The health impacts of public programs for the poor in Brazil and the United States

This dissertation examines the health impacts of large public programs for the poor in Brazil and the United States. The first paper evaluates the impact of Brazil's conditional cash transfer program, Bolsa Familia , on infant mortality. I use vital statistics data from 1998-2008 and take advantage of variation in levels of program coverage over time between and within municipalities to identify the impact of Bolsa Familia on infant mortality rates. Bolsa Familia is found to have significantly reduced infant mortality rates, with a greater impact during the post-neonatal period. The program's impact is greater in municipalities with higher baseline infant mortality rates. Furthermore, there are significant interaction effects with a large, national health program.;The second paper utilizes primary data collected in 2010 to examine the impact of Bolsa Familia on children's health care utilization and health outcomes. Detailed household surveys were conducted with randomly selected Bolsa Familia beneficiaries and non-beneficiaries in an urban slum in the northeast of Brazil. Propensity-score methods were used to control for differences between beneficiary and non-beneficiary children to estimate program impacts on health care utilization and health outcomes. Bolsa Familia was found to increase the odds of children's visits to the health post for growth monitoring, vaccinations, and checkups and the number of visits for growth monitoring and checkups. There were positive spillover effects on older siblings no longer required to meet the health conditionalities.;The third paper examines the impact of Medicaid coverage of tobacco dependence treatments on quit attempts and smoking among low-income Americans. Medicaid recipients have a higher rate of smoking, and their ability to successfully quit may be limited due to the cost of tobacco dependence treatments. This study utilizes BRFSS data from 1998-2009 to estimate the impact of Medicaid coverage of tobacco dependence treatments on quit attempts and smoking. Medicaid coverage of tobacco dependence treatments is found to significantly increase the probability of quit attempts among low-income women, and this effect is greatest among pregnant women. Coverage of tobacco dependence treatments also has a significant impact on the probability of being a current smoker among low-income women.