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Medicaid and Supplemental Nutrition Assistance Program (SNAP) are two large-scale safety net programs in the U.S. that provide public assistance to the low-income population. Over the years both programs have undergone several policy changes and have evolved to cover more needy individuals. This three-paper dissertation is a culmination of three research studies, two of which examine the effect of the Affordable Care Act’s (ACA) Medicaid expansion on outcomes of realized access to dental care i.e., dental visits and out-of-pocket dental care spending, respectively, while the third paper explores the relationship between SNAP participation and dental visits (realized access), and between SNAP participation and unmet dental care need due to cost (perceived access)., The few studies that have examined the impact of the Medicaid expansion on dental visits utilization have shown somewhat mixed findings and are mostly limited to examining early impacts (1-2 years post-expansion). Thus, Study I of this dissertation examined the longer-term impacts of states’ Medicaid expansions on dental visits utilization, by their adult dental benefits coverage level. Restricted data from the Medical Expenditure Panel Survey (MEPS) for the years 2011 through 2017 were obtained; the sample included adults aged 21-64 years with income up to 138% of Federal Poverty Level. A quasi-experimental Difference-In-Difference (DID) study design was used to examine the overall and year-by-year impacts of the Medicaid expansion on annual dental visits based on a states’ adult dental benefits coverage level (i.e., extensive, limited, and emergency-only/no benefits). Overall, expansion states, compared to non-expansion states, saw a 3-6 percentage point increase in annual dental visits in the post-expansion period (2014-2017), relative to the pre-expansion period (2011-2013). Year-by-year examinations revealed that the Medicaid expansion was associated with a significant increase in the likelihood of an annual dental visit among low-income adults in states with extensive benefits in 2014 (nearly 5 percentage points), and in states with limited and emergency-only/no dental benefits in both 2014 (6 percentage points for both) and 2016 (4 and 5 percentage points, respectively)., Expanding Medicaid also has the potential to reduce out-of-pocket dental care spending among low-income adults gaining coverage through Medicaid, especially among states that provide comprehensive adult dental benefits. Thus, Study II of this dissertation examined the impact of states’ Medicaid expansion on out-of-pocket dental care spending among low-income adults residing in states that provided extensive adult dental benefits. A DID study design with a two-part (hurdle) modeling approach was utilized to analyze post-expansion year-by-year changes in: a) the probability of incurring any out-of-pocket dental spending, and b) the amount of out-of-pocket spending (conditional on any spending) between expansion states with extensive benefits and non-expansion states. Overall, a greater proportion of adults in expansion states with extensive dental benefits (58%) reported zero dollars in out-of-pocket dental care spending, compared to those in non-expansion states (31%). Our DID analysis found that, compared to non-expansion states, adults residing in states that provided extensive adult dental benefits and expanded Medicaid were significantly less likely to incur any out-of-pocket dental spending in the first two years of implementing the expansion (2014 and 2015)., There is growing interest in examining SNAP’s spillover impacts on improving healthcare access and outcomes, postulated to be due to SNAP’s ability to reduce food-insecurity thereby potentially freeing up some financial and cognitive resources to seek care. Thus, Study 3 of this dissertation examined the association between participation in SNAP and realized and perceived access to dental care among low-income adults. A sample of SNAP income-eligible adults aged 19-64 was created by pooling MEPS data for the years 2011 to 2017. Applying a propensity score method to control for important differences in characteristics between participants and eligible non-participants, and using a Doubly-Robust approach, multivariable logistic regressions modelling the impact of SNAP participation on annual dental visits and unmet dental care need due to cost were performed. Interestingly, we found that SNAP participants, compared to eligible non-participants, have significantly lower odds of having an annual dental visit (approximately 20%) and significantly greater odds of reporting unmet dental care need due to cost (approximately 40%)., In conclusion, the results of the three studies in this dissertation provide some important insights into the dental care access impacts of the ACA’s Medicaid expansion and provide foundational evidence on the relationship between participation in the Supplemental Nutrition Assistance Program and dental care access among low-income adults. Results from Study I are suggestive of a positive link between the expansion of Medicaid and increased dental visits. However, longer-term impacts were less consistent and varied based on states’ adult dental coverage level thereby warranting further research. Study II results are encouraging and show that providing comprehensive dental benefits in Medicaid adult dental programs is protective against incurring any out-of-pocket expense for those who utilize dental care, with the potential to benefit more low-income individuals when these states expand Medicaid eligibility. Lastly, Study III results show that SNAP participation is associated with lower dental visits utilization and greater unmet dental care need due to cost. While we postulate that this may be due to several reasons, such as, SNAP benefits not being enough to offset non-food costs, and perhaps, the most disadvantaged of all SNAP-eligible families who tend to have fewer resources being more likely to enroll in the program, further research is needed to fully investigate and understand the underlying causal mechanisms through which these associations operate.

This dissertation focuses on strategies that entrepreneurs use to start and grow a startup. The first chapter studies the link between entrepreneurial programs and types of founders. Specifically, it studies the return for entrepreneurs who participated in accelerator programs that require founders to give up equity to participate in the program compared to founders that graduated from accelerators that do not require equity. The second chapter qualifies the textual structure of ICOs’ white papers using natural language processing (NLP) following a methodology introduced by Toubia et al., (2021). The chapter focuses on the relationship between speed, volume, and circuitousness and the success of ICOs., In Chapter 1, I exploit data on startups that graduated from accelerators that are heterogeneous in equity design. I study the dilemma of going big or staying small that has been challenging entrepreneurs to wisely decide whether to trade equity in exchange for capital investment and have a more valuable equity share or retain a majority equity stake and look for noteworthy opportunities in later stages. The major heterogeneity among accelerators that I focus on is equity investment and early-stage seed funding. Using matched sample analysis, I provide evidence that although participating in an equity-investment accelerator has beneficial effects on the post-accelerator performance of portfolio companies to reach the next round of fundraising faster, they raise less capital in 12-month, 18-month, and 24-month time horizons after graduation in comparison to graduates of equity-free accelerators. In fact, I find that founders with more years of corporate experience and higher-quality business ideas tend to shorten the path to success by participating in equity-investment accelerators. On the other hand, consistent with Hallen et al. (2020) who believe that a learning mechanism is the primary cause of accelerator effects on venture development, I find that, while ventures are heterogeneous and they learn at different rates and different depths, some entrepreneurs have already learned what to do, and it is accelerator equity design and seed investment that negatively impacts acceleration and slows down venture growth., Chapter 2 exploits the content of white papers that are published by Initial Coin Offering (ICO) campaigns. We study information exchanged between ICOs and investors via disclosed information in 2149 ICO white papers. We employ natural language processing (NLP) to quantify the structure of white papers and demonstrate their contribution to the success of ICOs. Following the content analysis procedure by Toubia et al. (2021), we elicit information from ICO textual sources by calculating three measures namely, speed, volume, and circuitousness. Our findings show that ICO projects with a well-written white paper that disclose risk and routinely return to previously discussed topics (i.e., circuitousness) are likely to raise more funds. Consistent with this, white papers that cover more ground (i.e., volume) contribute positively to the successful outcomes of ICO fundraising campaigns. In contrast, white papers that transit quickly between topics (i.e., speed) are less likely to have a positive impact.

My dissertation recovers the abolitionist might of the first nursing narrative of the U.S. Civil War, Louisa May Alcott’s Hospital Sketches (1863), which was published as a series of letters in Boston’s Commonwealth newspaper (1862-1896) in summer 1863 before its collection in a volume published by journalist James Redpath in fall 1863. As I uncover the abolitionist context of the original Sketches, I employ Alcott’s letters, the most enduring literary work to emerge from the pages of the Commonwealth, as an opportunity to examine the paper’s first year. Using practices of periodicals studies, I scrutinize the conditions and context in which the paper was produced in order to assess its goals, methods, and audience. I apply the same methods in my assessment of Hospital Sketches, tracing the reception of the letters in press reviews. I examine the founding of the Commonwealth in September 1862 just before the announcement of the Preliminary Emancipation Proclamation on September 22 and discuss its principled editors Moncure D. Conway and Franklin B. Sanborn along with its funder George Luther Stearns. Exploring their connection to John Brown’s militant abolitionism in the 1850s, I consider the paper’s aim to transform the war to preserve the union into a conflict against slavery after July 1862’s Second Confiscation Act and the Militia Act suggested the possibility. Additionally, I probe the way the Commonwealth initially defined itself as fully engaged in wartime political strategy, positioning itself against Boston’s powerhouse abolitionist newspaper and another Stearns-funded venture, The Liberator., Treating Alcott’s contributions during the weekly’s first year as a body of work that deserves comprehensive evaluation, I discuss her January 1863 short story “M.L.” alongside her series “Letters from the Mountains” and poem “Busy Bessie, At Her Spinning Wheel,” both published in fall 1863, noting Alcott’s use of the picturesque and travel sketches in her Commonwealth publications. I then discuss Hospital Sketches as it appeared in the weekly and in its collected edition, arguing that the two chapters Alcott added for the august compilation encourage an appraisal of the text as an abolitionist travel sketch. Finally, I track the development of the Sketches during the 1860s, concluding with their illustration by Alcott’s friend Elizabeth Greene in 1869’s Hospital Sketches and Camp and Fireside Stories., My dissertation shows Alcott exercising her literary dexterity by adapting Hospital Sketches for different audiences when she found success as a professional writer. In examining the Commonwealth, I also depict the context in which readers originally encountered her hospital drama and trace responses to it through press reviews and advertisements. By tying Hospital Sketches to the paper’s abolitionism, I not only investigate the use of literature to accelerate social reforms, but I also situate literary output as a primary strategy of the mid-war abolitionist effort. In addition to being aesthetically pleasing, literature could be deployed rhetorically to imagine reconstructive possibility as the promise of the Emancipation Proclamation flourished.

This dissertation focuses on developing solution approaches for logistics and transportation problems in disaster management and humanitarian applications motivated by real-world applications. We focus on developing improved preparedness and response methods for two kinds of humanitarian applications and evaluating these methods with real-world data., First, we have developed approaches for storing and distributing fuel to reduce the impact of disasters on islands. While most disaster-related studies focus on the mainland, this research fills this gap by providing distribution models appropriate for islands. After a disaster on an island, there is often an increased demand for fuel because islands often do not have refineries, and it could take several weeks for ships to arrive with more fuel. This study proposes a two-tier optimization approach to, first, determine how to allocate, preposition, and distribute fuel to the different regions (Chapter 1). Tier 1 focuses on the first few days after a disaster when there is no fuel available to the island other than what existed prior to the disaster. The results highlight the importance of establishing new locations with lower risk to preposition fuel. Next, we investigate how to strategically use ships to supplement the fuel after a disaster (Chapter 2). Tier 2 evaluates the strategic use of ships to reduce the arrival time of the shipments from outside sources. These results highlight the importance of using standby ships for fuel distribution., Second, we have studied how to identify the best roads and bridges in a road transportation network to strengthen to enable travel from population centers to healthcare facilities (HFCs) after a flood event (Chapter 3). Floods can deteriorate and block transport systems, leading to loss of access to HFCs. To mitigate these consequences, it is crucial to determine how changes to transportation infrastructure, such as road improvements, can improve access to emergency service facilities. The objective of this research, which addresses a pre-disaster planning problem to improve the residents accessibility to HCFs, is to minimize their travel times subject to budget and capacity restrictions. This work requires the use of geographic information systems (GIS) tools. Accordingly, we have used ArcGIS software to capture spatial data, analyze mapped data, visually display geographical data, and demonstrate solutions. We develop techniques for reducing the problem size on large road networks., In our study of two cities in Iowa, we demonstrate that the roads that are consistently selected for being upgraded are mostly the residential roads that guarantee accessibility within residential areas, even if they are far from HCFs. While a substantial number of papers in the literature define the available budget levels as the total number of upgradeable roads, our results revealed the flaw in those methods by showing that upgrading more miles of roads does not always yield a larger number of roads.

The Midwest region of the United States is one of the most heavily modified regions on earth. Because of this, obtaining regional conservation goals and creating sustainable use of natural resources is extremely challenging. In order to sustainably manage these natural resources, there needs to be an understanding of the social-ecological systems in which they reside. Various actors within social-ecological systems can impact natural resources through various activities and actions. Examining how these actors work within the different governance structures and the policy mechanisms they utilize is key to creating sustainable systems. However, creating these sustainable systems can be additionally difficult in areas where there is little public land and most of the property resides in private ownership. This dissertation works to advance our knowledge of conservation in highly fragmented regions by investigating governance, private land conservation, and access to natural resources in the US Midwest.The first study aims to examine conservation stakeholders’ views of working within polycentric governance systems to understand the informal interactions of protecting natural resources. This study uses 23 semi-structured interviews with those that work on conservation within the Iowa Great Lakes region, then analyzes their responses within McGinnis and Ostrom (2014)’s SES-Framework. The results indicate that there are a variety of environmental pressures impacting these Lakes. This study also highlights the difficulty of mitigating environmental pressures when the governance system relies heavily on voluntary conservation measures. Participants provide a variety of solutions to these issues that center around changes in policy to help mitigate these pressures. This study adds to our understanding of polycentric governance by providing empirical research of understudied SES-framework variables. The second research study adds to our knowledge of private land conservation by analyzing the use of conservation easements in the US Midwest. Using geospatial analysis, this study examines the relationship between socioeconomic variables and conservation easements at the county level. Afterward, we examine the attributes of the conservation easements themselves to understand the social and environmental characteristics of these areas at the state and county level. Lastly, we identify the land cover within the conservation easement boundaries as well as their surrounding landscape. The results indicates that there are no strong relationships between socio-economic variables and conservation easements at the county level. The characteristics of conservation easements found that, in some cases, the social and environmental attributes can be contradictory. This study highlights the need for further investigation of conservation easements as a mechanism for protecting private land. The third study expands our understanding of how conservationists view and manage access. Participants from the study in Chapter 2 answer questions concerning access to the Iowa Great Lakes as well as in their own projects. We categorize their responses within Ribot and Peluso (2003) mechanisms of access to better interpret the results. The results demonstrate that access is a multifaceted concept and that participants hold differing views of similar situations concerning access. Additionally, most of the participants state that there are barriers to accessing the Iowa Great Lakes. However, the participants are split when discussing management in their own projects, due to many of them working on private land conservation. This research also pinpoints areas to improve the management of access in the Iowa Great Lakes and elsewhere. These three papers contribute to our understanding of governance, policy, and access to natural resources in highly fragmented regions to create more sustainable systems in areas like the US Midwest.