Medicaid, Health, and the Moderating Role of Neighborhood Characteristics

J Urban Health. 2022 Feb;99(1):116-133. doi: 10.1007/s11524-021-00579-2. Epub 2022 Jan 4.


Neighborhood characteristics may moderate the effects of Medicaid coverage on health outcomes. Identifying this interplay can inform the design, targeting, and implementation of health policy. We combine data from the Oregon Health Insurance Experiment, which randomized access to Medicaid, with rich new data on multiple domains of neighborhood characteristics to assess the interaction between the local environment and the effect of insurance on health. Overall, we do not find that neighborhood characteristics substantially affect the relationship between gaining insurance and health outcomes, suggesting that Medicaid expansions are similarly effective across neighborhoods. This analysis highlights the complex relationship between health insurance coverage, neighborhood characteristics, and health.

Keywords: Medicaid; Population health; Social determinants of health.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Health Services Accessibility
  • Humans
  • Insurance Coverage
  • Insurance, Health
  • Medicaid*
  • Neighborhood Characteristics*
  • Oregon
  • Patient Protection and Affordable Care Act
  • United States