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Three Essays on Labor Economics and Health of Older American

Posted on:2019-03-25Degree:Ph.DType:Dissertation
University:The University of ChicagoCandidate:Ghandhi, JenniferFull Text:PDF
GTID:1474390017986289Subject:Public policy
Abstract/Summary:
The importance of determining the capacity of the health care labor force to meet the needs of older Americans continues to increase in the face of a rapidly aging population. This dissertation consists of three essays that examine two important public policy issues related to the population health of older Americans: rural-urban differences in health care provider supply and the relationship between labor market conditions and health outcomes.;Chapter 1 (with co-authors) asks why we observe rural-urban variation in physician supply. In describing characteristics of rural physicians, we show that their real and nominal wages exceed those of urban physicians. Given the observed magnitude of the rural physician deficit, we postulate that physician preferences for urban living outweigh large rural wage premiums and suggest that policies affecting the distribution of physician preferences may be more cost-effective in decreasing the rural provider deficit than those which offer financial incentives.;Chapter 2 asks whether the variation in supply-side opportunity costs of transportation relates to the quantity of care supplied in rural areas. It focuses on home-based primary care, which has recently been hailed as a quality-improving, cost-saving model of care for frail, homebound seniors. I find that house calls, despite evoking the image of a country doctor, are exceedingly rare in sparsely populated areas. By comparing the rural deficit of house calls to that of assisted living visits---where potential patients live in close proximity---I find that costs drive supply.;Chapter 3 diverges from the previous two essays to ask whether the relationship between individual joblessness and health outcomes differs depending on unemployment rates in the larger economy. It has been shown that while individual unemployment and health are negatively associated, mortality rates decline, paradoxically, in short recessions. I describe the association between individual unemployment and mortality before and after the Great Recession and find that short-term mortality in the post-recessionary period does not differ based on employment status.
Keywords/Search Tags:Health, Labor, Older, Care, Essays
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