I am a Postdoctoral Fellow at the Department of Health Policy and Management at UCLA. 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. Forthcoming. 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. Medicaid’s Lasting Impressions: Life-Course Mortality Consequences of Health Insurance at Birth. Revise and Resubmit.
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.
Sohn, H. Honey, I Lost Our Health Insurance: Spillovers in Health Insurance Coverage.
Health insurance policy affects more than just the primary subscribers. About a third of non-elderly adult Americans are insured as a dependent. Growing socioeconomic (SES) homogamy and dual-earner households are concentrating access to private health insurance among higher SES households. Lower SES households are increasingly more likely to have an uninsured spouse and thus, greater exposure to the adverse consequences of poor health. This article decomposes the diverging health coverage due to differences in own insurance coverage and differences in spousal coverage. Using the nationally representative, longitudinal Survey of Income and Program Participation (1996-2012), I build period-specific Markov models to compare patterns of insurance transitions between socioeconomic groups across periods. The SES disparity in private coverage spiked during periods of high job-loss following the two major recessions in 2001 and 2008. Higher SES men’s and women’s insurance coverages were barely affected due to their high likelihood of becoming insured by their spouses even as they lost their own. Wives’ insurance plans played a particularly large role in mitigating declines in higher SES men’s coverages during the most recent recession.
Sohn, H. Leaving the Nest with Golden Parachutes: Demographic Divergence in Parental Safety Nets.
Parents are increasingly supporting their children well into their adulthoods and often serve as safety-nets during periods of economic and marital instability. Improving life expectancies and health allow parents to provide for their children longer but greater union dissolution among parents can weaken the safety-nets that they can create. Greater mortality, non-marital childbearing, and divorce among lower socioeconomic (SES) families are reinforcing inequalities across generations. This article examines two female cohorts aged 25-49 from the 1988 (n = 3,823) and 2013 (n = 3,815) Panel Study of Income Dynamics Roster and Transfers Files. Higher SES women spent 3.3 years longer with two surviving and married parents than lower SES women in 1988. This disparity increased to 5.9 years in 2013 driven predominantly by higher rates of union dissolution among parents of lower SES women. Growing differences in paternal mortality also contributed to the rise in inequality.
Sohn, H. & Timmermans, S. Social Effects of Health Care Reform: The Impact of Medicaid Expansion under the Affordable Care Act on Volunteering
Do public health policy interventions result in pro-social behaviors? The Affordable Care Act (ACA)’s Medicaid expansions were responsible for the largest gains in public insurance coverage since its inception in 1965. These gains were concentrated in states that opted to expand Medicaid eligibility and provide a unique opportunity to study not just medical but also social consequences of increased public health coverage. This article examines the association between Medicaid and volunteer work. Volunteerism is implicated in individuals’ health and well-being yet it is highly correlated with a person’s existing socioeconomic resources. Medicaid expansions improved financial security and a sense of health—two factors that predict volunteer work—for a socioeconomic group that has had low levels of volunteerism. Difference-in-difference analyses of the Volunteer Supplement of the Current Population Survey (2010-2015) found increased reports of formal volunteering for organizations as well as informal helping behaviors between neighbors for low-income non-elderly adults who would have likely benefitted from expansions.
Department of Health Policy and Management
UCLA Fielding School of Public Health
650 Charles E. Young Dr. S., 31-293A CHS
Los Angeles, CA 90095
hesohn [at] ucla.edu