Couch-Locked with the Munchies: Effects of Recreational Marijuana Laws on Exercise and Nutrition

(with Monica Deza, Timothy R. Hodge, and Shooshan Danagoulian)

Journal of Policy Analysis and Management - 2026 [Link] or [Ungated]

Locking Out Prevention: Dental Care in the Midst of a Pandemic

(with Shooshan Danagoulian)

Health Economics - 2022 [Link] or [Ungated]

High School Graduation Rate in the Metro-Detroit Area: What Really Affects Public Secondary Education

Undergraduate Economic Review - 2009 [Link]

The Disproportionate Burden:  Health and Economic Outcomes of COVID-19 for Native American Communities

(with Emilia Simeonova, Randall Akee, Stephanie Carroll, and Ninez A. Ponce)

Major Revision at BMC Health Services Research - 2026 [Link]

Abstract:  Underserved minorities, and in particular American Indians and Alaska Natives (AIAN), experienced elevated mortality during the COVID-19 pandemic.  Little is known about the impact of pandemic-related restrictions on their health and economic wellbeing.  The California Health Interview Survey (CHIS) is a long-established state representative annual survey that asks various health related questions, surveying over twenty thousand people residing in California.  This study uses the CHIS from 2021 to 2023 and an oversample we commissioned on rural AIAN.  To our knowledge, this is the first representative study of the rates and correlates of long-COVID across AIAN and other races.  In addition to health outcomes, we examine job loss and reduced work hours due to the pandemic.

Indian Health Service Access and Disparities in COVID-19, Long-COVID, and Healthcare Utilization among American Indian and Alaska Native Populations  

(with Emilia Simeonova, Randall Akee, and Marina M. Gorzig)

Under Review - 2026

Abstract:  American Indian and Alaska Native (AIAN) communities experienced higher COVID-19 infection and mortality than white Americans. However, less is known about longer-term COVID-19 outcomes, changes in healthcare utilization, and the role of the Indian Health Service (IHS) in shaping these patterns. We combine self-reported data from the California Health Interview Survey with national electronic health record data from Truveta to examine COVID-19 diagnosis, mortality, long-COVID, healthcare utilization, and delayed care among AIAN and white populations. Across both data sources, AIAN individuals experienced higher rates of COVID-19 infection early in the pandemic. We also find higher rates of long-COVID among AIAN individuals, though this difference is more pronounced in self-reported data and converges by 2022 in electronic health records. AIAN people without IHS access had lower healthcare utilization prior to the pandemic, a decline in healthcare encounter in 2020, and a rapid return to pre-pandemic differences by 2022. AIAN people with IHS access consistently showed higher healthcare engagement, including greater recorded COVID-19 testing and vaccination. These findings suggest that IHS access did not eliminate COVID-19 disparities, but may have buffered disruptions in care and shaped how pandemic-related health outcomes were detected and managed. 

COVID-19 and Economic Stress for American Indian / Alaska Native Populations

(with Emilia Simeonova and Randall Akee)

Abstract:  (pending)

Comparison of Open Reduction Internal Fixation, Intramedullary Nailing, or Non-Rotationally Controlled Intramedullary Fixation for Distal Fibular Ankle Fractures: A Systematic Review and Meta Analysis

(with Anderson Lee, Robert Brandon Ponce, Quinn Steiner, Peter Bradbury, Andrew Froehle, and Robert Horne)

Under Review - 2026

Abstract:  OBJECTIVES: To compare clinical outcomes, radiographic reduction, union rates, operative parameters, and complication profiles among open reduction and internal fixation (ORIF), intramedullary nailing (IMN), and non–rotationally controlled intramedullary fixation (NRCIMF) for operative management of distal fibular fractures.  METHODS: Data Sources: A systematic search of PubMed, Embase, and Cochrane databases was performed.  Study Selection: Comparative studies reporting operative fixation of distal fibular fractures using ORIF with plate fixation, IMN, or NRCIMF constructs (including Rush rods, Kirschner wires, and intramedullary screws) were included.  Data Extraction: Data collected included patient-reported outcome measures, complication rates, radiographic reduction quality, fracture union, and operative time.  Methodological quality and risk of bias were assessed for included studies.  Data Synthesis: Twenty-three studies comprising 2113 patients met inclusion criteria.  Twenty-two studies reported outcomes following ORIF, 13 following IMN, and 11 following NRCIMF.  Meta-analysis of complication rates and patient-reported outcomes was performed when sufficient data were available.  RESULTS: Union rates, radiographic reduction quality, and functional outcomes—including American Orthopaedic Foot and Ankle Society (AOFAS), Olerud–Molander Ankle Score (OMS), and Visual Analog Scale (VAS) scores—were comparable across fixation modalities.  ORIF demonstrated higher complication rates and longer operative times compared with IMN and NRCIMF.  CONCLUSIONS: ORIF, IMN, and NRCIMF demonstrate comparable fracture union and functional outcomes for distal fibular fractures.  However, plate fixation may be associated with higher complication rates and longer operative times.  Implant selection should therefore be individualized based on fracture characteristics and patient-specific risk factors.

Measuring Treatment Exposure in Cannabis Policy Evaluation

Under Review - 2026 [Link]

Abstract: Accurate treatment timing is essential for credible causal inference in policy evaluation, yet cannabis policy studies employ a variety of treatment definitions, including legislative enactment, policy effective dates, and retail implementation. Because legal authorization frequently precedes consumer access by months or years, these measures are not necessarily interchangeable for outcomes that depend on realized market access. This paper introduces a harmonized dataset of statutory policy effective dates and retail implementation dates for medical and adult-use cannabis programs across all 50 U.S. states and the District of Columbia from 1996 through June 2026. Policy dates were compiled from enacted statutes, ballot initiatives, official regulatory documents, and publicly available records documenting the initiation of licensed retail sales. Medical cannabis programs exhibited substantially longer implementation delays than adult-use programs, with median delays of 30 and 13 months, respectively. By distinguishing statutory adoption from realized retail access, the dataset provides researchers with alternative measures of treatment timing that can be aligned with the mechanisms underlying specific policy outcomes. The accompanying source documentation promotes transparency, reproducibility, and comparability across future evaluations of cannabis legalization.

Convenience, Viability, and Access: Traditional Urgent Care in the United States

Submitted - 2026 [Link]

Abstract:  Traditional urgent care offers timely, walk-in treatment for acute conditions, but its contribution to healthcare access depends on where centers locate. This study examines whether the 2019 geography of traditional urgent care in the contiguous United States and District of Columbia more closely reflects unmet primary-care need or market conditions favorable to private entry. A proprietary dataset identifies approximately 7,900 centers meeting standardized criteria for extended hours, walk-in access, and on-site imaging. Facility locations are linked to 72,514 census tracts and 3,108 counties, American Community Survey characteristics, emergency departments, limited urgent care facilities, and federal primary-care shortage designations. Descriptive accessibility measures, two-part location models, and spatial specifications distinguish market entry from the number of centers after entry and compare local conditions with those in surrounding areas. Traditional urgent care is present in nearly half of counties but only 9.8% of census tracts. Entry and conditional counts are most consistently associated with urbanization, private insurance coverage, emergency departments, and limited urgent care facilities. Primary-care shortage status predicts entry only in selected specifications, while shortage intensity does not predict additional centers after entry. Spatial results show regional clustering across counties but local spacing across nearby tracts. Market-driven expansion has created broad national coverage, but it has not systematically directed additional capacity toward areas with the greatest measured shortages.

Air Pollution and Neonatal Health in Michigan: A Public Health Crises

(with Sara Sayeda and Shooshan Danagoulian)

Abstract:  Though the adverse impact of air pollution on infant’s health is well documented, little is known about its impact on low-income, medically underserved populations. Focused on Detroit, Michigan, a region with medically underserved populations, this research delves into the specific impact of air pollutants—carbon monoxide (CO), particulate matter 2.5 (PM2.5), and sulfur dioxide (SO2)—within the southern lower peninsula. Leveraging geolocation methodology and extensive datasets, the study reveals consistent negative effects of CO and SO2 on neonatal birth weight, gestational age and NICU admissions, with socioeconomic factors modulating these impacts. Trimester-specific analysis uncovers nuanced patterns, emphasizing the importance of considering each trimester separately. The study also highlights the divergent impact of air pollution on infants based on maternal education levels and its disproportionate effects on infants born to Black mothers. By shedding light on these complexities, the research contributes valuable insights into the multifaceted interplay of environmental and socioeconomic factors influencing infant health in Detroit. 

Competitive Analysis amongst the Onset of a Pandemic

Abstract:  Urgent care centers are a new and growing form of healthcare that allows for patient convenience, flexibility, and expediency outside the traditional framework of hospitals and physicians.  The competitive presence among healthcare providers matters to patients.  The onset of the pandemic reveals patient preference when dealing with the intrinsic considerations of preference, safety, and properly matched care.  Using SafeGraph foot-traffic Patterns data from January 2019 to June 2020, we analyze the impact of medical providers on weekly patient visits in Michigan’s metropolitan areas, using two indices for market concentration and medical access within two specifically defined geographic markets.  Each model also estimates the initial impact of the pandemic on provider visits.  Spatial markets are defined by the FTC using a provider-centric approach, where competition depends on proximity and competitive presence within a defined region centered on the provider’s location.  Spatial analysis of access to medical care and market concentration of four provider-types (urgent care, hospitals, physicians, and specialists) are used to estimate the influence on visits and stratified analysis of fifteen provider combinations of competitive presence.  Our models control for site and area characteristics using either inverse distance weighting to control for spatial effects.  All provider-types have inelastic responses to changes in market concentration and medical access.  We find urgent care experienced a 21% decline post pandemic onset.  Results indicate that hospitals and urgent care have an asymmetric substitution effect between them, and spillover and siphoning effects are present as providers rely on the presence and knowledge of other providers to develop patient volume, seen in the popularity of medical malls.  Urgent care providers operating in a competitive area indicates increased visits of all provider-types, greater than other competitive presence.  Both patients and providers may benefit from operating in specified medical zones for increased awareness of services available greater ease of transference of patients to other desired provider types.  

History and Recent Trends of Urgent Care

Abstract:  Urgent care is a rapidly growing field in medical care delivery that is quickly turning into newer forms of convenience care with pricing transparency.  Recent history of urgent care centers (UC), trends in the UC and convenient care markets, and recent empirical findings dealing with impacts on access to care, effects to emergency departments, and the future of the UC industry are examined.  The market for urgent care spans five decades of a varied history of growth, near collapse, rebranding, and potential over saturation in recent years.  Born from the development of emergency medicine practices in the early 1970s, physicians recognized a gap in coverage.  UCs offer an added level of convenience and access to care that rivals traditional forms of primary care delivery without the extreme cost and capital requirements on an emergency department.  Extended hours and flexibility in scheduling from UCs helped it change the landscape of medical care delivery, ushering in newer forms of care via retail clinics (RC).  The landscape of care is quickly changing to match shifting patient preferences for convenience and transparency in pricing.  UCs stand in between primary care physicians and RCs in the race to establish brand or service awareness and dominance.  UCs are broadening their scope of coverage and role as a medical provider, diminishing the prevalence of medical homes and competing directly with tech companies attempting to penetrate the newly forming convenient care market.  Adoption of an integrated electronic medical records system will help develop a congruent medical home and added level of convenience to cater to the newer generations of patients that are spurring this convenience revolution.  The future of UCs could be shifted further to a broader range of care in both the physical and telehealth space.  RCs and primary care physicians may also move further into adapting a broader range of services with higher levels of immediacy and convenience.

Medical Mobility on and near Tribal Reservations during the Onset of the Pandemic

(with Emilia Simeonova and Randall Akee)

Homegrown Externalities: Cannabis Cultivation and Neighboring Property Prices

(with Timothy R. Hodge and Aditya Patel (Student))

Mental Health and Cognition Outcomes Following Cannabis Legalization [abstract]

(with Alberto Ortega) 

Cannabis University: Student Enrollment and Sales at Nearby Cannabis Retailers [abstract]

(with Timothy R. Hodge and Joshua Hess)

Economic Impacts of Drug Reclassification Policies

(with Zainab Hans, Alberto Ortega, and Hsing-Fang Hsieh)

Family and Child Eating Habits: Impacts of Cannabis Legalization

(with Joshua Hess and Shooshan Danagoulian)

Recreational Cannabis Usage among Generations

(with Joshua Hess and Shooshan Danagoulian)

Turning the Page: Assessing the Impacts of Open Educational Resources on Community College Student Outcomes

(with Stacey Brockman, Molly Ledermann, and Amanda Weismann)

Medical Concordance Bias: Differences in Genders between Provider and Patient

Hospital Catchment Modeling based on Price Elasticity and Competitive Presence

(with Walter Ryley)

Risk Assessment of Recreational Marijuana Laws on Long Haul Trucking

(with Walter Ryley)

Oral: "Mental Health and Cognition Outcomes Following Cannabis Legislation." American Society for Health Economists, Annual Conference, June 2026, Minneapolis, MN.

Oral: "Cannabis University: Enrollment and Local Cannabis Retail Sales." American Society for Health Economists, Annual Conference, June 2026, Minneapolis, MN.

Oral: "Joint Consumption? Transaction Cost as a Determinant in the Relationship between Alcohol and Cannabis."

American Society of Health Economists, June 2026, Minneapolis, MN.

Midwest Economic Association, Annual Meeting, March 2026, Chicago, IL.

H2D2, University of Michigan, September 2025, Ann Arbor, MI.

Poster: "Differences in Health Related Outcomes Among American Indian / Alaskan Native Populations in California." American Society for Health Economists, Annual Conference, June 2025, Nashville, TN.

Oral: "Urgent Care Location Analysis." Wayne State University Economics Seminar, November 2024, Detroit, MI.

Oral: "Marijuana Munchies or Couch Lock: Effects of Recreational Marijuana Laws on Exercise and Nutrition."

American Society of Health Economists, Annual Conference, June 2025, Nashville, TN.

Bowling Green State University, Economics Colloquia, March 2025, Bowling Green, OH.

Western Michigan University, Friday Seminar Series, January 2025, Kalmazoo, MI.

American Economic Association, ASSA Annual Meeting, January 2025, San Francisco, CA.

American Society of Health Economists, June 2024, San Diego, CA.

Federal Drug Administration, Office of Economics and Analysis Brown Bag, April 2024, Silver Spring, MD.

Midwest Economic Association, March 2024, Chicago, IL.

Oral: “Competitive Analysis Amongst Healthcare Providers: Catchment Area Modeling by Firm and Patient Location.”

WSU Economics Seminar, November 2024, Wayne State University, Detroit, MI.

Southern Economic Association, November 2023, New Orleans, LA.

Western Economic Association International, July 2023, San Diego, CA.

Graduate Research Symposium, March 2023, Wayne State University, Detroit, MI.

Oral: "Locking Out Prevention: Dental Care in the Midst of a Pandemic", H2D2, March 2021, University of Michigan, Ann Arbor, MI.

Oral: “Bitcoin: The good, the bad, and the ugly.”, Birmingham-Bloomfield Coin Club, March 2018, Birmingham, MI.

"Marijuana Leads to Munchies and 'Couchlock'" Chicago Booth Review, by Áine Doris with Thomas Wilk, Monica Deza, Timothy Hodge, and Shooshan Danagoulian, January  13, 2025. [Link]

"Paying the Price: Health Care Inflation" Detroit Channel 7 News WXYZ, Keenan Smith Morning News with Thomas Wilk and Michael Greiner, February 17, 2022.

"Bitcoin: The Good, the Bad, and the Ugly" Oakland Legal News, by Thomas Wilk, Produced by John F. Sase, June 15, 2016 [Detroit Legal Press Version]

Code for Cannabis Retail Access Dates

Code for JPAM Couch-Locked with the Munchies