Increased female political representation associated with lower county-level uninsured and preventable hospitalizations rates in the US, 2013-2018
Document Type
Article
Publication Date
3-2023
Journal / Book Title
Public Health
Abstract
Although women comprise 50% of the population, females remain underrepresented in government. Inequitable female political representation, a form of structural sexism, may impact population health. Previous studies focused primarily on individual health behaviors and low- or middle-income countries. To date, no study has examined the association between female political representation and healthcare access and utilization, immediately policy-amenable outcomes, in the United States.
Study design
This was a repeated cross-sectional study.
Methods
This study uses 2013–2018 county-level data from the County Rankings. I performed multilevel analyses to determine the relationships between state-level female representation (% female state legislators) and two outcomes—the percentage of county-level population under age 65 years without health insurance (primary outcome) and the county-level preventable hospitalization rates (secondary outcome of interest). Potential confounders included county-level and state-level characteristics such as the unemployment rate. I also examined whether associations differed by political party control of the state legislature.
Results
In the fully adjusted model, one standard deviation difference in female political representation was associated with a decrease of 0.22 percentage points in county-level uninsured (95% confidence interval = −0.32, −0.12). The association between female political representation and preventable hospitalization rate differed according to state political party in control, with a decrease found only among counties in democratic/split controlled states (−80.51, 95% confidence interval = −149.65, −11.38).
Conclusions
The results suggest that policy intervention addressing the underrepresentation of women in government may help increase the proportion of uninsured and, under certain circumstances, decrease county-level unnecessary hospitalizations. However, further research is needed to better understand the role of political party control in modifying noted associations.
DOI
10.1016/j.puhe.2022.12.007
MSU Digital Commons Citation
Liu, Sze Yan, "Increased female political representation associated with lower county-level uninsured and preventable hospitalizations rates in the US, 2013-2018" (2023). Department of Public Health Scholarship and Creative Works. 229.
https://digitalcommons.montclair.edu/public-health-facpubs/229
Published Citation
Liu, SY. Increased female political representation associated with lower county-level uninsured and preventable hospitalizations rates in the United States, 2013–2018. Public Health 2023: 26:7-12.