Year: 2026
Type: preprint
Study design: Observational Study
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.
Source: medRxiv
Authors: Chris Heitzig, David Rehkopf
Institution: Stanford University
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7164857495