Table 2. Differences-in-Differences Analysisa.
| Group | Cardiovascular Deaths per 100 000 Residents per Year, Unadjusted, Mean (SD) | Difference-in-Differences Estimate (95% CI) | ||||
|---|---|---|---|---|---|---|
| Pre–Medicaid Expansion Period | Post–Medicaid Expansion Period | Unadjusted | P Value | Adjusteda | P Value | |
| Overall | ||||||
| Medicaid expansion states | 146.5 (132.4-160.7) | 146.4 (131.9-161.0) | −4.6 (−7.5 to −1.8) | .001 | −4.3 (−6.9 to −1.8) | .001 |
| Medicaid nonexpansion states | 176.3 (154.2-198.5) | 180.9 (158.0-203.8) | ||||
| Metropolitan counties | ||||||
| Medicaid expansion states | 139.4 (126.3-152.4) | 139.6 (125.9-153.3) | −4.0 (−6.5 to −1.6) | .001 | −3.7 (−6.3 to −1.2) | .005 |
| Medicaid nonexpansion states | 163.9 (144.1-183.7) | 168.1 (147.8-188.4) | ||||
| Nonmetropolitan counties | ||||||
| Medicaid expansion states | 168.5 (1513-185.6) | 168.9 (152.0-185.7) | −6.4 (−12.5 to −0.2) | .04 | −6.2 (−12.5 to 0.1) | .05 |
| Medicaid nonexpansion states | 227.0 (200.9-253.0) | 233.7 (206.4-261.0) | ||||
| Counties with >10% black residents in 2010 | ||||||
| Medicaid expansion states | 176.9 (157.8-196.1) | 175.2 (154.8-195.6) | −4.5 (−8.0 to −1.0) | .01 | −4.3 (−7.7 to −0.9) | .01 |
| Medicaid nonexpansion states | 199.9 (178.2-221.5) | 202.7 (179.6-225.7) | ||||
| Top 50th percentile for residents living in poverty in 2010b | ||||||
| Medicaid expansion states | 178.8 (160.9-196.4) | 177.9 (159.1-196.6) | −6.6 (−10.7 to −2.5) | .002 | −5.3 (−9.0 to −1.6) | .01 |
| Medicaid nonexpansion states | 205.4 (183.1-227.7) | 211.1 (187.5-234.8) | ||||
| Top 50th percentile for cardiovascular mortality in 2010c | ||||||
| Medicaid expansion states | 185.7 (174.5-196.9) | 187.0 (174.8-199.2) | −5.7 (−9.4 to −2.1) | .002 | −5.2 (−9.1 to −1.4) | .01 |
| Medicaid nonexpansion states | 206.5 (191.1-221.8) | 213.6 (197.2-229.9) | ||||
| Top 50th percentile for percentage of population uninsured in 2010d | ||||||
| Medicaid expansion states | 135.2 (117.5-152.8) | 130.1 (112.5-147.8) | −4.4 (−8.2 to −0.5) | .03 | −3.4 (−6.6 to −0.2) | .04 |
| Medicaid nonexpansion states | 174.1 (151.4-196.9) | 173.5 (149.8-197.2) | ||||
| Bottom 50th percentile for percentage of population uninsured in 2010e | ||||||
| Medicaid expansion states | 155.0 (137.7-172.2) | 155.3 (137.5-173.1) | −8.7 (−12.6 to −4.7) | <.001 | −7.5 (−12.0 to −3.0) | .001 |
| Medicaid nonexpansion states | 205.9 (175.4-236.3) | 214.9 (184.2-245.6) | ||||
Adjusted for 2013 National Center for Health Statistics Urban-Rural Classification designation (metropolitan vs nonmetropolitan county), percentage of residents living in poverty, percentage of adults unemployed, inflation-adjusted median household income, percentage of residents aged 40 to 64 years who were female, percentage of residents aged 40 to 64 years who were black, percentage of residents aged 40 to 64 years who were Hispanic, percentage of adult residents with diabetes in 2010, percentage of adult residents with obesity in 2010, percentage of adult residents who smoke in 2010, number of primary care clinicians per 100 000 residents, number of cardiologists per 100 000 residents, and percentage of residents aged 40 to 64 years with income less than 138% of the federal poverty limit with health insurance in 2010.
Greater than or equal to 15.2% of residents.
Greater than or equal to 145.1 deaths per 100 000 residents.
Greater than or equal to 39% of residents aged 40 to 64 years with income less than 138% of the federal poverty limit.
Less than 39% of residents aged 40 to 64 years with income less than 138% of the federal poverty limit.