Three Essays in Health Economics

In Chapter 1, we use low birth weight (LBW) and intrauterine growth restriction (IUGR) as proxies for a compromised intrauterine environment experienced by one generation, and examine its association with the LBW (or IUGR) status of the next generation. We create two three- generational samples using Taiwan birth certificates from 1978-2006 to study both maternal and paternal transmissions. The results show that the intergenerational transmission only occurs matrilineally and it is stronger among female offspring. We find weak evidence that females, but not males, born to areas with lower unemployment rate, higher average income, and higher parental education can be buffered from these effects.Chapter 2 uses the most recent vaccine scare in the U.S., the Measles-Mumps-Rubella (MMR)-autism controversy, to investigate how well-educated people respond to information differently when information is mixed. The controversy was first provoked by a paper linking autism to the childhood vaccine of MMR and was retracted years later due to scientific misconduct. We combine state-level information exposures with individual vaccination records from the National Immunization Survey, 1998-2011. Results show that the persistent increase in MMR non-uptake rate is driven by biased beliefs among well-educated mothers, which in turn leads to strong responses to only new information that confirms their beliefs. We find evidence that online search has a more influential impact on the high education group than mainstream media. Chapter 3 investigates the association between published hospital report card information and hospital relative attractiveness to commercial HMO insurers for CABG surgery in Pennsylvania during report card episodes 2006-2010. Relative bargaining position between hospitals and insurers are measured using aggregated changes in individual willingness-to-pay for a particular plan if a hospital is included in its network. Plan\u27s hospital networks are implied using PHC4 inpatient discharge data. Our results suggest that high charge hospitals in the most recent report card episode are 53.4% less attractive to insurers and low charge hospitals are 76.1% more attractive to insurers, given the plan\u27s network. Based on our calculation, low charge hospitals in the most recent report card episode are 20.5% more likely to have a new HMO contract

Parental Determinants of Islamophobic Attitudes in Offspring

There is empirical evidence that parents are a primary context influencing the development of prejudice in their children. This research extends that body of work to identify specific ways parents socialize prejudice towards the Muslim community. The current study thereby provides an original contribution by identifying important parenting processes that increase Islamophobic attitudes in offspring. Baumrind’s parenting styles framework and Rohner’s theory of Parental Acceptance-Rejection provided the theoretical foundation for the study. Participants were recruited using Amazon Mechanical Turk and data was collected via a Qualtrics survey. The sample consisted of 302 late adolescents (18-25) residing in the United States. 151 participants answered questions on maternal parenting and 151 participants answered questions on paternal parenting. Findings demonstrate that parental rejection, authoritarian parenting, and parental anti-Muslim discourse by both mothers and fathers impact offspring Islamophobia. Findings also indicate that some of that influence is explained through the increased aggression that results from rejection and authoritarian parenting. In addition, the current study employed a principal components analysis in order to assess the latent structure of Islamophobia as a construct and to further clarify the nature of the Islamophobia construct. The results highlight the central role of parenting in the development of prejudice and suggest important avenues for future research and intervention

Exploring Community Reentry After Incarceration with Recently Released American Indian/Alaska Native Persons

American Indian/Alaska Native (AI/AN) persons comprise 1.7% of the population in the United States (U.S.), 1.1% of the population in the state of Wisconsin (WI), and represent immense diversity with over 566 federally recognized Sovereign Nations. Despite their relatively small numbers, AI/AN persons suffer a wide variety of extreme biopsychosocial disparities. In Wisconsin, this includes the highest incarceration rate of any ethnic group. Building upon a community partnership, the project examined the areas of challenge and support for AI/AN persons in Wisconsin who sought reintegration into an urban community after incarceration. Via the Extended Case Method, the project explored the applicability of Danieli’s Trauma and the Continuity of Self: A Multidimensional, Multidisciplinary Integrative (TCMI) Framework, through the lenses of Historical Trauma (HT) and persistence. Participants presented with significant health and social disparities, consistent with the HT literature. Although there is little literature on the AI/AN experience of incarceration and reentry, the participants shared may stories of challenge that mirror those of other racial populations who do have an extant body of research in this area. However, the findings revealed more collectivist, less individually-focused, experiences that included emphases on family, community, and their tribal nations. These findings exposed some gaps in the utility of Danieli’s TCMI framework to address experiences at the collectivist level for AI/AN persons reintegrating. The findings seem to support the assertion already made in the literature that the TCMI framework may not well accommodate an understanding of incarceration and reintegration experiences among AI/AN groups. Recommendations to the partner agency, limitations, and implications for future research are described

Validation of the Portuguese version of the Community Assessment of Psychic Experiences and characterization of psychotic experiences in a Brazilian sample

Objective: We investigated: i) the reliability and validity of a Brazilian version of the Community Assessment of Psychic Experiences (CAPE), developed to detect and characterize psychotic experiences in the general population; and ii) the association between psychotic experiences, childhood adversity, and cannabis use in a population-based sample. Methods: We performed factorial analyses and generalized linear models with CAPE scores as the dependent variable in a sample composed of 217 first-episode psychosis patients, 104 unaffected biological siblings, and 319 non-psychotic population-based participants. Results: After removing seven items from its positive dimension and two items from its negative dimension, a 33-item Brazilian version of the CAPE showed acceptable adjustment indices (confirmatory fit index = 0.895; goodness of fit index = 0.822; parsimony goodness of fit index = 0.761; root mean square error of approximation [RMSEA] = 0.055, p [RMSEA p 0.05] = 0.04) and internal consistency in all its dimensions (4 0.70). Childhood adversity was associated with higher scores in all three dimensions, as well as with total score. Lifetime cannabis use was associated with higher scores only in the positive dimension. Conclusion: The proposed Brazilian version of the CAPE corroborates the tridimensional approach for assessing psychosis-proneness, and the frequency and severity of psychotic manifestations are distributed as a spectrum in the general population.FAPESP; CNPq; FC-Z; DLR; Fundação para a Ciência e a Tecnologia-FCT; FEDERinfo:eu-repo/semantics/publishedVersio

Effective Strategies for Teaching At-Risk African American Males: An Inservice Manual

The purpose of this project was to develop an inservice training manual to guide the delivery of teacher training sessions designed to implement effective teaching strategies for at-risk African American male students at Larchmont Elementary School, in the Tacoma, Washington school district