Exploring Health in Military Families: Does Continuity of Care Influence Patient Satisfaction?

To ensure mission-readiness for military members, support for their families is essential. Military family health and health care satisfaction has been a neglected area of study in this population. Satisfaction can be defined in terms of patient-, provider-, and practice-level factors and is influenced by continuity of care, which is often poor in transient military populations. Using a modified patient satisfaction survey, this study found that both the number of moves and assigned providers were significantly associated with continuity of care in military spouses. Further, continuity of care was a significant predictor of satisfaction with military health care.

THE PRICE SENSITIVITY OF DEMAND FOR HIGHER EDUCATION AMONG NON-TRADITIONAL STUDENTS

This dissertation examines the price sensitivity of demand for higher education among non-traditional students in the United States. Chapter 1 discusses the issues related to the demand for higher education. It presents the recent trends and reviews the literature addressing these issues. A major conclusion that emerges from this chapter is that the price sensitivity of demand for higher education appears to depend on the source of the variation in price and the characteristics of the students who face the price change. The baseline estimate for the price sensitivity of demand is that a $1,000 (in year 2000 dollars) decrease in tuition costs should result in a 4 percentage-point increase in enrollment for the traditional 18- to 24-year-old student. Chapter 2 examines the price sensitivity of demand for higher education for military spouses resulting from variation in tuition due to military-mandated moves across states. The data suggest that a $1,000 (in year 2000 dollars) decrease in the cost of 2-year schools is associated with a 1--1.5 percentage-point increase in the probability of attending college. This estimate is less than half the previous estimates due to in-state tuition price differences faced by the civilian 18- to 24-year-old population on a percentage-point basis. However, this represents a 7--10 percent increase for this population, and the magnitude of this metric is in line with previous estimates. This suggests tuition assistance can be an effective means of increasing enrollment for military spouses, but other barriers to education for this population may also need to be addressed. Chapter 3 examines the impact of a change in the tax treatment of savings set aside for higher education by those who decide to suspend their education and enter the workforce. The taxation of these funds appears to have increased the rate at which these funds are included in an employee's initial contract and the quantity of funds allocated. These results are counterintuitive if the tax preference was the primary reason for the savings plan. However, these results suggest the rationale for the savings plan was to offer targeted additional compensation to recruits with greater negotiating power. Taxation of funds previously set aside did not appear to have a statistically significant impact on their utilization. Point estimates of the price sensitivity of demand from changes in the out-of-pocket costs for higher education induced by the taxation of these funds were small and often not statistically significant. The results from this dissertation show responses to changes in the net cost of college that differ by the source of price variation and the population experiencing them. This is consistent with the previous literature. This dissertation contributes to the literature by providing estimates for the price sensitivity of demand for higher education to previously understudied non-traditional students.

Gospel Music Training, Performance Practice and Its Impact on Leadership Development and Performed Nationalism in a Collegiate Military Choir

Since America’s beginnings as a British colony, its musical standards have adhered to those of Western Europe. For this reason, musical forms native to America like Black folk spirituals and Gospel music have historically been marginalized in favor of music in the Western classical tradition. Today, a bias towards music of the Western classical tradition exists in those American universities that grant music degrees. While this bias is understandable, inclusion of Gospel music history and performance practice would result in a more complete understanding of American music and its impact on American nationalism. The United States Naval Academy is one of the few American universities that have consistently elevated the performance of Gospel music to the level of Western Classical music within its institutional culture. The motivations for writing this document are to provide a brief history of Gospel music in the United States and of choral music at the Naval Academy. These historical accounts serve as lenses though which the intersection of Gospel music performance practice and leadership development at the United States Naval Academy may be observed. During the last two decades of the twentieth century, Gospel music intersected American military culture at the U.S. Naval Academy. After a few student-led attempts in the 1970s, a Gospel Choir was formed in 1986 but by 1990, it had become an official part of the Music Department. Ultimately, it received institutional support and today, the Gospel Choir is one of three touring choirs authorized to represent the Academy in an official capacity. This document discusses the promotion of Gospel music by the Naval Academy in its efforts to diversify Academy culture and ultimately, Naval and Marine Corps leadership. Finally, this dissertation examines the addition of performed cultural expression (Gospel music) in light of a shift in American nationalism and discusses its impact on Naval Academy culture.

Crises and Crisis Generations: International Conflict and Military Participation in Politics

Why do states facing high levels of international threat sometimes have militaries that are heavily involved in politics and at other times relatively apolitical, professional militaries? I argue that the answer to this puzzle lies in a state's history of 'acute' international crises rather than its 'chronic' threat environment. Major international crises lead to professionalization and de-politicization of militaries in both the short- and long-term. International crises underscore the need for the military to defend the state and highlight military deficiencies in this regard. Accordingly, major international crises lead to military professionalization and withdrawal from politics in order to increase military effectiveness. This effect persists years, and decades, later due to generational shifts in the officer corps. As the "Crisis Generation" of officers become generals, they bring with them a preference for professionalization and de-politicization. They guide the military towards abstention from politics. I test this theory using a new global dataset on military officers in national governing bodies from 1964-2008 and find strong support for the theory. Major international crises lead to two waves of military withdrawal from government, years apart. Further statistical analysis finds that this effect is most strongly felt in the non-security areas of governing, while in some cases, international crises may lead to militaries increasing their involvement in security policy-making. Further, international crises that end poorly for a state — i.e., defeats or stalemates — are found to drive more rapid waves of military withdrawal from government. The statistical analysis is supported by a case illustration of civil-military relations in the People's Republic of China, which demonstrates that the crisis of the Korean War (1950-53) led to two waves of military professionalization and de-politicization, decades apart. The first occurred immediately after the war. The second wave, occurring in the 1980s, involved wholesale military withdrawal from governing bodies, which was made possible by the ascent of the "Crisis Generation" of officers in the military, who had served as junior officers in the Korean War, decades prior.