Ludovica Gazze (Massachusetts Institute of Technology)

“Hassles and Environmental Health Screenings: Evidence from Lead Tests in Illinois”

Abstract: Lead paint, a harmful environmental hazard, can still be found in millions of homes in the United States. Due to high inspection and clean-up costs, prevention programs target intervention to the relatively few homes where small children test positive for lead poisoning. Because children have to visit a doctor to get tested, only households willing to undergo this hassle self-select into screening. Is self-selection an effective targeting mechanism? I study screening take-up by analyzing geocoded 2001-2016 lead screening data on 2 million Illinois children. My empirical strategy exploits variation in travel costs due to healthcare providers’ openings and closings. I find that travel costs reduce screening among low- and high-risk households alike, without improving targeting. Consistent with low poisoning rates, high-risk households are only willing to pay $4-29 more than low-risk households for screening. Despite poor targeting, screening incentives may be cost-effective because of the externalities of lead exposure.