Economics Commons^™

Measuring Multi-Sector Contributions To Public Health Delivery Systems & Population Health, Glen P. Mays

Health Management and Policy Presentations

The National Longitudinal Survey of Public Health Systems has followed a nationally-representative cohort of U.S. communities since 1998 to measure the scope of public health activities implemented in each community and the range of organizations and sectors that contribute to each activity. With 16 years of follow-up observations, this survey allows us to study the effects of demographic, economic, and policy shocks on public health delivery systems, and estimate the health effects attributable to delivery system change.

Measuring Comprehensive Public Health Delivery Systems And Their Contributions To Population Health, Glen P. Mays

Health Management and Policy Presentations

Delivery and financing systems for public health services vary widely across U.S. communities, raising questions about the comparative effectiveness and efficiency of alternative structures. We summarize recent approaches for measuring alternative system configurations and estimating their health and economic effects.

Development And Pilot-Testing Of A Patient Decision Aid For Left Ventricular Assist Device Placement, Kristin Kostick, Estevan D. Delgado, Lidija A. Wilhelms, Courtenay R. Bruce, Jerry D. Estep, Matthias Loebe, Charles Minard, Jennifer S. Blumenthal-Barby

The VAD Journal

Objectives: This paper describes the development methodology and pilot-testing of a decision aid for Left Ventricular Assist Device (LVAD) placement, combining traditional needs-assessment with a novel user-centered approach.

Background: Studies indicate suboptimal patient understanding of the capabilities, lifestyle implications, and risks of LVAD therapy.

Methods and Results: We developed the decision aid in line with the Ottawa Decision Support Framework (ODSF) and the International Patient Decision Aids Standards (IPDAS) for ensuring quality, patient-centered content. Structured interviews were conducted with patients, caregivers, candidates for LVAD treatment, and expert clinicians (n=71) to generate content based on patient values and …

Food Store Choice Of Poor Households: A Discrete Choice Analysis Of The National Household Food Acquisition And Purchase Survey, Sofia B. Villas-Boas, Rebecca Taylor

University of Kentucky Center for Poverty Research Discussion Paper Series

Policymakers are pursing initiatives to increase food access for low-income households. However, due in part to previous data deficiencies, there is still little evidence supporting the assumption that improved food store access will alter dietary habits, especially for the poorest of U.S. households. This article uses the new National Household Food Acquisition and Purchase Survey (FoodAPS) to estimate consumer food outlet choices as a function of outlet type and household attributes in a multinomial mixed logit. In particular, we allow for the composition of the local retail food environment to play a role in explaining household store choice decisions and …

The Effect Of Food Price On Food Insecurity And Diet Quality: Exploring Potential Moderating Roles Of Snap And Consumer Competency, Yunhee Chang, Jinhee Kim, Swarn Chatterjee

University of Kentucky Center for Poverty Research Discussion Paper Series

Higher food prices may aggravate household food insecurity and hurt diet quality. Using a sample of low-income households from the National Household Food Acquisition and Purchase Survey (FoodAPS), this study examines whether local food prices affect food insecurity and nutritional quality of foods acquired, and how households use competent consumer behaviors to mitigate any adverse effects of price. Financial management practices, nutrition literacy, and conscientious food shopping practices were considered for consumer competency. Our findings indicate that low-income households in higher-cost areas, regardless of whether they participate in SNAP or not, are more likely to adopt loyalty or other store …

The Effects Of Benefit Timing And Income Fungibility On Food Purchasing Decisions Among Snap Households, Joshua P. Berning, Gregory Colson, Jeffery H. Dorfman, Travis A. Smith, Xiaosi Yang

University of Kentucky Center for Poverty Research Discussion Paper Series

The Supplemental Nutrition Assistance Program (SNAP) is the largest nutritional safety net in the United States. Prior research has found that participants have higher consumption shortly after receiving their benefits, followed by lower consumption towards the end of the benefit month. This “SNAP benefit cycle” has been found to have negative effects on beneficiaries. We examine two behavioral responses of SNAP participants that may work in tandem to drive much of the cycle: short-run impatience – a higher preference to consume today; and fungibility of income – the degree of substitutability between a SNAP dollar and a cash dollar. Using …

Variation In Food Prices And Snap Adequacy For Purchasing The Thrifty Food Plan, Erin Bronchetti, Garret Christensen, Benjamin Hansen

University of Kentucky Center for Poverty Research Discussion Paper Series

Whether Supplemental Nutrition Assistance Program (SNAP) benefits are adequate to provide food security for eligible households is an important and timely policy question. While the nominal value of SNAP benefits is fixed across states (except for Hawaii and Alaska), variation in food prices across geographic areas is dramatic, and the real value of SNAP benefits varies widely across the U.S. Our research provides new evidence on geographic variation in the adequacy of SNAP benefits to purchase the Thrifty Food Plan (TFP).

Using multiple methods to estimate the cost of the Thrifty Food Plan (TFP) faced by households across the nation, …

Food Security And Geographic Factors In Food Purchase And Acquisition Decisions: A Compilation Of Research Conducted Under Usda Cooperative Agreements 58-5000-1-0050 And 58-5000-3-0066, James P. Ziliak, Craig Gundersen

University of Kentucky Center for Poverty Research Discussion Paper Series

No abstract provided.

Supermarket Proximity And Price: Food Insecurity And Obesity In The United States, Janelle Downing, Barbara Laraia

University of Kentucky Center for Poverty Research Discussion Paper Series

Where we live matters for our health. The social, economic, and physical features of neighborhoods can play a powerful role in health and longevity. Neighborhood concentration of poverty and poor health have been shown to be linked. Residing in low-income neighborhoods has been associated with diet related chronic diseases such as obesity and diabetes.

The Relationship Between Neighborhood Food Environment And Food Store Choice On Purchasing Habits Among Snap And Lower Income Households, Usda Foodaps Data, Alison A. Gustafson, James E. Allen Iv, Nancy E. Schoenberg, Mark Swanson

University of Kentucky Center for Poverty Research Discussion Paper Series

The objective of the study was to determine relationship between neighborhood food store availability, store choice and food purchasing habits among Supplemental Nutrition Assistance Program (SNAP) participating households. The study sample consisted of SNAP households (n=1581) and low income households participating in the USDA's National Household Food Acquisition and Purchase Survey (FoodAPS) a nationally representative cross-sectional survey of American households with household food purchases and acquisitions data. Main Outcomes: 1) Food purchasing choices (sugar-sweetened beverages, fruits and vegetables, snacks, water, and milk) obtained from store receipts over a one-week period; 2) food shopping activities was obtained from a log book …

Influence Of Snap Participation And Food Environment On Nutritional Quality Of Food At Home Purchases, Amy Hillier, Benjamin Chrisinger, Tony E. Smith, Eliza Whiteman, Michael Kallan

University of Kentucky Center for Poverty Research Discussion Paper Series

A growing body of research describes how individuals make food shopping decisions in both time and space. The FoodAPS dataset provides a unique opportunity for understanding these patterns among a large sample across income, SNAP status, and settings. We addressed three questions in our research: (1) Where do participants shop for food at home (FAH) and how do individual characteristics interact with store characteristics and distance? (2) How does the nutritional content of foods purchased change as time from SNAP distribution increases? and (3) How does store choice influence the nutritional quality of FAH purchases? We used a conditional logit …

Do Snap Recipients Get The Best Prices?, Conrad Lyford, Raymond J. March, Carlos E. Carpio, Tullaya Boonsaeng

University of Kentucky Center for Poverty Research Discussion Paper Series

This paper examines the relationship between SNAP participation and prices paid for food items. To test this relationship, we develop an expensiveness index following the method of Aguiar and Hurst (2007) and use the FoodAPS data set. Using both the ordinary least squares method and controlling for endogeneity using an instrumental variables approach, we found SNAP participation did not hold a statistically significant relationship with the prices paid for food items when we controlled for consumer behavior and food market variables. This suggests that SNAP participants are not systematically disadvantaged in their food purchases. Additional efforts to further educate SNAP …

Causes And Consequences Of The Calorie Crunch, Michael A. Kuhn

University of Kentucky Center for Poverty Research Discussion Paper Series

Monthly welfare programs such as the Supplementary Nutrition Assistance Program (SNAP) produce consistent cycles of expenditure and consumption amongst recipients. Food insecurity and negative behavioral outcomes track these cycles. This paper leverages new data from the USDA, the FoodAPS survey, and to answer a variety of questions related to these phenomena: Are consumption and expenditure cycles correlated? Who bears the burden of food shortages at the end of each benefit month? Does diet quality track food expenditure? I find robust expenditure and consumption cycles in the FoodAPS data, but contrary to popular belief, they are only weakly correlated. The youngest …

Contextualizing Family Food Decisions: The Role Of Household Characteristics, Neighborhood Deprivation, And Local Food Environments, Sarah Bowen, Richelle Winkler, J. Dara Bloom, Lillian Macnell

University of Kentucky Center for Poverty Research Discussion Paper Series

We employ multilevel models with neighborhood and state effects (fixed effects and random effects) to analyze the associations between household characteristics, neighborhood characteristics, regional attributes and dietary quality. We use data from the USDA National Household Food Acquisition and Purchase Survey. Our dependent variable is a Healthy Eating Index that incorporates dollars spent and amount of food in several categories. Key explanatory variables at the household level include variables household financial condition, housing burden, home ownership, car access, household size. We include a variable for the number of large food stores in the neighborhood, a neighborhood deprivation index, and a …

An Overview Of Snap, Food Security, And Geographic Factors In Food Purchase And Acquisition Decisions, James P. Ziliak, Craig Gundersen

University of Kentucky Center for Poverty Research Discussion Paper Series

In April 2012 the Economic Research Service (ERS) and the Food and Nutrition Service (FNS) in the U.S. Department of Agriculture embarked on an ambitious new data collection enterprise known as the National Household Food Acquisition and Purchase Survey (FoodAPS). FoodAPS is innovative in that it is the first nationally representative household survey to collect comprehensive data on household food expenditures and acquisitions, including those obtained using benefits from food assistance programs. The survey includes data from 4,826 households, including Supplemental Nutrition Assistance Program (SNAP) households, low-income eligible households not participating in SNAP, and higher income households. FoodAPS is specifically …

Coffee In China: Market Trend And Consumer Demand, Jesse W. Mattingly

Theses and Dissertations--Agricultural Economics

Although it remains a tea consuming nation, both production and consumption of coffee in China has been increasing at double-digit rates and is not expected to slow down (International Coffee Organization (ICO), 2015). With investments and upward trends in production and rapid increases in consumption of coffee in China it is important for producers and retailers of the bean¹ in China to understand the new Chinese coffee consumer. Using survey data from Wuhan, China we help understand the Chinese coffee consumer by explaining their consumption using standard OLS regression. Results show that whether or not consumers make/brew their own …

Cost Of Living, Healthy Food Acquisition, And The Supplemental Nutrition Assistance Program, Sanjay Basu, Christopher Wimer, Hilary K. Seligman

University of Kentucky Center for Poverty Research Discussion Paper Series

We tested the hypothesis that high costs of living, such as from high housing rents, reduce the healthfulness of food acquisitions. Using the National Household Food Acquisition and Purchase Survey (2012-13), we examined the relationships between cost of living and food acquisition patterns among both SNAP participants and non-participants (N = 5,414 individuals from households participating in SNAP, 3,863 individuals from non-participating households <185% of the federal poverty threshold, and 5,036 individuals from non-participating households >185% of the federal poverty threshold). Indices for cost of living included county-level Regional Price Parities for major classes of expenditures and the geographic adjustment to the Supplemental Poverty Measure, which is based on rent prices. We …

Farmed And Wild-Caught Shrimp In Kentucky And South Carolina: Consumer Preference For Homegrown By Heroes, Community Supported Fishery, And Other Quality Attributes, Graham T. Soley

Theses and Dissertations--Agricultural Economics

As information regarding origin, production method, and environmental certifications characterize a progressing seafood market, scare analysis has been made to understand market responses. This study focuses on consumer preference for wild-caught and farm-raised shrimp with several attributes. These include the Homegrown By Heroes label and Best Aquaculture Practices certification, as well as other existing attributes including the Marine Stewardship Council and each state’s local label. Also considered are hypothetical labels including Community Supported Fishery (CSF) and National Oceanic & Atmospheric Administration (NOAA). This study surveys consumers in Kentucky and South Carolina while utilizing a choice experiment to elicit willingness-to-pay measures …

Income And Physical Activity Choices: A Comparison Between United States And China, Xiaowen Hu

Theses and Dissertations--Agricultural Economics

The low income population often appears to make poor health choices, including physical activity deficiency. Since outdoor physical activity does not have to be monetarily costly, one explanation for this phenomenon is related to the idea of time preference. Briefly, the benefit of future good health appears to be valued less by those with low income, and they face a choice between consumption today and better health in the future. The objective of this study is to further investigate the determinants of participation in physical activity with an emphasis on the effect of annual household income. This dissertation consists of …

The Determinants And Trends In Public-Private Wage And Fringe Benefit Differential, Sun Ki Choi

Theses and Dissertations--Economics

The decline in private sector wages in the aftermath of the Great Recession reopened a longstanding debate about whether public sector employees make more than private sector employees. However, much of this debate has only focused on the difference in wages over the past few years. This paper uses the Current Population Survey from 1995-2013 to examine how the federal-private wage differential has evolved over time. Wage regressions are estimated by year for federal and private sector workers. I then use these estimates to calculate the federal-private wage differential. This is augmented with selectivity bias corrections for each year. Probit …

Kentucky's Educational Performance & Points Of Leverage, Michael T. Childress

Issue Brief on Topics Affecting Kentucky’s Economy

This issue brief explores the links between obstacles students face and educational outcomes.

Kentucky Annual Economic Report 2016, Christopher R. Bollinger, William H. Hoyt, David Blackwell, Michael T. Childress

Kentucky Annual Economic Report

No abstract provided.

Three Essays On Unemployment Insurance In The 21St Century, Lewis H. Warren

Theses and Dissertations--Economics

My dissertation consists of three essays focusing on unemployment insurance (UI) and how it affects recipients. The first essay examines how UI generosity affects the search intensity of recipients through matching American Time Use Survey respondents to all of their observations in the Current Population Survey (CPS), the population from which they are drawn. Earnings from the CPS are then run through a benefit calculator that determines eligibility and benefit amounts which are used to determine how UI generosity affects search times. The second essay uses the Survey of Income and Program Participation to examine how lesser known policies affecting …

The Impact Of Cash Transfers On Labor Force Participation And Household Consumption: Evidence From Post-Apartheid South Africa, Steve M. M. Muchiri

Theses and Dissertations--Economics

The Old Age Pension (OAP) program for elderly South Africans puts a significant cash transfer in the hands of many poor households. This dissertation investigates its impact on labor force participation and consumption of selected household items. In the first half of the dissertation, we take advantage of a policy reform that lowered men's OAP eligibility age from 65 to 60 for men to match that of women for estimation identification. Using the General Household Survey data, we first demonstrate that both men and women respond to the eligibility age by dropping from labor force participation at the eligibility age, …

Three Essays On Export Concentration, International Environmental Agreements, And The Carbon Content Of Trade, Mihai Paraschiv

Theses and Dissertations--Economics

A common finding in the international trade literature is that economic integration leads to export diversification. By documenting a positive link between joining the European Economic and Monetary Union and bilateral export concentration, the leading essay shows that this is not always the case. Using a panel data approach, I find that exports between the Eurozone members are on average more concentrated than those among countries which do not share the euro. Central to this outcome is that some economic integration agreements, such as the European Economic and Monetary Union, may lead to a drop in not only trade but …

Vocational Rehabilitation Outcomes For Hispanic Consumers In Traditional Settlement Areas And New Immigrant Destinations: A 17-Year Trend Analysis, Karen E. Waddle Cinnamond

Theses and Dissertations--Social Work

At the end of the 20^th century, economic and political forces converged to create an unprecedented migration of Hispanics across and within U.S. borders. Many migrated for work in new destinations like the Southeast instead of traditional regions in the Southwest. In the Southeast many communities struggled to meet the economic and social needs of its newest members of a population that grew seemingly overnight.

The state-federal vocational rehabilitation system is an important service to meet the economic and social needs of people with disabilities that impair their ability to work. Current scholarship suggests Hispanics and other minorities experience …

Financial Implications Of The Medicaid Expansion For Academic Medical Centers, Madeleine Oritt

MPA/MPP/MPFM Capstone Projects

On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act (ACA), with the goal of reforming the United States health care system and providing insurance for millions of uninsured citizens and residents. One component of the legislation was the expansion of Medicaid eligibility, which would extend to include all individuals “under age 65 whose family income is at or below 138 percent of the federal poverty guidelines ($14,484 for an individual and $29,726 for a family of four in 2011)” (NCSL, 2015). This provision was challenged in the United States Supreme Court, which ruled …

An Examination Of Gender Income Gaps In And Out Of Government, Elisha Comer

MPA/MPP/MPFM Capstone Projects

No executive summary.

The Effect Of Per Capita Income On Broadband Access, Austin Coleman

MPA/MPP/MPFM Capstone Projects

The purpose of this inquiry is to determine the effect of income and ruralness on broadband access. This is relevant because of the economic effects of broadband access, which are not evenly distributed. The primary method of analysis employed was a multivariate regression model incorporating variables measuring broadband access, per-capita income, ruralness, race, and state-level effects. I found that income and ruralness were both significant, and that every $10,000 of per-capita income is associated with a change in broadband access rates of approximately 9%. The results also showed large, significant state-level effects that can be attributed to a combination of …

Brokers And Investment Advisors, Nathaniel Phillip Graham

Theses and Dissertations--Finance and Quantitative Methods

Brokers and investment advisors are a large and important part of the financial industry. Using a novel data set that includes the majority of the financial advisory industry, in this dissertation I document the size of the financial advisory industry and the prevalence of customer complaints in the industry, which I use as a proxy for misconduct. I then test for two potential drivers of advisors’ misconduct: professional standards in the form of fiduciary responsibilities and influence from social networks. I find that variation in fiduciary duties—specifically fiduciary versus suitability standards— does not appear to affect advisors’ propensity for misconduct. …