Working Paper: NBER ID: w27970
Authors: D Mark Anderson; Kerwin Kofi Charles; Daniel I Rees
Abstract: In 1966, Southern hospitals were barred from participating in Medicare unless they discontinued their longstanding practice of racial segregation. Using data from five Deep South states and exploiting county-level variation in Medicare certification dates, we find that gaining access to an ostensibly integrated hospital had no effect on Black postneonatal mortality. Similarly, there is little evidence that the campaign contributed to the trend towards in-hospital births among Southern Black mothers. These results are consistent with descriptions of the hospital desegregation campaign as producing only cosmetic changes and illustrate the limits of anti-discrimination policies imposed upon reluctant actors.
Keywords: hospital desegregation; postneonatal mortality; healthcare access; civil rights; Medicare
JEL Codes: I1; I14; J1; N12
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Gaining access to a Medicare-eligible hospital (I11) | Black postneonatal mortality rates (J13) |
| Hospital desegregation campaign did not contribute to the trend towards in-hospital births among southern black mothers (J79) | Black postneonatal mortality rates (J13) |
| Gaining access to a Medicare-eligible hospital did not reduce black postneonatal deaths due to pneumonia-influenza (I14) | Black postneonatal mortality rates (J13) |
| Gaining access to a Medicare-eligible hospital did not reduce black postneonatal deaths due to diarrhea (I14) | Black postneonatal mortality rates (J13) |