Abstracts Economics

ESSAYS ON THE ECONOMICS OF GENDER DISPARITIES IN THE HEALTH AND LABOR MARKETS

by Britni Wilcher

There are asymmetric effects by gender in the domain of health that interact with the labor market. Theoretical channels point to the quality of health technology and individual health investments to explain gender disparities. Less is known about how gender diverse clinical participation influences the quality of health technology innovation and how female unpaid labor impacts health investments. This dissertation examines: (1) how the sex composition of clinical trials impacts therapeutically novel drug risks, (2) how female unpaid labor interacts with health investments, and (3) the downstream impact of health investments on employment outcomes.Using novel data containing information about U.S. adverse drug reactions linked with the regulatory and therapeutic characteristics of drugs approved from 1996 – 2004, chapter one explores whether the 1998 FDA Demographic Rule requirement to provide an analysis of clinical safety and effectiveness data by sex when seeking approval for U.S. marketing shifted the sex balance of clinical trial populations and, in turn, improved drug safety for female patients. While the rule corresponded with improvements in the sex balance of clinical trial populations, mortality related to novel drugs in this period increased 226% with no differences when disaggregating by sex. This was driven, in part, by changes in the therapeutic composition of drugs over time.Chapter two examines how local labor market conditions affect maternal health. Mothers spend twice as much time on unpaid care work, yet they are the sole or co-breadwinner in nearly half of U.S. households. This dual time burden can increase exposure to health risks. I find that that unemployment reduces stress-related conditions (e.g., strokes), while employment growth increases stress-related conditions (e.g., heart disease). Unemployment also reduces medical care utilization (e.g., pap smears). Child care subsidies offset some of the negative impacts of employment growth by reducing heart disease and increasing routine medical care.The third chapter examines how paid family leave affects long-run maternal labor market detachment. In the absence of paid leave, maternal labor market detachment is nearly 30% following a birth; it attenuates over time but remains significantly different from zero as much as eleven years later. Access to paid family leave at the time of a birth significantly increases labor market participation by more than 5% in the year of a birth. This effect attenuates over time but remains significantly different from zero as much as five years later. The impacts are the largest for women with higher educational attainment.