Electronic Theses and Dissertations

Date

2019

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Economics

Committee Chair

Joonhyung Lee

Committee Member

William Smith,

Committee Member

Albert Okunade

Committee Member

Jamin Speer

Abstract

My dissertation consists of two essays in applied Microeconomics. I study the main determinants of Diabetes and breast cancer. My first essay is on diabetes, it assesses racial differences and the impact of health care coverage in self-Care management and quality of care for 9,805 diabetes patients in Texas. Using a multiple logistic regression model, I find that Hispanics with diabetes in Texas are still struggling to improve their self-management and gain access to quality care compared to Black and White non-Hispanics. For instance, 41.4% of Hispanics fail to perform daily foot care compared to 34.2% of White non-Hispanic and 25% of Black non-Hispanics. Furthermore, Hispanics are less likely to have a provider checking their AIC (OR: 0.54, 95%, CI, .45-.63) and Black (OR: 0.87, CI 0.67-1.12) compared to Whites. My results also indicate that having health care coverage and taking a diabetes self-management class significantly improves self-management and considerably reduces the race disparity. On my second essay, I take advantage of this 20-year cohort study of cancer survival data in Texas to study the main factors that can explain why some breast cancer patients live longer than others. Using a survival analysis which consists of performing a log-rank test, a survival time regression and a Cox proportional hazards regression, and dividing the data in groups based on the survival time then running a multinomial logistic regression, my results suggest that stage at diagnostic is the most important drivers of breast cancer survival, in fact, compared to stage1 survivors, survivors with stage IV are more likely to die with a hazard ratio of (14.02). I also find that being diagnosed with advanced grade will lead to short survival time. Furthermore, there are some racial disparities in survival time. Finally, I find that most of the disparities in terms of stage, grade, age, race and income occur in the first five years of survival. Those two essays lead to some policy recommendations such as facilitating access to quality of care for minorities in case of diabetes and promoting early breast cancer screening and diagnostic in vulnerable communities.

Comments

Data is provided by the student.

Library Comment

Dissertation or thesis originally submitted to ProQuest

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