Three Essays On The Economics Of Health Behaviors And Outcomes PDF Download

In recent years the `farm to table' trend, the idea of understanding linkages between agricultural supply, food systems, and the food that is consumed, has been growing in popularity. This dissertation takes this idea a step further and examines topics on the progression from `farm to health outcomes.' It is important to recognize not only that food systems impact the way consumers eat, but that those food choices impact health outcomes and the way that medical care is consumed. The three essays of this dissertation examine three separate points along this continuum to improve the understanding of how food systems, food choice, health outcomes, and healthcare consumption interact. The first essay evaluates factors associated with school districts' decisions to participate in farm to school (FTS) programs. I leverage the USDA's Farm to School Census to analyze factors associated with FTS participation, the types of FTS activities implemented, and the challenges faced by participating school districts. I use spatially articulate data to estimate the spatial spillover effects of FTS participation. The results demonstrate that both school characteristics and local farm production factors are associated with FTS participation. The estimated spatial spillover effect is positive, suggesting that areas with a high penetration of FTS activities have lower barriers associated with implementing FTS programs. In my second essay, I shift to evaluating how parent-child pairs make the daily school lunch decision. Meals served in the National School Lunch Program (NSLP) are on average more healthful than alternatives, implying that increasing participation in the NSLP can improve nutrition for a large number of children. However, there is little understanding of the household decision process that determines participation in the NSLP. This study uses a parent-child choice experiment to assess the impact of both parent and child on NSLP participation. The results show that both have a significant impact on the chosen meal, where parents are concerned with meal palatability and nutrition, while the child only cares about palatability. The decision is also influenced by the household structure and demographics, and the inclusion of local foods in the school lunch option. My final essay evaluates how access to medical care can impact lifestyle choices. I evaluate if there is an ex ante moral hazard effect in health insurance markets. Ex ante moral hazard occurs when an individual takes on more risk knowing they will not bear the full cost of the consequences. In the case of health insurance, this could mean taking on unhealthful eating habits knowing that if these habits lead to illness the cost of care will be covered by insurance. Using panel data from the National Longitudinal Youth Survey 1997, I find evidence of an ex ante moral hazard effect in BMI, binge drinking, and smoking, suggesting that people take on less healthful behaviors, holding all else constant, when they have health insurance. The existence of ex ante moral hazard suggests that insurance companies can seek efficiency gains by finding ways to structure policies that diminish this moral hazard effect.