Diabetes and the Life-Course: Evidence from Panel Data and Electronic Health Records
- 1Stanford University
Abstract
Diabetes screening can alter both clinical care and patient behavior, but its consequences for health and socioeconomic outcomes remain uncertain. We examine these consequences in a fuzzy regression discontinuity design using electronic health records from the American Family Cohort (AFC) and longitudinal data from the Health and Retirement Survey (HRS). In AFC, we find that the diagnosis discontinuity peaks at 13 percentage points within six months and attenuates until it becomes insignificant at 42 months. We find a smaller and shorter-lived discontinuity for related prescriptions. These discontinuities remain across alternative specifications. Apart from specification and treatment window-dependent improvements in weight, BMI, and serum glucose, we do not observe a pattern of sustained improvement in cardiometabolic outcomes as a result of diagnosis and related care. In HRS, the threshold induces reductions of 22 percentage points in working for pay and 20.6 percentage points in labor-force participation at the two year follow-up. We do not observe a corresponding change in retirement, suggesting that diabetes diagnoses may lead to respondents reducing work without retirement. These reductions remain after several sensitivity checks but do not persist beyond two years. These findings suggest that health screening for chronic conditions may temporarily reduce labor supply, making employment responses relevant to the evaluation of broader costs and benefits of screening.
JEL codesI12, I18, J14, J22, C21
Related
- Age trajectories of infant mortality among Palestinian refugees born in 2010-2020: evidence from electronic health records
- Scalable Causal-Interpretable Machine Learning for Cancer Prescreening Using Electronic Health Records
- An uncertainty-aware multimodal deep learning framework for Alzheimer’s disease classification using MRI and electronic health records
- Discovering latent phenotypic signatures of preterm birth and genetic risk using tensor decomposition on electronic health records
- Uncoded Clinical Features from Multilingual Electronic Health Records in Catalonia: Development and Validation Study
BibTeX
@misc{heitzig2026diabetes,
title = {{Diabetes and the Life-Course: Evidence from Panel Data and Electronic Health Records}},
author = {C. Heitzig and D. Rehkopf},
howpublished = {medRxiv},
year = {2026},
month = jun,
doi = {10.64898/2026.06.06.26355069},
url = {https://www.medrxiv.org/content/10.64898/2026.06.06.26355069v2},
note = {CC BY},
}
RIS
TY - UNPB
TI - Diabetes and the Life-Course: Evidence from Panel Data and Electronic Health Records
AU - C. Heitzig
AU - D. Rehkopf
PY - 2026
DA - 2026/06/06
PB - medRxiv
DO - 10.64898/2026.06.06.26355069
UR - https://www.medrxiv.org/content/10.64898/2026.06.06.26355069v2
AB - Diabetes screening can alter both clinical care and patient behavior, but its consequences for health and socioeconomic outcomes remain uncertain. We examine these consequences in a fuzzy regression discontinuity design using electronic health records from the American Family Cohort (AFC) and longitudinal data from the Health and Retirement Survey (HRS). In AFC, we find that the diagnosis discontinuity peaks at 13 percentage points within six months and attenuates until it becomes insignificant at 42 months. We find a smaller and shorter-lived discontinuity for related prescriptions. These discontinuities remain across alternative specifications. Apart from specification and treatment window-dependent improvements in weight, BMI, and serum glucose, we do not observe a pattern of sustained improvement in cardiometabolic outcomes as a result of diagnosis and related care. In HRS, the threshold induces reductions of 22 percentage points in working for pay and 20.6 percentage points in labor-force participation at the two year follow-up. We do not observe a corresponding change in retirement, suggesting that diabetes diagnoses may lead to respondents reducing work without retirement. These reductions remain after several sensitivity checks but do not persist beyond two years. These findings suggest that health screening for chronic conditions may temporarily reduce labor supply, making employment responses relevant to the evaluation of broader costs and benefits of screening. JEL codesI12, I18, J14, J22, C21
ER -