ArticleThe Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association2025
The uneven impact of Medicaid expansion on rural and urban Black, Latino/a, and White mortality.
Article in The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed.
- Medicaid Is an Important Driver of a Healthier North Carolina, But Not Enough to Dismantle Persistent Health Inequities.North Carolina medical journal · 2025Article
- Medicaid Expansion is Associated with Differences in Local Therapy for Non-small Cell Lung Cancer.Annals of surgical oncology · 2025Article
- Double vulnerability? Examining the effect of living in nonmetropolitan areas within non-expansion Medicaid states on health status among working-age adults in the United States, 2022-2024.SSM - population health · 2025Article
- The uneven impact of Medicaid expansion on rural and urban Black, Latino/a, and White mortality.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
Abstract
purposeTo determine the differential impact of Medicaid expansion on all-cause mortality between Black, Latino/a, and White populations in rural and urban areas, and assess how expansion impacted mortality disparities between these groups.
methodsWe employ a county-level time-varying heterogenous treatment effects difference-in-difference analysis of Medicaid expansion on all-cause age-adjusted mortality for those 64 years of age or younger from 2009 to 2019. For all counties within the 50 US States and the District of Columbia, we use restricted-access vital statistics data to estimate Average Treatment Effect on the Treated (ATET) for all combinations of racial and ethnic group (Black, Latino/a, White), rurality (rural, urban), and sex. We then assess aggregate ATET, as well as how the ATET changed as time from expansion increased.
findingsMedicaid expansion led to a reduction in all-cause age-adjusted mortality for urban Black populations, but not rural Black populations. Urban White populations experienced mixed effects dependent on years after expansion. Latino/a populations saw no appreciable impact. While no effect was observed for rural Black and Latino/a populations, rural White all-cause age-adjusted mortality unexpectedly increased due to Medicaid expansion. These effects reduced rural- and urban-specific Black-White mortality disparities but did not shrink the rural-urban mortality gap.
conclusionsThe mortality-reducing impact of Medicaid expansion has been uneven across racial and ethnic groups and rural-urban status; suggesting that many populations-particularly rural individuals-are not seeing the same benefits as others. It is imperative that states work to ensure Medicaid expansion is being appropriately implemented in rural areas.
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