Positive Income Shocks and Accidental Deaths among Cherokee Indians: A Natural Experiment

Tim-Allen Bruckner, University of California, Irvine
Ryan Brown
Claire Margerison Zilko, University of California, Berkeley

The literature finds that receipt of a large portion of income may increase risk-taking behavior. This work implies that persons with an unexpected gain in income will exhibit an elevated risk of accidental death. We test this hypothesis by capitalizing on a natural experiment in which Cherokee Indians received lump sum payments from a new casino. We applied fixed-effects Poisson regression to the monthly count of accidental deaths among Cherokee Indians spanning 1990 to 2006. Results support the hypothesis in that the risk of accidental death rises above expected levels during months of the large casino payments (relative risk = 2.95; 95% confidence interval = 1.06 – 8.25). Qualitative analyses support that increased vehicular travel and consumption of health-damaging goods may account for the almost three-fold rise in accident proneness. Our work expands on the scant literature that examines natural experiments to identify causal economic antecedents of health.

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Presented in Session 32: Income, Neighborhoods, and Health