In view of the economic and social transcendence of a region's labour market on its competitiveness, the quality of life of its citizens, its economic evolution or its level of resilience to external shocks and fluctuations, this thesis focuses on analysing the employment situation of those groups that traditionally had greater impediments when it comes to take part of the labour force: immigrants and women. Two lines of work have been established for the development of the thesis. The first one (Chapters 2 and 3) examines commuting patterns based on individual data, exploring the differential behaviour which is observed according to the immigrant status, on the one hand, and gender, on the other. Analysing the commuting patterns of both groups is relevant for understanding their employment situation as it reflects individual decisions and behaviour in the residential and labour spheres and is a good indicator of the likely existence of a spatial mismatch between labour supply and demand. Both analysis are based on a rich, nationally representative database and incorporate the use of econometric techniques of decomposition that are new in this field of study, and that allow quantifying the joint and individual influence of a wide range of explanatory factors. In this sense, Chapter 2 focuses on the differences in commuting length between native and immigrant employees in Spain, a relevant issue since immigrants' longer commuting times may reflect an imperfect spatial matching of their labour supply and demand with negative implications for their relative labour outcomes and their individual well-being. The research differentiates immigrants according to their origin. The evidence obtained shows that, although a relevant part of the explanation of the greater commuting observed for immigrants is related to observed elements such as a different use of modes of transport, they make overall significantly longer journeys when comparing with observationally similar natives. This commuting penalty occurs yet only in the case of immigrants from emerging countries, as it does not exist for those from advanced economies. Although the penalty is overall rather similar along several sociodemographic and occupational lines, it is much more pronounced for individuals living in large municipalities, which implies that previous analyses focusing on specific densely populated territories could overestimate the phenomenon. To conclude, the additional novel evidence about the potential explanations of the commuting penalty of immigrants shows that it does not seem to derive from a hypothetically greater tolerance to commuting. Chapter 3 examines gender differences in commuting in Spain, a relevant issue since women's shorter commuting times partially explain their poorer work outcomes. The analysis considers the importance of the level of education workers have. The evidence obtained indicates that although the shorter commuting times of women are partially explained by factors such as their greater household responsibilities, there is a systematic pattern of less mobility that persists when women are compared with men with the same characteristics. This pattern is consistent with the theoretical hypothesis that there are cultural or social constraints that restrict women's commuting and worsen their job opportunities. This circumstance is also consistent with the findings that there is no pattern of lesser mobility for certain groups of women whose behaviour is in general more assimilable to that of men, such as women without family responsibilities, and that the origin of the gender differences in commuting is not women's lesser tolerance for this phenomenon. The second line of work (Chapter 4) focuses on women and analyses the impact of the characteristics of the Labour Market Area of residence on their participation and employment rates in Spain. In view of the importance of regional attributes on individual employability, this analysis has made it possible to identify which regional factors favour or impede the good performance of women in the labour market. In this case, the territorial unit of analysis is the Spanish LMAs, areas which reflect the regional mobility of workers and which are coherent when analysing labour market phenomena. The use of these territorial areas has allowed an ad hoc recoding of the microdata from the 2011 Population and Housing Census, so that it is possible to know the Labour Market Area of residence of each of the individuals in the sample. Thanks to this database, average variables of the individual behaviour recorded in the census microdata for each of the LMAs have been calculated for the first time for Spain. This type of variable reflects the average characteristics of the composition of each market, allowing for a better measurement of the phenomenon. In addition, spatial econometric methods are used to detect possible spatial relationships between markets derived from the presence of spatial autocorrelation. These techniques allow us to determine the influence of the characteristics of the LMA on female participation and employment rates, as well as the effect of the characteristics of neighbouring markets. The evidence obtained shows the presence of notable territorial differences in the distribution of female participation and employment rates. When considering these spatial autocorrelation patterns in the models, a spatial distance matrix of 50 kilometres has been considered. The econometric results show that female participation rates follow a process of spatial autocorrelation in the residuals that may derive from the economic/regulatory situation influenced by belonging to the same Autonomous Community, and from social/cultural factors shared by the closest LMAs. Likewise, participation rates are positively influenced by certain internal characteristics of a market, especially the presence of the service sector and the proportion of women with a higher average level of education, and by the disturbance term of neighbouring regions. The employment rate, on the other hand, presents a process of local spatial dependence in which both the characteristics of a market and the characteristics and shocks derived from neighbouring markets are considered relevant. These results show, as in the case of participation, the existence of territorial relations between the closest markets that go beyond the strictly labour-related ones and that may derive from economic or legislative aspects. Among the explanatory regional characteristics considered to favour female employment are the higher proportion of women with a high level of education, the higher percentage of women employed in services and the higher average income level. To check the effect of the spatial relationships of Madrid LMA with its closest LMAs, the analysis has been complemented by extending the distance matrix to 67 kilometres. In line with the previous analysis, the results confirm the existence of a pattern of local spatial autocorrelation in the distribution of the female participation rate. Alternatively, the spatial pattern observed in female employment rates becomes localized in the endogenous variable. This global pattern is characterized by the chain transmission of spatial relationships from neighbours to neighbours. These results reveal that the importance in economic and employment terms of the Madrid LMA prevails over the other markets, and the importance of using territorial units appropriate to the object of study. Thus, previous analyses carried out in this field, based on territorial units that were probably too large on average, may have overestimated the spatial effect associated with the phenomena analysed. / Financiada por la Agencia Estatal de Investigación (Ministerio de Ciencia e Innovación, Gobierno de España) y el Fondo Social Europeo (FSE): Ayudas para contratos predoctorales para la formación de doctores, Subprograma Estatal de Formación del Programa Estatal de Promoción del Talento y su Empleabilidad en I+D+i, Plan Estatal de I+D+i 2017-2020 (ayuda PRE2018-085908). Con el apoyo de los proyectos CSO2017-86474-R (AEI, Plan Estatal de I+D+i), PID2020-114896RB-I00 (AEI/10.13039/501100011033, Plan Estatal de I+D+i) y AICO/2021/062 (Conselleria de Innovación, Universidades, Ciencia y Sociedad Digital; Programa de I+D+I de la Comunitat Valenciana).

Significant efforts have been undertaken in medicine to identify hospital and primary care service areas (eg, the Dartmouth Atlas of Health Care) using patient origin information. Similar research in dentistry is nonexistent. The goal of this dissertation was to develop and refine methods of defining dentist service areas (DSAs) using dental insurance claims. These service areas were then used as spatial units of analysis in studies that examined relationships between utilization of oral health services, dentist workforce supply, and service area characteristics. Enrollment and claims data were obtained from the Iowa Medicaid program for children and adolescents ages 3-18 years during calendar years 2008 through 2010. The first study described rates of treatment by orthodontists in children ages 6-18 years. Orthodontic DSAs were identified by small area analysis in order to examine regional variability in utilization. The overall rate of utilization was approximately 3%; 19 DSAs were delineated. Interestingly, children living in small towns and rural areas were significantly more likely to have received orthodontic services than those living in metropolitan and micropolitan areas. The second study identified 113 DSAs using claims submitted by primary care dentists (ie, general and pediatric dentists). Characteristics of these primary care DSAs were then compared with counties. Localization of care was used as a measure of how well each region approximated a dental market area. Approximately 59% of care received by Medicaid-enrolled children took place within their assigned service area versus 52% of care within their county of residence. Hierarchical logistic regression was used in the final study to examine the influence of spatial accessibility and the importance of place on the receipt of preventive dental visits among Medicaid-enrolled children. Children living in urban areas were more likely to have received a visit than those living in more rural areas. Spatial accessibility assessed using measures of dentist workforce supply and travel cost did not appear to be a major barrier to care in this population. More studies are needed to explore the importance of spatial accessibility and other geographic barriers on access to oral health services. The methods used in this dissertation to identify service areas can be applied to other populations and offer an appropriate method for examining revealed patient preferences for oral health care.