Date of Award

May 2018

Degree Type


Degree Name

Doctor of Philosophy (PhD)




Jeffrey D. Kubik


Lead, Public Health

Subject Categories

Social and Behavioral Sciences


This dissertation is comprised of three essays on health and public policy. My research examines how regulations and targeted programs impacted health outcomes.

The first two chapters use the unexpected shock of water borne lead in Flint Community Schools’ classrooms to estimate the causal impacts of lead on students’ cognitive and behavioral outcomes. The first paper focuses on the short-run academic achievement of elementary school children. At the average level of lead exposure, conservative estimates find that the share of students scoring proficient on statewide standardized exams drops by 6 to 9 points in math and drops by 12 to 14 points for reading. This represents an average of 3 to 5 students for a typical grade within a school. The second paper estimates the impact of lead exposure on student behavior. The analysis finds that during the Flint Water Crisis a typical grade within a school receives 8.6 additional disciplinary actions per year at the average level of lead exposure.

The third chapter focuses on the perennial topic of access to healthcare and health outcomes. Access in this case is measured by the supply of primary care physicians. The federal Health Professional Shortage Area initiative identifies underserved areas and makes them eligible for incentives to attract physicians. Using propensity score matching methods, an average 3 percent decline in mortality rates is found for areas that receive the designation.


Open Access