Date of Award

8-1-2022

Language

English

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

College/School/Department

Department of Economics

Content Description

1 online resource (xi, 87 pages) : illustrations (some color)

Dissertation/Thesis Chair

Pinka Chatterji

Committee Members

Kajal Lahiri, Gerald Marschke

Keywords

Pharmaceutical services insurance, Older people, Educational attainment, Medical care, Mortality, Youth with disabilities

Subject Categories

Economics

Abstract

This thesis studies determinants of health and socioeconomic disparities in the US. Specifically, it focuses on the following factors: (1) public health insurance, (2) medical care, and (3) adolescent health. The first and second essays test whether access to public health insurance may be an effective tool in remedying disparities in medical access and health outcomes. The third essay examines the gap in educational attainment between students with disabilities and those without, and the evolution of the gap over time.The first essay examines the effect of Medicare Part D, a voluntary prescription drug program, on education-related disparities in mortality. It shows that the prescription drug program reduces mortality gaps between low-educated and high-educated elderly Americans. The second essay analyzes mechanisms underlying the results found in the first chapter. To do that, it investigates the effects of Part D on drug insurance coverage and medical utilization, focusing on its varying effects by differing educational attainment. It shows that the effects of Part D on medical utilization are concentrated in low-educated populations who substantially gained drug insurance coverage through the policy. These results suggest that the effect of Part D on medical utilization is translated into health benefits, as the prescription drug program reduces mortality and the effect is magnified among those with lower educational attainment. Therefore, the health outcome gaps between low-educated and high-educated elderly Americans are significantly accounted for by the lack of drug insurance coverage among the former group. The third essay examines changes in educational outcomes of Americans with disabilities between the late 1970s and the late 1990s. It shows that the gap in educational attainment between the disabled and non-disabled increases over time. For men, the widen- ing gap in educational attainment difference is mainly driven by an increase in the difference in college graduation rates. For women, increases in the gaps appear in high school graduation, college attendance, and college graduation rates. A model of education investment for disabled students suggests two motivating factors for education investment decisions: 1) the cost of obtaining education, 2) the incentive to signal their productivity through education in order to overcome employers’ uncertainty about disabled workers. That is, if obtaining education is too burdensome for the disabled, they will lose incentive to obtain education. But, if the effect of the uncertainty is strong, then the incentive to signal will be preserved well or even increase. Consequently, the educational attainment gaps can be affected by the two conflicting forces.

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