A Quasi-Experimental Study of Medicaid Expansion and Urban Mortality in the American Northeast.
Front Public Health
; 9: 707907, 2021.
Article
in English
| MEDLINE | ID: covidwho-1775824
ABSTRACT
Objectives:
To investigate the association of state-level Medicaid expansion and non-elderly mortality rates from 1999 to 2018 in Northeastern urban settings.Methods:
This quasi-experimental study utilized a synthetic control method to assess the association of Medicaid expansion on non-elderly urban mortality rates [1999-2018]. Counties encompassing the largest cities in the Northeastern Megalopolis (Washington D.C., Baltimore, Philadelphia, New York City, and Boston) were selected as treatment units (n = 5 cities, 3,543,302 individuals in 2018). Cities in states without Medicaid expansion were utilized as control units (n = 17 cities, 12,713,768 individuals in 2018).Results:
Across all cities, there was a significant reduction in the neoplasm (Population-Adjusted Average Treatment Effect = -1.37 [95% CI -2.73, -0.42]) and all-cause (Population-Adjusted Average Treatment Effect = -2.57 [95%CI -8.46, -0.58]) mortality rate. Washington D.C. encountered the largest reductions in mortality (Average Treatment Effect on All-Cause Medical Mortality = -5.40 monthly deaths per 100,000 individuals [95% CI -12.50, -3.34], -18.84% [95% CI -43.64%, -11.67%] reduction, p = < 0.001; Average Treatment Effect on Neoplasm Mortality = -1.95 monthly deaths per 100,000 individuals [95% CI -3.04, -0.98], -21.88% [95% CI -34.10%, -10.99%] reduction, p = 0.002). Reductions in all-cause medical mortality and neoplasm mortality rates were similarly observed in other cities.Conclusion:
Significant reductions in urban mortality rates were associated with Medicaid expansion. Our study suggests that Medicaid expansion saved lives in the observed urban settings.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Urban Population
/
Mortality
/
Medicaid
Type of study:
Experimental Studies
/
Observational study
Limits:
Humans
/
Middle aged
Country/Region as subject:
North America
Language:
English
Journal:
Front Public Health
Year:
2021
Document Type:
Article
Affiliation country:
Fpubh.2021.707907
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