Economics ETDs

Publication Date

Summer 7-14-2018


Rural communities in the United States and developing countries face a common problem of access. Lack of clean water or medical specialists can be solved by current technology, but there is a lack of resources and understanding of the problems. Rural communities in developing countries have a lack of access to clean water. Expansion of current water infrastructure and sanitation facilities could be done, but these are large costly projects. The lack of clean water, however, has dire negative effects on child mortality, household morbidity and overall household earning potential. In the United States, rural communities face a similar problem with access to a medical specialist. These specialists are in high demand and limited quantity, and a rural hospital does not have the required resources to justify the employment of said specialist. The lack of these specialists leads to higher overall medical costs and much worse patient health outcomes. This dissertation investigates the potential positive effect when these disparities are reduced or removed. We will use a combination of methods (instrumental variables, difference and difference, synthetic control, etc..) to look at how access to clean water can improve household wealth ware indicators. We will compare two different modeling approaches to determine the best methods for modeling cost and health outcomes from reducing access to care disparities for stroke patients. We find in all instances that a reduction in disparities leads to better outcomes for the individual, household, and community as a whole.

Degree Name


Level of Degree


Department Name

Department of Economics

First Committee Member (Chair)

Matías Fontenla

Second Committee Member

Kira Villa

Third Committee Member

David van der Goes

Fourth Committee Member

Jami Nunez




Health, Education, Water, Synthetic Control, Markov Model, Nicaragua, Telemedicine

Document Type


Included in

Economics Commons