Associate Professor, Harvard Medical School
*Harvard PhD Program in Health Policy Alumnus & Faculty Member
Dissertation Title: "Hunt for the Right Counterfactual: Estimating Disparities in Minority Health Care"
The numerous studies of racial disparities in health services have not achieved consensus on the definition and method for measurement of disparities. In large part, the ambiguity in the definition of disparities stems from the lack of an observable counterfactual: In health services research, one cannot observe the counterfactual in which a black individual takes on white race or racial discrimination is eliminated. A similar situation occurs in studies of immigrant mental health. Exposure to the US has been found to be detrimental to mental health, but may be the result of differing immutable characteristics among immigrant cohorts. This dissertation applies and compares methods in non-linear models that adjust for some variables while allowing others to mediate differences. The methods are applied in Medicaid Managed Care and immigrant mental health settings. More rigorous comparison of different adjustment methods is conducted using total medical expenditure from MEPS data.