Health Economics Commons^™

Bridging Fiscal Sustainability And Health Equity: A Policy Analysis Of California’S Healthcare Coverage Safeguards, Guadalupe Castaneda Martinez

Master's Projects and Capstones

Without structural policy intervention, approximately 4.6 million Californians remain at risk of being uninsured by 2030, worsening racial and ethnic health disparities and hospital uncompensated care burdens. This policy analysis advocates for a hybrid universal coverage model combining sliding-scale subsidies (California Senate Bill 78) with full-scope Medi-Cal expansion for all income-eligible residents regardless of legal status (California Assembly Bill 133). The framework relies on existing funding mechanisms, including the Managed Care Organization tax and the Health Care Affordability Reserve Fund. Comparative analysis indicates that market-only subsidies leave severe equity gaps, whereas immediate single-payer transitions pose substantial fiscal and administrative risks. …

Linking Fishery Productivity To Child Health In The Coastal Tropics, Francisco Flores-Mejia

Master's Theses

Fish are a primary source of calories, macronutrients, and income for coastal communities around the world, but overfishing and environmental changes have dramatically reduced productivity in the majority of small-scale fisheries. The social costs of these losses are believed to be large, particularly in poorer communities, but most estimates of fishery productivity effects on households are contextual and difficult to generalize. We combine a remote sensing measure of pelagic fishery productivity with geolocated child health and growth data from 34 countries in the coastal tropics. We estimate that the difference between sustainedly good versus bad fishing conditions corresponds up to …

Spatial Analysis Of Maize Yields And Household Dietary Diversity In Sub-Saharan Africa: Causal Evidence From A Machine Learning Instrument, Addi Joof

Master's Theses

MAIZE YIELDS AND HOUSEHOLD DIETARY DIVERSITY IN SUB-SAHARAN AFRICA: EVIDENCE ON THE CAUSAL EFFECT FROM A MACHINE LEARNING INSTRUMENT

Addi Joof, University of San Francisco, May 2026

This paper provides estimates of the effect of maize yield on household dietary diversity across seven Sub-Saharan African countries, using data from 36,474 maize-growing households in the Living Standards Measurement Study Integrated Surveys on Agriculture (LSMS-ISA) panels for the period 2008--2021. OLS estimates which include district and country-by-wave fixed effects yield a positive and significant coefficient of 0.070 (SE = 0.006, p < 0.001), implying that a 10 percent increase in maize yield raises the Household Dietary Diversity Score (HDDS) by approximately 0.007 food groups. Because self-reported yields are subject to classical measurement error and unobserved household characteristics confound the OLS estimate, we construct an instrumental variable using a Random Forest model trained on satellite-derived agro-environmental features including the Enhanced Vegetation Index, Normalized Difference Vegetation Index, Growing Degree Days, precipitation, and soil moisture obtained from Google Earth Engine at the GPS-coordinate-by-year level. Our preferred 2SLS specification, which adds region fixed effects to absorb persistent sub-national geographic variation, returns a positive point estimate of 0.217 (SE = 0.206; 95% CI: -0.19 to +0.63, p = 0.294) larger than OLS and consistent with downward attenuation bias, but imprecisely estimated and statistically indistinguishable from zero at conventional levels. We interpret the OLS estimate of 0.070 as a credible lower bound on the true effect, with the IV evidence pointing to a moderately larger but uncertain magnitude. Heterogeneity analysis reveals a declining gradient across consumption quintiles the effect is strongest among the poorest households (Q1: 0.055, p < 0.01) and diminishes with wealth (Q5: 0.015, not significant) while showing no gradient across market-integration levels. These patterns are consistent with own-consumption, rather than market income from surplus sales, as the primary pathway from yield to dietary diversity. OLS estimates are positive and significant in five of six estimable countries. The findings suggest that maize yield improvements can serve as a nutrition co-investment, particularly for subsistence-oriented smallholders, though the available data do not permit a sharp causal quantification of the effect size.

Keywords: dietary diversity, maize yields, instrumental variables, Sub-Saharan Africa, LSMS-ISA, satellite …

Exploring The Impact Of Weekly Farmers’ Market In The City Of Carson, Ca In Promoting Equitable Access To Locally Grown Fruits And Vegetables, Daisy Lopez Valdez M.P.H.

Master's Projects and Capstones

Despite their many benefits to the community, farmers’ markets suffer from several important limitations. This paper will provide guidance on practices and interventions that can improve the effectiveness of the local Carson, California farmers’ market, known as the South Bay Pavilion Farmer’s Market, in increasing equitable access to and consumption of locally grown fruits and vegetables with the goal of reducing obesity and diabetes rates among residents.

The needs and assets assessment developed will evaluate the success of the City of Carson South Bay Pavilion Farmers’ Market and provide recommendations based on the findings. The proposed research will follow an …

The Impact Of Refractive Error Correction On Harvest Productivity In The Guatemalan Coffee Sector, Bryce C. Everett

Master's Theses

Providing refractive error correction has the potential to bolster productivity within developing countries. Current literature is in agreement that interventions targeting those with uncorrected visual impairment can realize benefits in various sectors, with particular regard to agriculture. The design of this experiment attempts to derive the intent-to-treat (ITT) effect stemming from the provision of glasses to coffee harvesters in Guatemala. Methodology incorporates two distinct approaches: an ANCOVA model with basic controls and a fixed effects model with a control for farm-specific harvest trends. With daily harvest weight observations serving as a proxy for productivity, and a sample of 321 participants …

Dose Higher Socioeconomic Status Associate With Better Mental Health Outcomes Among Primary Caregivers In Rural China?, Wenwen Zhang

Master's Theses

This study explores the intricate relationship between socioeconomic status (SES) and the mental health outcomes of primary caregivers in rural China, focusing on the Early Childhood Development (ECD) context in Ya'an. Anchored in a major intervention project launched in 2023, the study critically examines the hypothesis that higher socioeconomic status correlates with lower levels of negative emotions among caregivers.

Utilizing cross-sectional data, the research investigates how educational attainment and household income influence caregivers' mental health, measured through the DASS-21 score in three dimensions: stress, anxiety, and depression. The findings reveal that higher household income and educational levels are significantly associated …

Does Higher Socioeconomic Status Associate With Better Mental Health Outcomes Among Primary Caregivers In Rural China?, Wenwen Zhang

Master's Theses

This study explores the intricate relationship between socioeconomic status (SES) and the mental health outcomes of primary caregivers in rural China, focusing on the Early Childhood Development (ECD) context in Ya'an. Anchored in a major intervention project launched in 2023, the study critically examines the hypothesis that higher socioeconomic status correlates with lower levels of negative emotions among caregivers.

Utilizing cross-sectional data, the research investigates how educational attainment and household income influence caregivers' mental health, measured through the DASS-21 score in three dimensions: stress, anxiety, and depression. The findings reveal that higher household income and educational levels are significantly associated …

Assessing The Economic Consequences Of Sewage Overflows On California Housing Values, Nathalie M. Nyanga

Master's Projects and Capstones

Sewage overflows (SSOs) represent a critical environmental challenge in California, and the impact of SSOs on housing prices is a vital issue. The study aims to determine how the frequency of sewage overflow events affects housing price fluctuations and conduct an event study. Employing linear, lasso, ridge, and random forest regression analyses, the study predicts the severity of overflow. Notably, lasso regression emerges as the most effective model for predicting housing prices in the event of an SSO occurrence. Additionally, the event study analysis provides insights into the factors influencing housing prices.

The Impact Of High Temperatures On Child Anthropometric Outcomes Worldwide, Natalia A. Cancino Garcia

Master's Theses

High temperatures caused by climate change significantly impact society, including child nutrition. Our research focuses on the impact of high temperatures on the anthropometric outcomes of children aged 1 to 5 in 54 countries worldwide. We analyze the historical climate and anthropometric data to evaluate the effect of high temperature on weight-for-age (WAZ) and weight-for-height (WHZ) in children. Results indicate that high temperatures negatively affect child nutrition, particularly in areas above 20°C, and children in rural areas are more vulnerable. The impact of monthly temperature on child anthropometric outcomes varies across countries, regions, and cultural practices. Economic status alone is …

Impacts Of Rising Temperatures On Human Behavior With A Focus On Gender Differences, Stephanie Marie Emilia J. Hermoso

Master's Theses

Climate change is one of the biggest and most pressing issues the world is facing today. While its economic implications are substantial, it is also important to investigate the effects of climate change on human behavior. This paper examines the relationship of rising temperatures and its effect on an individual’s cooperative behavior – specifically egalitarianism, generosity, selfishness, and spite. This study will focus on the differences between how males and females react to the temperature. Research indicates that there are substantial behavioral differences between men and women. How do the economic decisions of men and women differ when interacted with …

The Child Nutrition Cost Of Weather Shocks In Nigeria, Danielle M. Abaya

Master's Theses

Child malnutrition is alarmingly high in Nigeria with the highest number of malnourished children, the second highest population of stunted children worldwide and 17 million Nigerians facing food insecurity. According to the World Health Organization, children are predicted to suffer about 80% of weather-related illnesses and deaths. As climate change continues to pose the greatest health threat and while scientists predict its irreversible effects in the next 10 years, countries such as Nigeria are already experiencing the burden of climate change today. This study uses total rainfall to measure precipitation and two Enhanced Vegetation Index variables, total change in greenness …

Using Machine Learning To Analyze Children’S Drawings As Indicators Of Mental Well-Being, Nicholas R. Lawrie

Master's Theses

Human figure drawings are a well-studied diagnostic tool for emotional distress in children. Cleft lip/palate is one of the most common birth defects in the world, and has been shown to negatively impact emotional well-being in childhood which can have negative economic consequences in adulthood. Utilizing a dataset of human figure drawings from children in India and survey data on mental health, this paper will assess the impact of corrective surgery on mental health outcomes, as well as assess the validity of the drawing emotional indicators themselves. The results indicate that while the emotional indicators may not be valid in …

The Health Costs Of Political Identity: Evidence From Public Safety Responses In The Us And A Natural Experiment In California, Sahiba Chopra

Master's Theses

The Covid-19 pandemic has brought political polarization in the US to the forefront of the battle against coronavirus. We find that for every one percentage point increase in votes for Trump there are 881 more Covid-19 cases and 17 more Covid-19 deaths. We find that these results are motivated by political identity as it is mediated through public safety behaviors like maskwearing and social distancing. In addition, a natural experiment in California during the first half of the pandemic in the US finds that 36% of the Covid-19 cases at the census tract level in California can be associated with …

Temperature Effects On Prevalence Of Sexually Transmitted Infections Among At-Risk Female Sex Workers In India, Rajshri Suresh

Master's Theses

Vulnerability to climate change varies depending on the baseline climate, sensitivity to given exposure, and the presence of social, political, cultural, and institutional inequalities that influence access to essential resources of livelihood, particularly among informal labor market participants. Within the risky informal labor market, the transient nature of sex work implies that sex workers suffer disproportional losses in health, income, protection, and other aspects of general well-being as a result of the effects of climate anomalies. In this paper, I investigate the effect of temperature on the prevalence of sexually transmitted infections in a high-risk population of female sex workers …

Temperature Effects On Prevalence Of Sexually Transmitted Infections Among At-Risk Female Sex Workers In India, Rajshri Suresh

Master's Theses

Vulnerability to climate change varies depending on the baseline climate, sensitivity to given exposure, and the presence of social, political, cultural, and institutional inequalities that influence access to essential resources of livelihood, particularly among informal labor market participants. Within the risky informal labor market, the transient nature of sex work implies that sex workers suffer disproportional losses in health, income, protection, and other aspects of general well-being as a result of the effects of climate anomalies. In this paper, I investigate the effect of temperature on the prevalence of sexually transmitted infections in a high-risk population of female sex workers …

Estimating Predictors Of Mental Well-Being Through Analysis Of Children’S Drawings: The Case Of Syrian Refugees, Stephanie Smith

Master's Theses

There are currently over 65 million individuals that have been forcibly displaced globally. The cumulative trauma that comes from the refugee experience and exposure to violence has proven to have long-term negative psychological outcomes and thus negative impacts on human capital in the long run. Given that over 50% percent of the global refugee population are children, the ability to efficiently and accurately assess their mental well-being is of critical importance. Using data from over 2000 refugee children in Jordan, I use machine learning techniques to find key predictors of psychological distress, PTSD, and exposure to violence found in children’s …

The Effect Of Sex Of Firstborn Children On Attitudes Towards Intimate Partner Violence, Shuvam Rizal

Master's Theses

What are the different ways in which one’s life is influenced by the sex of their children? Is there an effect on how they view Intimate Partner Violence? If so, is there a difference in how the male parent is affected by the sex of his child than the female parent? Bodies of conflicting Social Sciences literature suggest having a daughter makes one both more and less likely to engage in Intimate Partner Violence. In this paper, I approach this question through the use of a Linear Probability Fixed-Effects model on Demographic Health Surveys (DHS) datasets, using data from the …

Out-Of-Pocket Expenditure For Home And Facility Based Delivery Among Rural Women In Zambia: A Mixed-Methods, Cross-Sectional Study, Jeanette L. Kaiser, Kathleen L. Mcglasson, Peter C. Rockers, Rachel M. Fong, Thandiwe Ngoma, Davidson H. Hamer, Taryn Vian, Godfrey Biemba, Jody R. Lori, Nancy A. Scott

Nursing and Health Professions Faculty Research and Publications

Purpose: Out-of-pocket expenses associated with facility-based delivery are a well-known barrier to health care access. However, there is extremely limited contemporary information on delivery-related household out-of-pocket expenditure in sub-Saharan Africa. We assess the financial burden of delivery for the most remote Zambian women and compare differences between delivery locations (primary health center, hospital, or home).

Methods: We conducted household surveys and in-depth interviews among randomly selected remote Zambian women who delivered a baby within the last 13 months. Women reported expenditures for their most-recent delivery for delivery supplies, transportation, and baby clothes, among others. Expenditures were converted to …

The Effect Of Disability Status On Parental Input: A Study From India, Susann Skjoldhorne

Master's Theses

Human capital has for a long time been an important factor in economic growth theory. Previous literature shows a strong connection between parental input and the level of human capital attained by a child. The investment in child health and education has a positive effect on building human capital. When resources are scarce the allocation of resources will affect the opportunities that a child is given to achieve their potential. Gender preferences, birth order, and disabilities could all be factors that explain how parents chose to allocate their resources. Previous studies show that the distribution of parental input based on …

The Impact Of Cleft Lip/Palate And Clp Surgical Intervention On The Social Integration Of Adolescents In India, Mustafa Zahid

Master's Theses

Cleft Lip/Palate, a congenital orofacial anomaly, carries an incidence rate of approximately 1 in every 1000 births. In addition to the stigma associated with the condition, the varying levels of cleft severity might result in lower life outcomes which could include lower cognitive ability, physical and psychological well-being, social and behavioral outcomes of adolescents. This paper focuses on the social integration element of life outcomes, which is composed of the social inclusion and prosocial behavior of the adolescent. Despite the affordability of restorative surgeries, patients in rural areas of Low and Middle-Income Countries (LMICs) such as India face accessibility and …

Are Menstrual Cycles A Biological Determinant Of Well-Being Amongst Sierra Leonean Schoolchildren?, Ashwini Shridhar

Master's Theses

The influence of hormones and biology on behavior is a topic that is rife with controversy, especially when it comes to sexual hormones. There is even more murkiness when it comes to the topic of menstruation and knowledge about women’s menstrual cycles. Recent research on this topic have seen a link between the hormonal fluctuations during menstrual cycles and various behavioral implications on competition, cooperation, and risk behavior. This study tries to expand existing knowledge by examining whether there is a link between hormonal fluctuations during menstrual cycles and risk preferential behavior using economic experiments in the largely understudied context …

The Impact Of Cleft Lip And Palate Repair Surgery On Cognitive And Academic Outcomes For Teens In India, R Jeremiah Maller

Master's Theses

India has a backlog of nearly one million patients in need of cleft lip and palate repair. Unrepaired cleft results in social stigma and diminished health, psychological wellbeing, and academic functioning. Cleft repair surgery has the potential to restore functioning in these domains. However, the magnitude of the social, educational, and economic impact of cleft repair surgery has not been evaluated using statistically rigorous methods. An estimation of the academic and educational impact of cleft repair has implications for the appropriate allocation of public health resources. We analyze original data gathered from teenagers in West Bengal, India using the difference-in-differences …

Boosting Demand For Biofortified Foods: The Case Of Orange Fleshed Sweet Potato Bread In Tamale, Ghana, Tchassanty Ouro-Gbeleou

Master's Theses

Abstract: In the context of introducing biofortification of staple crops as a food-based approach to combat micronutrient malnutrition in Sub Saharan Africa (SSA), we carried out a survey in Tamale, Ghana to elicit consumers’ preference of and willingness to pay for one of the highly nutritious biofortified staple crop processed product: the Orange Fleshed Sweet Potato (OFSP) bread. Our results indicate that scores of respondents in the sample show preference for OFSP bread. The most important determinants of OFSP bread preference are its sweet taste and soft texture and consumers are willing to pay 0.634 pesewas more for the attribute …

The Causal Impact Of Cleft Lip And Palate Surgery On Psychological Wellbeing, Sam Manning

Master's Theses

Cleft lip and/or cleft palate (CL/P) are birth conditions in which a newborn has an opening in the roof of their mouth or a slit in their upper lip. Left untreated, CL/P can lead to speech impediments and an unsightly orofacial deformity. However, a sequence of simple, common surgical procedures can restore function with minimal scarring. To date, the psychological effects of being born with CL/P have been investigated in the literature, but the restorative impact of CL/P surgery on psychological wellbeing has not been rigorously evaluated. This study uses a quasi-experimental approach to estimate the impact of being born …

Patriarchal Norms, Bargaining, And Gendered Attitudes On Intimate Partner Violence, Anna Eckenrode

Master's Theses

How do the underlying mechanisms of social norms and bargaining power relate to the acceptance of intimate partner violence within households? How do short run and long run determinants of gender norms affect attitudes toward IPV? This study begins to decompose the dynamics of the acceptance of IPV within couples using data from the Demographic Health Survey, as well as examine the relationship in the context of patriarchal societies using data from the Ethnographic Atlas. I find that females are more accepting than males of intimate partner violence, and females becoming more educated is associated with her being less accepting …

Do Marketing Strategies Impact Condom Sales In Uganda?, Meyhar Mohammed

Master's Theses

What attracts people to buy condoms? HIV/AIDS remain one of the biggest health dangers of the world, especially in Sub-Saharan Africa. A lot of efforts have been pursued in the past two decades to drastically reduce prevalence of HIV and increase awareness about preventive mechanisms. In order to prevent relapse of success achieved so far, it is important to recognize transformation of consumer behavior due to growth in social networks, education and awareness over time. There are a lot of behavioral triggers captured by social marketing interventions in the field of public health. In an attempt to investigate the role …

Air Pollution And Fetal Loss In The Global Tropics, Shuqiao Cheng

Master's Theses

Abstract: Recent work has shown that in-utero air pollution has negative effects on both contemporaneous birth outcomes and long-term human capital outcomes. However, only a few studies explore the effects of in-utero exposure to air pollution on fetal loss, and none of the studies has been done in developing countries. In this study, we examine the impact of naturally caused CO and PM 2.5 on reproductive outcomes in 40 developing countries from 1997 to 2009. We present childbirths and birth gender as measures for potential fetal losses. The richest model identified using variation in pollution between pregnancies with controlling for …

Air Pollution, Temperature And Cognitive Performance In The Short Run: Evidence From Women’S Ability To Recall Dates, Ke Yang

Master's Theses

Abstract: Cognitive performance is important to productivity across many fields and potentially correlated to air pollution and extreme temperatures. We study the effects of daily ambient air pollution and monthly temperature on women’s ability of recalling dates across 42 developing countries from 1997 to 2009. We use an estimated natural air pollution data, and calculate the AQI to get an aggregate effect of air pollution. We find that one standard deviation increase in the AQI leads to a statistical decrease in women’s probability to recall dates such as birthdays, marriage date or children’s birthdays by 0.44 percentage point. Furthermore, there …

Does Infant Formula Availability Reduce Breastfeeding?, Ingvild Madsen Lampe

Master's Theses

Abstract: Several key studies highlight the importance of breastfeeding and there is a broad consensus that it plays a crucial role for a child's health and cognitive development. This is especially true for the poor in developing countries, where vulnerable infants' access to proper nutrition is vital. We investigate the effect of introducing infant formula into a market on changes in breastfeeding patterns. Using the Demographic Health Surveys and annual reports from the baby food industry between 1981 and 2002 in 11 tropical countries, we find evidence that import of infant formula significantly reduces breastfeeding duration. The effects are stronger …

Behavioral Determinants Of Biofortified Food Acceptance: The Case Of Orange-Fleshed Sweet Potato In Ghana, Chinonso E. Etumnu

Master's Theses

Biofortified foods are being introduced in sub-Saharan Africa as an important strategy to help address micronutrient malnutrition. However, there has been little research on factors that could play decisive roles in their successful introduction. This paper investigates the determinants of consumer acceptance of biofortified orange-fleshed sweet potato (OFSP) using data from a choice experiment conducted in Ghana. I find that OFSP is preferred to traditional white-fleshed and yellow-fleshed sweet potatoes as indicated by consumers' marginal willingness to pay for the three varieties. I also find that respondents' socio-economic characteristics do not have a significant effect on consumer acceptance of OFSP. …