Essays on the Economics of Public Health

• Main Author: Ward, Courtney
• Other Authors: Benjamin, Dwayne
• Language: en_ca
• Published: 2012
• Subjects: influenza; immunization; air quality; respiratory health; 0510
• Online Access: http://hdl.handle.net/1807/33833

This dissertation considers the economics of public health in the context of respiratory disease, a leading cause of morbidity and mortality. The pervasive nature of respiratory illness represents a significant reduction to health and longevity, but private actions to prevent illness may not consider the full-scale benefit of societal health improvement. In this thesis, I consider two determinants of respiratory illness: (1) the spread of influenza disease and (2) air pollution. In both cases, public policy aims to attenuate the effects of these factors by incentivizing or mandating preventative action. Because such interventions come at a cost, it is important to consider the magnitude of benefits associated with these actions. I consider each determinant in turn. First, I provide causal evidence on the health and economic consequences of an ongoing broad-scope vaccination program. The Ontario Influenza Immunization Campaign expanded the scope of vaccine coverage leading to a 20-percent increase in vaccination. Using the timing of this campaign and exogenous variation in vaccine quality, I link higher vaccination rates to decreases in lost-work-time, hospitalization, and death. Results indicate that, when vaccine quality is high, the program leads to higher gains for Ontario relative to other provinces and in short, an ounce of prevention is worth a pound of cure. Second, I provide evidence of the impact of air pollution on respiratory health. Recent changes in standards for air pollution are highly contentious and represent stringent constraints on economic activity. Evidence from this dissertation directly informs this debate. By linking daily pollution to hospital admissions for municipalities across Ontario, I study the impact of air pollution at levels below those historically considered. Results indicate that particulate matter has a significant effect on respiratory health of children but that ozone and carbon monoxide have little effect on respiratory hospitalizations for all age groups.