This dissertation consists of three essays, each focusing on one topic in economics of health behaviors in China. The first essay attempts to examine the determinants of alcohol demand with concentration on impact of alcohol price among Chinese adult population. The second essay estimates healthcare expenditure in China and evaluates the performance of econometric models. The objective of the third essay is to examine the time trend of obesity disparities across sociodemographic groups in school-aged youth population from 1991 to 2006 in mainland China.
This dissertation consists of three essays in health economics. The first chapter, "The Built Environment and Obesity in Philadelphia: The Use of Satellite Imagery and Transfer Learning," investigates the relationship between the built environment and health outcomes, specifically obesity prevalence in Philadelphia. The built environment can affect obesity prevalence through the physical activity environment and the food environment. The main innovation of this paper is to use a pre-trained convolutional neural network (CNN) to extract data representing the features of the built environment from high-resolution satellite imagery. Because of the lack of information on the food environment in satellite images, I combined a proxy variable for food access together with the feature variables to represent the characteristics of the built environment. I then employed the Elastic Net model to test the relationship between the feature variables of the built environment and obesity prevalence in Philadelphia. The results show that the built environment is highly associated with obesity prevalence. This study also provides some evidence that the features of the built environment that have been extracted from satellite imagery can reduce the role of food access in estimating obesity, as well as that adding these features can explain more variance of obesity. The second chapter, "Paid Maternity Leave and Child Health: Evidence from Urban China," uses the China Health and Nutrition Survey data to study whether the extension of paid maternity leave affects children's health outcomes in urban China. This paper uses the time variation of the implementation of a maternity leave policy across different provinces from 1987 to 1991 in China to estimate a two-way fixed-effects model. The results suggest that the expansion of paid maternity leave has no impact on children's health in urban China. The last chapter, titled "The Association between Paid Maternity Leave and Mothers' Health and Labor Outcomes in Urban China," studies whether the extension of paid maternity leave in 1987-1991 would affect the labor and health outcomes of mothers in urban China by using the China Health and Nutrition Survey data. Based on the variation in the implementation time of a paid maternity leave policy across different provinces, this paper employs a two-way fixed-effects model to estimate the policy impact on mothers' health and labor outcomes in China. The findings indicate that extending the duration of paid maternity leave is associated with an increased likelihood of mothers remaining employed after childbirth. However, the study also reveals a negative relationship between the extension of paid maternity leave and mothers' wage rates.
"This dissertation is composed of three studies that examine three different aspects of the health care system: health insurance, pharmacist and patient decision making, and physician and patient decision making. The first chapter discusses how the designs of New Cooperative Medical Scheme (NCMS), the health insurance for rural residents in China, vary cross counties and over time. I collect first-hand data about the details of the insurance for rural Chinese and contribute to the literature of evaluating the NCMS by providing evidence of the heterogeneity of the insurance. The second chapter studies how the regulations on pharmacist's behavior affect consumer demand for generic prescription drugs. It contributes to our understanding of how to control the expenditure growth on prescription drugs in the United States. The last chapter analyzes how physician and patient's behavior change when information about physician quality becomes more precise. It contributes to our understanding of whether report card programs on physician qualities are necessarily welfare improving. " --
In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
