Date of Award

4-30-2018

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Economics

First Advisor

James Marton

Second Advisor

Charles Courtemanche

Third Advisor

Kyle Mangum

Fourth Advisor

Douglas Roblin

Abstract

This dissertation has three essays analyzing the impact of economic conditions on risky behaviors and health outcomes. In the first essay, I estimate the effects of U.S. Metropolitan Statistical Area housing prices on a variety of health outcomes and risky health behaviors separately for homeowners and tenants. The constructed dataset consists of information on individuals from the 2002 - 2012 Behavioral Risk Factor Surveillance System combined with homeownership data from the March Current Population Survey and housing prices from Freddie Mac. I estimate positive results for homeowners in terms of their health and negative results for tenants when housing prices increase. I also find increases in risky behaviors among tenants associated with increases in housing prices, which may be driving the reduction in their health status. These estimated effects are concentrated among low income homeowners and tenants and do not persist in the long run. However, the effects of an increase in housing prices on being obese become more pronounced for homeowners in the long run, resulting in worse self-reported health.

The second essay estimates the impact of income inequality on health. The relative income hypothesis suggests that an individual’s health is impacted by the income of others. However, prior studies suffer from mixed empirical findings that could be due to a lack of annual individual income data with sufficient sample size. In this paper we apply a new methodology to calculate a variety of income inequality measures based on aggregate income and household size data from various Federal data sources. Our proposed methodology provides a way to express various income inequality measures as a function of the ratio of mean to median household income under the assumption that individual income is log-Normally distributed. This approach produces a variety of precise annual income inequality measures at different levels of geography, thus solving the sample size problem by incorporating externally calculated inequality measures. Combining the 2001-2012 editions of Behavioral Risk Factor Surveillance System with annual regional income inequality measures derived from our methodology enables us to estimate both the contemporaneous and the lagged effect of income inequality on individual health outcomes. In general, we find statistically significant evidence supporting the income inequality hypothesis and the relative deprivation hypothesis, which suggests that greater income inequality adversely affects health status in the United States.

In the third essay, In this paper we attempt to address a persistent question in the health policy literature: Does more public health spending buy better health? This is a difficult question to answer due to unobserved differences in public health across regions as well as the potential for an endogenous relationship between public health spending and public health outcomes. We take advantage of the unique way in which public health is funded in Georgia to avoid this endogeneity problem. Using a twelve year panel dataset of Georgia county public health expenditures and outcomes in order to address the “unobservables” problem, we find that increases in public health spending lead to increases in mortality by several different causes, including early deaths, heart disease deaths, and cancer deaths. We also find that increases in such spending leads to increases in morbidity from cancer, heart disease, diabetes, and asthma.

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