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Essays on Health Economics

Saenz, Christian
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Abstract

This dissertation consists of three essays examining topics in health economics.

The first essay studies the effect of sports spectating on drunk driving fatalities across 42 Super Bowls using a regression discontinuity-in-time design. I find that the Super Bowl increases motor vehicle fatalities by 17 percent increase at an annual social cost of $161 million within a 24-hour span. Emotional cues play an important role in explaining drunk driving deaths: wins increase fatalities more than losses but upset losses are comparatively more harmful than upset wins. My results point to sports spectating and emotion-induced drinking as important determinants of drunk driving.

The second essay uses restricted-access data from the National Vital Statistics System to study how ridesharing affects mortality from external causes. My identification strategy relies on spatial and temporal variation in UberX entry across U.S. counties. Among those aged 18 to 45, I find that UberX entry into an area is associated with 2.01 additional deaths per quarter per 100,000 population (roughly a 10 percent increase). I find that these deaths are primarily related to alcohol and drug use. I support a causal interpretation of my findings by presenting event studies, placebo analyses, sensitivity and heterogeneity analyses, and a variety of robustness checks, including difference-in-differences estimators that are robust to heterogeneous treatment effects.

The third essay evaluates drug regulation in the United States by examining the effects of the unexpected judicial exemption of e-cigarettes from drug regulation, compared to nicotine replacement therapy, which remained regulated as a drug. I find that this exemption led to significant increases in innovation, as evidenced by a rise in patent applications. Using variation in smoking rates across demographic groups prior to e-cigarette introduction, I estimate that from 2011 to 2019, e-cigarettes saved 677,000 life-years- approximately one-third of the estimated benefit of early HIV/AIDS drugs by year 2000- and increased social surplus by $8 billion annually. I show that reduced smoking is a key mechanism behind this mortality reduction, with statistically significant declines in mortality lagging smoking reductions by approximately four years.

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Date
2026-05-05
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Research Projects
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Keywords
Drug regulation, super bowl, traffic collisions, ridesharing, mortality, uber, e-cigarettes, tobacco, smoking
Citation
Embargo Lift Date
2026-05-05
DOI
CC licence
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