ALT The Labor Market and Health Impacts of Reducing Cesarean Section Deliveries Sarah Miller, Petra Persson, Maya Rossin-Slater and Laura R. Wherry Published online before print September 09, 2026, 1025-14609R2; DOI: https://doi.org/10.3368/jhr.1025-14609R2 Abstract We study an intervention that reduced cesarean deliveries among low-risk first-time mothers, using California birth records linked to earnings data. Exposed mothers were 8% less likely to have a c-section, with no adverse health effects. We find suggestive evidence that they were more likely to return to their pre-birth employer and had higher within-firm earnings rankings in the quarter postbirth. These labor market gains fade over time. However, mothers who had a second child were less likely to have a c-section or preterm delivery, suggesting our estimated effects from avoiding a first c-section may be lower bounds on total gains.

ALT Therapy to Reduce Violence and Improve Institutional Safety During Incarceration Mary Kate Batistich, William N. Evans, Tyler Giles and Rebecca Margolit-Chan Published online before print August 07, 2026, 0325-14167R2; DOI: https://doi.org/10.3368/jhr.0325-14167R2 Abstract We evaluate the impact of Step Up, a cognitive behavioral therapy program provided to inmates at the Lubbock County Detention Center in Texas. Step Up aims to address self-destructive thought and behavior patterns through a combination of group classes, one-on-one counseling, and a structured workbook. We compare individuals over time who enter the Step Up program to a group of eligible and interested nonparticipants in an unbalanced two-way fixed effects framework. Despite similarities in initial outcomes and outcome trends prior to program entrance, individuals who enter Step Up exhibit a 49% reduction in monthly behavioral incident rates relative to the comparison group. We find evidence that behavioral improveme

ALT Migration, Segregation, and Interracial Marriage Cameron Deal Published online before print August 07, 2026, jhr.1125-14624R1; DOI: https://doi.org/10.3368/jhr.1125-14624R1 Abstract Interracial marriage increased substantially in the late 20th century, concurrently with declines in regional and residential segregation. This paper studies whether these trends are related using two historical quasiexperiments and a stylized model of the marriage market. I use a shift-share instrument to find that the Great Migration increased interracial marriage in receiving communities, though this effect was absent in highly segregated cities. Using railroad density as an instrument, I also find that residential segregation decreased interracial marriage. Together, these findings indicate that internal migration and declining segregation contributed to the rise of interracial marriage in the non-Southern United States.

ALT Monopsony, Efficiency, and the Regularization of Undocumented Immigrants George J. Borjas and Anthony Edo Published online before print August 11, 2026, jhr.0925-14532R2; DOI: https://doi.org/10.3368/jhr.0925-14532R2 Abstract In 1981, President Mitterrand regularized the status of undocumented immigrants in France, who comprised 12 percent of the non-French workforce and about 1 percent of all workers. Employers have monopsony power over undocumented workers because the undocumented find it costly to participate in the open market. By alleviating this labor market imperfection, a regularization program can move the market closer to the efficient competitive equilibrium and increase employment and wages for the authorized workforce. Our empirical analysis reveals that the Mitterrand regularization program raised employment and wages for low-skill native and immigrant men and increased per-capita GDP.

ALT Providers, Places, and Children’s Mental Health Care Gabriel Swagel Published online before print August 07, 2026, jhr.0925-14511R1; DOI: https://doi.org/10.3368/jhr.0925-14511R1 Abstract Children’s mental health is the defining public health crisis of our time. Using the largest repository of private insurance claims in the United States, I provide the first systematic quantification of the variation in children’s mental health prescribing in the U.S. I separate variation due to 1) primary care provider (PCP) prescribing intensities, 2) regional practice environments, and 3) child health and demand. Equalizing PCP intensities would reduce the variance of provider prescribing rates by 50 percent for ADHD and 65 percent for antidepressants. Analyzing geographic variation alone significantly understates the extent of treatment variation and the role of providers.

ALT Adam Isen Associate Professor, John Hopkins University Coeditor Journal of Human Resources Editorial Board

ALT Refugees’ Economic Integration & Firms Abstract We explore whether a civic integration exam component dedicated to labor market training, namely the ONA - a type of job search assistance program, boosts refugees’ economic outcomes and the quality of firms they work for. Using linked employer-employee (monthly) data from 2014 to 2021 for the Netherlands and Regression Discontinuity design, we find that taking the ONA sped up and deepened the economic integration of refugees for at least 3 years in terms of increased employment probability and higher hourly wages. We further show that taking the ONA results in refugees working for larger, less routine-task intensive, higher wage firms. These results reflect improvements in both match efficiency and match quality. The ONA therefore does more than reduce search frictions: it equips refugees with the knowledge to navigate the labor market effectively and find employment that aligns better with their existing abilities and human capital.

ALT Before and after out-of-home placement Child health, education and crime Petra Gram Cavalca, Mette Ejrnæs and Mette Gørtz Published online before print July 13, 2026, 1122-12630R5; DOI: https://doi.org/10.3368/jhr.1122-12630R5 Abstract We investigate the short-term impact of the first placement in out-of-home care on child health, schooling and crime. Using administrative data and an event study, we document the development in outcomes for the average child in care. We find that primary health care utilization rises temporarily when entering care before returning to pre-intervention levels. School absenteeism and criminal charges decline markedly after placement and remain lower than preplacement levels within two years of placement. Using monthly data, we infer that the decision to place a child in care may be triggered by acute events such as hospitalization or criminality.

ALT The Unintended Consequences of Policing Technology Evidence from ShotSpotter Michael Topper and Toshio Ferrazares Published online before print July 13, 2026, 1024-13929R2; DOI: https://doi.org/10.3368/jhr.1024-13929R2 Abstract Technology is integral to police departments, automating officer tasks, but inherently changing their time allocation. We investigate this by studying ShotSpotter, a technology that automates gunfire detection. Following a detection, officers are dispatched to the scene, thereby reallocating their time. We leverage this shock to officers’ time allocation using the rollout of ShotSpotter across Chicago police districts to study the effects on 911 response. We find consequences for calls unrelated to gunfire—officers are dispatched slower (22%), arrive on-scene later (13%), and the probability of arrest is decreased 9%. Consequently, departments must evaluate their resource capacities prior to implementing technologies.

ALT Unveiling the Unseen Illness Public Health Warnings and Heat Stroke Lester Lusher and Tim Ruberg Published online before print July 13, 2026, 1224-14012R2; DOI: https://doi.org/10.3368/jhr.1224-14012R2 Abstract We utilize region-day variation in actual vs. forecasted weather conditions (i.e. forecasting errors) to comprehensively investigate the effects of the first public warning system for extreme heat events on behavioral and health outcomes in Japan. We find that heat alerts led to a 16% increase in ambulance-related hospital visits. An analysis of mechanisms suggests this is primarily driven by increased awareness and thus reporting of heat strokes that would otherwise have gone undetected, as opposed to substitution in health diagnoses. We further document evidence of avoidance behaviors (e.g. electricity usage).

ALT Gender Reveals in the Labor Market Evidence on Gender Signaling and Statistical Discrimination in an Online Health Care Market Haoran He, David Neumark and Qian Weng Published online before print July 13, 2026, 0325-14141R2; DOI: https://doi.org/10.3368/jhr.0325-14141R2 Abstract We study gender discrimination in an online health care market. Statistical discrimination implies that the impact of gender on prices should decline, and the impact of reviews increase, as reviews accumulate. However, in our context these implications do not hold, because doctors choose how strongly to signal gender. We develop a new test for the implications of statistical discrimination based on this choice. We find evidence consistent with statistical discrimination against female doctors in male-dominated fields, and vice versa. For example, female doctors mask gender more strongly initially in male-dominated fields, and the gender gap in signaling declines as reviews accumulate.

ALT Selection into Public Service Evidence from School Board Elections Stephen B. Billings, Hugh Macartney, Geunyong Park and John D. Singleton Published online before print July 13, 2026, 1024-13901R2; DOI: https://doi.org/10.3368/jhr.1024-13901R2 Abstract In this paper, we use narrowly-decided elections and housing transactions data to test for private returns from public office in the context of school boards in the U.S. We find no detectable effect of election to the school board on home prices in the neighborhoods of winning candidates. Stratifying by political affiliation reveals that homes appreciate in winning Republicans’ neighborhoods, but the estimate is not statistically robust. We do not find corresponding evidence for improvements in local school productivity, but we show that neighborhood public schools of Republican members also shift to serving more white students through attendance zone adjustments.

ALT Does Weaker Employment Protection Lower the Cost of Job Loss? Marco Francesconi and Daniela Sonedda Published online before print July 13, 2026, 0725-14408R2; DOI: https://doi.org/10.3368/jhr.0725-14408R2 Abstract Leveraging a major Italian reform enacted in July 2012 that eroded employment protection to workers on permanent contracts, we use detailed worker level administrative data to estimate how this reduction affected the cost of job loss. We employ a stacked event-study research design, comparing treated and untreated workers as they move from employment into nonemployment. Weakening employment protection led to additional penalties in terms of lower re-hiring earnings and lower re-employment probabilities. Heterogeneous effects of the reform deepened pre-existing divides, penalizing labor market outsiders, such as young workers, and curbing employment opportunities for individuals in poorer regions, such as the South.

ALT Immigration Enforcement and Origin Country Labor Markets Thomas Pearson Published online before print July 13, 2026, 0525-14310R2; DOI: https://doi.org/10.3368/jhr.0525-14310R2 Abstract This paper studies how increased immigration enforcement in the destination country impacts labor markets in the origin country. Using variation in Mexican migrant networks and Secure Communities (SC), a policy which expanded local immigration enforcement, I show that the deportation of Mexican migrants from the U.S. increases return migration to Mexico and decreases monthly earnings for workers there. The negative earnings effects are largest for workers most similar to return migrants in terms of their demographics, occupations, and employment types, and are consistent with increased labor market competition.

ALT Negative Supply Shocks and Delayed Health Care Evidence from Pennsylvania Abortion Clinics Andrea M. K. Hall Published online before print June 05, 2026, 0723-13015R2; DOI: https://doi.org/10.3368/jhr.0723-13015R2 Abstract In 2011, Pennsylvania passed regulations requiring abortion-providing facilities to meet ambulatory surgical facility standards, which ultimately caused the closure of almost half of the state’s abortion facilities. All closing facilities were geographically near facilities that remained open, meaning distance to the nearest clinic was unchanged while local clinic capacity fell. I use a difference-in-differences design supplemented with a synthetic control method and find that reduced clinic capacity caused 30-40 percent fewer abortions in the first 8 weeks of gestation and more abortions at later gestational ages. Evidence suggests an increase in birth rates for Black women, though these results are sensitive to specification and control group choices.

ALT School Construction and Intergenerational Human Capital Naveen Sunder Published online before print June 05, 2026, 0520-10939R3; DOI: https://doi.org/10.3368/jhr.0520-10939R3 Abstract This paper estimates the direct and intergenerational effects of one of the world’s largest school expansion policies. Starting in 1993-94, the District Primary Education Programme (DPEP) constructed over 100,000 new schools and served over 50 million children in India. Using a fuzzy regression discontinuity design I show that the policy increased enrollment, literacy and years of education for both male and female direct beneficiaries. Further, I find that children whose mothers were DPEP beneficiaries had higher scores on vernacular (18 percent), math (13 percent), and English (15 percent) tests, while Father’s DPEP exposure had no effect on children’s learning.

ALT Juggling Priorities Women’s Labor Market Opportunities and Household Consumption Patterns So Yoon Ahn and Yu Kyung Koh Abstract How do women’s relative labor market opportunities affect consumption patterns for married couples? While higher potential wages can enhance women’s bargaining power, shifting consumption toward their preferences, they may increase work hours, altering time constraints and spending. Using exogenous gender-specific wages and scanner data, we find higher female relative wages increase spending on convenience foods and decrease spending on fresh produce, contributing to higher obesity rates. This is primarily driven by women’s time reallocation given their disproportionate domestic responsibilities. Our findings suggest that the impacts of earned female income may differ from those of unearned income found in previous studies.

ALT Employers’ Language Proficiency Requirements and Hiring of Immigrants Magnus Carlsson, Stefan Eriksson and Dan-Olof Rooth Published online before print May 14, 2026, 1223-13300R3; DOI: https://doi.org/10.3368/jhr.1223-13300R3 Abstract Labor markets in advanced economies have undergone substantial change due to globalization, technological improvements, and organizational changes, making language proficiency increasingly important even in less skilled jobs. Has this development led employers to shy away from hiring immigrants with limited host-country language skills? We shed light on this question by conducting a large-scale field experiment, where we introduce common second-language features in immigrants’ resumes. We also conduct employer surveys to interpret our experimental results. Our main finding is that language proficiency has a strong positive effect on being invited to a job interview, even in typical immigrant entry jobs.