Suchergebnisse

In recent years, the government of Texas has enacted multiple restrictions and funding limitations on women's health organizations affiliated with the provision of abortion services. These policies have caused numerous clinic closures throughout the state, drastically reducing access to reproductive health care. We study the impact of these clinic closures on fertility rates by combining quarterly snapshots of health center addresses from a network of women's health centers with restricted geotagged data of all Texas birth certificates for 2008–2013. We calculate the driving distance to the nearest clinic for each ZIP-code and quarter, and find that an increase of 100 miles to the nearest clinic results in a 1.2 percent increase in the fertility rate. This increase is driven by a 2.4 percent increase in the fertility rate for unmarried women, while there is no statistically significant change for married women.

AbstractEnvironmental disasters can affect how individuals use healthcare services. We use the Flint water crisis to examine rates of avoidable emergency care, which is costly to both providers and patients, and office visits. In September 2015, the city of Flint issued a lead advisory to its residents, alerting them of increased lead levels in their drinking water, resulting from the switch in water source from Lake Huron to the Flint River. Using Medicaid claims for 2013 to 2016, we find that this advisory, which became national news, increased the share of enrollees who had lead tests performed by 1.7 percentage points. Additionally, it increased office visits immediately, and led to a reduction of 4.9 preventable, non‐emergent, and primary‐care‐treatable emergency room visits per 1,000 eligible children (8.3 percent). This decrease is present in shifts from emergency room visits to office visits across several common conditions. Our analysis suggests that children were more likely to receive care from the same clinic following lead tests and that establishing care reduced the likelihood parents would take their children to emergency rooms for conditions that would have been treatable in an office setting. Our results show that environmental disasters that induce health checkups can prompt individuals to change their type and venue of health care, particularly moving away from emergency departments and toward the office setting.