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Racial Differences in Health Insurance Coverage and Medical Expenditures in the United States

A Historical Perspective

Published online by Cambridge University Press:  04 January 2016

Melissa A. Thomasson
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Abstract

This article uses a unique data set from 1957 to examine the racial gap in health insurance coverage and the extent to which that gap influenced racial differences in health care spending. Results indicate that black households in 1957 were statistically significantly less likely to purchase health insurance than white households, even after controlling for differences in income, years of schooling, age, family size, marital status, and other personal and job-related characteristics. Findings in the article also provide weak support for the hypothesis that a racial gap in health insurance coverage contributed to racial differences in health care spending between blacks and whites; even after controlling for differences in income, education, and other characteristics, racial differences in medical expenditures were smaller for insured than for uninsured families, although the result is not statistically significant.

Type
Articles
Information
Social Science History , Volume 30 , Issue 4: The Persistence of the Health Insurance Dilemma , Winter 2006 , pp. 529 - 550
Copyright
Copyright © Social Science History Association 2006 

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References

Almond, Douglas V., Chay, Kenneth Y., and Greenstone, Michael (2001) “Civil rights, the war on poverty, and black-white convergence in infant mortality rates in Mississippi.” Working paper, University of California, Berkeley.Google Scholar
Almond, Douglas V., Chay, Kenneth Y., Greenstone, Michael, Sneeringer, Stacy, and Thomasson, Melissa (2005) “The 1946 Hospital Construction Act and infant mortality in the American South.” Working paper.Google Scholar
Anderson, Odin W., Collette, Patricia, and Feldman, Jacob J. (1958) “Family Medical Care Expenditures and Voluntary Health Insurance: A Five-Year Resurvey.” Data from the National Opinion Research Center, Chicago, converted to computer file.Google Scholar
Anderson, Odin W., Collette, Patricia, and Feldman, Jacob J. (1963) Family Medical Care Expenditures and Voluntary Health Insurance: A Five-Year Resurvey. Cambridge, MA: Harvard University Press.Google Scholar
Beardsley, Edward H. (1987) A History of Neglect: Health Care for Blacks and Mill Workers in the Twentieth-Century South. Knoxville: University of Tennessee Press.Google Scholar
Berger, Mark C., and Leigh, J. Paul (1989) “Schooling, self-selection, and health.” Journal of Human Resources 24: 433–55.Google Scholar
Brown, Michael K. (1999) Race, Money, and the American Welfare State. Ithaca, NY: Cornell University Press.Google Scholar
Collins, William J., and Thomasson, Melissa A. (2004) “The declining contribution of socioeconomic disparities to the racial gap in infant mortality rates, 1920-1970.” Southern Economic Journal 70: 746–76.Google Scholar
Currie, Janet, and Hyson, Rosemary (1999) “Is the impact of health shocks cushioned by socioeconomic status? The case of low birth weight.” American Economic Review 89: 245–50.Google Scholar
Cutler, David M., and Meara, Ellen (2003) “The rise in the ratio of black to white infant mortality since 1960.” Paper presented at the Allied Social Science Association Meetings, Washington, DC, January.Google Scholar
Dushi, Irena, and Honig, Marjorie (2005) “Offers or take-up? Explaining minorities’ lower health insurance coverage.” Working paper, Hunter College Department of Economics, August, urban.hunter.cuny.edu/RePEc/htr/papers/ERIU_Dushi_Honig_Aug_30_05.pdf (accessed May 11, 2006).Google Scholar
Edwards, Linda N., and Grossman, Michael (1979) “The relationship between children’s health and intellectual development,” in Mushkin, Selma and Dunlop, David (eds.) Health: What Is It Worth? Measures of Health Benefits. New York: Pergamon: 273–314.Google Scholar
Emery, George, and Emery, J. C. Herbert (1999) A Young Man’s Benefit: The Independent Order of Odd Fellows and Sickness Insurance in the United States and Canada, 1860–1929. Montreal: McGill-Queen’s University Press.Google Scholar
Emery, J. C. Herbert (1996) “Risky business? Nonactuarial pricing practices and the financial viability of fraternal sickness insurers.” Explorations in Economic History 33: 195–226.Google Scholar
Even, William E., and Macpherson, David A. (1990) “Plant size and the decline of unionism.” Economics Letters 32: 393–98.Google Scholar
Even, William E., and Macpherson, David A. (2003) “Racial and ethnic differences in pension wealth.” Research in Labor Economics 22: 203–25.Google Scholar
Faulkner, Edwin J. (1960) Health Insurance. New York: McGraw-Hill.Google Scholar
Gamble, Vanessa Northington (1989) The Black Community Hospital: Contemporary Dilemmas in Historical Perspective. New York: Garland.Google Scholar
Gordon, Colin (2003) Dead on Arrival: The Politics of Health Care in Twentieth-Century America. Princeton, NJ: Princeton University Press.Google Scholar
Grossman, Michael (1975) “The correlation between health and schooling,” in Terleckyj, Nestor E. (ed.) Household Production and Consumption. New York: Columbia University Press: 147–211.Google Scholar
Hecht, Pamela K., and Cutright, Phillips (1979) “Racial differences in infant mortality rates: United States, 1969.” Social Forces 57: 1180–93.Google Scholar
Hoyert, Donna L., Kung, Hsiang-Ching, and Smith, Betty L. (2005) Deaths: Preliminary Data for 2003. National Vital Statistics Reports, vol. 53, no. 15. Hyattsville, MD: National Center for Health Statistics, www.cdc.gov/nchs/data/nvsr/nvsr53/nvsr5315.pdf (accessed May 11, 2006).Google Scholar
Hunter, Tera W. (1997) To ’Joy My Freedom: Southern Black Women’s Lives and Labors after the Civil War. Cambridge, MA: Harvard University Press.Google Scholar
Kenkel, Donald S. (1991) “Health behavior, health knowledge, and schooling.” Journal of Political Economy 99: 287–305.Google Scholar
Kochanek, K. D., Murphy, S. L., Anderson, R. N., and Scott, C. (2004) Deaths: Final Data for 2002. National Vital Statistics Reports, vol. 53, no. 5. Hyattsville, MD: National Center for Health Statistics, www.cdc.gov/nchs/data/nvsr/nvsr53/nvsr53_05.pdf (accessed May 11, 2006).Google Scholar
Linder, Forrest E., and Grove, Robert D. (1947) Vital Statistics Rates in the United States, 1900–1940. Washington, DC: Government Printing Office.Google Scholar
MacDorman, M. F., and Rosenberg, H. M. (1993) Trends in Infant Mortality by Cause of Death and Other Characteristics, 1960–88. DHHS publication no. (PHS)93–1857. Hyattsville, MD: National Center for Health Statistics.Google Scholar
Manning, Willard G., Newhouse, Joseph P., Duan, Naihua, Keeler, Emmett B., Leibowitz, Arleen, and Marquis, M. Susan (1987) “Health insurance and the demand for medical care: Evidence from a randomized experiment.” American Economic Review 77: 251–77.Google Scholar
Margo, Robert A. (1995) “Explaining black-white wage convergence, 1940–1950.” Industrial and Labor Relations Review 48: 470–81.Google Scholar
Meara, Ellen (2001) “Why is health related to socioeconomic status? The case of pregnancy and low birth weight.” Working paper no. 8231, National Bureau of Economic Research.Google Scholar
Miller, Doug (2001) “What underlies the black-white infant mortality gap? The importance of birthweight, behavior, environment, and health care.” Working paper, University of California, Berkeley.Google Scholar
National Center for Health Statistics (1991) Vital Statistics of the United States, 1988. Vol. 2, Mortality, Part A. Hyattsville, MD: National Center for Health Statistics.Google Scholar
Ni, Hanyu, and Cohen, Robin (2004) “Trends in health insurance coverage by race/ethnicity among persons under 65 years of age: United States 1997–2001,” National Center for Health Statistics, www.cdc.gov/nchs/products/pubs/pubd/hestats/healthinsur.htm (accessed May 11, 2006).Google Scholar
Quadagno, Jill (2000) “Promoting civil rights through the welfare state: How Medicare integrated southern hospitals.” Social Problems 47: 68–89.Google Scholar
Seham, Max (1964) “Discrimination against Negroes in hospitals.” New England Journal of Medicine 271: 940–43.Google Scholar
Smith, David Barton (1999) Health Care Divided: Race and Healing a Nation. Ann Arbor: University of Michigan Press.Google Scholar
Smith, James P., and Welch, Finis R. (1989) “Black economic progress after Myrdal.” Journal of Economic Literature 27: 519–64.Google Scholar
Thomasson, Melissa A. (2003) “The importance of group coverage: How tax policy shaped U.S. health insurance.” American Economic Review 93: 1373–84.Google Scholar
Thomasson, Melissa A. (2004) “Early evidence of an adverse selection death spiral? The case of Blue Cross and Blue Shield.” Explorations in Economic History 41: 313–28.Google Scholar