Full Citation
Title: Essays on Wellbeing Disparities in the United States and Their Social Determinants
Citation Type: Dissertation/Thesis
Publication Year: 2024
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Abstract: This dissertation studies the social determinants of health and economic wellbeing in the United States and how they contribute to observed outcome disparities. Chapter 1 investigates the Great Migration of millions of Black Americans out of the South during the mid-20th century and how it impacted Southern racial inequality. The results provide novel empirical evidence for how this seminal event in U.S. history impacted the South, finding improvements for Black workers and reductions in the racial wage gap. Chapter 2 turns to a modern context and explores how social connections can help overcome barriers to public program take-up, which tends to be well below full enrollment. When states expanded eligibility rules for Medicaid—the low-income public health insurance program— many previously eligible individuals became enrolled. I find this effect was partially driven by learning from friends. Focusing on Medicaid-eligible people living in non-expansion states, those with more friends in states expanding Medicaid became more likely to enroll after the expansions, even though eligibility had not changed for themselves. The results show program experiences among one’s friends can improve their own program participation and highlight how policy changes can have indirect, geographically distant impacts propagated through social networks. Finally, Chapter 3 looks forward to project how current socioeconomic disparities in health and economic wellbeing will translate to disparities in future outcomes. Using a dynamic microsimulation model to forecast healthy life expectancy and expected economic resources among Americans nearing retirement age, we find significant disparities between economic status groups in expected future outcomes. These gradients have widened over time; inequality within the middle of the economic distribution grew between 1994 and 2018, in addition to expanding differences between the most and least advantaged.
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Authors: Chapel, Jack
Institution: University of Southern California
Department: Economics
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Pages: 1-240
Data Collections: IPUMS USA, IPUMS USA - Ancestry Full Count Data, IPUMS NHGIS
Topics: Labor Force and Occupational Structure, Poverty and Welfare, Race and Ethnicity
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