Increased female political representation associated with lower county-level uninsured and preventable hospitalizations rates in the US, 2013-2018
Journal / Book Title
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.
This was a repeated cross-sectional study.
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.
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).
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.
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.
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.