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The effects of occupational licensing reform for nurse practitioners on children's health

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  • Moiz Bhai
  • David T. Mitchell

Abstract

We examine how scope of practice reforms that allow nurse practitioners independent practice authority impact children's health. We exploit spatial and temporal variation in independent practice authority to implement a difference‐in‐differences research design using data from the first three waves of the National Survey of Children's Health. We find that these reforms have significant positive impacts on a commonly used and validated measure of children's health: parental evaluation of child health. As a result of this scope of practice reforms, parental evaluations of overall child health improve as parents increasingly rate their child as having Excellent Health. More importantly, we observe these improvements in health are driven primarily by older children and children from lower family income backgrounds. These findings indicate that an expansion in the supply of healthcare through occupational licensing reform can positively influence health outcomes for children. Such findings have important implications for mitigating child health inequality.

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  • Moiz Bhai & David T. Mitchell, 2024. "The effects of occupational licensing reform for nurse practitioners on children's health," Southern Economic Journal, John Wiley & Sons, vol. 91(1), pages 62-91, July.
  • Handle: RePEc:wly:soecon:v:91:y:2024:i:1:p:62-91
    DOI: 10.1002/soej.12592
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    References listed on IDEAS

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    1. Morris M. Kleiner & Alan B. Krueger, 2010. "The Prevalence and Effects of Occupational Licensing," British Journal of Industrial Relations, London School of Economics, vol. 48(4), pages 676-687, December.
    2. repec:pri:cheawb:case_paxson_economic_status_paper is not listed on IDEAS
    3. Charles Courtemanche & James Marton & Benjamin Ukert & Aaron Yelowitz & Daniela Zapata, 2018. "Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self‐Assessed Health," Southern Economic Journal, John Wiley & Sons, vol. 84(3), pages 660-691, January.
    4. Stange, Kevin, 2014. "How does provider supply and regulation influence health care markets? Evidence from nurse practitioners and physician assistants," Journal of Health Economics, Elsevier, vol. 33(C), pages 1-27.
    5. Morris M. Kleiner & Allison Marier & Kyoung Won Park & Coady Wing, 2016. "Relaxing Occupational Licensing Requirements: Analyzing Wages and Prices for a Medical Service," Journal of Law and Economics, University of Chicago Press, vol. 59(2), pages 261-291.
    6. Courtemanche, Charles & Friedson, Andrew & Koller, Andrew P. & Rees, Daniel I., 2019. "The affordable care act and ambulance response times," Journal of Health Economics, Elsevier, vol. 67(C).
    7. Markowitz, Sara & Adams, E. Kathleen & Lewitt, Mary Jane & Dunlop, Anne L., 2017. "Competitive effects of scope of practice restrictions: Public health or public harm?," Journal of Health Economics, Elsevier, vol. 55(C), pages 201-218.
    8. Jonathan Meer & Jeremy West, 2016. "Effects of the Minimum Wage on Employment Dynamics," Journal of Human Resources, University of Wisconsin Press, vol. 51(2), pages 500-522.
    9. Morris M. Kleiner & Alan B. Krueger, 2013. "Analyzing the Extent and Influence of Occupational Licensing on the Labor Market," Journal of Labor Economics, University of Chicago Press, vol. 31(S1), pages 173-202.
    10. Moiz Bhai & Irina Horoi, 2019. "Teacher characteristics and academic achievement," Applied Economics, Taylor & Francis Journals, vol. 51(44), pages 4781-4799, September.
    11. Alexander, Diane & Schnell, Molly, 2019. "Just what the nurse practitioner ordered: Independent prescriptive authority and population mental health," Journal of Health Economics, Elsevier, vol. 66(C), pages 145-162.
    12. James J. Heckman, 2012. "The developmental origins of health," Health Economics, John Wiley & Sons, Ltd., vol. 21(1), pages 24-29, January.
    13. Sara Markowitz & E. Kathleen Adams, 2022. "The Effects of State Scope of Practice Laws on the Labor Supply of Advanced Practice Registered Nurses," American Journal of Health Economics, University of Chicago Press, vol. 8(1), pages 65-98.
    14. Traczynski, Jeffrey & Udalova, Victoria, 2018. "Nurse practitioner independence, health care utilization, and health outcomes," Journal of Health Economics, Elsevier, vol. 58(C), pages 90-109.
    15. Charles Courtemanche & James Marton & Benjamin Ukert & Aaron Yelowitz & Daniela Zapata, 2017. "Early Impacts of the Affordable Care Act on Health Insurance Coverage in Medicaid Expansion and Non‐Expansion States," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 36(1), pages 178-210, January.
    16. Case, Anne & Fertig, Angela & Paxson, Christina, 2005. "The lasting impact of childhood health and circumstance," Journal of Health Economics, Elsevier, vol. 24(2), pages 365-389, March.
    17. E. Frank Stephenson & Erin E. Wendt, 2009. "Occupational Licensing: Scant Treatment in Labor Texts," Econ Journal Watch, Econ Journal Watch, vol. 6(2), pages 181-194, May.
    18. repec:pri:cheawb:case_paxson_economic_status_paper.pdf is not listed on IDEAS
    19. Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-255, March-Apr.
    20. Shishir Shakya & Alicia Plemmons, 2020. "Does Scope of Practice Affect Mobility of Nurse Practitioners Serving Medicare Beneficiaries?," Journal of Labor Research, Springer, vol. 41(4), pages 421-434, December.
    21. Charles Courtemanche & James Marton & Benjamin Ukert & Aaron Yelowitz & Daniela Zapata, 2019. "Effects of the Affordable Care Act on Health Behaviors After 3 Years," Eastern Economic Journal, Palgrave Macmillan;Eastern Economic Association, vol. 45(1), pages 7-33, January.
    22. John J. Perry, 2012. "State-Granted Practice Authority: Do Nurse Practitioners Vote with Their Feet?," Nursing Research and Practice, Hindawi, vol. 2012, pages 1-5, November.
    23. Morris M. Kleiner, 2016. "Battling over Jobs: Occupational Licensing in Health Care," American Economic Review, American Economic Association, vol. 106(5), pages 165-170, May.
    24. Edward Timmons & Robert Thornton, 2008. "The Effects of Licensing on the Wages of Radiologic Technologists," Journal of Labor Research, Springer, vol. 29(4), pages 333-346, December.
    25. Morris M. Kleiner, 2000. "Occupational Licensing," Journal of Economic Perspectives, American Economic Association, vol. 14(4), pages 189-202, Fall.
    26. Anne Case & Darren Lubotsky & Christina Paxson, 2002. "Economic Status and Health in Childhood: The Origins of the Gradient," American Economic Review, American Economic Association, vol. 92(5), pages 1308-1334, December.
    27. Timmons, Edward, 2016. "Healthcare License Turf Wars: The Effects of Expanded Nurse Practitioner and Physician Assistant Scope of Practice on Medicaid Patient Access," Working Papers 06858, George Mason University, Mercatus Center.
    28. Irina Horoi & Moiz Bhai, 2018. "New Evidence On National Board Certification As A Signal Of Teacher Quality," Economic Inquiry, Western Economic Association International, vol. 56(2), pages 1185-1201, April.
    29. Currie, Alison & Shields, Michael A. & Price, Stephen Wheatley, 2007. "The child health/family income gradient: Evidence from England," Journal of Health Economics, Elsevier, vol. 26(2), pages 213-232, March.
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    Cited by:

    1. Owen Fleming & Lilly Springer, 2025. "The Spillover Effects of Nurse Practitioner Scope of Practice Expansions on Safety Net Program Participation: Evidence from WIC," WORKING PAPERS SERIES IN THEORETICAL AND APPLIED ECONOMICS 202506, University of Kansas, Department of Economics, revised Mar 2025.

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