Attila Cseh, PhD

During this time period, I earned the following awards and recognitions:

* 2017-2019 Rea and Lillian Steele Summer Grant

* 2018 Faculty Scholarship (VSU)

Authors: Cseh, A. and T. M. Komarek, 2017. The United States (US) began to experience a boom in natural gas production in the 2000s due to the advent of hydraulic fracturing (fracking) and horizontal drilling technology. While the natural gas boom affected many people through lower energy prices, the strongest effects were concentrated in smaller communities where the fracking occurred. We analyze one potential cost to communities where fracking takes place: an increase of sexually transmitted diseases. We use a quasi-natural experiment within the Marcellus shale region plus panel data estimation techniques to quantify the impact of fracking activity on local gonorrhea incidences. We found fracking activity to be associated with an increase in gonorrhea. Our findings may be useful to public health officials. To make informed decisions about resource extraction, policy makers as well as regulators and communities need to be informed of all the benefits as well as the costs.

Authors: Cseh, A., B. C. Koford, and R. T. Phelps, 2015. Objective: The Affordable Care Act is currently in the roll-out phase. To gauge the likely implications of the national policy we analyze how the Massachusetts Health Care Reform Act impacted various hospitalization outcomes in each of the 25 major diagnostic categories (MDC). Methods: We utilize a difference-in-difference approach to identify the impact of the Massachusetts reform on insurance coverage and patient outcomes. This identification is achieved using six years of data from the Nationwide Inpatient Sample from the Healthcare Cost and Utilization Project. We report MDC-specific estimates of the impact of the reform on insurance coverage and type as well as length of stay, number of diagnoses, and number of procedures. Results: The requirement of universal insurance coverage increased the probability of being covered by insurance. This increase was in part a result of an increase in the probability of being covered by Medicaid. The percentage of admissions covered by private insurance fell. The number of diagnoses rose as a result of the law in the vast majority of diagnostic categories. Our results related to length of stay suggest that looking at aggregate results hides a wealth of information. The most disparate outcomes were pregnancy related. The length of stay for new-born babies and neonates rose dramatically. In aggregate, this increase serves to mute decreases across other diagnoses. Also, the number of procedures fell within the MDCs for pregnancy and child birth and that for new-born babies and neonates. Conclusions: The Massachusetts Health Care Reform appears to have been effective at increasing insurance take-up rates. These increases may have come at the cost of lower private insurance coverage. The number of diagnoses per admission was increased by the policy across nearly all MDCs. Understanding the changes in length of stay as a result of the Massachusetts reform, and perhaps the Affordable Care Act, requires MDC-specific analysis. It appears that the most important distinction to make is to differentiate care related to new-born babies and neonates from that related to other diagnostic categories.

Authors: Koford, B. C. and A. Cseh, 2015. We examine the effect of depressive symptoms on the labor market outcomes of older Americans using the Health and Retirement Study (HRS). We take advantage of the longitudinal nature of the HRS from 1994 to 2008 and employ panel data methods to control for time-invariant, individual unobserved heterogeneity. Models that do not take into account individual heterogeneity show that depressive symptoms significantly reduce wages for males and females. In contrast, models that explicitly take into account individual heterogeneity through fixed effect estimation show no economic or statistically significant reduction in wages for those with depressive symptoms.