Does leaving school in an economic downturn persistently affect body weight? Evidence from panel data

Because it is both common and associated with large social costs, obesity is arguably one of the most important health behaviors to study from an economic perspective.  Obesity rates have risen substantially in the U.S. since the 1970s and recent data suggest that 36% of adults are obese (Flegal et al. 2012).  Obesity the second leading cause of preventable death (Mokdad et al. 2004) and contributes to a host of morbidities including diabetes and heart disease (Dixon 2010).  As a result, obesity raises national medical care costs by $190.2 billion per year (Cawley & Meyerhoefer 2012) and lowers labor market productivity (Cawley, 2004).  

This study investigates one potential downstream cause of body weight: leaving school in an economic downturn.  Specifically, I compare the age 40 body weight of individuals who left school when the state unemployment rate was high with the age 40 body weight of individuals who left school when the state unemployment rate was low.  As such this study makes several important contributions to the economic literature.  First, it adds to the growing line of research that documents the importance of leaving school in an economic downturn by examining a previously unconsidered outcome: body weight.  Previous work has largely focused on labor market outcomes (Oyer 2006, 2008; Genda et al. 2010; Kahn 2010; Oreopoulos et al. 2012).  Second, this study extends the health economics literature on contemporaneous economic downturns and health (Ruhm 2000, 2005).  While previous studies have examined the short-run effects in the general population, I examine the persistent effects of experiencing an economic downturn during the school-to-work transition an important period for forming attachment to the labor market (Neumark 2002).  Third, this study builds on an emerging line of research that documents the importance of the initial occupation on later health outcomes and behaviors (Fletcher et al. 2011; Rashad Kelly et al. 2011).  

 I draw data from the National Longitudinal Survey of Youth 1979 Cohort and model body weight at age 40 as a function of the state unemployment rate at school-leaving, and exploit variation generated by volatility in the U.S. economy between 1976 and 1996 to identify body weight effects.  To address the potential endogeneity of both the time and location of school-leaving, I instrument the school-leaving state unemployment rate.  I follow the literature on the persistent effects of leaving school in an economic downturn and use instruments based on birth year, state of residence at age 14, and early life educational expectations (Oyer 2006; Kondo 2007; Kahn 2010; Oreopoulos et al. 2012; Maclean 2013). 

 My results suggest that economic conditions at school-leaving persistently affect body weight, and the relationship varies by sex.  Men who left school in an economic downturn have lower bodyweight, and are less likely to be overweight and obese at age 40 than otherwise similar men.  I find some evidence that leaving school in an economic downturn may increase body weight at age 40 for women.  Supplementary analyses document potential mechanisms and examine dynamics of the net relationship.