Three Essays on the Economics of Health Behaviors and Outcomes


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The final chapter examines the effect asthma and other chronic childhood illnesses on standardized test scores, absenteeism, and grade repetition. I find that asthma is related to significant increases in absenteeism and grade retention, but not to differences in standardized test scores.




Three Essays in Health Economics


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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 Economics


Book Description

This dissertation consists of three essays examining topics in health economics. The first essay examines the impact of education on 10-year mortality rates of minorities in the United States. I use the states' compulsory education laws to instrument the level of education in my cohort study of the effect of education on the mortality rates of minority groups (Blacks, Asians and Hispanics) born in the early twentieth century. I find that an increase in years of education significantly decreases the mortality rates for the White and Black populations, but not for the Asian and Hispanic populations. The second essay explores the effect of education on adult self-reported health (SRH), health behaviors (smoking, seatbelt use, and exercise), and health outcomes (body mass index (BMI), hypertension, and heart attack) by race and ethnicity using Medical Expenditure Panel Survey (MEPS) data from 2001-2011. I find racial and ethnic disparities in the education gradient on SRH that remain significant after controlling for income and other economic factors. I explore the pathway through which education influences health using three different econometric methods to estimate a causal effect. I find that education directly affects health behaviors and that health behaviors directly affect health outcomes including SRH, leading to an indirect impact of education on SRH. My third essay is written in collaboration with my adviser, Dr. Virginia Wilcox-Gok. We use the National Comorbidity Survey Baseline (NCS-1) dataset from 1990-1992 and O*NET (Occupational Information Network) to explore whether individuals diagnosed with depression before age 22 self-select as adults into occupations that accommodate their depressive disorders. Depressive disorder is a health problem that can start very early on in life, so it often limits educational attainment and adult earning. It is also a disorder that can be helped if diagnosed early. Because individuals with chronic depression may need more flexibility and less stress in the workplace to cope with their disorder, their adult occupational choice may depend on how accommodating the occupation's characteristics are to this disorder. We find that women with early-onset depressive disorder are more likely to be employed full time than men, while both men and women are likely to choose self-employment. Men with more frequent depressive episodes are less likely than women to choose occupations requiring higher levels of education, experience, and training. In contrast, women with early onset depressive disorder are more likely than men to take jobs in the service sector.







Three Essays in Health Economics


Book Description

Keywords: retiree health insurance, obesity, overweight, Food Stamp Program.







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.