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Supplement: The impact of Medicaid expansion on the rural mortality penalty in the United States (Postbac)

Award Number: R21AG083393
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/30/2023
PERIOD OF PERFORMANCE END DATE: 09/29/2026

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Supplement: The impact of Medicaid expansion on the rural mortality penalty in the United States (Postbac) - Project Summary (copied from Parent Grant) Rural areas in the United States (U.S.) have exhibited higher mortality rates than urban areas since the late 1990s, a pattern known as the rural mortality penalty. Recent research has found that the rural mortality penalty continues growing due to mortality associated with preventable causes (metabolic and cardiovascular causes, alcohol use, and mental health). The expansion of Medicaid adopted by many states in the U.S. had the potential to reduce death due to these and other causes by facilitating access to healthcare to people who were not eligible under previous eligibility thresholds. While some state in the nation adopted this expansion, a process that started in 2014, others rejected it. While the adoption/rejection of this expansion is well-documented, little is known about the role the adoption of this policy at the state level impacted well-established demographic phenomenon such as the rural mortality penalty. This project requests access to restricted data to produce mortality rates for the population aged 19-64, by sex and by race/ethnicity to conduct a novel analysis of the differences observed in the rural mortality penalty employing a difference-in-difference design. The project evaluate whether the Medicaid expansion impacted the rural mortality penalty emphasizing the overall population, and disparities by sex and race/ethnicity. The project will also be the first to explore whether the COVID-19 pandemic impacted rural/urban mortality dynamics based on state-level adoption of the expansion of Medicaid by 2020. The analytic approach will combine formal and mathematical demographic methods with novel statistical models to evaluate the impact of the expansion of Medicaid in rural/urban mortality dynamics. Findings from this project will illustrate the role that state-level policies have in shaping diverging or congruent trajectories in mortality and in the face of the ongoing COVID-19 pandemic.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $0 )
2026	2024	THE PENNSYLVANIA STATE UNIVERSITY	201 OLD MAIN	UNIVERSITY PARK	PA	16802	CENTRE	USA	Aging Research	001	1	12/12/2025	SUPPLEMENT FOR EXPANSION	$0
2026	2023	THE PENNSYLVANIA STATE UNIVERSITY	201 OLD MAIN	UNIVERSITY PARK	PA	16802	CENTRE	USA	Aging Research	000	1	12/5/2025	NEW	$0
														Subtotal = $0

Issue Date FY: 2024 ( Subtotal = $145,002 )
2024	2024	THE PENNSYLVANIA STATE UNIVERSITY	201 OLD MAIN	UNIVERSITY PARK	PA	16802	CENTRE	USA	Aging Research	003	1	9/10/2024	SUPPLEMENT FOR EXPANSION	$0
2024	2024	THE PENNSYLVANIA STATE UNIVERSITY	201 OLD MAIN	UNIVERSITY PARK	PA	16802	CENTRE	USA	Aging Research	001	1	1/29/2024	SUPPLEMENT FOR EXPANSION	$145,002
2024	2024	THE PENNSYLVANIA STATE UNIVERSITY	201 OLD MAIN	UNIVERSITY PARK	PA	16802	CENTRE	USA	Aging Research	002	1	7/26/2024	SUPPLEMENT FOR EXPANSION	$0
2024	2023	THE PENNSYLVANIA STATE UNIVERSITY	201 OLD MAIN	UNIVERSITY PARK	PA	16802	CENTRE	USA	Aging Research	000	1	1/3/2024	NEW	$0
														Subtotal = $145,002

Issue Date FY: 2023 ( Subtotal = $443,046 )
2023	2023	THE PENNSYLVANIA STATE UNIVERSITY	201 OLD MAIN	UNIVERSITY PARK	PA	16802	CENTRE	USA	Aging Research	000	1	9/19/2023	NEW	$443,046
														Subtotal = $443,046

Grand Total All Awards = $588,048

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Supplement: The impact of Medicaid expansion on the rural mortality penalty in the United States (Postbac)

Award Number: R21AG083393

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/30/2023

PERIOD OF PERFORMANCE END DATE: 09/29/2026

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