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A Multi-Method Analysis of the Role of Spatial Factors in Policy Analysis and Health Disparities Research

Rice, Ketra Lachell
http://rave.ohiolink.edu/etdc/view?acc_num=osu1365613669

Abstract Details

2013, Doctor of Philosophy, Ohio State University, Public Policy and Management.
The premise of this research rests on the idea that space has a significant influence on diet and health disparities and on the utilization of food assistance policies targeted towards minimizing those disparities. In the specific context of food deserts, this research integrates a multi-disciplinary conceptual approach and a multi-method approach to explore the relationships and interactions between people and spaces. The multi-disciplinary approach links spatial conceptual perspectives from rural sociology and health geography to provide the theoretical framework for the relevance of integrating space in policy analysis and diet and health disparities research. The multi-method approach provides a more comprehensive examination of diet and health disparities by allowing for the statistical testing of outcomes and the simulated exploration of policy interventions. This dissertation consists of a set of three interconnected essays. The first essay presents conceptual perspectives from a health geography and rural sociology lens and relates the perspectives to aggregate level participation rates for the Supplemental Nutrition Assistance Program (SNAP). Incorporating spatial econometric methods to measure county-level SNAP participation, the results from the analysis show variation in SNAP participation based on county characteristics. Understanding this geographic variation provides an opportunity to formulate SNAP policies and procedures which explicitly respond to and incorporate spatial differences across counties. The second essay expands the analysis of geographic variation by examining health outcomes at the individual-level in relationship to individual-level and county characteristics. This essay measures the consequences of lack of access to food by exploring the adverse health outcomes that can be attributed to the food environment. A hierarchical linear model is implemented and the results show that counties with a higher quality food environment predict higher levels of individual health status. The spatial disparity of the food environment on individual-level health outcomes coupled with the spatial disparity of SNAP participation suggested the need to further explore the complexity of the policy problem of diet and health disparities through an additional lens of simulation modeling. The third essay explores this using an agent-based simulation. I simulate a local food environment and observe changes in the environment as policy interventions are introduced. The results show that poor health status can persist in a poor food environment even with people-based interventions that increase low income consumers’ purchasing power. The place-based policy intervention that changed the environment subsequently changed consumption patterns and improved health outcomes. The understanding of spatial theory in policy context and the implementation of a multi-method approach for addressing the complexity of health disparities contributes to a perspective that the analysis of public policy and design of policy interventions requires a conceptual understanding of the spatial associations underlying the policies being investigated. Above all, this dissertation contributes to the body of knowledge of the complementarities of hierarchical linear modeling and agent-based modeling to examine the complexity of individual-level diet and health outcomes, and a recognition that geographic characteristics not only predict diet and health disparities but also predict the usage of assistance offered that seeks to minimize diet and health disparities.
Anand Desai (Advisor)
Rob Greenbaum (Committee Member)
Linda Lobao (Committee Member)
221 p.
Public Administration; Public Policy
Geography and Public Policy; Diet and Health Disparities; Food Deserts; Food Policy; Hierarchical Linear Modeling; Agent-Based Modeling

Recommended Citations

Citations

  • Rice, K. L. (2013). A Multi-Method Analysis of the Role of Spatial Factors in Policy Analysis and Health Disparities Research [Doctoral dissertation, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1365613669

    APA Style (7th edition)

  • Rice, Ketra. A Multi-Method Analysis of the Role of Spatial Factors in Policy Analysis and Health Disparities Research. 2013. Ohio State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1365613669.

    MLA Style (8th edition)

  • Rice, Ketra. "A Multi-Method Analysis of the Role of Spatial Factors in Policy Analysis and Health Disparities Research." Doctoral dissertation, Ohio State University, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=osu1365613669

    Chicago Manual of Style (17th edition)

osu1365613669
956
© 2013, all rights reserved.
This open access ETD is published by The Ohio State University and OhioLINK.