Medicaid Expansion and Firearm Suicide Mortality Among Black and White Men: A State-Level Retrospective Study, United States, 2000–2023.
Objectives. To examine whether the Affordable Care Act's Medicaid expansion was associated with changes in firearm suicide among Black and White men, recognizing that masculine norms such as self-reliance and reluctance to seek mental health care may shape how policy interventions influence men's he...
| Publicado en: | American Journal of Public Health Vol. 116; no. 8; pp. 1095 - 1104 |
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| Autores principales: | , , , , , |
| Formato: | Artículo |
| Publicado: |
American Public Health Association
Aug2026
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=195376238&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 195376238 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00900036 APH jtl: American Journal of Public Health issn: 00900036 maglogo: N pubinfo: dt: Aug2026 vid: 116 iid: 8 pid: 44 pub: American Public Health Association artinfo: ui: 195376238 10.2105/AJPH.2026.308581 ppf: 1095 ppct: 9 formats: tig: atl: Medicaid Expansion and Firearm Suicide Mortality Among Black and White Men: A State-Level Retrospective Study, United States, 2000–2023. aug: au: Rippey, Emily Caton, Lauren Simon, Samantha J. Testa, Alexander Jackson, Dylan B. Gutierrez, Carmen affil: Department of Public Policy, University of North Carolina at Chapel Hill, Chapel Hill, NC.; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC. Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA. School of Sociology, University of Arizona, Tucson, AZ.; School of Government and Public Policy, University of Arizona, Tucson, AZ. Department of Management, Policy, and Community Health, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX. Department of Population, Family, and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD. Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC.; Department of Public Policy, University of North Carolina at Chapel Hill, Chapel Hill, NC. Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC., su: Suicide risk factors African Americans Death Masculinity Psychology of men White people Retrospective studies Age distribution Help-seeking behavior Race Suicide Medicaid T-test (Statistics) Firearms Descriptive statistics Acquisition of property Surveys Medical records Acquisition of data Research methodology sug: subj: Suicide risk factors African Americans Death Masculinity Psychology of men White people Retrospective studies Age distribution Help-seeking behavior Race Suicide Medicaid All other sporting goods stores Small Arms Ammunition Manufacturing All other merchant wholesalers Administration of Human Resource Programs (except Education, Public Health, and Veterans' Affairs Programs) T-test (Statistics) Firearms Descriptive statistics Acquisition of property Surveys Medical records Acquisition of data Research methodology ab: Objectives. To examine whether the Affordable Care Act's Medicaid expansion was associated with changes in firearm suicide among Black and White men, recognizing that masculine norms such as self-reliance and reluctance to seek mental health care may shape how policy interventions influence men's health. Methods. We conducted a retrospective state-level analysis of firearm suicide mortality from 2000 to 2023 among US men aged 18 to 64 years. Difference-in-differences (DID) and synthetic DID models estimated changes in firearm suicide rates before and after Medicaid expansion after adjustment for sociodemographic and policy covariates. Results. Medicaid expansion was associated with a reduction of approximately 1.4 deaths per 100 000 among White men aged 35 to 49 years (95% confidence interval = −2.45, −0.39), but no consistent effects were observed for other groups. Firearm suicide increased across all subgroups, with the sharpest rises among younger Black men in both expansion and nonexpansion states. Conclusions. Medicaid expansion alone was insufficient to offset the drivers of men's firearm suicide risk. Reducing firearm suicides requires strategies combining expanded health coverage and approaches that challenge harmful masculine norms, advance racial equity, and reduce access to lethal means. (Am J Public Health. 2026;116(8):1095–1103. https://doi.org/10.2105/AJPH.2026.308581) pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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