journal of Political Science

Abstract: Online peer pressure has emerged as a potential tool to mobilize young American voters, but it remains unclear whether these voters are willing to pressure their peers and how effective it would be. In this online field experiment, college students choose whether to send an email that pressures their campus peers to register to vote for the 2020 U.S. Elections. The senders have a negative average willingness-to-pay (WTP) to send the email, meaning they would rather pay than pressure their peers. The experiment reveals two counteracting motives at play. On the positive side, senders believe that pressuring their peers will persuade them to register. On the negative side, they believe that their peers will dislike being pressured, which outweighs the positive motives. However, under anonymous messaging, they become much less sensitive to whether the recipient dislikes being pressured, and their average WTP turns positive. This pattern of behavior reflects voters who are motivated by the prospect of mobilizing their peers, but are restrained by self-interested concerns from social image costs or retaliation.Updated November 2023

Publications

Bottlenecks for evidence adoption (pdf, doi)

With Stefano DellaVigna and Elizabeth Linos

Journal of Political Economy (2024)

Abstract: Governments increasingly use randomized controlled trials (RCTs) to test innovations, yet we know little about how they incorporate results into policymaking. We study 30 US cities that ran 73 RCTs with a national nudge unit. Cities adopt a nudge treatment into their communications in 27% of the cases. We find that the strength of the evidence and key city features do not strongly predict adoption; instead, the largest predictor is whether the RCT was implemented using preexisting communication, as opposed to new communication. We identify organizational inertia as a leading explanation: changes to preexisting infrastructure are more naturally folded into subsequent processes.

Television and American consumerism (pdf, doi)

Journal of Public Economics (2022)

Abstract: How did the introduction of mass commercial television in the postwar era change American consumer behavior? Media scholars and U.S. historians claim that TV with its unprecedented advertising appeal drew Americans into a culture of upscaling and purchasing products for social status. I test this prevailing theory using newly digitized nationwide county-level retail sales data from the Census of Business series. I compare growth in retail sales between areas with and without local TV service over the unanticipated Federal Communications Commission (FCC) Freeze, which halted the licensing of new TV stations from 1948–52. I find three results that corroborate TV’s long-attributed role in American consumerism. First, during the Freeze, total retail sales in counties with TV access increased by 3–4% more on average than in counties without access. Second, the effect of TV was concentrated in the automobile sector, which alone accounted for a third of the total difference. Third, TV advertising led to higher growth in sales, but only for durable goods, which neatly aligns with both qualitative reports and theories of conspicuous consumption. Historians also propose that the suburban family life popularized in TV sitcoms became the mainstream representation of the American Dream in the 1950s. Consistent with these accounts, I find that the start of TV access coincides with greater activity in local highway construction and birthrates.

Work in progress

Correcting for geographic correlation with multiple outcomes

With Stefano DellaVigna, Guido Imbens, and David Ritzwoller