UC Berkeley

Chronic conditions contribute to vast sums of excess morbidity, mortality, and healthcare expenditures. Many leading risk factors for chronic conditions are related to behavior, including poor nutrition, alcohol misuse, and tobacco use. Literature from psychology, neuroscience, and behavioral economics suggests that aspects of the environment can encourage unhealthy behaviors. This dissertation uses natural experiments and new combinations of administrative data to explore the role of retail availability in the consumption of unhealthy foods, alcohol, and tobacco and health outcomes and service utilization for chronic conditions. The first paper assesses whether or not adults with diabetes residing in “food swamps” have higher rates of hospitalizations for complications. The second paper focuses on the privatization of liquor sales that occurred in Washington in 2012, investigating if the increase in liquor availability that followed privatization impacted hospitalizations for acute and chronic alcohol-related disorders and accidental injuries. The third paper analyzes the impact of CVS Health’s 2014 tobacco-free pharmacy policy on cigarette smoking among current smokers. Findings from these papers provide additional insight into to how governmental and organizational policies may be used to better prevent and manage chronic conditions.