Essays on Health and Labor Economics
Pauley, Gwyn Carter
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This dissertation focuses on health and labor economics. In particular, I study how access to health insurance affects both individuals and family members. I show that the effects of being insured in childhood are long lasting. I also find that caregivers whose child is enrolled in Medicaid are in better mental health. In a different line of work, I also study how a medical innovation affects individuals. In the first chapter, I show that access to health insurance during childhood has lasting consequences, well beyond the health outcomes considered in previous literature. I develop a theoretical model to show several mechanisms through which health insurance could play a role in determining later in life outcomes. I then use the Medicaid expansions for children of the late 1980s and early 1990s to test implications of this model. These reforms greatly expanded who qualified for Medicaid and provide exogenous variation in eligibility. I find that access to health insurance during childhood has heterogenous and lasting effects. There are two main channels through which this occurs: a change in insurance status and a change in parental labor supply. In the second chapter I show that having a child enrolled in Medicaid has a positive effect on the mental health of the caregiver. I use a measure of Medicaid generosity to show that child access to health insurance decreases the probability that the primary caregiver screens positive for serious mental illness. In addition, I show that there is an intergenerational link between caregiver mental health and child health. This implies that child access to health insurance may be even more important than previously thought. In the third chapter, my coauthors and I study the effect of medical breakthroughs on socioeconomic outcomes among a group of low-income, chronically ill women. For a group of women infected with HIV, we show that the introduction of an unanticipated HIV treatment innovation (known by its acronym, HAART) decreased domestic violence, lowered the use of illicit drugs and increased employment. We go on to provide a conceptual framework and additional empirical evidence suggesting how our findings might be linked.