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Author ORCID Identifier



Open Access Dissertation

Document Type


Degree Name

Doctor of Philosophy (PhD)

Degree Program

Public Health

Year Degree Awarded


Month Degree Awarded


First Advisor

Kimberley Geissler

Second Advisor

Michael Begay

Third Advisor

Jing Qian

Subject Categories

Econometrics | Economics | Health Economics | Health Services Research | Public Health


The study period (i.e., 1999-2014) is characterized by declining labor force participation rates, rising disability enrollment, varying healthcare utilization, and increasing and changing composition of healthcare provider employment. However, little is known about the effect labor force participation and disability enrollment both have on the US healthcare system (i.e., healthcare utilization and employment). This dissertation is comprised of three manuscripts answering questions related to these relationships. Results show that labor force participation is a more robust indicator than the unemployment rate for exploring the effect of the labor market on healthcare spending and health outcomes, with healthcare spending itself exhibiting a unique relationship with healthcare provider employment. In addition, results show that rising disability enrollment is also related with healthcare provider employment with a unique effect for mental and physical disability enrollment. Last, results show that the effect of disability programs on healthcare utilization and access extends beyond those receiving benefits to also include those applying for benefits. Collectively, this research demonstrates relationships between declining labor force participation, rising disability enrollment, and healthcare utilization and employment. Study findings may be used to support healthcare utilization and employment projections.