Racial Inequalities in Health and Social Policy: Examining the Relationship between Medicaid Spending and Self-Assessed Health among Poor Single Mothers

Single mothers often face worse health than their married counterparts. This disparity has been connected to single mothers’ economic disadvantage and lower societal position. As a result of this disadvantage, accessing healthcare and maintaining good health can be challenging. Publicly provided health insurance, such as Medicaid, however, may serve as an important buffer, helping to overcome the financial and social pressures of single motherhood and improving single mother health. Medicaid generosity may also narrow the health divide between white and nonwhite single mothers. This article considers the role of place and policy in alleviating or exacerbating health differences among poor single mothers. I find greater Medicaid spending corresponds with better self-rated health for poor single mothers and find an especially strong positive association between Medicaid spending and health for poor, Black single mothers. Specifically, poor single mothers in states with higher average spending on Medicaid between 1995-2019 are predicted to have higher self-rated health than single mothers in states with lower average Medicaid spending. This variation is associated with considerable spatial inequalities in health, as states that spend the least on Medicaid, per enrollee, also tend to have larger Black populations, further compounding patterns of place-based racial inequalities in health.