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Self-rated health, generalized trust, and the Affordable Care Act : A US panel study, 2006–2014

Mewes, Jan and Giordano, Giuseppe Nicola LU (2017) In Social Science and Medicine 190. p.48-56
Abstract

Previous research shows that generalized trust, the belief that most people can be trusted, is conducive to people's health. However, only recently have longitudinal studies suggested an additional reciprocal pathway from health back to trust. Drawing on a diverse body of literature that shows how egalitarian social policy contributes to the promotion of generalized trust, we hypothesize that this other ‘reverse’ pathway could be sensitive to health insurance context. Drawing on nationally representative US panel data from the General Social Survey, we examine whether the Affordable Care Act of 2010 could have had influence on the deteriorating impact of worsening self-rated health (SRH) on generalized trust. Firstly, using two-wave... (More)

Previous research shows that generalized trust, the belief that most people can be trusted, is conducive to people's health. However, only recently have longitudinal studies suggested an additional reciprocal pathway from health back to trust. Drawing on a diverse body of literature that shows how egalitarian social policy contributes to the promotion of generalized trust, we hypothesize that this other ‘reverse’ pathway could be sensitive to health insurance context. Drawing on nationally representative US panel data from the General Social Survey, we examine whether the Affordable Care Act of 2010 could have had influence on the deteriorating impact of worsening self-rated health (SRH) on generalized trust. Firstly, using two-wave panel data (2008–2010, N = 1403) and employing random effects regression models, we show that a lack of health insurance coverage negatively determines generalized trust in the United States. However, this association is attenuated when additionally controlling for (perceived) income inequality. Secondly, utilizing data from two separate three-wave panel studies from the US General Social Survey (2006–10; N = 1652; 2010–2014; N = 1187), we employ fixed-effects linear regression analyses to control for unobserved heterogeneity from time-invariant factors. We demonstrate that worsening SRH was a stronger predictor for a decrease in generalized trust prior (2006–2010) to the implementation of the Affordable Care Act. Further, the negative effect of fair/poor SRH seen in the 2006–2010 data becomes attenuated in the 2010–2014 panel data. We thus find evidence for a substantial weakening of the previously established negative impact of decreasing SRH on generalized trust, coinciding with the most significant US healthcare reforms in decades. Social policy and healthcare policy implications are discussed.

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author
organization
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type
Contribution to journal
publication status
published
subject
keywords
Health insurance, Healthcare reform, Income inequality, Longitudinal, Self-rated health, Social capital, Trust, United States
in
Social Science and Medicine
volume
190
pages
9 pages
publisher
Elsevier
external identifiers
  • scopus:85028017739
  • wos:000413135900006
ISSN
0277-9536
DOI
10.1016/j.socscimed.2017.08.012
language
English
LU publication?
yes
id
f639e5be-02ca-4977-b8c4-0f9f898a703f
date added to LUP
2017-09-06 11:37:54
date last changed
2018-01-16 13:25:07
@article{f639e5be-02ca-4977-b8c4-0f9f898a703f,
  abstract     = {<p>Previous research shows that generalized trust, the belief that most people can be trusted, is conducive to people's health. However, only recently have longitudinal studies suggested an additional reciprocal pathway from health back to trust. Drawing on a diverse body of literature that shows how egalitarian social policy contributes to the promotion of generalized trust, we hypothesize that this other ‘reverse’ pathway could be sensitive to health insurance context. Drawing on nationally representative US panel data from the General Social Survey, we examine whether the Affordable Care Act of 2010 could have had influence on the deteriorating impact of worsening self-rated health (SRH) on generalized trust. Firstly, using two-wave panel data (2008–2010, N = 1403) and employing random effects regression models, we show that a lack of health insurance coverage negatively determines generalized trust in the United States. However, this association is attenuated when additionally controlling for (perceived) income inequality. Secondly, utilizing data from two separate three-wave panel studies from the US General Social Survey (2006–10; N = 1652; 2010–2014; N = 1187), we employ fixed-effects linear regression analyses to control for unobserved heterogeneity from time-invariant factors. We demonstrate that worsening SRH was a stronger predictor for a decrease in generalized trust prior (2006–2010) to the implementation of the Affordable Care Act. Further, the negative effect of fair/poor SRH seen in the 2006–2010 data becomes attenuated in the 2010–2014 panel data. We thus find evidence for a substantial weakening of the previously established negative impact of decreasing SRH on generalized trust, coinciding with the most significant US healthcare reforms in decades. Social policy and healthcare policy implications are discussed.</p>},
  author       = {Mewes, Jan and Giordano, Giuseppe Nicola},
  issn         = {0277-9536},
  keyword      = {Health insurance,Healthcare reform,Income inequality,Longitudinal,Self-rated health,Social capital,Trust,United States},
  language     = {eng},
  month        = {10},
  pages        = {48--56},
  publisher    = {Elsevier},
  series       = {Social Science and Medicine},
  title        = {Self-rated health, generalized trust, and the Affordable Care Act : A US panel study, 2006–2014},
  url          = {http://dx.doi.org/10.1016/j.socscimed.2017.08.012},
  volume       = {190},
  year         = {2017},
}