Health Issues Affecting Vulnerable Populations

This dissertation examines how public and nonprofit programs and policies influence the health and well-being of vulnerable populations using a mixed-methods approach. Chapter 1 evaluates the relationship between implementation of the Affordable Care Act in Colorado and important measures of health care access, health care utilization, and general health. The second chapter explores the complex web of health and economic challenges facing households that rely on public and nonprofit food assistance and the strategies they use to acquire and manage their supply of food. Chapter 3 focuses on how changes in the munificence of the Supplemental Nutritional Assistance Program benefits correlate with the level of food insecurity among low-income households and their use of nonprofit food pantries and soup kitchens. Study findings suggest that the extension of health insurance to low-income households previously unable to afford coverage and an increase in SNAP benefit levels above current levels are likely to improve access to health care and bolster the food security of many vulnerable households. Furthermore, the findings suggest that a reduction in the size and scope of public food assistance programs are likely to lead to an increase in the demand for nonprofit assistance. Given that many nonprofit programs are reliant on charitable donations, the quantity and quality of aid is subject to volatility, which could lead to a deterioration in health and well-being of many low-income households currently reliant on publicly-funded assistance.