Essays in Health Economics

Author: Guth, Daniel Robert

Year: 2023

Degree: Dissertation (Ph.D.)

Advisor: Rosenthal, Jean-Laurent

Committee Members: Alvarez, R. Michael; Rosenthal, Jean-Laurent; Shum, Matthew S.; Xin, Yi; Xu, Benjamin Y.

Option: Social Science

DOI: 10.7907/xz1z-zw28

Abstract

This thesis consists of three health economics papers, two studying the effectiveness of policy interventions on the opioid epidemic, and one on the effects of air pollution on school absences. The first two chapters were coauthored with Shiyu Zhang, a former Caltech graduate student.

The first chapter examines the market for prescription opioids following the OxyContin Reformulation, an event that made OxyContin harder to misuse. Using detailed prescription opioid sales data from 2006 to 2014, we show that event did not reduce overdose deaths but led individuals to switch to generic oxycodone as a substitute for OxyContin.

The second chapter examines geographic spillover effects from state prescription drug monitoring programs (PDMPs). We show that these policies reduce prescription opioid sales and opioid overdose deaths in the state they are enacted in. However, because they only track opioids sold locally, these programs induce individuals to drive across state lines to purchase opioids and avoid these regulations.

The final chapter examines the effects of air pollution on NYC school absences using daily changes in wind direction. I show that PM2.5 and Ozone concentrations are strongly influenced by wind patterns, and exposure to these two pollutants causes detectable increases in absences over the following two days. Reductions in PM2.5 pollution over time have prevented approximately 381,000 absences annually in NYC which increases school funding by $19 million.

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