http://hdl.handle.net/10027/7406 Wed, 22 May 2013 09:15:56 GMT 2013-05-22T09:15:56Z http://hdl.handle.net/10027/9792 Quality of Life in Rural Illinois: Housing and Access to Health Care This dissertation focuses on two measures of rural quality of life in Illinois: housing values and health care access. Through estimating housing price trends, evaluating policy impacts on rural hospital structures, and valuing rural hospitals as local amenities, rural quality of life in Illinois can be better understood. Using sales transaction data from the Illinois Department of Revenue, the first essay compares the median and Case-Shiller housing price capabilities to measure housing price appreciation and depreciation in Illinois between 2000 and 2009. The Case-Shiller method captured the housing bubble in metro (excluding Chicago), micro and rural areas in Illinois. While rural areas in Illinois did not experience housing price fluctuations as large as Chicago, the Case-Shiller method corrects the assertion that rural America did not experience a housing bubble. The second essay details the changes in rural Illinois hospital structures resulting from the 1997 Balanced Budget Act and the 1999 Balanced Budget Recovery Act. These acts created a Critical Access Hospital certification aimed at slowing the rate of hospital closures across the United States. The results show that CAH certification appears to have aided in maintaining health care in rural areas. Using hedonic estimation, the third essay focuses on the impact of a CAH compared to that of a full-service hospital on housing values. This essay compares the effect of Crawford Memorial Hospital (a CAH) on Crawford county housing values to the effect of McDonough District Hospital on McDonough county housing values. Crawford is a rural county with a small Critical Access Hospital. McDonough is, according to USDA's Urban Influence Codes, considered a micro county. The results suggest that a Critical Access Hospital has similar effects on housing values as the full-service hospital. Therefore, the results of this paper support the hypothesis that preserving a Critical Access Hospital is as useful as preserving a full-service hospital, in terms of the benefits to the local housing values. Thu, 21 Feb 2013 06:00:00 GMT http://hdl.handle.net/10027/9792 2013-02-21T06:00:00Z http://hdl.handle.net/10027/9622 The Importance of Household Responses to Competing Disease Risks Child mortality is a persistent problem in sub-Saharan Africa that policymakers have up to now been unable to solve. The Millennium Development Goals set the bar for progress at a two-thirds reduction by the year 2015 (UNDP 2011). However, there has been nowhere near sufficient progress to meet this goal. While the child mortality rate in sub-Saharan Africa had fallen from 18 percent in 1990 to 13 percent in 2009, the total number of child deaths has increased from 3,937,000 in 1990 to 3,976,000 in 2009. Additionally, the share of under-five deaths coming from Sub-Saharan Africa increased from 31 percent in 1990 to 50 percent in 2009 (UNICEF et al. 2010). Policymakers seeking to reduce child mortality and meet this goal have long sought to identify what programs are effective and why, but up to now have been unsuccessful. A common explanation for this failure is that health production is a complicated process that depends on many interrelated health inputs that all involve choices (Rutstein 2002). I thus argue in this dissertation that understanding how households make decisions about investment in interrelated health inputs is essential to improving child health. Here I focus specifically on how households respond to competing disease risks in making health input decisions. I argue that a better understanding of this decision-making process will enable policymakers to answer key questions about why programs are effective in reducing child mortality. Here I have specifically addressed two questions: 1) why does the effect of the same program differ by program site and 2) why do families spend little on disease prevention and have high price sensitivity for it when they spend relatively large amounts on medical treatment. I developed a theoretical model of household allocation with competing disease risks for children to demonstrate that household will respond to child health programs by investing in more disease prevention for their children and that this response will differ by determinants of household allocation to children. This differential response will lead to mortality effects that vary by these determinants of household allocation. I developed an additional theoretical model of parents’ decisions to invest in disease prevention or spend on medical treatment in the presence of competing disease risks. I demonstrated that high levels of competing disease risks will decrease investment in disease prevention, increase price sensitivity for prevention, and increase the use of medical treatment when sick. I applied these two models to the questions raised above and evaluate them empirically using data from sub-Saharan Africa. I find empirical support for both models. Fri, 14 Dec 2012 06:00:00 GMT http://hdl.handle.net/10027/9622 2012-12-14T06:00:00Z http://hdl.handle.net/10027/9576 The Effect of Policy and Social Interaction Variables on Youth Smoking in Low and Middle Income Countries This dissertation investigates the effect of policy and social interaction variables on youth smoking among countries which conduct the Global Youth Tobacco Survey (GYTS). This is the first study to use GYTS data to investigate the effect of peer smoking on individual smoking. In the second part of the dissertation, I estimate the effect of cigarette prices on youth cigarette smoking among a group of less developed countries from the GYTS. This first chapter investigates the effect of peer smoking on individual smoking among middle-school students in 109 low and middle income countries. I address endogeneity in school choice and unobserved school-level characteristics through the use of school fixed-effects. Identification arises by comparing students in different grades within the same school. I instrument in order to address the simultaneity in individual and peer behavior. I correct for measurement error in the peer variable through the use of instruments and address the upward bias in IV estimates by modeling the measurement error through the use of GMM. The evidence suggests that the measurement error is in fact mean-reverting. On average, increasing the share of one’s peers who smoke by 10 percent increases the probability that an individual will smoke by 2-4.5% percentage points. Peer effects vary when the analysis is conducted among five geographic sub-regions and at the country level. This second chapter investigates the effect of cigarette prices on smoking prevalence and consumption among youth in 38 Global Youth Tobacco Survey (GYTS) countries. I employ two-way fixed effects to address country level unobservables which may be correlated with smoking use among youth over time. I control for local level variables that affect smoking among youth. The estimated total price elasticity is -1.5, -0.6 through participation and -0.9 through conditional demand. This estimate suggests that a 10 percent increase in price reduces cigarette use among youth by 15 percent among high income and less developed countries. Restricting the analysis to only less developed countries produces a total price-elasticity of cigarette use of -2.2, -0.6 through participation and -1.6 through consumption. Thu, 13 Dec 2012 06:00:00 GMT http://hdl.handle.net/10027/9576 2012-12-13T06:00:00Z http://hdl.handle.net/10027/9507 The Cost of Delinquent Property Tax Collection Three Essays in Local Public Finance Property tax delinquency can be costly for local governments and taxpayers. There are four important state government policies that affect the cost of property tax delinquency for taxpayers; penalties, interest fees, tax lien sales, and time to tax foreclosure. Penalties are a one-time fee applied to a tax bill when not paid on time. Interest fees are recurring, applied to a tax bill the duration of delinquency. Tax lien sales introduce additional penalties, uncertain interest fees, and private tax foreclosure. Private tax foreclosure is more costly and faster than public tax foreclosure. The first section of the dissertation documents state differences in penalties, interest fees, tax lien sales, and time to tax foreclosure. Higher penalties and interest increase the costs of property tax delinquency for delinquent taxpayers. The second section estimates the responsiveness of taxpayers to differences in penalties and interest fees. The third section estimates to what extent property tax delinquency is affected by tax lien sale induced changes in interest rates charged to delinquent taxpayers. The final section estimates the responsiveness of interest rates to differences in tax lien sale auction design. The dissertation contributes to the literature because it is the first to describe cross-state variation in four important delinquent tax collection policies; penalties, interest fees, tax lien sales, and tax foreclosure. The dissertation is the first to estimate the responsiveness of taxpayers to differences in penalties, interest, and tax lien sales. The dissertation is the first to estimate the responsiveness of interest rate differences in tax lien sale auction design. Property tax delinquency, the untimely payment of property taxes, is administratively and financially costly for local governments. Local governments cut services or raise taxes when property tax delinquency is high. Delinquent property tax bills require notification and monitoring. Penalties, interest fees, and tax lien sale policies set many decades in the past do not adequately cover costs for local governments. Estimating the responsiveness of taxpayers to penalties, interest fees, and tax lien sales is an important first step in designing policies which adequately cover property tax delinquency costs for local governments. Thu, 13 Dec 2012 06:00:00 GMT http://hdl.handle.net/10027/9507 2012-12-13T06:00:00Z