Venue: The Fuqua School of Business, Duke University, 1 Towerview Drive, Durham, NC 27708-0120
Presentation
The Impact of Hospital Integration on Black-White Differences in Mortality: A Case Study of Motor Vehicle Accident Death Rates
Prior to the Civil Rights Era hospitals in the American South could, and routinely did, refuse medical care to Black patients even in emergency situations. When in need of medical care a sick or injured African-American would have to find a "Blacks-only" facility, or face very limited accommodations in "Whites-only" institutions. This situation changed, however, in the mid-1960s when hospitals became racially integrated.
This paper studies the impact of hospital integration on racial differences in deaths from motor vehicle accidents. We use detailed micro-data from the US Vital Statistics matched with hospital survey information from 1959-1978. The analysis is conducted first using state-level data and then at the county levels for the state of Mississippi. We document that there was a sharp increase in the black motor vehicle accident death rate in the South in the mid-1960s.
After analyzing state level data, we investigate the role of minority medical care access in Mississippi using unique and previously unexploited county-level data. Using GIS methods we compute a race-specific measure of distance to the nearest hospital before and after integration, which occurred in 1965. We find that, on average, distance to nearest hospital fell by 50 miles for blacks after integration. We also show that distance and accident mortality were positively correlated: increases in distance to the nearest hospital were associated with higher mortality. Combining the treatment effects of distance with integration, we find that hospital integration reduced African-American mortality from car accidents by 20 percent.