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Essays on Emotional Well-Being, Health Insurance Disparities and Health Insurance Markets University of New Mexico UNM Digital Repository Economics ETDs Electronic Theses and Dissertations Summer 7-15-2020 Essays on Emotional Well-being, Health Insurance Disparities and Health Insurance Markets Disha Shende Follow this and additional works at: https://digitalrepository.unm.edu/econ_etds Part of the Behavioral Economics Commons, Health Economics Commons, and the Public Economics Commons Recommended Citation Shende, Disha. "Essays on Emotional Well-being, Health Insurance Disparities and Health Insurance Markets." (2020). https://digitalrepository.unm.edu/econ_etds/115 This Dissertation is brought to you for free and open access by the Electronic Theses and Dissertations at UNM Digital Repository. It has been accepted for inclusion in Economics ETDs by an authorized administrator of UNM Digital Repository. For more information, please contact [email protected], [email protected], [email protected]. Disha Shende Candidate Economics Department This dissertation is approved, and it is acceptable in quality and form for publication: Approved by the Dissertation Committee: Alok Bohara, Chairperson Richard Santos Sarah Stith Smita Pakhale i Essays on Emotional Well-being, Health Insurance Disparities and Health Insurance Markets DISHA SHENDE B.Tech., Shri Guru Govind Singh Inst. of Engr. and Tech., India, 2010 M.A., Applied Economics, University of Cincinnati, 2015 M.A., Economics, University of New Mexico, 2017 DISSERTATION Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Economics At the The University of New Mexico Albuquerque, New Mexico July 2020 ii DEDICATION To all the revolutionary figures who fought for my right to education iii ACKNOWLEDGEMENT This has been one of the most important bodies of work in my academic career so far. It would not have been possible without the people who directly or indirectly supported me throughout my doctoral journey. Firstly, I want to thank my mother, Kalpana, for believing in my dreams and ambitions; my father, Vasant, for his constant support throughout my academic and professional career. I also want to express gratitude towards my loving siblings, Shirani, Snehal and Purvesh and my brothers-in-law Ritesh and Atish for encouraging me not to give up. Also, I am thankful for the presence of my little nephews and niece in my life as they always cheer me up especially during stressful times. I learnt a lot during my doctoral program and most importantly it helped improve my rational and critical thinking skills. Coming from a background of a computer science engineer with the experience of working in a corporate world, academia was a new world for me. I felt it would be tough to make a successful transition to the economics program since this area was new to me. However, with the help of my professors and mentors from my masters and doctoral programs this transition became easier. I sincerely want to thank my doctoral advisor, Prof. Alok Bohara for giving me the opportunity to work under his guidance and for helping me navigate through complex challenges in my doctoral program. He is one of the most knowledgeable people I met, and I wish to gain at least half the knowledge that he has. I cannot thank enough my dissertation committee member, Prof. Richard Santos, for always looking after me throughout my doctoral program and for always being available to answer my questions. My doctoral journey would have been difficult without his support. I also want to express my deepest gratitude towards Dr. Claudia Diaz Fuentes for choosing me to work with her and helping me develop the final research paper in my dissertation. I learnt a lot from her about doing the high- quality research and following the best research practices. Finally, I want to thank my other iv dissertation committee members Dr. Sarah Stith and Dr. Smita Pakhale for their valuable feedback and comments on my dissertation. Throughout my life, I gained a great deal of knowledge from my teachers, professors and mentors. While some of them have directly helped me to achieve my goals, others have given me important life lessons. I would not be where I am without them and I want to thank each one of them. v Essays on Emotional Well-being, Health Insurance Disparities and Health Insurance Markets BY DISHA SHENDE B.Tech., Shri Guru Govind Singh Inst. of Engr. and Tech., India, 2010 M.A., Applied Economics, University of Cincinnati, 2015 M.A., Economics, University of New Mexico, 2017 Ph.D., Economics, University of New Mexico, 2020 ABSTRACT This dissertation has three research papers. First paper looks at the effect of social networks on emotional well-being of cancer patients by studying the response of social networks on their depression symptoms. Using the data from a primary survey conducted in Nepal, the study finds that social networks significantly reduce depression symptoms among cancer patients. The results strongly advocate for the importance of the social networks in improving their emotional well-being. Second paper examines the health coverage disparities among Hispanic and non- Hispanic young adults in five southwestern states of the United States. Using the pooled data from American Community Survey 2015-2017, the study finds that despite ACA, ethnic-racial group, gender, education, income, employment status, age, school going status are still the key determinants of health coverage among young adults. States that expanded Medicaid showed a significant improvement in the health coverage of young adults. Findings also indicate that the disparities in health coverage among Hispanic and non-Hispanic young adults are largely attributed to the citizenship status and living in a household where language other than English is spoken. Third paper studies the association between increased market concentration and plan premiums for individuals and families from 2015-2020 in insurance marketplaces, as well as the impact of Medicaid expansion on the plan premiums. Results show a significant positive effect of high market concentration on plan premiums for all individuals and families regardless of Medicaid expansion status. This study emphasizes the importance of insurer competition in health insurance markets and can be useful in state and federal governments’ decisions regarding insurance market regulation. vi Table of Contents CHAPTER 1 ................................................................................................................................... 1 CHAPTER 2 ................................................................................................................................... 5 Introduction ............................................................................................................................................. 5 Literature Review .................................................................................................................................... 7 Conceptual Framework and Hypothesis ............................................................................................... 9 Stress Buffering Model: ........................................................................................................................................ 9 Direct Effect Model: ........................................................................................................................................... 10 Data and Measures ................................................................................................................................ 11 Data - Survey ...................................................................................................................................................... 11 Measures............................................................................................................................................................. 12 Empirical Model .................................................................................................................................... 15 Results..................................................................................................................................................... 19 Conclusion .............................................................................................................................................. 21 References .............................................................................................................................................. 24 Appendix ................................................................................................................................................ 34 Tables ................................................................................................................................................................. 34 Table 1: PHQ-9 Severity Index and its classification......................................................................................... 34 Table 2: Variables for Social Networks ............................................................................................................. 35 Table 3: Variables for Stress Appraisal .............................................................................................................. 36 Table 4: Summary Statistics of Cancer Patients ................................................................................................. 36 Table 5: Estimates for Depression Symptoms among Cancer Patients .............................................................
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