The effect of Medicaid expansion on cancer mortality racial disparity
This thesis aims to understand the extent to which Medicaid expansion in Louisiana affected cancer mortality racial disparity. The paper proceeds as follows. The background section will present the motivations behind and context surrounding the topic. The data & methodology section will describe the study population, data collection, and statistical analysis used; the analysis is conducted using an interrupted time series approach to determine associations between Medicaid expansion and cancer mortality by race, sex, and Health Service Area. The following section will present the statistically significant findings on first quarter changes in mortality, post-expansion changes, and divergences from pre-period trends, compared to control non-expansion counties. The discussion section will interpret these results in the context of insurance uptake, urban-rural trends, and regional cancer risk throughout Louisiana. This thesis concludes that there was an immediate and dramatic reduction in cancer mortality racial disparity in concurrence with Medicaid expansion but given the timing and lack of maintained reductions over time, Medicaid expansion is not the sole cause of the observed decrease. This thesis contributes to many strands of literature on the effects of Medicaid expansion on health outcomes, cancer and general mortality, and racial and geographic disparities and will provide insight to other demographically similar states in their decisions to expand Medicaid.