The War on Poverty's Experiment in Public Medicine: Community Health Centers and the Mortality of Older Americans

Martha Bailey, University of Michigan
Andrew Goodman-Bacon, University of Michigan

In 1965, the Community Health Center (CHC) program began a bold experiment in the delivery of primary care. This paper uses the rollout of the first Community Health Centers (CHCs) to estimate the long-term health effects of increasing access to primary care. Using a county-level panel of mortality outcomes, the results show that CHCs reduced age-adjusted mortality rates among those 50 and older by almost 2 percent within 10 years. These reductions were concentrated among cardiovascular-related deaths. The implied 6- to 8-percent decrease in one-year mortality risk among the treated amounts to 18 to 24 percent of the 1966 poor-nonpoor mortality gap for this age group. Large effects for those 65 and older suggest that increased access to primary care has long-term benefits, even for populations with near universal health insurance.