Essays on Health Economics



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The dissertation consists of two applied health economics studies on early childhood environment and the short- and long-term health outcomes. The first study uses detailed birth registries and health insurance claims records from Taiwan to examine the effects of exposure to adverse events while in utero on pregnancy outcomes. My coauthors and I study the impact of the 1999 Taiwan earthquake on fetal mortality and pregnancy outcomes. We compare the pregnancy outcomes of women who resided in areas with high earthquake intensity (i.e., higher on the Seismic scale) to those who resided in areas with low earthquake intensity, and compare pregnancies that were exposed to the earthquake to those pregnancies that were not exposed to the earthquake. Our results suggest that the incidence of fetal mortality increases by 4.4 and 3.2 percent for those who have in utero exposure to the earthquake in the most earthquake-affected regions during the first and second trimesters, respectively. We find that almost all of the losses that occur during first-trimester exposure are due to the loss of male fetuses.

The second study explores the relationship between early childhood environment and mental health later in life. I examine the impact on psychological well-being later in life of poor intrauterine environment caused by severe typhoons that took place in Taiwan. By exploiting time and regional variation, I compare the mental health of individuals who were exposed to severe typhoons while in utero in landfall counties to those who had no fetal exposure to severe typhoons. I find that the likelihood of mental disorders in adulthood resulting from fetal exposure to severe typhoons increased by 11. Exposed individuals are also more likely to use psychiatric drugs and have more psychiatric-related healthcare utilization. The effects are most prominent for women. My results suggest that natural disasters could have adverse impacts beyond infant health and adult physical health.



Early childhood, Health, Fetal origins, Natural disasters