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Hazed and Confused: The Effect of Air Pollution on Dementia


  • Kelly C. Bishop
  • Jonathan D. Ketcham
  • Nicolai V. Kuminoff


We find that long-term exposure to fine-particulate air pollution (PM2.5) degrades health and human capital among older adults by increasing their risk of developing Alzheimer’s disease and related dementias. We track U.S. Medicare beneficiaries’ cumulative residential exposures to PM2.5 and their health from 2004 through 2013, leveraging within- and between-county quasi-random variation in PM2.5 resulting from the expansion of Clean Air Act regulations. We find that a 1 ìg/m3 increase in decadal PM2.5 increases the probability of a dementia diagnosis by 1.68 percentage points. The effects are as large or larger when we adjust for mortality-based sample selection and additional Tiebout-sorting dynamics. We do not find relationships between decadal PM2.5 and placebo outcomes. Our estimates suggest that the federal regulation led to nearly 182,000 fewer people with dementia in 2013, yielding $214 billion in benefits. Further, PM2.5’s effect on dementia persists below the current regulatory thresholds.

Suggested Citation

  • Kelly C. Bishop & Jonathan D. Ketcham & Nicolai V. Kuminoff, 2018. "Hazed and Confused: The Effect of Air Pollution on Dementia," NBER Working Papers 24970, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:24970
    Note: AG EEE HE

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    Cited by:

    1. Catherine Hausman & Samuel Stolper, 2020. "Inequality, Information Failures, and Air Pollution," NBER Working Papers 26682, National Bureau of Economic Research, Inc.
    2. Persico, Claudia L & Johnson, Kathryn R., 2020. "Deregulation in a Time of Pandemic: Does Pollution Increase Coronavirus Cases or Deaths?," IZA Discussion Papers 13231, Institute of Labor Economics (IZA).
    3. Jill Furzer & Boriana Miloucheva, 2020. "The Long Arm of the Clean Air Act: Pollution Abatement and COVID-19 Racial Disparities," Working Papers tecipa-668, University of Toronto, Department of Economics.
    4. Diane Alexander & Hannes Schwandt, 2019. "The Impact of Car Pollution on Infant and Child Health: Evidence from Emissions Cheating," Working Paper Series WP-2019-4, Federal Reserve Bank of Chicago.
    5. Burkhardt, Jesse & Bayham, Jude & Wilson, Ander & Carter, Ellison & Berman, Jesse D. & O'Dell, Katelyn & Ford, Bonne & Fischer, Emily V. & Pierce, Jeffrey R., 2019. "The effect of pollution on crime: Evidence from data on particulate matter and ozone," Journal of Environmental Economics and Management, Elsevier, vol. 98(C).
    6. Dube, Benjamin, 2021. "Why cross and mix disciplines and methodologies?: Multiple meanings of Interdisciplinarity and pluralism in ecological economics," Ecological Economics, Elsevier, vol. 179(C).
    7. Janet Currie & Reed Walker, 2019. "What Do Economists Have to Say about the Clean Air Act 50 Years after the Establishment of the Environmental Protection Agency?," Journal of Economic Perspectives, American Economic Association, vol. 33(4), pages 3-26, Fall.
    8. Wes Austin & Stefano Carattini & John Gomez Mahecha & Michael Pesko, 2020. "COVID-19 Mortality and Contemporaneous Air Pollution," International Center for Public Policy Working Paper Series, at AYSPS, GSU paper2016, International Center for Public Policy, Andrew Young School of Policy Studies, Georgia State University.

    More about this item

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • Q53 - Agricultural and Natural Resource Economics; Environmental and Ecological Economics - - Environmental Economics - - - Air Pollution; Water Pollution; Noise; Hazardous Waste; Solid Waste; Recycling

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