Imposing Policy on Reluctant Actors: The Hospital Desegregation Campaign and Black Postneonatal Mortality in the Deep South

In 1966, Southern hospitals were barred from participating in Medicare unless they discontinued their longstanding practice of racial segregation. Using data from five Deep South states and exploiting county-level variation in Medicare certification dates, we find that gaining access to an ostensibly integrated hospital had no effect on Black postneonatal mortality. Similarly, there is little evidence that the campaign contributed to the trend towards in-hospital births among Southern Black mothers. These results are consistent with descriptions of the hospital desegregation campaign as producing only cosmetic changes and illustrate the limits of anti-discrimination policies imposed upon reluctant actors.

1966年，南方的医院被禁止参与医疗保险，除非它们停止长期以来的种族隔离做法。利用来自美国南方腹地五个州的数据，并利用医疗保险认证日期在县一级的差异，我们发现，进入一家表面上取消了种族隔离的医院对黑人新生儿后期死亡率没有影响。同样，几乎没有证据表明这场运动对南方黑人母亲在医院分娩的趋势有促进作用。这些结果与对医院废除种族隔离运动只产生表面变化的描述相符，并说明了强加给不情愿的行为者的反歧视政策的局限性。