HEALTH, AGING AND SOCIO-ECONOMIC CONDITIONS IN MEXICO

We investigate the long-term effect of childhood and adult socio-economic conditions on the health of the elderly in Mexico. We utilize a panel of individuals aged 50 and above from the Mexican Health and Aging Survey to examine whether the transition from good health in 2001 to good health in 2003 is affected by the conisions under which the individual lived at the age of 10, accounting for education and income. We find that socio-economic conditions affect the health of the elderly in Mexico. Individuals with higher levels of income and from higher childhood socio-economic backgrounds are more likely to remain in good health, conditional on their health in 2001. Our paper contributes to the literature of the long-term effects of socio-economic status by considering the case of the elderly in a developing country.

Composite Dissolving Microneedles for Coordinated Control of Antigen and Adjuvant Delivery Kinetics in Transcutaneous Vaccination

Transcutaneous administration has the potential to improve therapeutics delivery, providing an approach that is safer and more convenient than traditional alternatives, while offering the opportunity for improved therapeutic efficacy through sustained/controlled drug release. To this end, a microneedle materials platform is demonstrated for rapid implantation of controlled-release polymer depots into the cutaneous tissue. Arrays of microneedles composed of drug-loaded poly(lactide-co-glycolide) (PLGA) microparticles or solid PLGA tips are prepared with a supporting and rapidly water-soluble poly(acrylic acid) (PAA) matrix. Upon application of microneedle patches to the skin of mice, the microneedles perforate the stratum corneum and epidermis. Penetration of the outer skin layers is followed by rapid dissolution of the PAA binder on contact with the interstitial fluid of the epidermis, implanting the microparticles or solid polymer microneedles in the tissue, which are retained following patch removal. These polymer depots remain in the skin for weeks following application and sustain the release of encapsulated cargos for systemic delivery. To show the utility of this approach the ability of these composite microneedle arrays to deliver a subunit vaccine formulation is demonstrated. In comparison to traditional needle-based vaccination, microneedle delivery gives improved cellular immunity and equivalent generation of serum antibodies, suggesting the potential of this approach for vaccine delivery. However, the flexibility of this system should allow for improved therapeutic delivery in a variety of diverse contexts.Massachusetts Institute of Technology. Ragon Institute of MGH, MIT and HarvardNational Institutes of Health (U.S.) (Award AI095109)United States. Army Research Office (Contract W911NF-07-D-0004

Essays on Health Economics

This dissertation consists of three essays on health economics. The first chapter provides empirical evidence on the impacts of government reimbursement of long-term care. We apply a regression discontinuity design using administrative data from South Korea to estimate the impact of subsidies for formal home and institutional care on informal care use and medical expenditures. We find that reimbursement leads to increases in formal long-term care utilization, even accounting for crowd out of private spending. Among individuals who are partially dependent for some activities of daily living (ADLs), we find that increased use of formal home care has no impact on the use of informal care at the extensive margin or on medical expenses. Among individuals who are partially dependent for several ADLs, we find that increased use of institutional care leads to reductions in informal care and medical expenses. Among individuals who are completely dependent for several ADLs, we find that substitution of home care for institutional care leads to substantial decreases in medical spending. The second chapter studies state laws passed in the late 1990s that required health insurers to cover diabetes related equipment, supplies, and education. We assess the impact of these mandates on health related behavior and labor market outcomes. We find no significant effects for diabetics or groups with higher prevalence of diabetes in terms of exercise, diet, income, or employment. These results are robust to different specifications and datasets. The third chapter provides empirical evidence on both outcomes and potential mechanisms resulting from information obtained from screening. We apply a regression discontinuity design using administrative data from South Korea to estimate the impact of different classifications of overall health that vary discontinuously with blood sugar level. We find that secondary examinations due to a "disease suspected" classification leads to follow-up rates greater than 50%. However, we find few impacts otherwise, including short and medium run medical activity and longer run health outcomes. We also find that the responsiveness to the classifications among the highest income quintiles is lower than among the other quintiles, consistent with more educated individuals incorporating information directly from the blood sugar measure itself

Health, aging and childhood socio-economic conditions in Mexico

We investigate the long-term effect of childhood socio-economic conditions on the health of the elderly in Mexico. We utilize a panel of individuals aged 50 and above from the Mexican Health and Aging Survey and find that the conditions under which the individual lived at the age of 10 affect health in old age, even accounting for education and income. This paper contributes to the literature of the long-term effects of childhood socio-economic status by being the first, to our knowledge, to consider exclusively the case of the elderly in a developing country.Health Aging Mexico