2023 Publications


Theories of Financial Hardship and Measures of the Construct in Health Datasets: Empirical Applications for Illinois and the Metro / Nonmetro Populations of the Nation

This paper shows how the construct “financial hardship” should be measured based on its role in the theory. Theories from economics, psychology, and sociology guided the search for existing measures of the construct in published databases such as the Medicare Beneficiary Survey. Results of data analysis show that perceptual measures of financial hardship such as the ones in the Medicare Beneficiary Survey lack content validity – the semantic correspondence of the measure with the construct’s definition is inadequate.

An Empirical Analysis of Financial Hardship Associated with Alzheimer’s Disease and Related Dementia: Metro and Nonmetro Patients

This paper explores financial hardships among ADRD patients using data from the National Health and Aging Trends Study. Results of data analysis indicate financial hardship among the non-Whites and the 75-84-year-old patients.

Burden of Health Care Costs for Persons with Alzheimer’s Disease and Related Dementia

What is the typical out-of-pocket spending on healthcare for individuals afflicted with Alzheimer’s Disease and Related Dementia? This paper addresses this and other related questions using microdata from the Health and Retirement Study. Results of data analysis indicate that the average out-of-pocket spending is around $2,383 per month and the patient’s social security income covers less than one half of this cost.

Exploring the Other Side of Alzheimer’s Disease and Related Dementia: Informal Caregivers

This paper investigates metro-nonmetro differences in caregiving for sufferers of Alzheimer’s Disease and Related Dementia. Based on the reasoning that caregiving is learned vicariously, for example, through observation, differences in both observer characteristics and external reinforcement were analyzed for both the geographies. Data are from National Health and Aging Trends Study. Data analysis suggests that a typical caregiver is a female age 50 and above with a high school education. On average, caregivers in the metro work for longer hours, 6hours per day in the metro compared to 4hours in the nonmetro.

Urban-Rural Differences in Mental Health Concerns: Findings from a Survey of the American General Population

This research provides stylized facts about mental health in the metro and the nonmetro and thus opens pathways for further research on the topic; survey data from the National Alliance on Mental Illness were used to gain insights into residents’ perceptions / knowledge about mental health.  Results of data analysis suggest that “mental healthcare” is a worrisome topic for more of the metro residents than the nonmetro ones.  Furthermore, increasing federal and state funding for mental health care is strongly supported by metro residents, but not so strongly by nonmetro residents.

Telemedicine and the Carbon Footprint of Healthcare: An Empirical Analysis of Illinois Counties

The US healthcare sector is a significant contributor to greenhouse gas generation and thus climate change. This study explores the role of telemedicine in reducing environmental emissions; Illinois counties are the geographical unit of analysis. Results of data analysis indicate that Illinoisans had 14.9mil telemedicine visits in 2021 and these visits resulted in carbon savings of approximately 70mil to 91mil kilograms.

Cost of Dementia in Illinois: Metro versus Nonmetro

This paper explores metro-nonmetro differences in the prevalence of Alzheimer’s dementia. Data analysis suggests that more nonmetro Illinoisans experience cognitive difficulties; dementia is less of a concern for metro residents, men, and for persons not enrolled in Medicare / Medicaid Programs; and Alzheimer’s dementia cost is estimated at $76.9billion.

Health Related Beliefs of Ethnic Groups: An Exploratory Analysis

This paper tests the proposition that one’s cognitive representations of health are related to one’s perceptions about happenings in the community. Microdata from a telephone survey of adults aged 18 and older informed the empirical analysis. Results show that ethnic minorities view illness as one’s loss of personal control; this implies that treatment must address the patient’s perceptions about interpersonal transgressions or misconduct.

Gender and Health in the Midwest, Metro versus Nonmetro: Insights from the National Health Interview Survey

Research suggests that men and women exhibit varied symptoms for the same disease, for example, stroke. Almost one-in-four Midwestern women in the metro and the nonmetro suffer from anxiety disorder. This paper explores the causal role of sex / gender in the association between anxiety medication and life satisfaction. Empirical analysis suggests that taking anxiety medication would lower one’s life satisfaction.

Patient Satisfaction with Rural Health Centers

This research uses microdata from a health center patient survey to explore patients’ service quality perceptions and satisfaction with health centers. Results of empirical analysis show that Black patients are more skeptical of health center service quality than other ethnicities.

Race Differences in Physicians’ Annual Incomes in Illinois: Metro versus Nonmetro

Race is a social construct.  Although the median wealth of a White family is 10 times the median wealth of a Black family, race should be less of a determinant of earnings, a proxy for wealth, in professional occupations such as physicians where demand for services outstrip supply by many folds.  This argument was empirically tested using microdata from the ACS, 2018 and 2021.  Results suggest that Illinois has a diverse healthcare workforce and demographics such as race and place of work do not impact physician earnings.

Climate and Mortality in Nonmetro Illinois: Retrospective Study, 1999-2021 and Projections of Mortality for 2030

Climatic predictions for the Illinois region are for extreme heat, heavy rainfall, and flashfloods, which suggest that heat-related illness and waterborne disease would be salient public-health concerns. Data analysis reveals that maximum temperatures in the nonmetro during 1999-2021 have increased at an annual compound growth rate of 0.32%. Specifically, of the 12,883 deaths that occurred during the summer months of 1999 to 2021, an estimated 5,926 to 6,828 of the deaths could be attributed to heat-related mortality. Ceteris paribus, heat-related mortality is expected to grow at an ACGR of 1.6% and reach 6,841 to 7,884 deaths by 2030.

Dental Care Use in the Midwest: Metro vs. Nonmetro

This research is about dental care use; motivations for care and likelihood of visiting a dentist or dental clinic are researched. The Midwest region was the geographical unit of analysis. Three sources of data were pooled to gain insights into user behavior, both for the metro and the nonmetro. Empirical analysis suggests that a larger proportion of minorities in the nonmetro delay dental care due to costs, 38% of the minorities compared to 5% of the Whites.

Worker Burnout in Healthcare: Metro vs. Non-Metro

This study shows that more than one-in-two healthcare workers, both in the metro and the non-metro, are burned out. Data are from the USA Today / Ipsos survey of healthcare workers, fielded during February 9-16, 2022. Demographics such as education and income do not correlate with burnout; in other words, one’s level of education and income are independent of being burned out on the job. Prevention strategies such as humanization of work schedules are recommended.

Health Policy for Rural Illinois, Data for Policy Development

This paper provides data for heath policy for rural Illinois; the state’s metropolitan data are provided for comparison purposes. The construct, “health policy”, is conceptualized to be a function of four factors: healthcare access, cost, quality, and equity; each facet, in turn, was measured using indicators derived from multiple data sources. Data analysis suggests that disparity in healthcare between the Whites and the minority population is more pronounced in the non-metro and is getting worse.

Health and Healthcare Disparities in Illinois, Metro vs. Nonmetro

This paper addresses the question, “What is the status of health and healthcare disparities in Illinois” using data from three sources: American Community Survey, 2017-2021; Health Cost & Utilization Project, 2018-2020, and Behavioral Risk Factor Surveillance System (BRFSS), 2021. Data analysis suggests that health disparities exist in Illinois – affordability, or the inability to pay the doctor, has prevented a majority of the Hispanics in the nonmetro from seeing a doctor in the past 12 months. The largest potential for improvement in minority health lies in behavioral risk factors, smoking and lack of exercise.

Physical Activity of Illinoisans in the Metro and the Nonmetro

This research shows that more nonmetro Illinoisans are physically inactive compared to their metro counterparts. Data analysis reveals that 80% of nonmetro residents are either overweight (Body-Mass Index more than 25, but less than 30) or obese (Body-Mass Index greater than or equal to 30). Logistic analysis of physical activity with various predictors suggests that daily intake of fruits contributes positively to the log odds of exercising.

Hospitals in Illinois that are Likely to Seek the Rural Emergency Hospital Designation: An Exploratory Analysis

The Rural Emergency Hospital designation offers current Critical Access Hospitals and rural Prospective Payment System hospitals with fewer than 50 beds to furnish emergency department and observation services. A principal component analysis of microdata from the CMS suggests that there are 13 potential REH members in Illinois, 10 in the nonmetro and three in the metro.