I am a postdoctoral scholar at UCLA’s California Center for Population Research (K99/R00 Pathway to Independence Award), and I will be joining the Sociology Department at Emory University in August 2020. I hold a joint Ph.D. in Demography and Sociology from the University of Pennsylvania. My research intersects health policy with family demography, social stratification, and health across the life-course.
I study health policy and family demography to examine how unequal access to health insurance and informal safety nets create socioeconomic inequalities between individuals and families. People have various safeguards to help them through unexpected illness and poor health. Formal health insurance reduces the financial burden and eases access to care. Immediate and extended family members may help pay bills, share housework, and offer emotional support. Existing work has established that the strength of these safety nets is stronger for those who already have higher income, greater education, and better health. My research completes the missing link in the cycle and examines how disparate safety nets contribute to the persistent reinforcement of socioeconomic status (SES) and health.
Sohn, H. 2020. Will you be covered during the next recession? Unequal safety-nets for private health insurance in the United States. Health Policy OPEN. (Link)
Health insurance coverage for working-age adults in the United States is still predominantly determined by their jobs or their spouse’s jobs. This article revealed that SES disparities in access to a spouse’s coverage as a safety-net significantly contributed to the inequities in coverage loss during economic instability. Using the longitudinal Survey of Income and Program Participation (1996–2012), this article examines insurance transitions between socioeconomic groups during the two most recent recessions in the United States. The SES disparity in private coverage spiked during periods of high job-loss. Higher SES men’s and women’s coverages were barely affected as they became insured by their spouses even as they lost their own. Wives’ insurance plans played a large role in mitigating declines in higher SES men’s coverages during the 2008 recession.
Sohn, H. 2019. Fraying Families: Demographic Divergence in Parental Safety-Nets. Demography. 56(4), 1519-1540. (Link)
Parents are increasingly supporting their children well into adulthood and often serve as a safety net during periods of economic and marital instability. Improving life expectancies and health allows parents to provide for their children longer, but greater union dissolution among parents can weaken the safety net they can create for their adult children. Greater mortality, nonmarital childbearing, and divorce among families with lower socioeconomic status may be reinforcing inequalities across generations. This article examines two cohorts aged 25–49 from the 1988 (n = 7,246) and 2013 (n = 7,014) Panel Study of Income Dynamics Roster and Transfers Files. In 1988, adults with a college degree had two surviving parents living together for 1.8 years longer than nongraduates. This disparity increased to 6.8 years in 2013. This five-year increase in disparity was driven predominantly by higher rates of union dissolution among parents of adults with less education. Growing differences in paternal mortality also contributed to the rise in inequality.
Sohn, H. & Timmermans, S. 2019. Inequities in Newborn Screening: Race and the Role of Medicaid. Social Science and Medicine Population Health. (Link)
Newborn Screening (NBS) is a State-run program that mandates all newborns to be screened for a panel of medical conditions to reduce infant mortality and morbidity. Medicaid is a public health insurance program that expanded access to care for low-income infants. NBS mandates and Medicaid rolled out state-by-state in the 1960s, 70s, and 80s, which are considered significant programs that improved infant health in the latter half of the 20th Century. This article utilized variation in States’ timing of NBS mandates and Medicaid implementation to examine changes in infant mortality rates among white and African American infants associated with NBS, Medicaid, and their interaction. The analyses used data from birth and death certificates in the US Vital Statistics from 1959 to 1995. We find that the implementation of NBS mandates alone was not associated with significant declines in infant mortality and coincided with increases in within-state racial inequities. States experienced mortality declines and reduction in racial inequities after implementing Medicaid with NBS mandates.
Sohn, H. 2017. Racial and Ethnic Disparities in Health Insurance Coverage: Dynamics of Gaining and Losing Coverage over the Life-Course. Population Research and Policy Review. (Link)
Health insurance coverage varies substantially between racial and ethnic groups in the United States. Compared to non-Hispanic whites, African Americans and people of Hispanic origin had persistently lower insurance coverage rates at all ages. This article describes age- and group-specific dynamics of insurance gain and loss that contribute to inequalities found in traditional cross-sectional studies. It uses the longitudinal 2008 Panel of the Survey of Income and Program Participation (N=114,345) to describe age-specific patterns of disparity prior to the Affordable Care Act (ACA). A formal decomposition on increment-decrement life-tables of insurance gain and loss shows that coverage disparities are predominately driven by minority groups’ greater propensity to lose the insurance that they already have. Uninsured African Americans were faster to gain insurance than non-Hispanic whites but their high rates of insurance loss more than negated this advantage. Disparities from greater rates of loss among minority groups emerge rapidly at the end of childhood and persist throughout adulthood. This is especially true for African Americans and Hispanics and their relative disadvantages again heighten in their 40s and 50s.
Sohn, H. 2015. Health Insurance and the Risk of Divorce: Does Having Your Own Insurance Matter? Journal of Marriage and Family, 77(4), 982-995. (Link)
Most American adults under 65 obtain health insurance through their employers or their spouses’ employers. The absence of a universal health care system in the United States puts Americans at considerable risk for losing their coverage when transitioning out of jobs or marriages. Scholars have found evidence of reduced job mobility among individuals who are dependent on their employers for health care coverage. In this study, the author found similar relationships between insurance and divorce. She applied the hazard model to married individuals in the longitudinal Survey of Income Program Participation (N = 17,388) and found lower divorce rates among people who were insured through their partners’ plans without alternative sources of their own. Furthermore, she found gender differences in the relationship between health care coverage and divorce rates: Insurance-dependent women had lower rates of divorce than men in similar situations. These findings draw attention to the importance of considering family processes when debating and evaluating health policies.
Sohn, H. 2017. Medicaid’s Lasting Impressions: Life-Course Mortality Consequences of Health Insurance at Birth. Social Science and Medicine 177:205-212.(link)
This article examines lasting mortality improvements associated with availability of Medicaid at time and place of birth. Using the US Vital Statistics (1959-2010), I exploit the variation in when each of the 50 states adopted Medicaid to estimate overall infant mortality improvements that coincided with Medicaid participation. 0.23 less infant deaths per 1000 live births was associated with states’ Medicaid implementation. Second, I find lasting associations between Medicaid and mortality improvements across the life-course. I build state-specific cohort life-tables and regress age-specific mortality on availability of Medicaid in their states at time of birth. Cohorts born after Medicaid adoption had lower mortality rates throughout childhood and into adulthood. Being born after Medicaid was associated with between 2.03 and 3.64 less deaths per 100,000 person-years in childhood and between 1.35 and 3.86 less deaths per 100,000 person-years in the thirties. The association between Medicaid at birth and mortality was the strongest in the oldest age group (36-40) in this study.
UCLA California Center for Population Research
337 Charles E. Young Dr. E., Suite 4284
Los Angeles, CA 90095
hesohn [at] ucla.edu