Three Essays in Health Economics: Evidence from U.S. Policies

Abstract

In the United States, food security and nutrition have become public health priorities for both children and adults, as many families lack adequate nutrition or reliable access to food. Additionally, for infants it is argued by medical professionals that breastfeeding is the best source of nutrition, and yet breastfeeding rates in the U.S. remain low. In this dissertation I use rigorous empirical methodologies to examine the health and behavioral consequences of two policies that have been widely implemented in recent years in response to these public health concerns. In the first chapter, I analyze the effects of a rollout of state policies requiring hospitals to promote breastfeeding and find that they significantly increased breastfeeding initiation and duration, with the largest effects for low-educated mothers. Following state law adoption there is also a significant reduction in maternal smoking during the postpartum period, and a substantial reallocation of maternal time, with mothers spending more time caring for the infant, more time on unpaid domestic work, and less time on formal work. In the second and third chapters, I analyze a novel program that provides children with universal access to free meals at school, known as the Community Eligibility Provision (CEP). I find that household spending on grocery purchases decreases after children gain access to free school meals, but that overall diet quality also decreases. Evidence that previously eligible households experience large effects on grocery spending, combined with evidence of large reductions in food insecurity from CEP, suggest that application and stigma costs may have prevented already-eligible households from participating in the national school lunch program prior to the adoption of CEP. In the final chapter, I show evidence that access to CEP decreased food insecurity and resulted in improved health for teens. In particular, I find that high school students go to the doctor less, have fewer incidences of asthma, are more likely to get eight or more hours of sleep, and report improved mental health following the increased access to meals at school.