Health Regulation Consequences for Subnational Mortality in the United States, 1990–2018

Denys Dukhovnov, University of California, Berkeley

This study evaluates the quantitative impact of state health regulation on state and county group mortality in the United States in the span of 28 years. State health policies (SHP) across stats are not qualitatively equivalent. The variation in intended impact and scope of health issues in the target population present barriers for comparative policy analyses. This presents a challenge in coding of the available data on health regulation in a coherent manner, to evaluate its impact across the country. In this paper I create a synthetic summary measure of SHP that incorporates a qualitative aspect, while simultaneously being quantitatively relative and longitudinally cumulative. I run a series of spatial econometric panel models with the SHP measure along with socioeconomic, demographic, and political contextual factors to estimate the contribution of health regulation to observed mortality differences. Preliminary results of the models demonstrate that state health policy could explain up to 30% of the longevity gap between states with the best and the worst life expectancy outcomes in the recent decades. At the same time, county group outcomes mortality/longevity is less affected by SHP, but it is more susceptible to neighboring area influences.

Keywords: Population Policies, Spatial Demography, Mortality and Longevity, Inequality, Disadvantage and Discrimination

See extended abstract.