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The impact of Medicaid expansion on the rural mortality penalty in the United States

医疗补助扩大对美国农村死亡率的影响

基本信息

批准号：
10726695
负责人：
Alexis R Santos-Lozada
金额：
$ 44.3万
依托单位：
PENNSYLVANIA STATE UNIVERSITY, THE
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-09-30 至 2025-09-29
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10726695
关键词：
Address Adopted Adoption Adult Age Aging Alcohol consumption Area COVID-19 COVID-19 mortality COVID-19 pandemic COVID-19 pandemic effects Cardiovascular system Categories Censuses Cessation of life Code County Data Death Records Demography Development Differential Mortality Disparity District of Columbia Elderly Eligibility Determination Ethnic Origin Exhibits Exploratory/Developmental Grant Geography Goals Health Insurance Health Policy Health Status Healthcare Income Insurance Coverage Link Longevity Low income Mathematics Measures Medicaid Mental Health Metabolic Methodology Methods Mortality Decline National Institute on Aging Outcome Pattern Persons Policies Population Principal Investigator Privacy Process Race Records Reduce health disparities Research Research Design Role Rural Scientist Shapes Standardization Statistical Models Techniques Testing Training United States United States National Center for Health Statistics Urbanization Variant Vital Statistics Work access restrictions aged deprivation design disability expectation experience federal policy health care availability innovation insight interest mortality mortality disparity mortality statistics novel population health residence rural area rural counties sex sex disparity socioeconomics trend urban area urban disparity

项目摘要

Project Summary Rural areas in the United States (U.S.) have exhibited higher mortality rates than urban areas since the late 1990s, a pattern known as the rural mortality penalty. Recent research has found that the rural mortality penalty continues growing due to mortality associated with preventable causes (metabolic and cardiovascular causes, alcohol use, and mental health). The expansion of Medicaid adopted by many states in the U.S. had the potential to reduce death due to these and other causes by facilitating access to healthcare to people who were not eligible under previous eligibility thresholds. While some state in the nation adopted this expansion, a process that started in 2014, others rejected it. While the adoption/rejection of this expansion is well-documented, little is known about the role the adoption of this policy at the state level impacted well-established demographic phenomenon such as the rural mortality penalty. This project requests access to restricted data to produce mortality rates for the population aged 19-64, by sex and by race/ethnicity to conduct a novel analysis of the differences observed in the rural mortality penalty employing a difference-in-difference design. The project evaluate whether the Medicaid expansion impacted the rural mortality penalty emphasizing the overall population, and disparities by sex and race/ethnicity. The project will also be the first to explore whether the COVID-19 pandemic impacted rural/urban mortality dynamics based on state-level adoption of the expansion of Medicaid by 2020. The analytic approach will combine formal and mathematical demographic methods with novel statistical models to evaluate the impact of the expansion of Medicaid in rural/urban mortality dynamics. Findings from this project will illustrate the role that state-level policies have in shaping diverging or congruent trajectories in mortality and in the face of the ongoing COVID-19 pandemic.

项目总结