Three Essays on Health Behaviors and the Need for New Policy


Book Description

This dissertation consists of three essays, each on one emerging public health issue that calls for new policy making. The first essay studies 15,000 adult individuals from a longitudinal dataset, the China Health and Nutrition Survey, collected in China 1991-2006. It explores the effects of food prices on obesity and shows evidence that while obesity corresponds to food prices changes, the effects might not always be accurately captured by Body Mass Index (BMI), but by a more direct measure of body fat - triceps skinfold thickness (TSF). The second essay extends the first essay and focuses on health implications of obesity on outcomes such as hypertension and diabetes. The sample is limited to non-obese individuals with a BMI less than 28. TSF, as a proxy for body fat, is shown to have significant independent effects on health. The third essay looks at unintended consequences of a new drug innovation, Viagra, and its successors, Cialis, and Levitra. It finds that erectile dysfunction (ED) medication users have a higher rate of STDs. Because most ED drug consumers are 40+ males, who are above the typical age range where routine STD tests are recommended, this finding reveals a new health threat to older populations and potentially the general public as a whole.







Three Essays in Health Economics


Book Description

This dissertation contains three essays in the field of health economics and health policy. The first essay studies the effects of legalizing medical use of marijuana on marijuana use and other risky health behaviors. I examine the restricted-use data from the National Survey of Drug Use and Health (NSDUH), which is a repeated cross sectional data set with state identifiers from 2004 to 2012. During this period, 9 states and Washington D.C. allowed patients with medical conditions to use marijuana. I estimate difference-in-differences (DID) models to examine the impacts of these policy changes on risky health behaviors. Allowing medical use of marijuana does not lead to higher marijuana use among the overall population and the youth. However, I find that medical marijuana laws (MMLs) are positively and significantly associated with marijuana use among males and heavy pain reliever users. The second essay is a joint work with John Cawley and tests a novel hypothesis: that these health disparities across education are to some extent due to differences in reporting error across education. We use data from the pooled National Health and Nutrition Examination Survey (NHANES) Continuous for 1999-2012, which include both self-reports and objective verification for an extensive set of health behaviors and conditions, including smoking, obesity, high blood pressure, high cholesterol and diabetes. We find that better educated individuals report their health behaviors more accurately. This is true for a wide range of behaviors and conditions, even socially stigmatized ones like smoking and obesity. We show that the differential reporting error across education leads to underestimates of the true health disparities across education that average 19.3%. The third essay is a joint work with Rachel Dunifon and studies how state regulations related to the quality of child care centers-such as teachers' education and degree requirements, staff to child ratios, maximum group size, and unannounced inspection compliance requirement-are predictive of children's health, developmental and cognitive outcomes. State level policies that are related to improving the productivity of child care center teachers by having a higher staff to child ratios and advanced schooling requirement are predictive of child's weight related outcomes and cognitive outcomes.







Three Essays on Health, Risk and Behavior


Book Description

Health-related decisions could be explained by a variety of factors, ranging from the perception of the risk the activity involves to the knowledge of the long-term effects of the decision. An individual deciding to eat unhealthy or not to exercise could face health problems in the long-run. Individuals with health issues have been found to be more risk averse when it comes to financial decisions, such as portfolio allocation. Financial incentives to engage in healthier behaviors have been successful but short-lived. Prior research leaves many questions such as: What are the factors that explain why an individual decides to engage in healthy or unhealthy behaviors? Are risk preferences a determinant in the decision to seek treatment for an illness? Do beliefs about the outcome of unhealthy and healthy decisions play a role? This dissertation aims at investigating the following questions: How do social aspects of risk impact health-related decisions? And, more broadly, what is the relationship between health, risk preferences and perception and behavior? I focus on three main applications: flu vaccinations, asthma in children and the impact of chronic illnesses (and other joint risks) in risky decisions. This dissertation investigates different ways in which risk, health and behavior interact with each other. I focus on three health-related applications: flu vaccines, asthma and how health influences individual risk preferences. The findings of these three chapters are intended to contribute to the discussion of how health impacts behavior and the perception of risk. I also analyze the effect of different sources of endogeneity, such as the beliefs about the flu vaccine and the severity of an influenza episode, beliefs about the severity of asthma or the effectiveness of treatments to tackle an asthma episode. This research will help policy makers better understand how risk perceptions about the outcomes of different health-related behaviors. I aim at continuing the conversation about which would be the best way to incentivize healthy behaviors and modify negative views of treatments to deal with chronic illnesses.




Three Essays on Health, Housing, and Risky Behaviors


Book Description

The purpose of this dissertation is to understand the causal relationships which link public policies to risky behaviors, housing, and health. Geographic variation in policy exposure, housing resources, or healthcare access generates socially meaningful and policy-relevant impacts on mental and physical health. The three essays which comprise this dissertation consider how state- and local-level public policies and healthcare infrastructure impact these health outcomes. Chapter One investigates the impact of nuisance ordinances (a housing-related policy) on substance-use related mortality rates in Ohio. Chapter Two explores how changes in access to psychiatric- and substance-use-related treatment affect subsequent eviction rates. Finally, Chapter Three examines the heterogeneous effect of cannabis- and opioid-related laws on licit- and illicit-opioid-related mortality rates. The goal of these findings is to generate policy recommendations and encourage debates that account for the potential unintended consequences of policies on mental health and risky behaviors.




Essays on the Economics of Family Health Behavior and Child Health


Book Description

Parental behavior has potentially large implications for child health and child economic outcomes. In three essays, I explore two topics: how the health behavior of parents impacts their children's health and wellbeing, and the degree to which policy can alter parental behavior such that child health improves. The first essay examines how cash transfers to pregnant single mothers via the Earned Income Tax Credit (EITC) improve child birth weight. The second essay shows that cigarette taxes reduce maternal smoking and improve childhood health outcomes. The final essay documents the correlation between parental and teen smoking using the Current Population Survey Tobacco Use Supplement. As a whole, this dissertation contributes to our understanding of how health transmits from parent to child, an important mechanism in the intergenerational transmission of inequality.




Three Essays on Health and Family Economics


Book Description

This dissertation contains three empirical essays that explore the effects of natural disasters and family transitions on long-term child outcomes and short-term parental behavior. The first essay ("Impact of Shocks in Utero and in Early Life on Stunting: the Case of Philippines' Typhoons") assesses the long-term effects of natural disasters early in life on health outcomes, mainly stunting, and explores some of the possible channels causing those long term effects. The second essay ("Effects of Natural Disasters on Fertility Behavior: Evidence of Treatment Heterogeneity") assesses the effects of natural disasters also, typhoons in particular, on fertility behavior, and explores the existence of treatment heterogeneity. Finally, the third essay ("Parents' shared and solo time with children: Composition and correlates") studies different correlates of the composition of parental time investments under the perspective of a child, and explores how that composition changes when parents adapt to the birth of a new child.







Three Essays in Health Economics with a Focus on Consumer Behavior


Book Description

This work spans the two fields of health economics and health policy and applied microeconomics with a focus on consumer behavior. Each chapter focuses on a separate question and evaluates its consequences and impacts on consumers and society. The questions in this paper identify (1) the optimal health expenditures in society from a theoretical perspective and compare the results with the Medicare reimbursement scheme, (2) the causal impact of the risk perception of COVID-19 on consumption expenditure changes in the U.S., and finally, (3) how a sudden health shock experienced by a family member affects his spouse's healthcare expenditures through the behavioral spillover channel.