IDEAS home Printed from https://ideas.repec.org/p/tow/wpaper/2024-09.html
   My bibliography  Save this paper

Historical Racial Oppression and Healthcare Access: Unveiling Disparities Post-ACA in the American South

Author

Listed:
  • Vinish Shrestha

    (Department of Economics, Towson University)

Abstract

This study investigates geographical disparities in the implementation and effectiveness of the Affordable Care Act (ACA) by linking them to the historical legacy of racial oppression in the American South. Using a cross-border regression discontinuity design that leverages variations in racial oppression intensity, we find that bordering counties in states with less oppressive regime experienced significantly greater benefits from the ACA compared to neighboring counties in more oppressive states. This divergence in insurance outcomes, which did not exist before the ACA, underscores the influence of historical racial regimes on contemporary policy efficacy. Furthermore, we demonstrate that political preferences from the Jim Crow era are correlated with the observed variations in ACA effectiveness. Our findings suggest that the racialization of the ACA is deeply rooted in the historical context of racial oppression in the American South.

Suggested Citation

  • Vinish Shrestha, 2024. "Historical Racial Oppression and Healthcare Access: Unveiling Disparities Post-ACA in the American South," Working Papers 2024-09, Towson University, Department of Economics, revised Jul 2024.
    • Handle: RePEc:tow:wpaper:2024-09
    as

    Download full text from publisher

    File URL: http://webapps.towson.edu/cbe/economics/workingpapers/2024-09.pdf
    File Function: First version, 2024
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Nico Voigtländer & Hans-Joachim Voth, 2012. "Persecution Perpetuated: The Medieval Origins of Anti-Semitic Violence in Nazi Germany," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 127(3), pages 1339-1392.
    2. Sarah Miller & Norman Johnson & Laura R Wherry, 2021. "Medicaid and Mortality: New Evidence From Linked Survey and Administrative Data," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 136(3), pages 1783-1829.
    3. Alston, Lee J. & Ferrie, Joseph P., 1985. "Labor Costs, Paternalism, and Loyalty in Southern Agriculture: A Constraint on the Growth of the Welfare State," The Journal of Economic History, Cambridge University Press, vol. 45(1), pages 95-117, March.
    4. Borgschulte, Mark & Vogler, Jacob, 2020. "Did the ACA Medicaid expansion save lives?," Journal of Health Economics, Elsevier, vol. 72(C).
    5. Michael Tesler, 2012. "The Spillover of Racialization into Health Care: How President Obama Polarized Public Opinion by Racial Attitudes and Race," American Journal of Political Science, John Wiley & Sons, vol. 56(3), pages 690-704, July.
    6. Nathan Nunn & Leonard Wantchekon, 2011. "The Slave Trade and the Origins of Mistrust in Africa," American Economic Review, American Economic Association, vol. 101(7), pages 3221-3252, December.
    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. Vinish Shrestha, 2023. "The Long Shadow of American Slavery: Its Influence on the Affordable Care Act," Working Papers 2023-02, Towson University, Department of Economics, revised Jul 2024.
    2. Luigi Guiso & Paola Sapienza & Luigi Zingales, 2015. "Corporate Culture, Societal Culture, and Institutions," American Economic Review, American Economic Association, vol. 105(5), pages 336-339, May.
    3. James Kai-sing Kung, 2022. "On the Origins and Persistent Effects of the World’s First Meritocratic Institution," Comparative Economic Studies, Palgrave Macmillan;Association for Comparative Economic Studies, vol. 64(4), pages 563-581, December.
    4. Guiso, Luigi & Herrera, Helios & Morelli, Massimo, 2016. "Cultural Differences and Institutional Integration," Journal of International Economics, Elsevier, vol. 99(S1), pages 97-113.
    5. Julia Cagé & Valeria Rueda, 2016. "The Long-Term Effects of the Printing Press in Sub-Saharan Africa," American Economic Journal: Applied Economics, American Economic Association, vol. 8(3), pages 69-99, July.
    6. Maseland, Robbert, 2021. "Contingent determinants," Journal of Development Economics, Elsevier, vol. 151(C).
    7. Melissa Dell & Benjamin A Olken, 2020. "The Development Effects of the Extractive Colonial Economy: The Dutch Cultivation System in Java," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 87(1), pages 164-203.
    8. Melissa Dell & Nathan Lane & Pablo Querubin, 2018. "The Historical State, Local Collective Action, and Economic Development in Vietnam," Econometrica, Econometric Society, vol. 86(6), pages 2083-2121, November.
    9. Nathan Nunn, 2012. "Culture and the Historical Process," Economic History of Developing Regions, Taylor & Francis Journals, vol. 27(S1), pages 108-126.
    10. Anke Becker, 2019. "On the Economic Origins of Restrictions on Women's Sexuality," CESifo Working Paper Series 7770, CESifo.
    11. Andrew Dickens, 2022. "Understanding Ethnolinguistic Differences: The Roles of Geography and Trade," The Economic Journal, Royal Economic Society, vol. 132(643), pages 953-980.
    12. Eleonora Guarnieri & Ana Tur-Prats, 2023. "Cultural Distance and Conflict-Related Sexual Violence," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 138(3), pages 1817-1861.
    13. Liu, Xianda & Hou, Wenxuan & Main, Brian G.M., 2022. "Anti-market sentiment and corporate social responsibility: Evidence from anti-Jewish pogroms," Journal of Corporate Finance, Elsevier, vol. 76(C).
    14. Lewis Davis & Claudia R. Williamson, 2018. "Open Borders for Business? Causes and Consequences of the Regulation of Foreign Entry," Southern Economic Journal, John Wiley & Sons, vol. 85(2), pages 508-536, October.
    15. Fenske, James & Wang, Shizhuo, 2023. "Tradition and mortality: Evidence from twin infanticide in Africa," Journal of Development Economics, Elsevier, vol. 163(C).
    16. Choi, Jaerim & Lim, Sunghun, 2023. "Ostrom Meets the Pandemic: Lessons from Asian Rice Farming Traditions," 97th Annual Conference, March 27-29, 2023, Warwick University, Coventry, UK 334543, Agricultural Economics Society - AES.
    17. Stelios Michalopoulos & Elias Papaioannou, 2020. "Historical Legacies and African Development," Journal of Economic Literature, American Economic Association, vol. 58(1), pages 53-128, March.
    18. J Dustin Tracy & Kevin A James & Hillard Kaplan & Stephen Rassenti, 2021. "An investigation of health insurance policy and behavior in a virtual environment," PLOS ONE, Public Library of Science, vol. 16(4), pages 1-26, April.
    19. Fouka, Vasiliki & Schlaepfer, Alain, 2017. "Agricultural Returns to Labor and the Origins of Work Ethics," MPRA Paper 78556, University Library of Munich, Germany.
    20. Chen, Shuo & Ding, Haoyuan & Lin, Shu & Ye, Haichun, 2022. "From past lies to current misconduct: The long shadow of China's Great Leap Forward," Journal of Development Economics, Elsevier, vol. 157(C).

    More about this item

    Keywords

    ACA; Oppressive racial regime; Disparity; American South.;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • D02 - Microeconomics - - General - - - Institutions: Design, Formation, Operations, and Impact
    • B15 - Schools of Economic Thought and Methodology - - History of Economic Thought through 1925 - - - Historical; Institutional; Evolutionary

    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:tow:wpaper:2024-09. 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: Juergen Jung (email available below). General contact details of provider: https://edirc.repec.org/data/detowus.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.