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May 2020

David Becker, PhD dbecker@uab.eduAssociate Professor, Health Care Organization and Policy

Broad research focus?

The impact of public policy on healthcare systems, healthcare costs, and quality of care; behavioral responses to policies and incentives; limits of financial incentives.

What brought you to the SOPH?

Coming out of a Ph.D. Program in economics, I faced the choice between the more theory-based world of economics or the applied policy world of public health.

From the interview process, I knew the SOPH was the place for me. Public Health researchers study issues that really matter. And in the Department of Health Care Organization and Policy, I found a group of economists and other faculty who were interested in studying the implications of health policy. I had never actually taken a course in health economics as an undergraduate, but I wound up working at a healthcare consulting firm and then fell into a research assistant position at Stanford where I was immersed in Medicare claims data. Dan Kessler and Mark McClellan were fantastic mentors, with whom I co-authored several papers. This incredible opportunity led me to pursue my Ph.D. at Berkeley where my dissertation focused on Medicare policy. My “job market paper” examined differences in treatment and outcomes for heart attack patients hospitalized on weekends versus weekdays.

Most exciting project you are working on right now?

During the past week, my son and I have been staking out our neighborhood Publix and Walmart. I was curious to know whether or not Birmingham grocery shoppers were wearing face coverings (before Mayor Woodfin mandated it). We'd park our car by an exit and one of us would record while the other described the people we saw exiting the store. We collected data on gender, race/ethnicity, age category, and cart usage. We recorded 100 people during each outing, which took about 45 minutes at Publix and 20 minutes at Walmart. My son was able to experience the complete research "life cycle", from coming up with the research question to collecting, entering, and analyzing data. We wrote up our results from the first 500 observations and it was published as an op-ed on AL.com.

Other ongoing projects?

I am the program director of HCOP's DrPH program and enjoy working with our many wonderful students. I am also the PI of a long-standing research contract with ALL Kids, the Alabama Children’s Health Insurance Program. Over the past decade, my HCOP colleagues and I have published over 20 papers from this unique collaboration. During the past year, I have also been leading a project that examines the impact of new Blue Cross Blue Shield restrictions on the allowable days supplied for initial opioid prescriptions.

Any research questions that are on your wish list?

Although much of my work has focused on health care policy, I remain interested in the relationship between social status, stress, and health. A few years ago, colleagues and I examined whether getting into the Baseball Hall of Fame increased life expectancy. We exploited the discrete cut-off for induction and found that those who just narrowly missed selection experienced reductions in life expectancy. Our results suggest that expectations play a critical role in the effects of status attainment on health. I'd love to expand on this work to examine the implications of status competition and stress on health. I am particularly interested in the extent to which the narrowing of the gender gap in life expectancy in the US is the result of the transformation of gender roles over the past 50 years.

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