Date of Completion

5-3-2018

Embargo Period

4-19-2023

Keywords

Health economics, public health insurance, Medicaid, Internet, health behaviors, Affordable Care Act, nurses

Major Advisor

Kenneth Couch

Associate Advisor

Melanie Guldi

Associate Advisor

David Simon

Field of Study

Economics

Degree

Doctor of Philosophy

Open Access

Open Access

Abstract

This dissertation research contributes to the areas of health and labor economics. In the first essay, Melanie Guldi (University of Central Florida), David Simon (University of Connecticut), and I attempt to explain and understand the growth in obesity in the United States using the expansion of broadband Internet providers in the U.S in the early 2000s. Our results suggest 1.2 million white women became overweight due to the expansion in broadband Internet access. Possible mechanisms include increased sedentary time and binge drinking. The second and third essays focus on effects of public health insurance programs. In the second essay, I examine effects of public health insurance programs for low-income childless adults, a group with a high rate of uninsurance. Using the expansion of public health insurance coverage to low-income childless adults across states in the early 2000s, I estimate effects on public and private health insurance coverage and, because individuals may decrease their labor supply to qualify for coverage. My estimates suggest these programs increased low-educated childless women’s public health insurance coverage by 1.5 to 1.7 percentage points. Effects on labor supply are small, positive, and not statistically significant, suggesting little change in labor supply to qualify for insurance coverage. The third essay examines the effect of the Patient Protection and Affordable Care Act Medicaid expansions on the labor market for nurses. Using the Medicaid expansions as a plausibly exogenous increase in the demand for nurses, I find a 1.5 percent increase in hours worked per week (30 minutes). The increase in hours is larger in rural areas, consistent with a larger increase in insurance coverage in these areas. For licensed practical nurses, employment increased by 11 percent and hours worked per week increased by 2.4 percent (nearly 1 hour). Registered nurses’ hours increased by 1.2 percent (nearly 30 minutes). I do not find any consistent negative effects on patient ratings of nursing care and hospital-acquired infection rates. The increase in hours is driven by a shift from part-time to full-time work, likely ruling out fatigue as a mechanism for changes in quality.

Available for download on Wednesday, April 19, 2023

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