The Impact of Health Insurance on Preventive Care and Health Behaviors: Evidence from the First Two Years of the ACA Medicaid Expansions

The U.S. population receives suboptimal levels of preventive care and has a high prevalence of risky health behaviors. One goal of the Affordable Care Act (ACA) was to increase preventive care and improve health behaviors by expanding access to health insurance. This paper estimates how the ACA‐facilitated state‐level expansions of Medicaid in 2014 affected these outcomes. Using data from the Behavioral Risk Factor Surveillance System, and a difference‐in‐differences model that compares states that did and did not expand Medicaid, we examine the impact of the expansions on preventive care (e.g., dental visits, immunizations, mammograms, cancer screenings), risky health behaviors (e.g., smoking, heavy drinking, lack of exercise, obesity), and self‐assessed health. We find that the expansions increased insurance coverage and access to care among the targeted population of low‐income childless adults. The expansions also increased use of certain forms of preventive care, but there is no evidence that they increased ex ante moral hazard (i.e., there is no evidence that risky health behaviors increased in response to health insurance coverage). The Medicaid expansions also modestly improved self‐assessed health.     

Methodological and Ethical Challenges in Partnering for Refugee Research: Evidence From Two Australian Studies

In this article we reflect on methodological and ethical challenges encountered while conducting two large, nationally funded studies on refugee resettlement in Australia. We focus on collaborative research partnerships, specifically with “industry partners,” wherein the partners may have different understandings of the research process and different agendas, and with bilingual research assistants. We analyze methodological challenges primarily pertaining to collecting good-quality data in cross-cultural contexts and ethical challenges concerned with ensuring confidentiality in recently arrived, tightly knit communities where community insiders assisted in accessing respondents and collecting data.     

Secularizing Religion: Hindu Extremism as a Modernist Discourse

In this article, I suggest that Hindu nationalism, like many other religious extremist ideologies, is a modern discourse rooted in modern categories such as a homogenous national identity, objective science and history, hyper-masculinity, and secularism. To demonstrate the above claims, I undertake a close analysis of the writings of V.D. Savarkar, a key founder of "Hindutva" or Hindu nationalism. I show how he retools Hinduism by removing all aspects of religiosity/piety while replacing it with a primarily political-secular identity that places an exclusive Hindu nation at the center.     

Mine smartness and the community voice in mine-risk education: lessons from Afghanistan and Angola

Mine-risk education programmes will fall short of their intended impact for as long as they fail to take into account local responses—knowledge, logic and everyday practices—to mine threats. Community information, systematically collected through household and institutional surveys, can help to define and understand endogenous ‘mine smartness’. The same evidence provides insight into the impact of mine-risk education, including its unintended consequences. Using six criteria of mine smartness, ciet carried out evaluations of mine-risk education in Afghanistan (1997) and Angola (1999). The first clear lesson to be drawn from these evaluations is that people in mine-affected areas do generate their own broadly effective means of facing the daily threat of mines. The second lesson is that people take risks for reasons that make sense to them: ‘education’ that landmines are dangerous probably adds little value for them. The third lesson is that mine-risk education that does not take into account these first two lessons can cause harm. The evaluations produced evidence of unintended risk-taking by people exposed to mine-risk education programmes.