Explaining State Differences in the Implementation of the Patient Protection and Affordable Care Act: A South/Non‐South Comparison*

Travis, Rick; Morris, John C.; Mayer, Martin; Kenter, Robert C.; Breaux, David A.

doi:10.1111/ssqu.12297

Cited by 7 publications

(13 citation statements)

References 26 publications

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“…The Northeastern states have higher relative lung cancer survival, better health rankings, lower health uninsured rate, and higher health spending per capita compared to the Southern states. This phenomenon can be explained by the similar characteristics among adjacent states, which include the demographics [percentage of total African American population by region according to the 2010 Census: Northwest (17%), Midwest (18.1%), South (55.0%), and West (9.8%)], numbers of physicians per capita, socioeconomic conditions, the availability of medical services, incomes of residents, and the levels of benefits provided by public and private health programs (22)(23)(24)(25)(26)(27). Affordability and access to state-of-the art cancer care are important factors for geographic differences of cancer survival.…”

Section: Discussionmentioning

confidence: 99%

State-Level Disparity in Lung Cancer Survival in the United States

et al. 2020

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The cancer mortality-to-incidence ratio (MIR) can serve as a population-based indicator for cancer care outcomes. In the US, evaluation of lung cancer survival by individual states has not been evaluated. Objective: To assess the association between lung cancer survival by using MIRs and state-level health disparities in the United States. Methods: We calculated 5-year lung cancer MIR averages from 2011 to 2015 using the United States Cancer Statistics (USCS) data. America's Health Rankings (AHR) is a platform using weighted measures in five different categories to calculate annual state health rankings. Five-year averages from 2011 to 2015 of the health uninsured rate and 4-year averages from 2011 to 2014 of health spending per capita were obtained from the U.S. Census Bureau and Centers for Medicare & Medicaid Services. Linear regression analyses were performed to determine the associations between cancer survival value (CSV) = (1-MIR) × 100% and state health variables. Results: During the study period, the 5-year averages of age-adjusted incidence, mortality rates, and CSVs were 60.3 ± 2.1 per 100,000 population, 43.4 ± 2.1 per 100,000, and 27.9 ± 3.9%, respectively. Among the 50 states, Connecticut had the highest CSV (38.6 ± 1.7%) whereas Nevada had the lowest CSV (18.7 ± 6.5%). Hawaii had the highest health ranking and Mississippi had the lowest ranking in 2016. States with better health rankings, lower health uninsured rates, and higher health spending were significantly associated with higher CSVs (R 2 = 0.418, P < 0.001; R 2 = 0.352, P < 0.001; R 2 = 0.142, P = 0.007, respectively). Conclusions: There are significant differences in lung cancer survival within the United States. Lung cancer survival by using CSV was strongly associated with state health disparities, and it can be an applicable measure to evaluate the state-level health disparities in the United States.

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Section: Discussionmentioning

confidence: 99%

State-Level Disparity in Lung Cancer Survival in the United States

et al. 2020

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“…While some scholars (see Shafer and Johnston, 2006) conclude there is little policy distinctiveness remaining, other scholars (Steed, Moreland, and Baker, 1990; Cochrane, 2001; Breaux et al., 2002) argue that the South has become the policy “leader,” in the nation as more states adopt policies that look more like those originating the South. On the other hand, a different stream of research (Travis et al., 2016; Prysby and Riesser, 2013) finds support for southern policy distinctiveness. Finally, and most relevant to this edition, the South has consistently been found to be more violent and aggressive (Lee, Thomas, and Ousey, 2009; Messner, Baller, and Zevenbergen, 2005), more likely to own a gun (Parker et al., 2017), more likely to carry their gun as a part of their self‐protection (Kleck and Gertz, 1995), and less likely to support restrictions on gun purchases (Brennan, Lizotte, and McDowall, 1993; Kahan and Braman, 2003; Smith, 1980; Wolpert and Gimpel, 1998).…”

Section: Continuance Of Southern Distinctiveness?mentioning

confidence: 99%

Introduction to the symposium: A reexamination of southern distinctiveness through the lens of firearm policy

LaPlant

Morris

Shields

2021

Social Science Quarterly

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Objective: This article reviews the extant literature on southern politics and gun/firearm ownership in the South as a precursor to three symposium papers. Methods: We employ standard literature review techniques to synthesize two significant bodies of literature. The latter part of the article introduces the three papers in the symposium. Results: We find that the papers in this symposium share two common themes: continued southern distinctiveness, and the importance of the role of race in southern politics and policymaking. Conclusion:We find support for a hypothesis that the South remains distinctive as a region in the policy arena of gun ownership/firearm policy.The political, social, cultural, and economic role of firearms in American society has been a flash point for decades, and recently has become a significant point of contention. Arguments tend to coalesce around differing definitions and interpretations of the Second Amendment, personal freedom, community safety, personal security, and a host of other values. As Stone (1997) so aptly illustrates, differences in value definition may be found at the root of nearly all policy disagreements. As hyperpartisanship has combined with an increase in mass shootings, economic uncertainty, racial tensions, and a number of high-profile incidents involving gun violence, the issue of firearm policy has been thrust firmly into the public spotlight.Like many policy arenas, the nature of the policy problem is not felt equally across the nation, nor are the policy choices to address those problems the same across states. State political culture, history, political control, and a range of other factors have led to a broad patchwork of state policies regarding firearms, all against a backdrop of limited federal law on the topic. States have thus taken very different positions on firearm ownership and the means through which firearms are regulated (or not regulated) within the states. In this sense, states are truly "policy laboratories" (Dror, 1968). While state variation is clearly evident, a less-examined question concerns the degree to which regional policy differences can be detected.While regional studies have largely faded from scholarly agendas, a clear exception is the region of the American South. While studies of most regions in the nation have fallen into disfavor, regional studies of the South have seen something of a resurgence in the past two decades. A field of study led by V.O. Key's seminal Southern Politics in State and Nation (1949), students, and scholars of southern politics has grappled

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“…In addition, empirical evidence suggests that states took a wide range of different paths in terms of their support or opposition to the ACA (see Barrileaux ; Barrileaux and Rainey ; Haeder and Weimer ; Travis et al . ). This previous research has sought state‐level explanations of implementation decisions, typically employing a 50‐state model to identify common factors in state choices (see e.g., Barrileaux and Rainey ; Mayer, Kenter, and Morris ).…”

mentioning

confidence: 97%

“…We begin this article with a review of the ACA, and a brief discussion of the elements of the dependent variable developed for previous statistical analysis (see Mayer, Kenter, and Morris ; Travis et al . ). We then present a discussion of the four case study states (Alabama, Michigan, California, and New Hampshire).…”

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State Implementation of the Affordable Care Act: Four Case Studies

et al. 2018

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The Affordable Care Act (ACA) has been the subject of one of the most contentious policy issues in recent memory. Previous research has tracked the volatility of state decisions over a three-year period, 2012, 2013, and 2014, using an index ranking states by their policy decisions regarding whether they were in support or opposition to the ACA. The present study suggests state legislatures may increasingly be making health-care choices based on the needs of the citizens in the state and less on partisanship. This article employs a case study methodology to examine the health-care policy decisions made in four states: Alabama, which ranked as one of the staunchest opponents; Michigan, which scored as neutral; California, which scored as highly supportive; and New Hampshire, which moved from opposition to support during the reviewed three-year time frame. This research examines influences driving these decisions at the state level.

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Explaining State Differences in the Implementation of the Patient Protection and Affordable Care Act: A South/Non‐South Comparison*

Cited by 7 publications

References 26 publications

State-Level Disparity in Lung Cancer Survival in the United States

State-Level Disparity in Lung Cancer Survival in the United States

Introduction to the symposium: A reexamination of southern distinctiveness through the lens of firearm policy

State Implementation of the Affordable Care Act: Four Case Studies

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