Social and Behavioral Sciences Commons^™

Three Essays On Health, Food, And Agricultural Economics, Saber Feizy

Theses and Dissertations--Agricultural Economics

This dissertation comprises three distinct but interrelated projects that explore the intersection of agriculture, nutrition, and economics. The first project investigates the impact of Community Supported Agriculture (CSA) food programs on the health outcomes of its participants. Using fixed effects models and a matching algorithm, the study finds that while conventional fixed effects models indicate a significant effect of CSA participation on diet-related medical expenditures, our modified time-heterogenous fixed effects model did not find a meaningful effect. The results of the matching method are consistent with those of our modified model.

The second project examines racial disparities in the prevalence …

Clinical Geography: A Commentary Response, Jessica M. Finlay, Graham D. Rowles

Graduate Center for Gerontology Faculty Publications

No abstract provided.

Kentucky Annual Economic Report 2022, Michael W. Clark, James P. Ziliak, Simon Sheather

Kentucky Annual Economic Report

This report is one of the important ways that the Center for Business and Economic Research fulfills its mission to examine various aspects of Kentucky’s economy as directed by the Kentucky Revised Statutes (KRS 164.738). The analysis and data presented here cover a variety of topics that range from a discussion of Kentucky’s current economic climate to a broad presentation of factors affecting the economy.

The report covers numerous dimensions of Kentucky’s economy including the effects of COVID-19. As the pandemic approaches its third year, COVID-19 continues to dominate the economic narrative. Many aspects of the economy have improved substantially …

"Think Of The Situation In A Positive Light": A Look At Cognitive Reappraisal, Affective Reactivity And Health, Jessica Chloe Maras

Theses and Dissertations--Psychology

How individuals regulate their emotions is critical for maintaining health and well-being. For example, reframing a stressful situation in a positive light, a form of cognitive reappraisal, is beneficial for health and well-being outcomes. However, it is currently unclear why this relationship exists. One potential mechanism could be how one emotionally reacts to stressors in daily life, termed affective reactivity. The current study examined longitudinal associations that spanned 20 years between cognitive reappraisal and health outcomes and subjective well-being and if affective reactivity mediated this relationship. Participants completed waves 1-3 of the Midlife in the United States (MIDUS) Survey series …

Driving Habits, Cognition, And Health-Related Quality Of Life In Middle-Aged And Older Adults With Hiv, Josiah J. Robinson, Tess Walker, Cierra Hopkins, Brittany Bradley, Peggy Mckie, Jennifer S. Frank, Caitlin N. Pope, Pariya L. Fazeli, David E. Vance

Graduate Center for Gerontology Faculty Publications

Cognitive impairment is known to increase with aging in people living with HIV (PLWH). Impairment in cognitive domains required for safe driving may put PLWH at risk for poor driving outcomes, decreased mobility, and health-related quality of life (HRQoL). This study described the driving behaviors of middle-aged and older PLWH and examined correlations between driving behaviors and cognitive functioning (Aim 1), and driving behaviors and HRQoL domains (Aim 2). A sample of 260 PLWH ages 40 and older completed a comprehensive assessment including a battery of cognitive tests, an HRQoL measure, and a measure of self-reported driving habits. Associations between …

Clinical Geography: A Proposal To Embrace Space, Place And Wellbeing Through Person-Centered Practice, Jessica M. Finlay, Graham D. Rowles

Graduate Center for Gerontology Faculty Publications

This essay envisions how geography can operationalize nuanced understandings of space and place to enrich the lives of individuals across the lifespan. We propose a focused integration of geography into person-centered practice: a clinical geography dedicated to working directly with people to promote optimal physical and mental health outcomes and wellbeing. Our proposal integrates spatial modifications to facilitate access and utility, behavioral interventions to maximize effectiveness in using space, and therapeutic engagement to nurture a deeper sense of ‘being in place’ that enhances wellbeing and quality of life. This focus is timely given societal instability and precariousness resulting from incongruous …

Effects Of The Affordable Care Act On Health Care Access And Self-Assessed Health After 3 Years, Charles J. Courtemanche, James Marton, Benjamin Ukert, Aaron Yelowitz, Daniela Zapata

Economics Faculty Publications

Using data from the Behavioral Risk Factor Surveillance System, we examine the causal impact of the Affordable Care Act on health-related outcomes after 3 years. We estimate difference-in-difference-in-differences models that exploit variation in treatment intensity from 2 sources: (1) local area prereform uninsured rates from 2013 and (2) state participation in the Medicaid expansion. Including the third postreform year leads to 2 important insights. First, gains in health insurance coverage and access to care from the policy continued to increase in the third year. Second, an improvement in the probability of reporting excellent health emerged in the third year, with …

Early Effects Of The Affordable Care Act On Health Care Access, Risky Health Behaviors, And Self-Assessed Health, Charles J. Courtemanche, James Marton, Benjamin Ukert, Aaron Yelowitz, Daniela Zapata

Institute for the Study of Free Enterprise Working Papers

The goal of the Affordable Care Act (ACA) was to achieve nearly universal health insurance coverage through a combination of mandates, subsidies, marketplaces, and Medicaid expansions, most of which took effect in 2014. We use data from the Behavioral Risk Factor Surveillance System to examine the impacts of the ACA on health care access, risky health behaviors, and self-assessed health after two years. We estimate difference-in-difference-in-differences models that exploit variation in treatment intensity from state participation in the Medicaid expansion and pre-ACA uninsured rates. Results suggest that the ACA led to sizeable improvements in access to health care in both …

Consumer's Guide To Regulatory Impact Analysis: Ten Tips For Being An Informed Policymaker, Susan Dudley, Richard Belzer, Glenn C. Blomquist, Timothy Brennan, Christopher Carrigan, Joseph Cordes, Louis A. Cox, Arthur Fraas, John Graham, George Gray, James Hammitt, Kerry Krutilla, Peter Linquiti, Randall Lutter, Brian Mannix, Stuart Shapiro, Anne Smith, W. Kip Viscusi, Richard Zerbe

Economics Faculty Publications

Regulatory impact analyses (RIAs) weigh the benefits of regulations against the burdens they impose and are invaluable tools for informing decision makers.We offer 10 tips for nonspecialist policymakers and interested stakeholders who will be reading RIAs as consumers.

1. Core problem: Determine whether the RIA identifies the core problem (compelling public need) the regulation is intended to address.
2. Alternatives: Look for an objective, policy-neutral evaluation of the relative merits of reasonable alternatives.
3. Baseline: Check whether the RIA presents a reasonable “counterfactual” against which benefits and costs are measured.
4. Increments: Evaluate whether totals and averages obscure relevant distinctions and trade-offs.
5. Uncertainty: Recognize …

The Impact Of A Civic Service Program On Biopsychosocial Outcomes Of Post 9/11 U.S. Military Veterans, Monica M. Matthieu, Karen A. Lawrence, Emma Robertson-Blackmore

Social Work Faculty Publications

Volunteering as a health promotion intervention, improves physical health, mental health, and social outcomes particularly in older adults, yet limited research exists for veterans. We conducted a preliminary study to explore whether volunteering impacts a variety of biopsychosocial outcomes, including symptoms of post-traumatic stress disorder (PTSD) and depression, among returning military veterans from Iraq and Afghanistan. A survey enrolling a prospective cohort of United States (U.S.) veterans who served in the military after 11 September 2001 and who participated in a national civic service program was conducted. A total of 346 veterans completed standardized health, mental health, and psychosocial self-report …

Using Natural Experiments To Identify The Effects Of Snap On Child And Adult Health, Daniel P. Miller, Taryn W. Morrissey

University of Kentucky Center for Poverty Research Discussion Paper Series

The Supplemental Nutrition Assistance Program (SNAP; formerly known as food stamps) can have important impacts that extend beyond its intended aims to improve food security and nutrition, particularly for health and health care use. This project examined the impact of SNAP receipt and benefit level on the health of adults and children using two natural experiments to address selection bias: 1) state policy variation in SNAP in an instrumental variables (IV) analysis; and, 2) the temporary expansion of SNAP benefits and eligibility provided through the American Recovery and Reinvestment Act (ARRA) in a difference-in-difference (DD) approach. We used restricted data …

The Real Value Of Snap Benefits And Health Outcomes, Hilary W. Hoynes, Erin Bronchetti, Garret Christensen

University of Kentucky Center for Poverty Research Discussion Paper Series

The food stamp program (SNAP) is one of the most important elements of the social safety net and is the second largest anti-poverty program for children in the U.S. (only the EITC raises more children above poverty). The program varies little across states and over time, which creates challenges for quasi-experimental evaluation. Notably, SNAP benefit levels are fixed across 48 states; but local food prices vary widely, leading to substantial variation in the real value of SNAP benefits. In this study, we leverage time variation in the real value of the SNAP benefit across markets to examine the effects of …

Service Before Self: The Health Consequences Of Working In Public Child Welfare, Austin Garrett Griffiths

Theses and Dissertations--Social Work

Child welfare workers respond to human tragedy and the job stresses associated with their positions that may result in their own trauma, secondary traumatic stress, compassion fatigue, emotional exhaustion, and burnout. Workers continue to leave their positions at alarming rates, influencing service quality and the ability to meet the needs of vulnerable populations. Decades of research have attempted to solve this national crisis by identifying salient factors found to influence the child welfare worker's experience and intention to leave their position. However, the problem prevails.

Addressing a major gap in the literature, this mixed methods study took a unique approach …

Public Health Spending And Its Contributions To The Total Spend On Health, Glen P. Mays

Health Management and Policy Presentations

This presentation provides an overview of recent research on governmental public health expenditures and their interaction with medical spending, carried out through the Robert Wood Johnson Foundation supported initiatives on Public Health Services and Systems Research (PHSSR) and the new Systems for Action research program. This work illustrates the value of tracking resource use across multiple sectors that influence health and well-being in American communities. As such, this work can inform the ongoing dialogue about methodologies for summarizing total health spending for the U.S. and for state and local areas.

Measuring Progress To Comprehensive Public Health Systems, National Preparedness, And A Culture Of Health, Glen P. Mays

Health Management and Policy Presentations

This update describes recent progress on two national health measurement initiatives: The National Health Security Preparedness Index and the National Longitudinal Survey of Public Health Systems. These longitudinal data sources offer valuable perspectives on how health security practices and public health delivery systems are changing across the U.S.

Impact Of Education On Medicaid Eligibility, Christopher R. Bollinger

Issue Brief on Topics Affecting Kentucky’s Economy

The individual mandate of the Affordable Care Act (ACA) coupled with the Medicaid expansion in Kentucky makes reducing Medicaid eligibility rates of crucial importance. This brief examines the link between education and eligibility for Medicaid for the citizens of Kentucky. In general, the relationship is nearly mechanical in that higher education leads to higher incomes. Since income is the key determining factor of Medicaid eligibility, and because of the individual mandate eligibility is mostly equivalent to participation, our estimates show that higher education reduces the likelihood that an adult will be on Medicaid or have children and family members on …

Education For Your Health!, Christopher R. Bollinger

Issue Brief on Topics Affecting Kentucky’s Economy

The health of the people of Kentucky is of high concern for policymakers and citizens alike. Individuals want to live healthy, productive lives, while policymakers recognize that chronic illnesses cost the state in myriad ways. In this brief, we examine the link between educational attainment and health outcomes. We focus on two groups of health outcomes. The first are behavioral and include choices: tobacco use, alcohol use, obesity, and exercise. The second group are outcomes highly associated with these behaviors: heart attack, angina, stroke, and diabetes. The Center for Disease Control (CDC) estimates that these four diseases may cost Kentuckians …

Learning From Delivery System Behavior, Dynamics & Interactions To Advance A Culture Of Health, Glen P. Mays

Health Management and Policy Presentations

A new "Systems for Action" national research program flows directly from the Robert Wood Johnson Foundation's Culture of Health action framework. This program will build evidence on how best to align the delivery and financing systems for medical care, public health, and community services & supports so as to promote wellbeing and resiliency, realize efficiencies in resource use, and reduce inequities in health.

Does Medicaid Crowd Out Other Public Health Spending? Projecting Aca’S Health & Economic Effects, Glen P. Mays

Health Management and Policy Presentations

Research Objective: Twenty-six states are expanding Medicaid eligibility under the Affordable Care Act (ACA) in 2014, and while federal funds cover most costs for newly eligible recipients, states must share the additional costs of covering previously-eligible state residents who newly enroll in Medicaid in response to ACA’s expanded outreach and enrollment incentives. States, together with their local government counterparts, also provide the vast majority (87%) of public sector funds for public health programs designed to promote health and prevent disease and injury on a population-wide basis. Fiscal constraints and generous federal matching funds create strong budgetary incentives for states to …

Producing Population Health: Collective Action Requires Infrastructure, Incentives & Evidence, Glen P. Mays

Health Management and Policy Presentations

Population health improvement strategies are collective action problems that require targeted infrastructure, incentives, and information to succeed. Research on collective action problems and solutions in public health and other spheres of practice offer insight for the successful scale and spread of population health innovations.

Grandparents As Parents: Investigating The Health And Well-Being Of Trauma-Exposed Families, Ginny Sprang, Moon Choi, Jessica Eslinger, Adrienne Whitt-Woosley, Rachel Looff

Center on Trauma and Children Reports

An excerpt from the introduction:

Over the past two decades, the number of grandparents serving as primary caregivers for their grandchildren has steadily increased. Nationally, 42% of all grandparents living with grandchildren function as the primary caregivers (U.S. Census, 2006).

In the southern region of the country, this phenomenon is particularly salient, and expected to continue, with estimates that range from 7% to 15% higher than in 2000 (U.S. Census, 2004). Kentucky is no exception, with 67,394 children living with their grandparents, 58.8% of those grandchildren fall under the responsibility of their grandparents (American Community Survey, 2005). In fact, Region …

Health & Wellness In The Business Context, Michael T. Childress

Issue Brief on Topics Affecting Kentucky’s Economy

No abstract provided.

The Health Implications Of Violence Against Women: Untangling The Complexities Of Actual And Chronic Effects: Part Two, Carol E. Jordan

Office for Policy Studies on Violence Against Women Publications

No abstract provided.

The Health Implications Of Violence Against Women: Untangling The Complexities Of Acute And Chronic Effects: Part One, Carol E. Jordan

Office for Policy Studies on Violence Against Women Publications

No abstract provided.