Doctor of Philosophy, The Ohio State University, 2021, Agricultural, Environmental and Developmental Economics
There are many determinants of health such as individual dietary and health-related habits, constraints such as money and time, as well as market goods and services such as medical care, access to health insurance, and environmental conditions. In this dissertation, I focus on three key elements of household and individual consumption behaviors that are tied to economics of health and nutrition—policy, preferences, and consumption self-control.
In the first essay, I demonstrate how receiving subsidized health care services can lead to new patterns of household consumption, specifically, undertaking fewer preventative health measures by the targeted households. This topic has received less attention in the literature. To do this, I investigate the effects of recent Medicaid expansions on eligible households' quarterly food and non-food expenditures using state and time variation in Medicaid expansion. Using an event-study design, and a triple difference-in-differences framework, I find that the Medicaid eligible households from expansion states spent less on fresh produce per adult and more on over-the-counter medications and remedies while not changing their expenses on frozen fruits and vegetables which have similar nutritional value as fresh fruits and vegetables. The robust reduction in fresh produce expenditures and increase in expenditures on over-the-counter medications and remedies suggest that while expanded public health insurance increases formal healthcare activity, it decreases informal preventative non-healthcare expenditures. These findings may begin to shift the focus in the literature on the unintended consequences of Medicaid expansion from sins of commission, i.e., moral hazard responses such as increased smoking, alcohol use and junk food consumption, to sins of omission, i.e., responses in which preventative health habits erode.
In the second essay, I focus on healthy eating in institutions such as schools and colleges, which is promoted in (open full item for complete abstract)
Committee: Brian Roe (Advisor); H Allen Klaiber (Committee Member); Zoë Plakias (Committee Member); Wuyang Hu (Committee Member)
Subjects: Agricultural Economics