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The Impact of Public Health Policy: The Case of Community Health Centers

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  • Fred Goldman
  • Michael Grossman

Abstract

The aim of this paper is to assess the impact of the Community Health Center (CHC) on health levels in the U.S. Using infant mortality as the underlying health indicator, a time series of large counties as the data set, and multivariate regression techniques, we investigate the extent to which the presence of a program in a county affects future mortality. We find that CHCs have negative and statistically significant impacts on white and black infant mortality rates.The centers have larger effects on black infant mortality than on white infant mortality. The reduction in the black infant mortality rate between 1970 and 1978 due to the CHC system amounts to one death per thousand live births or approximately 12 percent of the observed decline.This result is particularly striking in light of the well-known higher infant mortality rate of blacks. A reduction in the excess mortality rate of black babies has been dentfied as a goal of public health policy for a number of years. Our results suggest that community health centers have the potential to make a substantial contribution to the achievement of this goal.

Suggested Citation

  • Fred Goldman & Michael Grossman, 1982. "The Impact of Public Health Policy: The Case of Community Health Centers," NBER Working Papers 1020, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:1020
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    1. Michael Grossman & Steven Jacobowitz, 1981. "Variations in infant mortality rates among counties of the United States: The roles of public policies and programs," Demography, Springer;Population Association of America (PAA), vol. 18(4), pages 695-713, November.
    2. Mark R. Rosenzweig & T. Paul Schultz, 1982. "The Behavior of Mothers as Inputs to Child Health: The Determinants of Birth Weight, Gestation, and Rate of Fetal Growth," NBER Chapters, in: Economic Aspects of Health, pages 53-92, National Bureau of Economic Research, Inc.
    3. Michael Grossman & Steven Jacobowitz, 1981. "Variations in Infant Mortality Rates among Counties in the United States: The Roles of Social Policies and Programs," NBER Working Papers 0615, National Bureau of Economic Research, Inc.
    4. Judith R. Lave & Samuel Leinhardt, 1972. "The Delivery of Ambulatory Care to the Poor: A Literature Review," Management Science, INFORMS, vol. 19(4-Part-2), pages 78-99, December.
    5. Fuchs, Victor R. (ed.), 1982. "Economic Aspects of Health," National Bureau of Economic Research Books, University of Chicago Press, number 9780226267852, October.
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    1. Hope Corman & Dhaval Dave & Nancy E. Reichman, 2018. "Evolution of the Infant Health Production Function," Southern Economic Journal, John Wiley & Sons, vol. 85(1), pages 6-47, July.
    2. Garrett Anstreicher, 2021. "Does increasing health care access reduce disability insurance caseloads? Evidence from the rural United States," Health Economics, John Wiley & Sons, Ltd., vol. 30(4), pages 786-802, April.
    3. Olena Y. Nizalova & Maria Vyshnya, 2010. "Evaluation of the impact of the Mother and Infant Health Project in Ukraine," Health Economics, John Wiley & Sons, Ltd., vol. 19(S1), pages 107-125, September.
    4. Corman, Hope & Grossman, Michael, 1985. "Determinants of neonatal mortality rates in the U.S. : A reduced form model," Journal of Health Economics, Elsevier, vol. 4(3), pages 213-236, September.
    5. Mora-García, Claudio A. & Pesec, Madeline & Prado, Andrea M., 2024. "The effect of primary healthcare on mortality: Evidence from Costa Rica," Journal of Health Economics, Elsevier, vol. 93(C).
    6. Subhalaxmi Mohapatra, 2017. "Health inequity and health outcome: a causal linkage study of low and middle income countries," Quality & Quantity: International Journal of Methodology, Springer, vol. 51(6), pages 2475-2488, November.
    7. Subhalaxmi Mohapatra, 2022. "Health Expenditures, Health Infrastructure and Health Status in SAARC Countries: A Panel Data Analysis," Vikalpa: The Journal for Decision Makers, , vol. 47(3), pages 205-216, September.
    8. Hope Corman & Theodore J. Joyce & Michael Grossman, 1985. "Birth Outcome Production Functions in the U.S," NBER Working Papers 1729, National Bureau of Economic Research, Inc.
    9. Esra Kose & Siobhan M. O'Keefe & Maria Rosales-Rueda, 2022. "Does the Delivery of Primary Health Care Improve Birth Outcomes? Evidence from the Rollout of Community Health Centers," NBER Working Papers 30047, National Bureau of Economic Research, Inc.
    10. Bancalari, Antonella & Bernal, Pedro & Celhay, Pablo & Martinez, Sebastian & Sánchez, María Deni, 2024. "An Ounce of Prevention for a Pound of Cure: Basic Health Care and Efficiency in Health Systems," IDB Publications (Working Papers) 13433, Inter-American Development Bank.
    11. Anderson, D. Mark & Charles, Kerwin Kofi & Rees, Daniel I., 2020. "The Federal Effort to Desegregate Southern Hospitals and the Black-White Infant Mortality Gap," IZA Discussion Papers 13920, Institute of Labor Economics (IZA).
    12. Enrica Chiappero‐Martinetti & Paola Salardi & Francesco Scervini, 2019. "Estimating conversion rates: A new empirical strategy with an application to health care in Italy," Health Economics, John Wiley & Sons, Ltd., vol. 28(6), pages 748-764, June.

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