What is a school-based health center?

Whether it was to deal with scrapes on the playground or to get treatment for your “illness” that kept you out of class, everyone who went to school has an experience with the school nurse’s office. Over the past few decades, though, policymakers have been turning to schools more and more to provide health care services.

Intervention in childhood can be the most cost-effective time to provide preventative health care, impacting things like test scores and propensity to develop chronic disease later in life. Due to policy changes like the Children’s Health Insurance Act (CHIP) and the Affordable Care Act, many low-income children have gained health insurance coverage but have not necessarily gained access to health care. Health care deserts and lack of information held by parents have conspired to make it difficult for children to gain access to health care when they need it most.

Enter the school-based health center. In its simplest form, a school-based health center is a medical clinic that is located on a school campus. Proximity to the place where children spend most of their days allows a school-based health center to provide preventative and screening care in a way that regular health centers are not able to.

The Ohio School-Based Health Alliance, a statewide organization focused on supporting school-based health centers across the state, has established a six-point definition of a “school-based health center.”

School-based health centers are health care centers based on school campuses serving students at that school and sometimes their families, school personnel, and community members. These centers focus on primary care and sometimes provide behavioral health, vision, oral, and other health services as needed by the community. Center staff work to improve both health and educational outcomes and coordinate care with school nurses and other school personnel to ensure services are complementary and not duplicative. School-based health centers are run by outside organizations like federally qualified health centers, hospitals, public health departments and nonprofit agencies and provide care during the school day. They also conform to federal, state, and local medical licensing, information, and consent laws.

School-based health centers are not a replacement for the nurse’s office system: they are a complement that provide different services and supports. Nurse’s offices are focused on triage, public health functions, and providing universal care for students. School-based health centers allow care to also be targeted, providing clinical care that is scheduled and focused on the needs of students in a specific community. Investing in school-based health centers does not create a replacement for school nurse’s offices: a system that invests in health centers without investing in nurse’s offices could lead to more public health problems in the long-run. But by complementing resources already available, school-based health centers can create a more resilient overall health system.

School-based health centers help the community deal with access gaps, utilize the school as a locus of health care issues, and deal with youth mental health issues.

In March 2024, the National Residency Match Program announced that the percentage of pediatric-residency positions that were filled through the program fell from 97% in 2023 to 92% in 2024. This means fewer doctors are training to help children, making it more difficult for children to get access to primary care. Families also face barriers due to transportation issues. In a study done on access to primary care, families cited transportation barriers as a top 3 issue for why they could not make primary care appointments. Families are also juggling work, insurance changes, and long wait times, which make access to primary care difficult. School-based health centers help reduce these barriers by locating qualified primary care workers in places of easy access to children: schools.

School-based health centers also help schools face the reality that they are acting as de facto health care providers. Teachers, school counselors, and administrators are managing health conditions like asthma, diabetes, anxiety, and traumatic stress on a daily basis. My fiancée is a high school math teacher, but I often joke (only half facetiously) that she is a social worker who happens to also teach math. With a wide range of parent involvement in children's lives, many children turn to teachers and other adults at school for help with health issues. School-based health centers help bring professionals with training that teachers, administrators, and often even school nurses don’t have to the school context to handle these tasks.

All this is happening at a time when children’s mental health issues are on the rise. According to the Centers for Disease Control and Prevention, 16% of children age 12-17 have a current, diagnosed condition, 8.7% have a current, diagnosed depression condition, and 6.8% have a current, diagnosed behavioral disorder. These conditions impact a child’s ability to learn, but they also impact teachers’ ability to teach in the classroom and other children’s ability to learn. Providing proper screening and referral for these conditions through school-based health centers can be an effective tool for treating these conditions and improving the educational environment for children.

The rise of in school-based health centers reflects the reality that schools have become central locations for health care delivery to children. Schools are where children spend a significant proportion of their time, so it should not be surprising that this is where they will receive health care, especially students with chronic conditions. State investment in school-based health centers reflects not only this fact but also the fact that investing in children is a long-term investment in the state’s education system, economy, and public health.

School-based health centers will not solve all health problems for children. They are, however, a useful tool for promoting individual health and providing services in places where children go throughout the week and year. By removing barriers to access, school-based health centers can help identify conditions that may not be identified otherwise and can provide care that school nurses are not equipped to provide without sacrificing their vital triage and public health functions. The growth of school-based health centers represents an adaptation of the health care system to meet needs and promote public health where children are today.

What the EPA’s health impact rule change means

In a recent rule, the Environmental Protection Agency decided that they would no longer be considering the monetary value of health impacts that result from the emission of fine particles. Their justification for this change is that there is uncertainty around how to monetize these health impacts. The EPA is saying that they still plan to quantify these impacts, just not monetize them. Still, this change is likely to have significant impacts in terms of rulemaking and seems very likely to reduce restrictions on polluters. 

We’ve actually written before about some of the discourse surrounding calculations for the value of statistical life and how this is an open discussion in the field of cost-benefit analysis. The EPA is just stating the facts when they say that there is uncertainty around the best way to monetize health impacts.

However, uncertainty is not a reason to ignore an impact entirely. 

As far as I am aware, there is nobody in the cost-benefit analysis world that thinks that the value of statistical life is an invalid way to monetize health impacts. There are plenty of discussions about what the best estimate is, but everyone agrees there should be some estimate. 

Ignoring the dollar value of lives saved will make future EPA cost-benefit analyses incomplete. I don’t expect every possible outcome to be measured and monetized, but evidence has shown that humans tend to ascribe a significant amount of value to reducing their risk of death. It is so often true that the value of lives saved is the largest economic benefit to a program or policy, especially those that involve harmful pollutants like PM2.5.

A better way to handle this uncertainty would have been through sensitivity analysis. Other agencies have their preferred values for the value of statistical life, researchers have been advancing the research on what the value of statistical life should be, particularly for groups not involved in the labor market. Analysts can always (and should always) talk about the uncertainty of their estimates, meaning this should be standard practice no matter what.

Another reason EPA should continue to use these estimates in their cost-benefit analysis is that cost-benefit analysis is not the only determining factor when it comes to choosing policies! There are completely valid reasons for EPA or anyone else to do a cost-benefit analysis, determine that a policy has costs that outweigh benefits, and choose to implement it anyways. Choosing to ignore an impact doesn’t make it go away, it just means we have less information and are likely to make worse decisions.

One of the most common problems with research is when people are overly confident about a result and it turns out to be wrong. This is why at Scioto Analysis we spend so much time talking about sensitivity analysis. To safeguard against overconfidence, we need to show people how our estimates may vary when they are exposed to real world conditions. 

This EPA rule change feels intentionally misleading to me. Whether it’s fair or not, calling a research project a cost-benefit analysis and assigning a monetary value to a policy change attaches it to the credibility of all the researchers who have spent their lives working on this topic. Voluntarily ignoring a major outcome and presenting the results as finished cost-benefit analysis not only leads to worse decisions, but it harms the credibility of the entire research field.

Original Analysis: Oklahoma Minimum Wage Hike would Boost State Economy

A new labor market and economic impact analysis from This Land Research and Communications Collaborative, produced by Scioto Analysis, finds that raising Oklahoma’s minimum wage to $15 would increase earnings for low-income families, reduce low-wage employment across the state, close wage gaps between groups, and generate more than $1.1 billion in annual economic growth.

“The analysis shows that a $15 minimum wage would improve earnings for workers across Oklahoma while growing the state’s overall economy,” Rob Moore, Principal for Scioto Analysis said, “These findings make clear that raising the minimum wage is an effective tool for reducing low-wage employment and boosting household incomes in both rural and urban areas.”

Key Findings from the Report

• A $15 Wage Boosts Earnings. Workers directly affected by the policy will see a 25% increase in weekly earnings, with the average impacted worker gaining $100 more per week—or roughly $4,200 more per year. This additional income would help Oklahoma families keep pace with rising costs and strengthen long-term economic security.

• Oklahoma’s Wage Gap with the Nation Narrows. Oklahoma workers currently earn 25% less than the average U.S. worker, even after accounting for cost-of-living differences. A $15 minimum wage will cut that gap nearly in half, giving Oklahomans a more competitive wage relative to the rest of the country.

• Low-Wage Work Drops Sharply. The share of Oklahomans in low-wage jobs will fall by 29% under a $15 minimum wage, with more than 100,000 workers rising above low-wage status. This shift would lead to reduced economic volatility and greater workforce stability for employers.

• Oklahoma’s Economy Grows by Over $1 Billion. Higher earnings and increased spending will boost the state’s GDP by $1.1 billion annually, the report finds. Additionally, employers will benefit from an estimated $880 million in productivity gains, driven by lower turnover and higher worker retention.

• Rural–Urban Wage Gaps Shrink. Wage disparities across counties will narrow substantially under a $15 wage. For many counties, especially in rural Oklahoma, the gains would be as large  as those seen in urban centers.

This study is the fourth in a series of studies conducted by Scioto Analysis on the minimum wage in Oklahoma. Refer to the Scioto Analysis projects page for past studies on the minimum wage’s impact on housing, public safety, and health.

Is Ohio’s population decline overrated?

According to the Ohio Department of Development, Ohio’s population will shrink from 11.8 million people in 2020 to 11.1 million people in 2050.

To many policymakers in Ohio, this is a key public policy issue. Last year, Gov. Mike DeWine urged university officials to ramp-up recruitment efforts to “keep more talent in the state of Ohio.”

There is some truth to the benefits of population growth to population vitality.

New people means new ideas, new businesses, new consumers. I like living in a city with a vibrant immigrant community where I can eat foods from places like the Philippines and go to karaoke nights where people sing Brazilian standards.

I also like having friends from states ranging from Pennsylvania to California who have different backgrounds and life experiences from me.

But population decline can be a symptom as much as a cause of quality of life problems, if not more.

The slowest-growing states in the country, West Virginia and Mississippi, are also states that struggle with the highest poverty rates, lowest educational attainment, and lowest life expectancies.

Understanding causality is hard here, though.

Surely people with higher education and income have more ability to move from state to state, meaning part of what is causing these poor statistics is just losing people who are better off.

On the other hand, there are reasons they are leaving, too, that could be attributed to quality of life.

Then there are the exceptional states like Vermont, which is one of the slowest growing states in the country despite having one of the lowest poverty rates and some of the highest educational attainment and life expectancies among U.S. states.

Clearly there is something happening with Vermont. Meanwhile, Montana had bottom-five population growth in 2024, but is around the middle of the country when it comes to poverty, education, and life expectancy.

So what should we make of Ohio’s population growth trajectory?

Compared to the rest of the country, Ohio has a high poverty rate (top half of U.S. states), low bachelor’s degree attainment (bottom half of U.S. states), and low life expectancy (bottom half of U.S. states). That means Ohio looks a lot more like the Mississippis and West Virginias of the country than it looks like Vermont and Montana.

If this is the case, population decline could be an indicator for deeper quality of life problems in the state.

Ultimately, these other statistics matter more to Ohio’s trajectory than population growth.

If Ohio lost 700,000 residents on net due to births, natural deaths, and migration rates but the poverty rate declined, bachelor’s degree attainment improved, and life expectancies rose, I think pretty much everyone would agree the state would be better off than it was before.

Targeting public policy toward reducing poverty, increasing educational attainment, and improving public health will likely lead to a more well-off state population than one that focuses squarely on population growth.

Let’s realize that quality of life is the most important consideration for Ohio residents, not how many people decide to move in or out of the state.

This commentary first appeared in the Ohio Capital Journal.

Federal changes to SNAP may kill the program in many states

Earlier this week, I wrote about three economic stories to keep an eye out for in 2026. One of these was changes that were coming to Supplemental Nutrition Assistance Program (SNAP, formerly known as “food stamps”) benefits as a result of the One Big Beautiful Bill Act. Today, I wanted to dive a bit deeper into this topic since it could end up being one of the most significant changes to our social safety net in a generation.

Throughout the history of the program, SNAP has been funded almost exclusively by the federal government. Aside from administrative costs, states have previously just been able to receive money and disburse it to people who claim benefits. In Ohio, that’s about 1.4 million people receiving over $3 billion in benefits each year. None of that $3 billion came out of Ohio’s state budget, though the administration of the program did cost Ohio about $150 million.

The Georgetown Center on Poverty and Inequality estimates that Ohio is going to be on the hook for about $540 million after this change, an increase of 268%. For context, Ohio expects to bring in about $28.7 billion in tax revenue during FY 2025, and that is projected to increase to $29.7 billion in FY 2026.

That means that this change in SNAP benefits is roughly equivalent to 2% of all of Ohio’s tax revenue, and of the projected $1 billion increase from FY 2025 to FY 2026 over half would have to be spent on covering this new bill rather than increasing funding across social services like education and Medicaid. 

States can't afford to spend over half of their annual budget increases on an individual program, that money is already being accounted for elsewhere. If states are going to cover these increased expenditures, they will either need to dramatically cut spending elsewhere or make significant increases to their tax revenues. 

Even if states were able to raise this amount of money easily, it would still be difficult to maintain a balanced budget because SNAP is an entitlement program. That means anyone who is eligible for benefits gets to receive them, which leads to unpredictable expenditures year-to-year. 

The alternative to entitlement programs are block grants, but the last time a major entitlement program got block granted it meant that the number of people receiving benefits and the benefit amounts cratered. 

States are looking at a lose-lose scenario. Either they need to significantly raise taxes and remain flexible to unpredictable changes in benefit claims, or they need to slash the third largest anti-poverty program in the country, behind only Social Security and the Earned Income Tax Credit. 

In 2026, we will see what the future of the SNAP program will be across the country. Unless there is some sort of unforeseen policy change, we are likely to see many states drop the SNAP program, which will likely lead to increases in poverty rates across the country. Without the support provided by the SNAP program, many families are going to find their budgets stretched at a time when they are still reeling from the elevated inflation rate of the past five years.

Who is moving out of Ohio?

In a blog post I wrote last month, I looked at affordability in Ohio and found that it is more affordable than most other states, especially in housing. One question I asked was this: why are people moving out of Ohio if it's so much cheaper to live here? Between 2020 and 2024, Ohio experienced a negative net migration rate, ranking 39th in net domestic migration across all 50 states. So who is moving out, and where are they going?

I decided to dive into American Community Survey data to answer these questions. The American Community Survey asks questions that allow us to compare the current residence of households in 2024 to their residence in 2023. This means we can analyze the households that moved out of Ohio versus those that stayed. According to the data, around 85,700 households moved out of Ohio between 2023 and 2024. Among those movers, the most common destinations were Florida, Michigan, Pennsylvania, and Texas.

Of the top ten destinations for Ohio movers, Florida and Texas have the highest average ages, at about 52 and 43 respectively. For comparison, the average age of those staying in Ohio is 41. This suggests that many Ohioans moving to Florida and Texas may be retirees or mid-to-late career professionals moving for better employment opportunities. Another key difference between Florida, Texas, and Ohio is income tax policy, which may be a driver for those in peak earning years or about to enter retirement. On the other hand, the youngest Ohio emigrants are bound to New York (average age 26) and Illinois (average age 27). This suggests many Ohioans may be moving to megacities like New York City or Chicago as college students or young professionals.

Looking at the average income for these top destinations tells us more about who is moving out of Ohio compared to who is staying. The income variable in the data shows current household income, meaning for migrants, what they make in their new state, and for Ohioans, how much they make in Ohio in 2024. The average income for those who stayed in Ohio was about $43,000, which places Ohio in the middle compared to the top ten destination states.

The highest average household incomes for movers are in Texas, Arizona, and Florida at $92,000, $83,000, and $73,000 respectively. This suggests these may be the top three states Ohioans are moving to for better employment and income opportunities or anticipating retirement. Interestingly, while many move to Michigan, their average income there is only $40,000, which is actually lower than the average for those staying in Ohio. Conversely, the lowest average incomes for movers are in Indiana, New York, and Kentucky at $33,000, $36,000, and $37,000 respectively. This provides more evidence that young people who typically earn less are leaving Ohio for big-city destinations like New York, or in the case of Indiana and Kentucky, young people may be moving to nearby states as college destinations.

To get a complete picture of Ohio migration, we can also look at who is moving into Ohio from other states. Most Ohioans from out of the state are coming from Florida, Kentucky, Pennsylvania, and Michigan.

The age ranges for those moving into Ohio are a lot tighter, with the youngest average movers coming out of Maryland at about 28 years old and the oldest average movers coming out of Florida at about 44 years old. One of the most interesting takeaways is that Florida is the most common destination for both emigrants from and immigrants to Ohio. In both scenarios, these movers have the highest average age of any group, suggesting a heavy flow of retirees or older professionals moving back and forth.

The average age for movers coming into Ohio from New York is the second highest at 31. This might support my previous theory: young professionals or college students move to bigger cities like New York City at a young age but return to Ohio as they get older.

Comparing the average income moving into Ohio versus leaving Ohio reveals a disparity in the value of moving into or out of Ohio. For instance, households moving from Florida to Ohio earn an average of $55,000 and households moving from California to Ohio earn an average of $43,000. However, when Ohioans leave for those same states, they often see much higher returns. For example, those moving to Florida jump to an average income of $73,000, and those moving to California jump to an average income of $61,000. Ultimately, the data suggests that moving into Ohio often happens at a lower income bracket, while moving out of Ohio provides a jump in pay for the average household. 

The trend of income changing between states is missing an important piece of context: the cost-of-living in Ohio is far lower than states like Florida and California. Even if households are earning less in Ohio, their expenses are less in Ohio too. However, it is still worth considering that movers into Ohio may not be seeing the same spikes in income that movers out of Ohio are seeing in other states.

3 economics stories to watch out for in 2026

Happy New Year! Over the last couple of weeks, we’ve recapped Scioto Analysis’ past year, the general landscape of research, and I’ve reflected on my time so far with Scioto. Now, I want to take some time to look forward, and speculate a bit about what I think will be some of the biggest economic stories of 2026. 

What’s going to happen with SNAP benefits?

The way SNAP benefits are going to work in 2026 is going to change dramatically because of the One Big Beautiful Bill Act. Previously, the Federal Government funded SNAP and gave money to the states. Aside from some administrative costs, states were just getting money and distributing it.

However, now states are required to pay some of the benefit costs themselves. According to research done by the Georgetown Center on Poverty and Inequality, this is going to cause most states to start paying hundreds of millions of dollars. California and Florida are going to be on the hook for over $1 billion each.

This change may mean that states have to cut back their SNAP programs and limit participation. It’s difficult for states to raise that amount of money, especially because states (with a few exceptions) need to have balanced operating budgets. How this story plays out will have major ramifications for poverty and inequality across the country. 

What counts as a healthy economy?

Earlier this month, my colleague Rob wrote a blog post about the claim made by a financial advisor that the poverty line should be $140,000 instead of $32,000 for a family of four. This is based on the fact that spending habits have changed in the past 60 years since the poverty line was first introduced. 

When I read this article, my first thought was about how different people perceive the health of the economy. What does it mean for people or a whole nation to be doing well?

We at Scioto have calculated indicators such as the Genuine Progress Indicator to provide an alternative to Gross Domestic Product that tries to capture some other sentiments we have about what a healthy economy looks like. 

There are so many ways to try and pin down how people are doing. There are competing definitions of what it means to be middle class, there is the official poverty measure and the supplemental poverty measure, some groups prefer not using poverty measures and instead looking at the ALICE criteria. With diversion between unemployment rates, inflation rates, gross domestic product growth, and consumer sentiment as we enter the new year, which indicators rise to the top is a story to follow in 2026.

What will the Federal Reserve do with interest rates?

One of the biggest open questions going into 2026 is what will happen at the Federal Reserve once Jerome Powell’s term ends. In recent meetings, there has been uncharacteristic disagreement among Federal Reserve officials about rate cuts. At the heart of the debate is whether slow job growth or high inflation is a bigger threat.

President Trump has made it clear that he wishes the Fed had been more aggressive with cutting interest rates over the last year. It seems almost certain at this point that the next chair of the central bank will be an economist who believes inflation is largely under control, and that rate cuts are appropriate. Many people are worried that this could signal a weakening of the independence of the Federal Reserve, which would have negative ramifications across the economy. 

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2026 will have its fair share of economics stories to follow. State and local policymakers are going to have a whole set of new challenges and opportunities to work through in the new year.

Original Analysis: Home Visiting Programs Support Child Development

This morning, Scioto Analysis published a cost-benefit analysis about the impacts of Help Me Grow, a home visiting program in Ohio. Using analysis from the Washington State Institute for Public Policy, we estimate that Help Me Grow creates a net benefit of $112 million, with about $3.30 in benefits created for every $1.00 in costs.

Ohio is falling behind in kindergarten readiness scores while childcare subsidies remain low compared to other states. One solution to this problem is home visiting, which matches new and expecting mothers with a nurse, social worker, early childhood specialist, or paraprofessional who conducts home visits and provides assistance to families. Home visiting can help to reduce parental stress, increase access to childcare, and improve kindergarten readiness.

The Help Me Grow home visiting program in Ohio supports 13,000 families per year. The main contributing factors are $117 million in benefits from increased labor market earnings due to reduced child abuse and neglect, $17.7 million in benefits from less social spending due to reduced child abuse and neglect, and $12.1 million in benefits from less smoking later in life. Home visiting also creates benefits to employment, crime, and out-of-home placement.

We conducted 10,000 simulations of the current Help Me Grow home visiting program in Ohio with different variables and costs to test our model. We found that home visiting creates a positive net value for Ohio in 81% of trials, with the middle 90% of outcomes between -$97 million and $320 million in net social benefits.

For the 2026-2027 biennium, Ohio plans to expand the Help Me Grow home visiting by 23%. We estimate that this expanded program will produce a net benefit of $138 million, $26 million more benefits than the status quo. As Ohio expands Help Me Grow more, the number of families served increases, which increases the total benefit to Ohio.

Intergenerational poverty and goods we wish didn’t exist: Two economics papers I enjoyed in 2025

Every year, I like to look back at some of the academic research papers that I thought were impactful over the past year. Previously, I tried to do something akin to “The Important Papers of 202X,” but the truth is I could not possibly read enough to say with any certainty that the papers I came across were better than some that I missed. Additionally, academic papers take years to write, and I sometimes come across research that hasn’t been published yet, or I read something that has been in the works for years and only recently published. So, I’ve decided that this year I’m going to be a little more loose with my rules and just write about two papers I read this year that I found interesting. 

Intergenerational persistence of poverty in five high-income countries

This paper’s author Zach Parolin won the Association of Public Policy Analysis and Management’s David Kershaw award for his work studying how persistent poverty is in different countries. The idea behind this paper is fairly straightforward: If we assume that a country has perfect equality of opportunity, then whether or not you are in poverty as an adult should be independent of whether you experienced poverty as a child. 

So, using data from the United States, Australia, Germany, Denmark, and the United Kingdom, Parolin measured how much childhood poverty contributed to the likelihood of adult poverty, and explored the mechanisms that drove those disparities. He found that in the United States, intergenerational poverty effects were much stronger. In other words, Americans who experienced child poverty are significantly more likely to also experience adult poverty compared to children who experience poverty in those other countries.

The main driver of this effect he identified was a relatively weak tax and transfer system compared to those other countries. One of the key takeaways from this paper was if the United States had a tax and transfer system similar to that of the other study nations, we could cut the intergenerational persistence of poverty by one-third.

Goods that people buy but wish did not exist

The name of this paper by Cass Sunstein says it all. There exist goods that people spend money on (sometimes quite a lot) that they do not gain wellbeing from consuming. The main idea is that non-consumption creates worse negative effects compared to consumption, and so people choose to consume these goods anyways. 

Sunstein opens his paper by asking us to imagine that our friend is hosting a party we aren’t interested in going to. Because the party is happening, we feel pressured to go in order to avoid sending the signal to our friends that we don’t like parties, or perhaps we don’t care about them enough to show up. The best case scenario would be if the party was cancelled by the host, freeing us of the social need to attend. In this case, our preference ordering would be 1) nobody attends, 2) we attend along with everyone else, 3) we stay home while everyone else is at the party.

The key characteristic of the goods in question here are that many people would prefer they didn’t exist altogether, but because they do exist people feel compelled to consume them. This is different from something like a home security system that many people don’t get direct welfare from but often purchase anyway. Those goods are sometimes referred to as defensive expenditures, and they don’t quite fit this description because people don’t care about the existence of home security systems, they wish that crime didn’t exist. 

One major example Sunstein discusses is social media. If you ask someone how much they would need to be paid in order to stay off social media for a month, they will tell you that it would take quite a bit of money, around $50. This seems to suggest that people benefit from social media. 

However, you get a different answer if you flip the question on its head. People actually have a willingness to pay for eliminating social media altogether. Some people actually benefit from the existence of social media, but on average it appears that people wish it didn’t exist for everyone.

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These two papers exemplify what draws me to economics the most. The ability to take complicated topics like poverty or seemingly irrational decisionmaking and find a way to quantify it and model it. I’m looking forward to another year of learning in 2026, and I hope everyone has a pleasant end to their 2025.

Debunking the myth: suicide rates do not spike during the holidays

You ever have one of those moments where you realize something you’ve believed for years was completely false? That is something that happened to me last week.

The Planet Money newsletter this week was a round-up of great stories about the holidays. Topics covered included whether stock prices predictably increase during the holidays, why gas prices don’t increase with airline ticket prices during the holidays, and a classic paper by famous scrooge Joel Waldfogel arguing the inefficiency of gift giving.

But it wasn’t any of these that left me shocked. It was instead a two-paragraph story they had about how suicides don’t increase during the holidays.

Am I the only one who didn’t know this? Just last weekend, I was watching the 1984 comedy-horror classic Gremlins with my fiancée and one of the main characters was saying that suicide rates go up during the holidays. Neither of us batted an eye: it seemed to be an incontrovertible fact.

If you clicked the link above, you may be disappointed. The article defending the controversial claim is available for a cool $64 from BMJ journals. But have no fear! The NIH has made the scant review available for free. In this two page review of fifteen studies, six conducted between the mid 80s and early 2000s that were deemed high-quality, a consultant and a physician conclude “suicide and parasuicide rates go down around Christmas (emphasis added).”

Is this true? In recent data, this also seems to be the case. The Centers for Disease Control and Prevention makes fatal injury data available through its Web-based Injury Statistics Query and Reporting System. Using this data, you can see that suicide incidence per month is lower in December from 2021 to 2024 than every other month save one: February. Once you account for the fact that February has three fewer days than December, December is far lower than any other month, with average daily suicides anywhere from 4% (November) to 14% (August) higher in any other given month. Overall, the daily suicide rate is 7% lower in December than it is for the year as a whole. So from 2021 to 2024, suicide rates plunged to their lowest rates of the year in December. This trend has been so consistent over the past four years that December was the lowest daily suicide rate in 2022, 2023, and 2024. In 2021, January’s suicide rate was 0.2% lower than December and April’s was 1.3% lower.

So yes, suicide rates do go down in December.

So why does the myth persist?

One explanation is media. The University of Pennsylvania’s Annenberg School of Communication has been tracking media coverage of the “suicides increase during the holidays” myth for decades and finds dozens of stories nationwide every year perpetuating the myth. Last year was the lowest year in nearly two decades with 19 news reports reporting the myth. A typical year over the course of the study has over 50 news reports claiming suicides spike during the holidays.

I wonder if there is a connection here with the cultural exaggeration of Seasonal Affective Disorder. Despite widespread attention among the general population, studies of the disorder say that, at the high end, population prevalence is only 10% and is likely closer to 1-2%. A retrospective meta-analysis pegged the lifetime incidence of Seasonal Affective Disorder in the single-digits.

The mistaken association people have between the weather and well-being is well-documented. In a landmark study, Nobel-prize winning behavioral economist Dan Kahneman surveyed students at Ohio State University and the University of California, Los Angeles on perceptions of happiness. Both students in Ohio and southern California believed climate and weather was a strong predictor of happiness and both students in Ohio and southern California agreed that weather and climate was better in southern California than it is in Ohio. Despite this, students in California did not report being happier than students in Ohio.

Kahneman calls this mistake a “focusing illusion.” In Kahneman’s words, “nothing in life is as important as you think it is while you are thinking about it.” You see this all the time: students stressed out of their minds about an exam that they will not even remember in a few months, people excited about the prospects for a promotion to a job that will feel normal in a year. Weather is a particularly potent example of this.

No doubt the experience of walking across an academic quad or waiting at a bus stop is different on a 20-degree January morning in Ohio than it is on a 70-degree any-time-of-the-year day in Los Angeles. But what the best evidence shows is that this experience is fleeting. Eventually you get to class or on the bus, to work or home, and then things like whether you have close friends or a spouse, you are involved in your community, and you have a stable job and income impact happiness.

Maybe this is the missing piece of the puzzle around the “suicides go up during the holidays” myth. If well-being is more highly correlated with relationships, involvement, employment, and security than it is with weather, then we should not be surprised that suicides go down during the holidays. The holidays are a time when people spend time with family. If anything, people without connections are not more lonely as the pop culture parable goes. They are just as lonely as ever, while people who are living on the edge, who may usually feel lonely, find connection with others that they do not usually have.

So what can we do to reduce suicide risk in the face of this knowledge? The Annenberg School has collaborated with media organizations to develop a set of guidelines for reporting on suicide that reduce contagion. People should also be aware of 988, a crisis line that someone struggling with suicidal thoughts can dial to connect with someone. In addition to these tools, timing awareness campaigns around months that actually see higher suicide rates like in the summer can be more effective than focusing on the mythological winter rates.

You learn something new every day. Hopefully learning new things can help us make better decisions that will ultimately improve lives.