The War on Poverty's Experiment in Public Medicine: Community Health Centers and the Mortality of Older Americans

Am Econ Rev. 2015 Mar;105(3):1067-1104. doi: 10.1257/aer.20120070.


This paper uses the rollout of the first Community Health Centers (CHCs) to study the longer-term health effects of increasing access to primary care. Within ten years, CHCs are associated with a reduction in age-adjusted mortality rates of 2 percent among those 50 and older. The implied 7 to 13 percent decrease in one-year mortality risk among beneficiaries amounts to 20 to 40 percent of the 1966 poor/non-poor mortality gap for this age group. Large effects for those 65 and older suggest that increased access to primary care has longer-term benefits, even for populations with near universal health insurance. (JEL H75, I12, I13, I18, I32, I38, J14).

MeSH terms

  • Aged
  • Aged, 80 and over
  • Community Health Centers / standards*
  • Community Health Centers / trends
  • Forecasting
  • Humans
  • Middle Aged
  • Mortality* / trends
  • Poverty* / statistics & numerical data
  • Poverty* / trends
  • Primary Health Care
  • Public Health
  • United States