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The Impact of Economic Recession on the Health of Adult Nevadans

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The Impact of Economic Recession on the Health of Adult Nevadans UNLV Theses, Dissertations, Professional Papers, and Capstones December 2017 The Impact of Economic Recession on the Health of Adult Nevadans Ariana Goertz University of Nevada, Las Vegas Follow this and additional works at: https://digitalscholarship.unlv.edu/thesesdissertations Part of the Biostatistics Commons, and the Epidemiology Commons Repository Citation Goertz, Ariana, "The Impact of Economic Recession on the Health of Adult Nevadans" (2017). UNLV Theses, Dissertations, Professional Papers, and Capstones. 3133. http://dx.doi.org/10.34917/11889695 This Thesis is protected by copyright and/or related rights. It has been brought to you by Digital Scholarship@UNLV with permission from the rights-holder(s). You are free to use this Thesis in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s) directly, unless additional rights are indicated by a Creative Commons license in the record and/ or on the work itself. This Thesis has been accepted for inclusion in UNLV Theses, Dissertations, Professional Papers, and Capstones by an authorized administrator of Digital Scholarship@UNLV. For more information, please contact [email protected]. THE IMPACT OF ECONOMIC RECESSION ON THE HEALTH OF ADULT NEVADANS BY Ariana D. Goertz Bachelor of Arts in American Studies University of New Mexico 2009 Bachelor of Science in Anthropology University of New Mexico 2011 A thesis submitted in partial fulfillment of the requirements for the Master of Public Health Department of Environmental and Occupational Health School of Community Health Sciences Division of Health Sciences The Graduate College University of Nevada, Las Vegas December 2017 Copyright 2017 by Ariana D. Goertz All Rights Reserved Thesis Approval The Graduate College The University of Nevada, Las Vegas May 3, 2017 This thesis prepared by Ariana D. Goertz entitled The Impact of Economic Recession on the Health of Adult Nevadans is approved in partial fulfillment of the requirements for the degree of Master of Public Health Department of Environmental and Occupational Health Sheniz Moonie, Ph.D. Kathryn Hausbeck Korgan, Ph.D. Examination Committee Chair Graduate College Interim Dean Timothy Bungum, Ph.D. Examination Committee Member Paulo Pinheiro, Ph.D. Examination Committee Member Alan Schlottmann, Ph.D. Graduate College Faculty Representative ii ABSTRACT Recessions are generally considered to cause negative consequences, but recent studies have provided evidence that some health outcomes improve as the economy deteriorates. The relationship between economic downfalls and health is not straightforward; it is important to look at how health has been impacted in one of the areas hit hardest by the recession. Las Vegas, Nevada was previously considered recession-proof, seemingly unaffected by previous economic downturns exhibited by the rest of the country. However, during the Great Recession of 2007- 2009, Las Vegas led the country in highest rates of unemployment and foreclosures. This was quite a collapse for a city that previously led the country in population and job growth for several decades. Using data from Behavioral Risk Factor Surveillance System (BRFSS), this study examined the effect of unemployment rates on the health status for adults living in Las Vegas, Nevada. This study aimed to contribute to the understanding of how recessions impact health by evaluating BRFSS data that proceeds, coincides, and follows the Great Recession (2006-2011). Multiple logistic regression analysis was used to understand to what extent health status has been impacted for groups based on employment and health insurance status, as well as several demographic factors. Results show that employment status was associated with fair to poor health before and after, but not during the recession. Individual level of education was the biggest risk factor of fair to poor health while younger age was protective against fair to poor health. These findings are important in future work to improve health by considering economic and demographic implications that may reduce those suffering from poor health. iii TABLE OF CONTENTS ABSTRACT ........................................................................................................................................ iii TABLE OF CONTENTS....................................................................................................................... iv LIST OF TABLES ................................................................................................................................ vi INTRODUCTION ............................................................................................................................... 1 Background ...................................................................................................................................... 4 LITERATURE REVIEW ....................................................................................................................... 7 Physical Health ................................................................................................................................. 7 Health Insurance Coverage .............................................................................................................. 9 Research Objectives ....................................................................................................................... 12 Research Questions ....................................................................................................................... 13 METHODOLOGY ............................................................................................................................ 15 Conceptual Model .......................................................................................................................... 15 Data Sources and Sample .............................................................................................................. 16 Variables ........................................................................................................................................ 17 Weighing the Sample ..................................................................................................................... 20 Statistical Analysis .......................................................................................................................... 20 RESULTS......................................................................................................................................... 22 Demographics ................................................................................................................................ 22 Rao-Scott Statistic .......................................................................................................................... 25 Demographic Factors Associated with Health ............................................................................... 26 Independent Variables Associated with Health ............................................................................. 28 Final Significance Model ................................................................................................................ 31 DISCUSSION ................................................................................................................................... 38 iv Summary of Findings ..................................................................................................................... 39 Strengths and Limitations .............................................................................................................. 41 Recommendations for Public Health Policy and Future Research ................................................ 42 CONCLUSION ................................................................................................................................. 44 APPENDICES .................................................................................................................................. 45 Appendix A: Health and Demographic Questions from BRFSS ...................................................... 45 Appendix B: List of Acronyms ........................................................................................................ 50 Appendix C: BRFSS Weights Table ................................................................................................. 51 REFERENCES .................................................................................................................................. 52 CURRICULUM VITAE ...................................................................................................................... 58 v LIST OF TABLES Table 1: Average Annual Unemployment Rate for Pre, During, and Post Recessionary Periods (2006-2011). .................................................................................................................................. 19 Table 2: Descriptive Characteristics of independent and dependent variables in Las Vegas MMSA, BRFSS 2006-2011 (N=4,284) ......................................................................................................... 22 Table 3: Demographic characteristics of included subjects in Las Vegas MMSA, BRFSS 2006-2011 (N=4,284) .....................................................................................................................................
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