@article {11479, title = {The Hidden Role of Racial Wealth Disparities in Older Adults{\textquoteright} Vulnerability to COVID-19}, journal = {Research Square}, year = {Forthcoming}, abstract = {Background: To examine racial and ethnic differences in wealth and other economic, exposure and baseline health-related risks of COVID-19 among older adults in the U.S. Methods: Using rich data on wealth and long-term care use among older Americans unique to the 2016 Health and Retirement Study, we quantify differences in COVID-19 vulnerability among non-Hispanic white, non-Hispanic Black and Hispanic respondents aged 50+. We measure wealth, other economic (insurance, income); exposure (long-term care, employment, telework, household size); and health (chronic conditions, smoking) risk stratified by age (50-64, 65+). Results: Blacks and Hispanics face dramatically greater financial risk that potentially increases exposure to COVID-19, relative to whites; Blacks and Hispanics are four to five times more likely to have no financial wealth. Blacks are also more likely than whites to use long-term care. Blacks and Hispanics also are less likely to have health insurance and face greater risk of exposure to COVID-19 because they are less likely to telework, and Hispanic older adults reside in larger households. Black and Hispanic older adults are also more likely to have a chronic condition associated with worse COVID-19 outcomes. Conclusions: Our results suggest that wealth differences may play a substantial role in contributing to the very large racial and ethnic disparities in the health burden of COVID-19. Racial disparities in long-term care, where COVID-19 risks are higher, contribute to make older Black Americans even more vulnerable to COVID-19.}, keywords = {COVID-19, Racial wealth disparities}, isbn = {2693-5015}, doi = {10.21203/rs.3.rs-271452/v1}, author = {Ruth Winecoff and Padmaja Ayyagari and Melissa McInerney and Kosali I. Simon and M Kate Bundorf} } @article {10978, title = {ACA Medicaid Expansion Associated With Increased Medicaid Participation and Improved Health Among Near-Elderly: Evidence From the Health and Retirement Study}, journal = {Inquiry : a journal of medical care organization, provision and financing}, volume = {57}, year = {2020}, abstract = {The Affordable Care Act (ACA) dramatically expanded health insurance, but questions remain regarding its effects on health. We focus on older adults for whom health insurance has greater potential to improve health and well-being because of their greater health care needs relative to younger adults. We further focus on low-income adults who were the target of the Medicaid expansion. We believe our study provides the first evidence of the health-related effects of ACA Medicaid expansion using the Health and Retirement Study (HRS). Using geo-coded data from 2010 to 2016, we estimate difference-in-differences models, comparing changes in outcomes before and after the Medicaid expansion in treatment and control states among a sample of over 3,000 unique adults aged 50 to 64 with income below 100\% of the federal poverty level. The HRS allows us to examine morbidity outcomes not available in administrative data, providing evidence of the mechanisms underlying emerging evidence of mortality reductions due to expanded insurance coverage among the near-elderly. We find that the Medicaid expansion was associated with a 15 percentage point increase in Medicaid coverage which was largely offset by declines in other types of insurance. We find improvements in several measures of health including a 12\% reduction in metabolic syndrome; a 32\% reduction in complications from metabolic syndrome; an 18\% reduction in the likelihood of gross motor skills difficulties; and a 34\% reduction in compromised activities of daily living (ADLs). Our results thus suggest that the Medicaid expansion led to improved physical health for low-income, older adults.}, keywords = {crowd-out, difference-in-differences, Health Status, Insurance Coverage, Medicaid, near-elderly adults, Patient Protection and Affordable Care Act}, isbn = {1945-72430046-9580}, doi = {10.1177/0046958020935229}, author = {Melissa McInerney and Ruth Winecoff and Padmaja Ayyagari and Kosali I. Simon and M Kate Bundorf} } @article {11272, title = {Nursing Home Use Expectations and Wealth Accumulation Among Older Adults}, number = {WI20-01}, year = {2020}, institution = {Center for Financial Security, University of Wisconsin-Madison}, address = {Madison, WI}, abstract = {Long-term care represents a significant cost to older adults in the US, and nursing home use is an important part of long-term care. It is therefore important to understand how older adults make nursing home-related decisions. This study analyzes the determinants of older adults{\textquoteright} nursing home use expectations, their relationship with actual nursing home use in the future, and the association between nursing home use expectations and older adults{\textquoteright} decisions regarding wealth accumulation. The findings indicate that older adults update their nursing home use expectations rationally and their nursing home use expectations have strong predictive power for actual nursing home use in the future, but these expectations are not statistically significantly associated with wealth accumulation. }, keywords = {Disparities, Nursing home use, Subjective Expectations, wealth accumulation}, url = {https://cfsrdrc.wisc.edu/publications/working-paper/wi20-01}, author = {Padmaja Ayyagari and Wang, Yang} } @article {Ayyagari2019HealthIA, title = {Health Insurance and Early Retirement Plans: Evidence from the Affordable Care Act}, journal = {American Journal of Health Economics}, volume = {5}, year = {2019}, pages = {533-560}, abstract = {Understanding how individuals make retirement plans is key to designing effective policy. In particular, access to affordable insurance during retirement can play an important role in the labor supply decisions of older adults. In this study, I examine the impact of the 2010 Affordable Care Act (ACA) on the retirement plans of older adults. The ACA includes several provisions that significantly increase access to affordable insurance not tied to employment. I find that the ACA decreased the subjective probability of working past age 62 by 5.6 percentage points, representing a 9.9 percent decline, among persons without employer sponsored retiree coverage relative to persons with employer sponsored benefits. On average, individuals expect to retire about 3.6 to 7.2 months earlier due to the ACA.}, keywords = {Affordable Care Act, Employer Sponsored Retiree Health Insurance, Job Lock, Subjective Retirement Expectations}, url = {https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3281097}, author = {Padmaja Ayyagari} } @article {doi:10.1177/0019793919891973, title = {The Impact of Income-Related Medicare Part B Premiums on Labor Supply}, journal = {ILR Review: The Journal of Work and Policy}, year = {2019}, pages = {0019793919891973}, abstract = {The 2003 Medicare Modernization Act introduced income-related premiums on Medicare coverage for professional services (Part B) for the first time. Beginning in 2007, higher-income households were required to pay higher premiums for Part B coverage, which raises the price of Medicare relative to employer-sponsored health insurance for these households. The authors exploit this exogenous change in Medicare policy to examine the impact of Part B premiums on the labor supply decisions of older adults. They find that higher Medicare premiums delay retirement. Findings have important implications for Medicare policy and labor markets.}, keywords = {Labor, Labor Dynamics, Medicare, Medicare Part B}, doi = {10.1177/0019793919891973}, url = {https://doi.org/10.1177/0019793919891973}, author = {Padmaja Ayyagari and Frank A Sloan} } @article {10466, title = {The Impact of Medicare Part D on Emergency Department Visits.}, journal = {Health Economics}, volume = {26}, year = {2017}, month = {2017 04}, pages = {536-544}, abstract = {

The Medicare Part D program introduced prescription drug coverage for seniors in 2006. We examine the impact of this program on the use of emergency department (ED) care. Using a difference-in-differences model, we find declines in the number of ED visits for non-emergency care but not for emergency care, suggesting that Part D may have led to better management of health and reduced unnecessary use of EDs. Copyright {\textcopyright} 2016 John Wiley \& Sons, Ltd.

}, keywords = {Aged, Delivery of Health Care, Emergency Service, Hospital, Female, Humans, Insurance Coverage, Insurance, Health, Male, Medicare Part D, Middle Aged, prescription drugs, Surveys and Questionnaires, United States}, issn = {1099-1050}, doi = {10.1002/hec.3326}, author = {Padmaja Ayyagari and Dan M. Shane and George L Wehby} } @article {8371, title = {The Impact of Retirement on Smoking Behavior}, journal = {Eastern Economic Journal}, volume = {42}, year = {2016}, note = {Times Cited: 0 0}, pages = {270-287}, publisher = {42}, abstract = {We use data from the Health and Retirement Study to examine the relationship between retirement and smoking decisions. Retirement might affect smoking behavior through a change in the opportunity cost of time, job-related factors or income. To estimate the causal effect of retirement on smoking habits, we exploit eligibility for Social Security benefits at age 62 to account for the endogeneity of retirement. We find suggestive evidence that retirement increases the probability of smoking among ever smokers, but this effect is sensitive to the econometric specification used. We also find evidence of heterogeneity in the impact of retirement.}, keywords = {Health Conditions and Status, Retirement Planning and Satisfaction}, doi = {10.1057/eej.2014.51}, author = {Padmaja Ayyagari} } @article {8539, title = {Medicare Part D and Portfolio Choice {\textdagger}}, journal = {American Economic Review}, volume = {106}, year = {2016}, month = {Jan-05-2016}, pages = {339 - 342}, abstract = {Economic theory suggests that medical spending risk affects the extent to which households are willing to accept financial risk, and consequently their investment portfolios. In this study, we focus on the elderly for whom medical spending represents a substantial risk. We exploit the exogenous reduction in prescription drug spending risk due to the introduction of Medicare Part D in the U.S. in 2006 to identify the causal effect of medical spending risk on portfolio choice. Consistent with theory, we find that Medicare-eligible persons increased risky investment after the introduction of prescription drug coverage, relative to a younger, ineligible cohort.}, keywords = {Healthcare, Investing, Medicare/Medicaid/Health Insurance, Older Adults}, issn = {0002-8282}, doi = {10.1257/aer.p20161125}, url = {http://pubs.aeaweb.org/doi/10.1257/aer.p20161125}, author = {Padmaja Ayyagari and Daifeng He} } @article {8815, title = {Prescription drug coverage and chronic pain.}, journal = {Int J Health Econ Manag}, volume = {16}, year = {2016}, month = {2016 Jun}, pages = {189-200}, abstract = {

Chronic pain is one of the most common chronic conditions affecting more than 50~\% of older adults. While pain management can be quite complex, prescription drugs are the most commonly used treatment modality. In this study, I examine whether increased access to prescription drugs due to the introduction of the Medicare Part D program in 2006 led to better management of pain among the elderly. While prior work has identified increases in the utilization of analgesics due to the introduction of Medicare Part D, the extent to which this increase in drug use actually improved the well-being of older adults is not known. Using data from the Health and Retirement Study, I employ a difference-in-differences strategy that compares pre versus post 2006 changes in pain related outcomes between Medicare eligible persons and a younger ineligible group. I find that Medicare Part D significantly reduced pain related activity limitations among a sample of older adults who report being troubled by pain.

}, keywords = {Analgesics, Chronic pain, Humans, Insurance Coverage, Medicare Part D, prescription drugs, Retirement, United States}, issn = {2199-9031}, doi = {10.1007/s10754-016-9185-5}, url = {http://link.springer.com/10.1007/s10754-016-9185-5}, author = {Padmaja Ayyagari} } @article {10465, title = {The Role of Medical Expenditure Risk in Portfolio Allocation Decisions}, journal = {Health Economics}, volume = {26}, year = {2016}, month = {2016/10/09}, abstract = {Economic theory suggests that medical spending risk affects the extent to which households are willing to accept financial risk, and consequently their investment portfolios. In this study, we focus on the elderly for whom medical spending represents a substantial risk. We exploit the exogenous reduction in prescription drug spending risk because of the introduction of Medicare Part D in the U.S. in 2006 to identify the causal effect of medical spending risk on portfolio choice. Consistent with theory, we find that Medicare-eligible persons increased risky investment after the introduction of prescription drug coverage, relative to a younger, ineligible cohort. Copyright {\textcopyright} 2016 John Wiley \& Sons, Ltd.}, keywords = {allocation decisions, Medical Expenses, Portfolios}, url = {https://www.researchgate.net/publication/308993822_The_Role_of_Medical_Expenditure_Risk_in_Portfolio_Allocation_Decisions}, author = {Padmaja Ayyagari and Daifeng He} } @article {8321, title = {Does prescription drug coverage improve mental health? Evidence from Medicare Part D}, journal = {Journal of Health Economics}, volume = {41}, year = {2015}, note = {Times Cited: 0 0}, pages = {46-58}, publisher = {41}, abstract = {The introduction of the Medicare Prescription Drug program (Part D) in 2006 resulted in a significant increase in access to coverage for older adults in the U.S. Several studies have documented the impact of this program on prescription drug utilization, expenditures and medication adherence among older adults. However, few studies have evaluated the extent to which these changes have affected the health of seniors. In this study we use data from the Health and Retirement Study to identify the impact of the Medicare Part D program on mental health. Using a difference-in-difference approach, we find that the program significantly reduced depressive symptoms among older adults. We explore the mechanisms through which this effect operates and evaluate heterogeneity in impact. (C) 2015 Elsevier B.V. All rights reserved.}, keywords = {Health Conditions and Status, Healthcare, Medicare/Medicaid/Health Insurance}, author = {Padmaja Ayyagari and Dan M. Shane} } @article {NBERw21484, title = {The Impact of Social Security Income on Cognitive Function at Older Ages}, journal = {American Journal of Health Economics}, year = {2015}, abstract = {Prior literature has documented a positive association between income and cognitive function at older ages, however, the extent to which this association represents causal effects is unknown. In this study, we use an exogenous change in Social Security income due to amendments to the Social Security Act in the 1970s to identify the causal impact of Social Security income on cognitive function of elderly individuals. We find that higher benefits led to significant improvements in cognitive function and that these improvements in cognition were clinically meaningful. Our results suggest that interventions even at advanced ages can slow the rate of decline in cognitive function.}, keywords = {Cognition, cognitive function, Social Security, Social Security Benefits}, doi = {10.3386/w21484}, url = {http://www.nber.org/papers/w21484}, author = {Padmaja Ayyagari and Frisvold, David} } @article {8259, title = {Smoking and cognitive functioning at older ages: Evidence from the Health and Retirement Study}, journal = {Journal of the Economics of Ageing}, volume = {6}, year = {2015}, pages = {13}, publisher = {6}, abstract = {It has long been established that smoking has detrimental health effects on the human body and leads to early mortality. However, the evidence regarding the link between smoking behavior and cognitive function in old age is mixed. While nicotine has been shown to improve cognitive functioning in some medical studies, current smokers typically perform worse than non-smokers on cognitive tests in population based studies. We use the Health and Retirement Study to evaluate the role of unobserved factors in explaining these conflicting findings. Results from individual fixed effects models show that much of the lower cognitive function of current and former smokers relative to never smokers can be attributed to unobserved differences between these groups.}, keywords = {Demographics, Health Conditions and Status, Methodology}, doi = {10.1016/j.jeoa.2015.06.001}, url = {http://www.sciencedirect.com/science/article/pii/S2212828X15000183}, author = {Padmaja Ayyagari and Asia Sikora Kessler} } @article {7917, title = {Understanding heterogeneity in price elasticities in the demand for alcohol for older individuals.}, journal = {Health Econ}, volume = {22}, year = {2013}, month = {2013 Jan}, pages = {89-105}, publisher = {22}, abstract = {

This paper estimates the price elasticity of demand for alcohol using Health and Retirement Study data. To account for unobserved heterogeneity in price responsiveness, we use finite mixture models. We recover two latent groups, one is significantly responsive to price, but the other is unresponsive. The group with greater responsiveness is disadvantaged in multiple domains, including health, financial resources, education and perhaps even planning abilities. These results have policy implications. The unresponsive group drinks more heavily, suggesting that a higher tax would fail to curb the negative alcohol-related externalities. In contrast, the more disadvantaged group is more responsive to price, thus suffering greater deadweight loss, yet this group consumes fewer drinks per day and might be less likely to impose negative externalities.

}, keywords = {Adult, Aged, Aged, 80 and over, Alcohol Drinking, Alcoholic Beverages, Behavior, Body Height, Costs and Cost Analysis, Female, Health Status, Humans, Male, Middle Aged, Models, Econometric, Socioeconomic factors, Taxes, United States}, issn = {1099-1050}, doi = {10.1002/hec.1817}, author = {Padmaja Ayyagari and Deb, Partha and Jason M. Fletcher and William T Gallo and Jody L Sindelar} } @article {7657, title = {Education and health: evidence on adults with diabetes.}, journal = {Int J Health Care Finance Econ}, volume = {11}, year = {2011}, note = {Ayyagari, Padmaja Grossman, Daniel Sloan, Frank 2R37-AG-17473-05A1/AG/NIA NIH HHS/United States Research Support, N.I.H., Extramural United States International journal of health care finance and economics Int J Health Care Finance Econ. 2011 Mar;11(1):35-54. Epub 2011 Jan 7.}, month = {2011 Mar}, pages = {35-54}, publisher = {11}, abstract = {

Although the education-health relationship is well documented, pathways through which education influences health are not well understood. This study uses data from a 2003-2004 cross sectional supplemental survey of respondents to the longitudinal Health and Retirement Study (HRS) who had been diagnosed with diabetes mellitus to assess effects of education on health and mechanisms underlying the relationship. The supplemental survey provides rich detail on use of personal health care services (e.g., adherence to guidelines for diabetes care) and personal attributes which are plausibly largely time invariant and systematically related to years of schooling completed, including time preference, self-control, and self-confidence. Educational attainment, as measured by years of schooling completed, is systematically and positively related to time to onset of diabetes, and conditional on having been diagnosed with this disease on health outcomes, variables related to efficiency in health production, as well as use of diabetes specialists. However, the marginal effects of increasing educational attainment by a year are uniformly small. Accounting for other factors, including child health and child socioeconomic status which could affect years of schooling completed and adult health, adult cognition, income, and health insurance, and personal attributes from the supplemental survey, marginal effects of educational attainment tend to be lower than when these other factors are not included in the analysis, but they tend to remain statistically significant at conventional levels.

}, keywords = {Aged, Cognition, Cross-Sectional Studies, Diabetes Complications, Diabetes Mellitus, Female, Health Behavior, Health Knowledge, Attitudes, Practice, Health Services, Humans, Male, Patient Education as Topic, Self Efficacy, Sex Factors, Socioeconomic factors, Time Factors}, issn = {1573-6962}, doi = {10.1007/s10754-010-9087-x}, author = {Padmaja Ayyagari and Grossman, Daniel and Frank A Sloan} } @article {7556, title = {The effect of job loss on overweight and drinking.}, journal = {J Health Econ}, volume = {30}, year = {2011}, month = {2011 Mar}, pages = {317-27}, publisher = {30}, abstract = {

This paper examines the impact of job loss due to business closings on body mass index (BMI) and alcohol consumption. We suggest that the ambiguous findings in the extant literature may be due in part to unobserved heterogeneity in response and in part due to an overly broad measure of job loss that is partially endogenous (e.g., layoffs). We improve upon this literature using: exogenously determined business closings, a sophisticated estimation approach (finite mixture models) to deal with complex heterogeneity, and national, longitudinal data from the Health and Retirement Study. For both alcohol consumption and BMI, we find evidence that individuals who are more likely to respond to job loss by increasing unhealthy behaviors are already in the problematic range for these behaviors before losing their jobs. These results suggest the health effects of job loss could be concentrated among "at risk" individuals and could lead to negative outcomes for the individuals, their families, and society at large.

}, keywords = {Alcohol Drinking, Body Mass Index, Female, Humans, Longitudinal Studies, Male, Middle Aged, Overweight, Unemployment, United States}, issn = {1879-1646}, doi = {10.1016/j.jhealeco.2010.12.009}, author = {Deb, Partha and William T Gallo and Padmaja Ayyagari and Jason M. Fletcher and Jody L Sindelar} } @article {7546, title = {Job loss and depression: the role of subjective expectations.}, journal = {Soc Sci Med}, volume = {72}, year = {2011}, month = {2011 Feb}, pages = {576-83}, publisher = {72}, abstract = {

Although the importance of expectations is well documented in the decision-making literature, a key shortcoming of the empirical research into effects of involuntary job loss on depression is perhaps its neglect of the subjective expectations of job loss. Using data from the US Health and Retirement Study surveys we examine whether the impact of job loss on mental health is influenced by an individual{\textquoteright}s subjective expectations regarding future displacement. Our results imply that, among older workers in the age range of 55-65 year, subjective expectations are as significant predictors of depression as job loss itself, and ignoring them can bias the estimate of the impact of job loss on mental health.

}, keywords = {Adaptation, Psychological, Aged, Bias, depression, Empirical Research, Health Surveys, Humans, Mental Health, Middle Aged, Stress, Psychological, Unemployment, United States}, issn = {1873-5347}, doi = {10.1016/j.socscimed.2010.11.014}, author = {Mandal, Bidisha and Padmaja Ayyagari and William T Gallo} } @article {7485, title = {The Impact of Job Stress on Smoking and Quitting: Evidence from the HRS.}, journal = {B E J Econom Anal Policy}, volume = {10}, year = {2010}, note = {Using Smart Source Parsing}, month = {2010 Jan 01}, publisher = {10}, abstract = {

Job-related stress might affect smoking behavior because smoking may relieve stress and stress can make individuals more present-focused. Alternatively, individuals may both self-select into stressful jobs and choose to smoke based on unobserved factors. We use data from the Health and Retirement Study to examine how job stress affects the probability that smokers quit and the number of cigarettes smoked for current smokers. To address the potential endogeneity of job stress based on time invariant factors, we include individual fixed effects, which control for factors such as ability to handle stress. Occupational fixed effects are also included to control for occupational characteristics other than stress; time dummies control for the secular decline in smoking rates. Using a sample of people who smoked in the previous wave, we find that job stress is positively related to continuing to smoke among recent smokers. The results indicate that the key impact of stress is on the extensive margin of smoking, as opposed to the number of cigarettes smoked.

}, issn = {1935-1682}, doi = {10.2202/1935-1682.2259}, url = {http://www.bepress.com/bejeap/vol10/iss1/art27}, author = {Padmaja Ayyagari and Jody L Sindelar} } @article {7423, title = {The longevity gap between Black and White men in the United States at the beginning and end of the 20th century.}, journal = {Am J Public Health}, volume = {100}, year = {2010}, month = {2010 Feb}, pages = {357-63}, publisher = {100}, abstract = {

OBJECTIVES: We sought to assess whether the disparity in mortality rates between Black and White men decreased from the beginning to the end of the 20th century.

METHODS: We used Cox proportional hazard models for mortality to estimate differences in longevity between Black and White Civil War veterans from 1900 to 1914 (using data from a pension program) and a later cohort of male participants (using data from the 1992 to 2006 Health and Retirement Study). In sensitivity analysis, we compared relative survival of veterans for alternative baseline years through 1914.

RESULTS: In our survival analysis, the Black-White male difference in mortality, both unadjusted and adjusted for other influences, did not decrease from the beginning to the end of the 20th century. A 17\% difference in Black-White mortality remained for the later cohort even after we controlled for other influences. Although we could control for fewer other influences on longevity, the Black-White differences in mortality for the earlier cohort was 18\%.

CONCLUSIONS: In spite of overall improvements in longevity, a major difference in Black-White male mortality persists.

}, keywords = {Aged, Black or African American, Health Status Disparities, Humans, Longevity, Longitudinal Studies, Male, Men{\textquoteright}s health, Middle Aged, Mortality, Proportional Hazards Models, Survival Analysis, United States, Veterans, White People}, issn = {1541-0048}, doi = {10.2105/AJPH.2008.158188}, author = {Frank A Sloan and Padmaja Ayyagari and Salm, Martin and Grossman, Daniel} } @article {5747, title = {Job Loss: Eat, drink and try to be merry?}, number = {15122}, year = {2009}, institution = {The National Bureau of Economic Research}, address = {Cambridge, MA}, abstract = {This paper examines the impact of job loss from business closings on body mass index (BMI) and alcohol consumption. We improve upon extant literature by using: exogenously determined business closings, a sophisticated estimation approach (finite mixture models) to deal with complex heterogeneity, and national, longitudinal data (Health and Retirement Study). For both alcohol consumption and BMI, we find evidence that individuals who are more likely to respond to job loss by increasing unhealthy behaviors are already in the problematic range for these behaviors before losing their jobs. Thus health effects of job loss could be concentrated among at risk individuals.}, keywords = {Employment and Labor Force, Health Conditions and Status}, doi = {10.3386/w15122}, author = {Deb, Partha and William T Gallo and Padmaja Ayyagari and Jason M. Fletcher and Jody L Sindelar} } @article {5765, title = {Sin Taxes: Do Heterogeneous Responses Undercut Their Value?}, number = {15124}, year = {2009}, institution = {The National Bureau of Economic Research}, address = {Cambridge, MA}, abstract = {This paper estimates the price elasticity of demand for alcohol using Health and Retirement Survey data. To account for unobserved heterogeneity in price responsiveness, we use finite mixture models. We recover two latent groups, one is significantly responsive to price but the other is unresponsive. Differences between these two groups can be explained in part by the behavioral factors of risk aversion, financial planning horizon, forward looking and locus of control. These results have policy implications. Only a subgroup responds significantly to price. Importantly, the unresponsive group drinks more heavily, suggesting that a higher price could fail to curb drinking by those most likely to cause negative externalities. In contrast, those least likely to impose costs on others are more responsive, thus suffering greater deadweight loss yet with less prevention of negative externalities.}, keywords = {Health Conditions and Status, Methodology, Public Policy}, doi = {10.3386/w15124}, author = {Padmaja Ayyagari and Deb, Partha and Jason M. Fletcher and William T Gallo and Jody L Sindelar} }