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Policy Analysis and Management (PAM) Theses

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Undergraduate Honors Theses in the Department of Policy Analysis and Management (PAM)in the College of Human Ecology.

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    The disparities in the Changes in Health Care Usage During the COVID-19 Pandemic
    Lopez May, Martina (2021-05-07)
    Health disparities have long been reported in healthcare research. Whether it is health outcomes, comorbidity rates, or healthcare access, minority race and low income patients consistently have less access and worse health. This paper looks at if the trends in healthcare access have persisted during the COVID-19 pandemic by measuring the change in patient healthcare use between 2019 (pre-pandemic) and 2020 (during the pandemic). Symphony Health data was used to study over two million patients nationwide from May to November of both years. Their interactions with healthcare were counted. Changes in patient visits across income, location and gender were studied. Women displayed a smaller change in visits compared to men in both cohorts. Also, the change in visits was seen to decrease as income increased in the COIVD population. The most notable trend that the data showed was that Black patients specifically, showed a dramatic difference between COVID and the general population cohorts. Two regressions were run, and Black patients showed a net decrease in visits if they were in the general population, but a large increase if they were in the COVID cohort relative to their equivalent white counterparts. This is consistent with the previously noted pattern of Black patients receiving lower quality and quantity of care until the patient is in dire need of extensive healthcare. Policy recommendations include increasing bias training in healthcare settings and increasing access to populations who were lacking it during the pandemic due to practices shutting down.
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    Tell Me More: Release of the 2014 IPCC AR5 Synthesis Report and Climate Change Opinions in the United States
    Fallk, Murray (2020-06-03)
    Climate change is a consequential and urgent issue. Now more than ever, there is a strong global scientific consensus on the occurrence of climate change and its human causes, as demonstrated in the Intergovernmental Panel on Climate Change’s (IPCC) most recent assessment report—the 2014 AR5 Synthesis Report. Understanding public opinion on this issue is essential due to the public’s ability to set the policy agenda and establish policymakers’ goals. Using repeated cross-sectional survey data from 2011 to 2017 from the Yale Program on Climate Change Communications’ “Climate Change in the American Mind” study, the objective of this paper is to examine the influence of the 2014 IPCC AR5 Synthesis Report on public belief in the occurrence and cause of climate change in the United States. Conducting a series of linear probability models (LPMs), this paper finds no significant change in the public’s belief that climate change is happening and human activities are mostly to blame directly stemming from the Synthesis Report’s release. However, this analysis confirms and builds upon prior literature and polling data revealing growing partisan differences in climate change beliefs. Despite the growing partisan divide on climate change opinions, this analysis does find a significant, increasing shift in opinion toward the scientific consensus. This paper concludes that, while the direct influence of the AR5 Synthesis Report on public opinion is not statistically significant, the Report is likely one of many factors contributing to the public’s growing belief in climate change and its anthropogenic influences.
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    The impact of Medicare-funded GME on physician training, the healthcare workforce, and hospital quality
    Brace, Hailey (2019-05-30)
    Medicare is the largest single program providing explicit support for graduate medical education (GME) in the United States, funding about 20% of all direct medical education (DGME) costs. However, Medicare also enforces a time-invariant, hospital-specific cap on the number of residents it supports per year. Despite the enormous public investment in graduate medical education, previous research has not addressed how Medicare’s DGME funding caps affect the number of residents per hospital, the general healthcare workforce, or healthcare quality. Exploiting a policy stipulation from the Affordable Care and Patient Protection Act, this paper examines the effect of Medicare-funded DGME on 1) the supply of medical residents, physicians, and physician assistants at the county level and 2) the quality of healthcare provision at the hospital level. The results suggest that an increased DGME funding cap is correlated with an increase in the county-level number of residents, but with a two-year lag from the date of the cap increase. The number of primary care residents is significantly higher beginning three years after the initial cap increase, and the number of nurse practitioners shows a significant increase four years after the cap is raised. Within the first five years after a cap increase, no significant change was detected in the county-level supply of physicians. No significant change in quality was detected at the hospital level.
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    A Tale of Cane and Corn: Evaluating Compliance Opportunities for Brazilian Sugarcane Ethanol under a Low Carbon Fuel Standard (LCFS)
    Marcel Adamkiewicz, Patrcik (2018-05-09)
    It is the purpose of this paper to investigate the potential for Low Carbon Fuel Standard (LCFS) compliance to be achieved using Brazilian Sugarcane ethanol. This was first done finding the true effects of the policy in California to date and then by modelling abatement costs and feasibility under various scenario assumptions. Since its implementation in California, it was found the policy has incentivized relatively higher Sugarcane ethanol blends (5.4% higher relative to the control) and increased E85 infrastructure to the point where E15-E20 blends could be possible in the near future. The model which this paper proposes then found that if E15 blending is possible by 2020, full compliance could be achieved via Sugarcane ethanol blending at a relatively low compliance cost ($112/TonCO2), with only minor improvements in Biodiesel blends and credit banking necessary. If the state is still constrained by the E10 blend wall in 2020, compliance will be more difficult, requiring additional investments in other low-CI fuels as well as B15-B20 Biodiesel blends. Compliance in 2030 will be costlier, and, even at E20 blending, would still require increased credit banking from other low-CI fuels as well as higher Biodiesel blends (B30) and an LCFS credit price of at least $202/TonCO2. The marginal abatement costs of Sugarcane ethanol blending, are, however, highly subject to RFS RIN pricing, as well as CARBOB prices and average Carbon Intensity values for Sugarcane ethanol.
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    MISSING THE MARK: AN EVALUATION OF THE FEDERAL TRADE COMMISSION’S RED FLAG INITIATIVE AS A LONG-TERM SOLUTION TO DECEPTIVE WEIGHT LOSS PRODUCT ADVERTISING
    Schein, Mara (2018-05-07)
    This study examines the efficacy of the Federal Trade Commission’s Red Flag initiative (2003), which aimed to curb the prevalence of seven deceptive (“Red Flag”) claims in over-the-counter weight loss product advertising. The principal component of this effort was the Commission’s promotion of voluntary guidelines which encouraged media outlets to screen advertisements for the seven Red Flag claims prior to publication. By analyzing the content of all English-language advertisement airings appearing in nationally circulated print magazines or any (local or national) TV programs between 2010 and 2011, this study evaluates the success of the Red Flag initiative as a long-term regulatory solution to deceptive advertising in this market. This study finds that the Federal Trade Commission’s Red Flag initiative, which essentially relied on industry self-regulation, failed to halt the dissemination of the seven Red Flag claims during the time period analyzed. Moreover, in response to the Commission’s actions, manufacturers appear to have engaged in offsetting behaviors and employed other creative content to imply the same “deceptive” information in their advertising, allowing them to avoid scrutiny while continuing to mislead consumers. The study explores both individual consumer and market consequences of the findings as well as raises policy implications for future regulatory action.
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    Immigration Enforcement and Crime: Evidence from the 287(g) and Secure Communities Programs
    Jackson, Rebecca (2018-05-04)
    The primary question of this analysis is whether policies that create a streamlined deportation process for unauthorized immigrant offenders decrease crime rates. Using the policy variations of Section 287(g) of the Immigration and Nationality Act and the Secure Communities program, I estimate the effect of immigration policy enforcement on crime rates using a difference-in-difference strategy. The results are congruent with previous immigration enforcement literature estimating that neither program had a meaningful effect on crime rates. While there is no strong evidence pointing to negative effects of the programs on crime, certain specifications and subsamples analyzed in this paper show that the 287(g) program may be associated with an increase in crime. I suggest that this effect may be driven by changes in crime detection and recommend replication with more precise crime and victimization data to strengthen the estimates and provide evidence for understanding the mechanisms through which these programs operate.