Quality of Life in Rural Illinois: Housing and Access to Health Care

This dissertation focuses on two measures of rural quality of life in Illinois: housing values and health care access. Through estimating housing price trends, evaluating policy impacts on rural hospital structures, and valuing rural hospitals as local amenities, rural quality of life in Illinois can be better understood. Using sales transaction data from the Illinois Department of Revenue, the first essay compares the median and Case-Shiller housing price capabilities to measure housing price appreciation and depreciation in Illinois between 2000 and 2009. The Case-Shiller method captured the housing bubble in metro (excluding Chicago), micro and rural areas in Illinois. While rural areas in Illinois did not experience housing price fluctuations as large as Chicago, the Case-Shiller method corrects the assertion that rural America did not experience a housing bubble. The second essay details the changes in rural Illinois hospital structures resulting from the 1997 Balanced Budget Act and the 1999 Balanced Budget Recovery Act. These acts created a Critical Access Hospital certification aimed at slowing the rate of hospital closures across the United States. The results show that CAH certification appears to have aided in maintaining health care in rural areas. Using hedonic estimation, the third essay focuses on the impact of a CAH compared to that of a full-service hospital on housing values. This essay compares the effect of Crawford Memorial Hospital (a CAH) on Crawford county housing values to the effect of McDonough District Hospital on McDonough county housing values. Crawford is a rural county with a small Critical Access Hospital. McDonough is, according to USDA's Urban Influence Codes, considered a micro county. The results suggest that a Critical Access Hospital has similar effects on housing values as the full-service hospital. Therefore, the results of this paper support the hypothesis that preserving a Critical Access Hospital is as useful as preserving a full-service hospital, in terms of the benefits to the local housing values.