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The Political Economy and Health

Paper Session

Saturday, Jan. 5, 2019 2:30 PM - 4:30 PM

Atlanta Marriott Marquis, M103
Hosted By: National Economic Association
  • Chair: Jevay Grooms, Howard University

The Political Economy of Death: Do Coroners Perform as well as Medical Examiners in Determining Suicide?

Jose M. Fernandez
,
University of Louisville

Abstract

The determination of death in the US can have strong financial implications. For example, a declaration of suicide can nullify life insurance benefits. However, the intent of death may be made by an elected official who is not required to have any medical training. Medical examiners and coroners determine cause of death when the death is sudden, violent, or untimely. Consequently, these officials can affect counts of sudden infant death syndrome, homicide, and suicide in a state. This paper uses a diff-in-diff model to estimate the effect of elected coroners versus appointed medical examiners on a state's suicide rate. Elected coroners need not receive training in 13 states, must receive initial and continuous training in 16 states, and are required to be physicians in 4 states. We exploit state policy changes to the minimum required training elected coroners must complete. Data on the underlying intent of death is collected from the CDC Wonder mortality files from 1968 - 2015.

Racial Disparities, Food Insecurity and Health among Low Income United States Households

Fafanyo Asiseh
,
North Carolina A&T State University
Obed Quaicoe
,
North Carolina A&T State University

Abstract

Food insecurity continues to be a major issue in most households. In the U.S, millions of people are still food insecure. Food insecurity is linked with the health of individuals. When people are food insecure they are less likely to eat healthy meals which will then have an impact on their health. In this study, we analyze the food choices and food insecurity among low income households in the U.S and how these differ by race using the National Household Food Acquisition and Purchase Survey (FoodAPS). We model household food choices using a conditional logit model to estimate the existence and magnitude of food insecurity among different races. Preliminary results from our study show that among low income households African Americans were more food insecure than other races. Additionally, African Americans reported lower knowledge of healthy food programs compared to other races. Comparing SNAP recipients with non SNAP recipients, we find that food insecurity was higher among the low income non SNAP recipients.

(D)ACA and Immigration Changes: What is the Effect of a Change in Legal Status on Health Coverage?

Monica Garcia-Perez
,
St. Cloud State University

Abstract

Currently, the future of Dreamers is still in debate. Further, possible changes to legal immigration processes are also being considered. Under the Affordable Care Act (ACA), Dreamers have the same eligibility for health care and coverage as undocumented immigrants. That is, they are not eligible. Replicating DACA only extends the issues that this group has with regard to their level of health coverage, especially for low income individuals. DREAMers are not eligible to purchase health insurance in a Marketplace, even at full cost, and they are not eligible for federal tax credits to make private health
insurance in the Marketplace affordable. Like undocumented immigrants, they may be eligible for a separate program available regardless of immigration status. Yet, unlike undocumented immigrants, DREAMers are able to apply for jobs that could provide health benefits. Using 2011-2016 ACS, and taking advantage of the different level of health services provided to all residents across states where there are large shares of DREAMers, the goal of this paper is twofold. First, we evaluate the impact that DACA may have had on health insurance coverage through the availability of employer sponsored insurance (ESI). Second, we estimate the impact of treating DREAMers similar to Legal Permanent Residents under the ACA. This second scenario offers an opportunity to evaluate the impact that an immigration reform regarding DACA would have in the long run to health coverage of this population. The methodology considers the components of DACA's eligibility and the likelihood of applying given individual characteristics and the underlying selectivity in the process.

Pricing Daughters and the Economic Burden of Disease: Evidence from the Meningitis Belt

Belinda Archibong
,
Barnard College
Francis Annan
,
Columbia University

Abstract

In this paper we study the impacts of climate-induced health shocks on development outcomes and gender inequalities in human capital investment, using evidence from the meningitis belt in sub-Saharan Africa (SSA). The meningitis belt consists of 23 countries in SSA, extending from Senegal to Ethiopia, and making up over 700 million individuals, that are frequently exposed to meningitis epidemics. We investigate the effects of the epidemics in the meningitis belt on reducing parental investment in girls' education and human capital by inducing early marriage of girls in exchange for a bride price to pay
for costs associated with the epidemics. We assemble a new survey dataset over 2018-2019 on bride price in Niger and neighboring Nigeria, two countries in the meningitis belt, to test predictions of our model and examine the impacts of meningitis epidemics on the gender gap in human capital investment through its effect on the bride price and marriage markets in these countries. The paper results will contribute to research on the role of household coping strategies in worsening future gender inequities in the aftermath of climate-induced health shocks.

Health Insurance Coverage among Mexican American Men under the ACA: A Tale of Two States, 2012-2015

David van der Goes
,
University of New Mexico
Richard Santos
,
University of New Mexico

Abstract

This study seeks to answer the questions: under two different state-level implementations of the Affordable Care Act (ACA), how did health insurance coverage rates change for Mexican American men, and what contributed to those changes. California and Texas are two states which provide a unique opportunity to assess the insurance coverage of Mexican American under the ACA. Geographically, over 60 percent of the Mexican American population in the nation resides in California or Texas (U.S. Census Briefs, Hispanic Population 2010). Moreover, California chose to expand the state Medicaid program under the ACA provision and build a state health insurance exchange; Texas did not expand the state Medicaid program or to create a state exchange for private health insurance.

In the United States, the lack of health insurance coverage among Mexican Americans is striking; one in every three Mexican Americans age 64 years and under did not have private or public health insurance coverage prior to the full implementation of the Affordable Care Act (Centers for Disease Control and Prevention, 2012). Among the nation’s uninsured, Mexican Americans accounted for nearly one in every 4 persons without any type of health insurance in 2013 (López, 2015).
We find that Mexican American men in California increased coverage by 14 points (59% to 73%) while in Texas the increase half as large (52% to 59%). The gap in California also closed from 25 points to 18 points after the ACA. In Texas the coverage gap moved from 29 to 27 points. The relative gains in CA decrease to about 5 points in the DDD model when controlling for age, citizenship, English level, health status, income, education, marital status, family size, hours worked, industry and occupation.
Discussant(s)
Mark Paul
,
New College of Florida
Alberto Ortega
,
Whitman College
Joaquín Alfredo-Angel Rubalcaba
,
University of North Carolina-Chapel Hill
Jevay Grooms
,
Howard University
JEL Classifications
  • I1 - Health
  • H0 - General