IDEAS home Printed from https://ideas.repec.org/p/nbr/nberwo/20653.html
   My bibliography  Save this paper

The War on Poverty's Experiment in Public Medicine: Community Health Centers and the Mortality of Older Americans

Author

Listed:
  • Martha J. Bailey
  • Andrew Goodman-Bacon

Abstract

This paper uses the rollout of the first Community Health Centers (CHCs) to study the longer-term health effects of increasing access to primary care. Within ten years, CHCs are associated with a reduction in age-adjusted mortality rates of 2 percent among those 50 and older. The implied 7 to 13 percent decrease in one-year mortality risk among beneficiaries amounts to 20 to 40 percent of the 1966 poor/non-poor mortality gap for this age group. Large effects for those 65 and older suggest that increased access to primary care has longer-term benefits, even for populations with near universal health insurance.

Suggested Citation

  • Martha J. Bailey & Andrew Goodman-Bacon, 2014. "The War on Poverty's Experiment in Public Medicine: Community Health Centers and the Mortality of Older Americans," NBER Working Papers 20653, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:20653
    Note: AG DAE DEV EH PE
    as

    Download full text from publisher

    File URL: http://www.nber.org/papers/w20653.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Richard K. Crump & V. Joseph Hotz & Guido W. Imbens & Oscar A. Mitnik, 2009. "Dealing with limited overlap in estimation of average treatment effects," Biometrika, Biometrika Trust, vol. 96(1), pages 187-199.
    2. Hilary W. Hoynes & Diane Whitmore Schanzenbach, 2009. "Consumption Responses to In-Kind Transfers: Evidence from the Introduction of the Food Stamp Program," American Economic Journal: Applied Economics, American Economic Association, vol. 1(4), pages 109-139, October.
    3. Janet Currie & Jonathan Gruber, 1996. "Health Insurance Eligibility, Utilization of Medical Care, and Child Health," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 111(2), pages 431-466.
    4. Hoynes, Hilary & Page, Marianne & Stevens, Ann Huff, 2011. "Can targeted transfers improve birth outcomes?: Evidence from the introduction of the WIC program," Journal of Public Economics, Elsevier, vol. 95(7-8), pages 813-827, August.
    5. Sox, C.M. & Swartz, K. & Burstin, H.R. & Brennan, T.A., 1998. "Insurance or a regular physician: Which is the most powerful predictor of health care?," American Journal of Public Health, American Public Health Association, vol. 88(3), pages 364-370.
    6. Martha J. Bailey & Andrew Goodman-Bacon, 2015. "The War on Poverty's Experiment in Public Medicine: Community Health Centers and the Mortality of Older Americans," American Economic Review, American Economic Association, vol. 105(3), pages 1067-1104, March.
    7. David Cutler & Ellen Meara, 2001. "Changes in the Age Distribution of Mortality Over the 20th Century," NBER Working Papers 8556, National Bureau of Economic Research, Inc.
    8. Finkelstein, Amy & McKnight, Robin, 2008. "What did Medicare do? The initial impact of Medicare on mortality and out of pocket medical spending," Journal of Public Economics, Elsevier, vol. 92(7), pages 1644-1668, July.
    9. Lee, K.S. & Paneth, N. & Gartner, L.M. & Pearlman, M.A. & Gruss, L., 1980. "Neonatal mortality: An analysis of the recent improvement in the United States," American Journal of Public Health, American Public Health Association, vol. 70(1), pages 15-21.
    10. Simeonova, Emilia, 2013. "Doctors, patients and the racial mortality gap," Journal of Health Economics, Elsevier, vol. 32(5), pages 895-908.
    11. Orley Ashenfelter & Michael Greenstone, 2004. "Using Mandated Speed Limits to Measure the Value of a Statistical Life," Journal of Political Economy, University of Chicago Press, vol. 112(S1), pages 226-267, February.
    12. Martha J. Bailey, 2012. "Reexamining the Impact of Family Planning Programs on US Fertility: Evidence from the War on Poverty and the Early Years of Title X," American Economic Journal: Applied Economics, American Economic Association, vol. 4(2), pages 62-97, April.
    13. Bailey, Martha J. & Duquette, Nicolas J., 2014. "How Johnson Fought the War on Poverty: The Economics and Politics of Funding at the Office of Economic Opportunity," The Journal of Economic History, Cambridge University Press, vol. 74(2), pages 351-388, June.
    14. Hoynes, Hilary & Page, Marianne & Stevens, Ann Huff, 2011. "Can targeted transfers improve birth outcomes?," Journal of Public Economics, Elsevier, vol. 95(7), pages 813-827.
    15. Douglas Almond & Hilary W. Hoynes & Diane Whitmore Schanzenbach, 2011. "Inside the War on Poverty: The Impact of Food Stamps on Birth Outcomes," The Review of Economics and Statistics, MIT Press, vol. 93(2), pages 387-403, May.
    16. Genia Long & David Cutler & Ernst R. Berndt & Jimmy Royer & Andrée-Anne Fournier & Alicia Sasser & Pierre Cremieux, 2006. "The Impact of Antihypertensive Drugs on the Number and Risk of Death, Stroke and Myocardial Infarction in the United States," NBER Working Papers 12096, National Bureau of Economic Research, Inc.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Martha J Bailey & Hilary Hoynes & Maya Rossin-Slater & Reed Walker, 2024. "Is the Social Safety Net a Long-Term Investment? Large-Scale Evidence From the Food Stamps Program," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 91(3), pages 1291-1330.
    2. Hilary Hoynes & Diane Whitmore Schanzenbach & Douglas Almond, 2016. "Long-Run Impacts of Childhood Access to the Safety Net," American Economic Review, American Economic Association, vol. 106(4), pages 903-934, April.
    3. Deborah A. Cobb-Clark & Nathan Kettlewell & Stefanie Schurer & Sven Silburn, 2023. "The Effect of Quarantining Welfare on School Attendance in Indigenous Communities," Journal of Human Resources, University of Wisconsin Press, vol. 58(6), pages 2072-2110.
    4. 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.
    5. Dora L. Costa, 2015. "Health and the Economy in the United States from 1750 to the Present," Journal of Economic Literature, American Economic Association, vol. 53(3), pages 503-570, September.
    6. Nicolas R. Ziebarth, 2018. "Social Insurance and Health," Contributions to Economic Analysis, in: Health Econometrics, volume 127, pages 57-84, Emerald Group Publishing Limited.
    7. Michael DiNardi & Melanie Guldi & David Simon, 2019. "Body weight and Internet access: evidence from the rollout of broadband providers," Journal of Population Economics, Springer;European Society for Population Economics, vol. 32(3), pages 877-913, July.
    8. Mitrut, Andreea & Tudor, Simona, 2018. "Bridging the gap for Roma: The effects of an ethnically targeted program on prenatal care and child health," Journal of Public Economics, Elsevier, vol. 165(C), pages 114-132.
    9. Verónica Amarante & Marco Manacorda & Edward Miguel & Andrea Vigorito, 2016. "Do Cash Transfers Improve Birth Outcomes? Evidence from Matched Vital Statistics, Program, and Social Security Data," American Economic Journal: Economic Policy, American Economic Association, vol. 8(2), pages 1-43, May.
    10. Douglas Almond & Janet Currie, 2011. "Killing Me Softly: The Fetal Origins Hypothesis," Journal of Economic Perspectives, American Economic Association, vol. 25(3), pages 153-172, Summer.
    11. Doyle, Mary-Alice & Schurer, Stefanie & Silburn, Sven, 2022. "Unintended consequences of welfare reform: Evidence from birthweight of Aboriginal children in Australia," Journal of Health Economics, Elsevier, vol. 84(C).
    12. Jones, Jordan W. & Courtemanche, Charles & Marton, James, 2018. "The Impacts of the Food Stamp Program on Mortality," 2018 Annual Meeting, August 5-7, Washington, D.C. 273845, Agricultural and Applied Economics Association.
    13. Owen O'Donnell & Eddy Van Doorslaer & Tom Van Ourti, 2013. "Health and Inequality," Tinbergen Institute Discussion Papers 13-170/V, Tinbergen Institute.
    14. Lindo, Jason M., 2011. "Parental job loss and infant health," Journal of Health Economics, Elsevier, vol. 30(5), pages 869-879.
    15. Doyle, Mary-Alice & Schurer, Stefanie & Silburn, Sven, 2020. "Unintended Consequences of Welfare Reform: Evidence from Birth Outcomes of Aboriginal Australians," IZA Discussion Papers 13543, Institute of Labor Economics (IZA).
    16. Monica Harber Carney, 2021. "The impact of mental health parity laws on birth outcomes," Health Economics, John Wiley & Sons, Ltd., vol. 30(4), pages 748-765, April.
    17. Adrienne M. Lucas & Nicholas L. Wilson, 2018. "Can At-Scale Drug Provision Improve the Health of the Targeted in Sub-Saharan Africa?," American Journal of Health Economics, University of Chicago Press, vol. 4(3), pages 358-382, Summer.
    18. Liu, Yinan & Zai, Xianhua, 2022. "Does Aging at Home Make Older Adults Healthy: Evidence from Medicaid Home and Community-Based Services," GLO Discussion Paper Series 1079 [rev.], Global Labor Organization (GLO), revised 2022.
    19. Elira Kuka, 2020. "Quantifying the Benefits of Social Insurance: Unemployment Insurance and Health," The Review of Economics and Statistics, MIT Press, vol. 102(3), pages 490-505, July.
    20. Fidel Gonzalez & Santosh Kumar, 2018. "Prenatal care and birthweight in Mexico," Applied Economics, Taylor & Francis Journals, vol. 50(10), pages 1156-1170, February.

    More about this item

    JEL classification:

    • I28 - Health, Education, and Welfare - - Education - - - Government Policy
    • I3 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty
    • J14 - Labor and Demographic Economics - - Demographic Economics - - - Economics of the Elderly; Economics of the Handicapped; Non-Labor Market Discrimination
    • J18 - Labor and Demographic Economics - - Demographic Economics - - - Public Policy

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:nbr:nberwo:20653. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: the person in charge (email available below). General contact details of provider: https://edirc.repec.org/data/nberrus.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.