Essays on Emotional Well-being, Health Insurance Disparities and Health Insurance Markets

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Essays on Emotional Well-being, Health Insurance Disparities andHealth Insurance Markets, Is A Well-Researched Topic, It Is To Be Used As A Guide Or Framework For Your Research.

ABSTRACT

This dissertation has three research papers. First paper looks at the effect of social networks on emotional well-being of cancer patients by studying the response of social networks on their depression symptoms. Using the data from a primary survey conducted in Nepal, the study finds that social networks significantly reduce depression symptoms among cancer patients. The results strongly advocate for the importance of the social networks in improving their emotional well-being. Second paper examines the health coverage disparities among Hispanic and non-Hispanic young adults in five southwestern states of the United States. Using the pooled data from American Community Survey 2015-2017, the study finds that despite ACA, ethnic-racial group, gender, education, income, employment status, age, school going status are still the key determinants of health coverage among young adults. States that expanded Medicaid showed a significant improvement in the health coverage of young adults. Findings also indicate that the disparities in health coverage among Hispanic and non-Hispanic young adults are largely attributed to the citizenship status and living in a household where language other than English is spoken. Third paper studies the association between increased market concentration and plan premiums for individuals and families from 2015-2020 in insurance marketplaces, as well as the impact of Medicaid expansion on the plan premiums. Results show a significant positive effect of high market concentration on plan premiums for all individuals and families regardless of Medicaid expansion status. This study emphasizes the importance of insurer competition in health insurance markets and can be useful in state and federal governments’ decisions regarding insurance market regulation.

Table of Contents

CHAPTER 1 ………………………………………………………………………………………………………………….. 1
CHAPTER 2 ………………………………………………………………………………………………………………….. 5
Introduction …………………………………………………………………………………………………………………………… 5
Literature Review …………………………………………………………………………………………………………………… 7
Conceptual Framework and Hypothesis ………………………………………………………………………………….. 9
Stress Buffering Model: ………………………………………………………………………………………………………………………. 9
Direct Effect Model: …………………………………………………………………………………………………………………………. 10
Data and Measures ……………………………………………………………………………………………………………….. 11
Data – Survey …………………………………………………………………………………………………………………………………… 11
Measures…………………………………………………………………………………………………………………………………………. 12
Empirical Model …………………………………………………………………………………………………………………… 15
Results………………………………………………………………………………………………………………………………….. 19
Conclusion ……………………………………………………………………………………………………………………………. 21
References ……………………………………………………………………………………………………………………………. 24
Appendix ……………………………………………………………………………………………………………………………… 34
Tables …………………………………………………………………………………………………………………………………………….. 34
Table 1: PHQ-9 Severity Index and its classification…………………………………………………………………………….. 34
Table 2: Variables for Social Networks ………………………………………………………………………………………………. 35
Table 3: Variables for Stress Appraisal ……………………………………………………………………………………………….. 36
Table 4: Summary Statistics of Cancer Patients ……………………………………………………………………………………. 36
Table 5: Estimates for Depression Symptoms among Cancer Patients …………………………………………………….. 39
Table 6: Mediation Analysis of Depression Symptoms in Cancer Patients using Structural Equation Modelling (Choosing best model) ………………………………………………………………………………………………………………………. 40
Table 7: Mediation Analysis of Depression Symptoms in Cancer Patients by Gender using Structural Equation Modelling ……………………………………………………………………………………………………………………………………….. 42
Table 8: Hypothesis table ………………………………………………………………………………………………………………….. 43
Figures …………………………………………………………………………………………………………………………………………… 47
Figure 1: Cancer Incidences in Nepal (Province Level)…………………………………………………………………………. 47
Figure 2: Cancer Incidences in Nepal (District Level) …………………………………………………………………………… 47
Figure 3: Distribution of Cancer Types ……………………………………………………………………………………………….. 48
Figure 4: Mean Level of Depression Symptoms among Cancer and Control Groups ………………………………… 48
Figure 5: Distribution of Severity of Depression Symptoms (continuous and categorical) by Cancer and Control Groups ………………………………………………………………………………………………………………………………… 49
Figure 6: Mean level of Depression Symptoms by Gender ……………………………………………………………………. 49
Figure 7. Stress Buffering Model and Direct Effect Model ……………………………………………………………………. 50
Table 9: Estimates of depression symptoms (categorical) in cancer patients by gender using Structural Equation Modelling ………………………………………………………………………………………………………………………….. 44
Table 10: Mediation Analysis of Depression Symptoms (continuous) in Cancer Patients ………………………….. 45
Table 11: Mediation Analysis of Depression Symptoms (continuous) in Cancer Patients by Gender ………….. 46
Survey Questionnaire ……………………………………………………………………………………………………………. 51
Survey Protocol…………………………………………………………………………………………………………………….. 72
CHAPTER 3 ………………………………………………………………………………………………………………… 96
Introduction …………………………………………………………………………………………………………………………. 96
Literature Review …………………………………………………………………………………………………………………. 97
Summary Statistics ……………………………………………………………………………………………………………… 101

Empirical model …………………………………………………………………………………………………………………. 103
Results………………………………………………………………………………………………………………………………… 106
Multinomial Logistic Regression ………………………………………………………………………………………………………. 106
Blinder-Oaxaca Decomposition ……………………………………………………………………………………………………….. 108
Conclusion ………………………………………………………………………………………………………………………….. 111
References ………………………………………………………………………………………………………………………….. 114
Appendix ……………………………………………………………………………………………………………………………. 122
Figures …………………………………………………………………………………………………………………………………………. 122
Figure 1: Uninsured Rates by Ethno-racial Groups …………………………………………………………………………….. 122
Figure 2: Private Insurance Rates among Employed Youth (age 18-26) ………………………………………………… 122
Figure 3: Uninsured Rates among Young Adults Neither in School nor in the Labor-force (NSNL) (age 18-26) …………………………………………………………………………………………………………………………………………………….. 123
Tables …………………………………………………………………………………………………………………………………………… 124
Table 1: Summary Statistics of Young Adults in the Southwest United States by Ethno-racial Group (age 18-26) ………………………………………………………………………………………………………………………………………………… 124
Table 2: Multinomial Logistic Regression on Health Insurance Coverage among Young Adults in Southwest United States ………………………………………………………………………………………………………………………………….. 127
Table 3(a): Multinomial Logistic Regression on Health Insurance Coverage Among Young Men in Southwest United States ………………………………………………………………………………………………………………………………….. 129
Table 3(b): Multinomial Logistic Regression on Health Insurance Coverage Among Young Women in Southwest United States ………………………………………………………………………………………………………………….. 131
Table 4: Employment Rates Among Young Adults in the Southwest United States ………………………………… 133
Table 5: Health Insurance Coverage Among White and Hispanic Young Adults in the Southwest United States …………………………………………………………………………………………………………………………………………………….. 133
Table 6: Oaxaca Decomposition of Private Insurance Coverage Among White and Hispanic Young Adults in Southwest United States ………………………………………………………………………………………………………………….. 134
Table 7: Summary Statistics of Neither in School not in the Labor-force Young Adults in Southwest United States…………………………………………………………………………………………………………………………………………….. 135
Table 8: Blinder-Oaxaca Decomposition of Health Insurance Coverage Among Young Adults Neither in School nor in Labor-force (NSNL) …………………………………………………………………………………………………… 136
CHAPTER 4 ………………………………………………………………………………………………………………. 137
Introduction ……………………………………………………………………………………………………………………….. 137
Literature Review ……………………………………………………………………………………………………………….. 139
Data ……………………………………………………………………………………………………………………………………. 142
Variables ……………………………………………………………………………………………………………………………………….. 144
Descriptive Statistics …………………………………………………………………………………………………………… 146
Model …………………………………………………………………………………………………………………………………. 146
Results………………………………………………………………………………………………………………………………… 148
Conclusion ………………………………………………………………………………………………………………………….. 149
References ………………………………………………………………………………………………………………………….. 151
Appendix ……………………………………………………………………………………………………………………………. 158
Tables …………………………………………………………………………………………………………………………………………… 158
Table 1: Descriptive statistics from 2015-2020 …………………………………………………………………………………… 158
Table 2: Descriptive statistics by Monopoly vs Non-Monopoly 2015-2020 …………………………………………… 159
Table 3: Panel Regression with Random Effects to Estimate the Effect of Market Concentration on SLCSP Premiums for Individuals of Different Age Groups 2015-2020…………………………………………………………….. 160
Hypothesis Table ……………………………………………………………………………………………………………………………. 161
Table 4: Pooled OLS Regression to Estimate the Effect of Market Concentration on SLCSP Premiums for Individuals of Different Age Groups 2015-2020 ………………………………………………………………………………… 162

Table 5: Panel Regression with Fixed Effects to Estimate the Effect of Market Concentration on SLCSP Premiums for Individuals of Different Age Groups 2015-2020…………………………………………………………….. 163
Maps and Graphs …………………………………………………………………………………………………………………………. 164
Figure 1: Insurer Participation in year 2014 ……………………………………………………………………………………….. 164
Figure 2: Insurer Participation in year 2020 ……………………………………………………………………………………….. 165
Figure 3: Premiums Changes over the years 2015-2020 ………………………………………………………………………. 166
Figure 4: Average Premiums from 2015-2020 in GRAs with/without Monopoly …………………………………… 166
CHAPTER 5 ………………………………………………………………………………………………………………. 167
STATA CODES ………………………………………………………………………………………………………….. 169

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Additional information

Author

Disha Shende

No of Chapters

5

No of Pages

270

Reference

YES

Format

PDF

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