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We develop a spatial equilibrium model to evaluate the efficiency and distributional impacts of the leading air quality regulation in the United States: the National Ambient Air Quality Standards (NAAQS). We link our economic model to an integrated assessment model for air pollutants which allows us to capture endogenous changes in emissions, amenities, labor, and production. Our results show that the NAAQS generate over $23 billion of annual welfare gains. This is roughly 80 percent of welfare gains of the second-best NAAQS design, but only 25 percent of the first-best emission pricing policy. The NAAQS benefits are concentrated in a small set of cities, impose substantial costs on manufacturing workers, improve amenities in counties in compliance with the NAAQS, and reduce emissions in compliance counties through general equilibrium channels. These findings highlight the importance of accounting for geographic reallocation and equilibrium responses when quantifying the effects of environmental regulation.

The past century witnessed a dramatic improvement in public health, the rise of modern medicine, and the transformation of the hospital from a fringe institution to one essential to the practice of medicine. Despite the central role of medicine in contemporary society, little is known about how hospitals and modern medicine contributed to this health transition. In this paper, we explore how access to the hospital and modern medicine affects mortality. We do so by leveraging a combination of novel data and a unique quasi- experiment: a large-scale hospital modernization program introduced by The Duke Endowment in the early twentieth century. The Endowment helped communities build and expand hospitals, obtain state-of-the-art medical technology, attract qualified medical personnel, and refine management practices. We find that access to a Duke-supported hospital reduced infant mortality by 10%, saving one life for every $20,000 (2017 dollars) spent. Effects were larger for Black infants (16%) than for White infants (7%), implying a reduction in the Black-White infant mortality gap by one-third. We show that the effect of Duke support persisted into later life with a 9% reduction in mortality between the ages of 56 and 65. We further provide evidence on the mechanisms that enabled these effects, finding that Endowment-supported hospitals attracted higher-quality physicians and were better able to take advantage of new medical innovations.

We study how ambient lead exposure impacts learning in elementary school by leveraging a natural experiment where a large national automotive racing organization switched from leaded to unleaded fuel. We find increased levels and duration of exposure to lead negatively affect academic performance, shift the entire academic performance distribution, and negatively impact both younger and older children. The average treated student in our setting has an expected income reduction of $5,200 in present value terms. Avoiding said treatment has an effect size similar to improving teacher value added by one-fourth of a standard deviation, reducing class size by 5 students, or increasing school spending per pupil by $750. The marginal impacts of lead are larger in impoverished, non-white counties, and among students with greater duration of exposure, even after controlling for the total quantity of exposure.

We study the role of two important and interacting inputs to education: environmental quality and nutrition. Using a unique natural experiment in lead exposure, we show that increased quantity and duration of exposure to lead negatively affect academic performance, shift the entire academic performance distribution, and negatively affect both younger and older children. We provide the first quasi-experimental evidence linking known quantities of lead emissions to decreased test scores; information essential for policies addressing ambient lead and lead emission sources. 10 additional kilograms of lead emissions --- a quantity similar to the annual emissions of an airport or a median lead-emitting industrial facility in the United States --- reduces standardized test scores by 0.07 standard deviations. We estimate this corresponds to an average income reduction of $9,000 per treated student in present value terms. Marginal impacts are larger in impoverished, non-white counties and among students with greater duration of exposure, conditional on total exposure. We further find that factors correlated with better nutrition --- most notably consumption of calcium-rich foods like milk --- mitigate the link between lead exposure and educational outcomes. Our results indicate that improved child nutrition can help combat the negative effects of lead and address several prominent social issues, including racial test gaps, human capital formation across income groups, and environmental justice.