Gao, Yitong
(2023)
Examining impacts of public policies on chronic non-cancer pain and mental health outcomes.
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
This is the latest version of this item.
Abstract
Chronic non-cancer pain and mental health conditions affect millions of adults. Both are leading causes of disease burden in the U.S. This dissertation examines the impacts of public policies on diagnosed chronic non-cancer pain and mental health outcomes among commercially insured adults.
Chapter one examines the impact of medical cannabis program implementation on diagnosed chronic non-cancer pain among commercially insured individuals ages 21-64 and Medicare Advantage enrollees ages 65 and older between January 1, 2011 – December 31, 2019. Results from stacked difference-in-differences regression models indicated that medical cannabis program implementation was not associated with any meaningful changes in diagnosed chronic non-cancer pain in either cohort. Future research should continue to investigate the impact of medical cannabis on chronic non-cancer pain outcomes.
Chapter two examines the impacts of medical and recreational cannabis dispensary openings on diagnosed suicidality, proportion of individuals with a mental health prescription, and average days covered with a mental health prescription. We included commercially insured individuals ages 21 years and older diagnosed with a mental health condition between January 1, 2011-December 31, 2020. Stacked difference-in-differences regression estimates indicated medical cannabis dispensary opening was associated with 1.1 (95% CI: [-1.9, -0.2] and 0.9 (95% CI: [-1.6, -0.1]) percentage-point reductions, on average, in the proportion of individuals with a mental health prescription and average days covered with a prescription. Future research is needed to understand the explanatory mechanisms of this observed association between medical cannabis access and mental health treatment.
The COVID-19 pandemic increased caregiving demands of families by restricting childcare. Women reported providing more childcare and greater stress related to COVID-19 disruptions than men. In chapter three, we conducted an interrupted time series study to examine whether suicidality trends differed by sex among commercially insured parents ages 26-64 years with a dependent child <5 years from January 1, 2016-September 30, 2021 before and after the onset of the pandemic. An additional 1,040 female parents were diagnosed with suicidality after March 2020, on average, compared with male parents before March 2020. Public health policymakers should consider increasing supports for parents, with a particular focus on sex differences in suicide risk.
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Details
| Item Type: |
University of Pittsburgh ETD
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| Status: |
Unpublished |
| Creators/Authors: |
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| ETD Committee: |
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| Date: |
15 May 2023 |
| Date Type: |
Publication |
| Defense Date: |
28 March 2023 |
| Approval Date: |
15 May 2023 |
| Submission Date: |
28 April 2023 |
| Access Restriction: |
2 year -- Restrict access to University of Pittsburgh for a period of 2 years. |
| Number of Pages: |
233 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Public Health > Health Policy & Management |
| Degree: |
PhD - Doctor of Philosophy |
| Thesis Type: |
Doctoral Dissertation |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
health policy, health services research |
| Date Deposited: |
15 May 2023 14:08 |
| Last Modified: |
15 May 2023 14:08 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/44870 |
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Examining impacts of public policies on chronic non-cancer pain and mental health outcomes. (deposited 15 May 2023 14:08)
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