Dissertation: Policy and the Life Course
I focused my dissertation work on Medicaid policy, health inequities, and late life health and care needs. Because Medicaid is means-tested, this program offers a unique policy to explore the interconnected consequences of socioeconomic status, health, and other forms of marginalization in late life.
My first chapter, “Experiences Gaining Access to Medicaid in Older Adulthood: A North Carolina Case Study”, is a qualitative study, exploring how older adults become eligible for and apply for Medicaid. I conduct qualitative interviews with caregivers of older adults in long-term care (LTC) setting, as well as staff, to describe this process. I develop several hypotheses that I then test with a large dataset, the Health and Retirement Survey (HRS). In this chapter, “Life Course Predictors of Medicaid Enrollment”, I assess sociodemographic and health-related predictors of Medicaid enrollment after age 50. In the final chapter, “Transitions, Deficit Accumulation, and Medicaid’s Role at the End of Life”, I use restricted data from the HRS to study when transitions in care setting and insurance status occur. I determine how long adults over 65 can expect to live in various care states and degrees of frailty before they die.