Health and economic geography in the US : policy interventions for public health

Doctoral Thesis
Author
Χριστόπουλος, Κωνσταντίνος
Christopoulos, Konstantinos
Date
2023View/ Open
Keywords
USA ; Premature mortality ; Convergence analysis ; Years of potential life lost ; Wage inequality ; Economic efficiency ; Spatial econometrics ; COVID-19 pandemic ; Lockdown measuresAbstract
Despite the fact that health and wealth are very much related, health policies tend to ignore the social and economic mechanisms behind health disparities. In this thesis I examine two subjects: premature mortality, and COVID-19 government interventions. To elaborate, I first study whether premature mortality, measured by the years of potential life lost (YPLL), converges among the U.S. states, by gender and by race. Based on these results, I also examine which mortalities, as well as health spending components, led to divergence. A novel convergence methodology is employed to this end for the years 1979--2017. Findings suggest that for males and blacks, all U.S. states converge to a steady-state, while for females, whites, and total population, the states form convergence clubs. These clubs differ mainly in infant, cardiovascular, and unintentional injury mortalities, with the ones with the lesser YPLL located mainly on the West and east coast. In conclusion, preventable deaths seem to be the main driver of premature mortality and spending on health does not appear to play a major role. Second, I study the association between the current COVID-19 pandemic government responses and the equity-efficiency relation. More specifically, wage inequality is the inequality in question. Cross-sectional data from the contingent US states for the year 2020 and a spatial econometric model specification were the data and the method used for the analysis, respectively. The main finding is that the association of State government responses to COVID-19 with the relation depend σ on the income of the States. Additionally, an inverted-U relationship between wage inequality and efficiency was found. These heterogenous effects may play a role into regional integration.