Primary Submission Category: Mortality
Understanding Mortality at the Regional Level through Policy and Characteristics
Authors: Fatima Frausto,
Presenting Author: Fatima Frausto*
PRWORA was the first clear departure from federal uniformity to divergence due to state preferences. While welfare and labor policies initially diverged with the change in policies, other policy domains, such as immigration and criminal justice, have become increasingly polarized. Given the varying political ideologies influencing state-level policy decisions, this research examines the relationship between policy domains and mortality using the 1997-2014 National Health Interview Survey Linked Mortality File (NHIS-LMF).
This project investigates the relationships between regional policy domains and mortality outcomes by aggregating and analyzing mortality data across 4 regions. All-cause mortality will be tested across three characteristics: individual characteristics (age, gender, race/ethnicity, and education); regional contexts (share of democrats in the state house, poverty rate); and policy domains (civil rights, criminal justice, education, environment, immigration, health/welfare, labor, economic, firearms, and tobacco taxes.) Because the NHIS-LMF only provides geographical information at the regional level, the regional and policy measures are averaged by region and year. Stratified Cox regression models were calculated for the entire sample and NH White, NH Black, and Hispanic subsamples.
Preliminary results show that in the full model, more liberal civil rights domains are associated with a significantly lower risk of dying. The Hispanic and NH White subsamples had significantly lower risks of death in more liberal civil rights domains. Tobacco taxes and immigration policies were significant for the Hispanic subsample, while the NH White subsample had a significantly lower risk of dying with greater shares of Democrats in the lower state chambers. Future regressions are planned to look at regional subsamples and expand individual and regional characteristics to look at employment, wealth, and foreign-born population measures.