Research

Job Market Paper

Mental Healthcare Facilities and Mortality: Evidence from Local Access and Insurance Expansion

Abstract (click to expand)

Do mental health treatment facilities save lives? Using County Business Patterns data (1999-2016) and within-county variation, I provide the first causal evidence that mental health infrastructure reduces mortality broadly. Each additional facility prevents 1.56 deaths per 100,000 residents from all causes annually, with mental and behavioral disorder (MBD) mortality declining by 0.079%. A 10% increase in facilities lowers overall mortality by 0.5% and MBD mortality by 2%. Three key findings emerge: (1) facility closures increase mortality ten times more than openings reduce it, revealing asymmetries with welfare implications; (2) Medicaid expansion amplifies facility effectiveness by 26% in high-uninsurance counties, demonstrating that insurance and infrastructure are complements, not substitutes; (3) facilities operate through multiple mechanisms beyond direct treatment, serving as gateways to disability programs and enabling pharmaceutical access. Effects concentrate among elderly and less-educated populations who face the highest access barriers. Event studies using the Sun and Abraham (2021) estimator show immediate, persistent effects with no pre-trends. The benefit-cost ratio exceeds 4-to-1, with each facility generating $11.7 million in annual net benefits. Results indicate that neither insurance expansion nor infrastructure investment alone maximizes health benefits; coordinated policies addressing both dimensions are essential for reducing mortality.

Working Papers

  1. Public Payment Mandates and Provider Supply (with Lauren Hoehn-Velasco and Yu-Ting Huang)
    Status: Under review
    IZA Discussion Paper 18149 | SSRN

  2. Unlocking Health Potential: Health Effects of Free Maternal and Child Health Care Program (with Tejendra Singh)
    Status: Under review
    OSF Preprint

  3. The Effect of Online Sports Gambling Laws on Time Use (with Owen Fleming and Tejendra Singh)
    Status: Working paper
    OSF Preprint

    Media: Investopedia, Bipolar & Bipartisan

  4. Health Effects of Ambulance Deserts (with Tejendra Singh)
    Status: Working paper
    OSF Preprint

Work in Progress

  1. Insurance Expansion, Behavioral Responses, and Emergency Medical Infrastructure: Evidence from the ACA

  2. Long Drive to Safety: Health Effects of Losing Access to Stroke Care

  3. Health Effects of Mental Health Treatment Facilities Closures

  4. Beyond the Prescription: Does Health Insurance Improve Social and Emotional Well-Being?

  5. Higher Education as Regional Development: Labor Market Impacts of Nigeria’s 2011 Federal University Expansion (with Godwin Aipoh)

Pre-Doctoral Publications

  1. Factors influencing choice of healthcare facilities utilisation by rural households in Ogun State, Nigeria (with K. Aboaba, A. Akamo, T. Obalola, O.A. Bankole, A.O. Oladele)
    Agricultura Tropica et Subtropica, 2023
    Paper

  2. Capital Structure and Firm Performance among the listed Agro-Allied Firms in Nigeria (with N. Olasehinde)
    African Journal of Sustainable Development, 2020
    Paper