Author ORCID Identifier

https://orcid.org/0009-0005-3810-3720

Semester

Spring

Date of Graduation

2024

Document Type

Dissertation

Degree Type

PhD

College

Chambers College of Business and Economics

Department

Economics

Committee Chair

Daniel Grossman

Committee Member

Jane Ruseski

Committee Member

Alicia Plemmons

Committee Member

Heather Stephens

Abstract

In the first chapter I identify the impact of fentanyl exposure misinformation- namely, the erroneous belief that momentary, passive contact with the potent opioid fentanyl can be seriously harmful- on first responder behavior during overdose events, and on overall opioid-related mortality. I examine changes in opioid-related mortality following one particularly well-covered episode involving an Ohio police officer in 2017, wherein the officer appeared to experience an acute opioid overdose after touching what was believed to be fentanyl. Employing a synthetic differences-in-differences identification strategy, I find areas with greater media exposure to this misinformation exhibit marked increases in opioid overdose deaths; as well as preliminary evidence to suggest that overdose interventions performed by first responders were less effective and argue that this represents an increased hesitancy to render aid due to the potential presence of fentanyl. These results point to the existence of a heretofore unrecognized driving factor behind the current opioid epidemic, as well as to the need for policy intervention to counteract further dissemination of such adverse misinformation.
The second chapter builds on these initial findings from the preceding chapter and
principally examines the effects of misinformation on the actions of first responders in responding to opioid overdoses in New York State. By utilizing data that distinguishes naloxone administrations across law enforcement officers, emergency medical services, and community opioid overdose programs groups, I examine the relative change in first responder behavior by type following a well-covered media event credited with popularizing the erroneous belief that momentary contact with the opioid fentanyl is lethal. I find evidence to suggest that law enforcement officer resuscitations using naloxone following this event decreased significantly in frequency, and argue that this represents an increased
hesitancy to render aid due to unfounded fears of fentanyl exposure. These results highlight the potential adverse effects that misinformation pose to public health outcomes, and offer an alternative perspective to understand previous empirical research which has shown inconsistent results regarding the effectiveness of harm reduction policies. In the third chapter I employ microdata from the Census Bureau’s experimental Household Pulse Survey to examine Medicaid participation impacts on the COVID-19 vaccination decision and find that program recipients exhibited lower proclivities to be vaccinated relative to demographically-similar households insured through some alternative provider. Additionally, I observe that administrative burden, measured by state-level easements in the program enrollment process, is associated with significant declines in self-reported vaccination hesitancy. These results suggest the psychic and time costs accompanying the enrollment or benefits utilization processes may be negatively influencing other health behaviors, and highlight the significant policy implications of loosening Medicaid enrollment protocols on public health outcomes.

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