# Educational Attainment, Geography, and U.S. Adult Mortality Risk

> **NIH NIH R01** · SYRACUSE UNIVERSITY · 2020 · $234,084

## Abstract

PROJECT SUMMARY
Rising rates of maternal mortality and severe maternal morbidity highlight an unmet need for
continuous and comprehensive health insurance coverage for women long before pregnancy
and well after childbirth. Advanced maternal age (≥35 years old) and low socioeconomic status
are important risk factors for severe maternal morbidity, making it particularly important that low-
income, older mothers have continuous health insurance coverage. In 2014 and later, under the
Affordable Care Act (ACA), 37 states and DC (as of 2020) expanded Medicaid thresholds to
include low-income adults. Although not targeted at mothers, ACA Medicaid expansions may
have improved the continuity of Medicaid coverage from the pre-conception through the post-
partum period by expanding eligibility to all adults (including childless adults) with incomes
below 138% of the Federal Poverty Level. In this proposed study, we examine whether ACA
Medicaid expansions are associated with maternal health outcomes and behaviors among
women ages 18-49, with a focus on older mothers (≥35 yr.). We use difference-in-difference
methods and data from Vital Statistics birth certificate records from 2010-2018. To measure
states’ Medicaid expansion status, we create an indicator of whether the mother lived in a state
that expanded Medicaid in the year prior to the child’s birth. To capture potential age-specific
variation, we also create simulated measures of Medicaid eligibility by maternal age, state, and
year. The findings from this work are intended to provide policy-relevant, timely information on
the potential role of the ACA Medicaid expansions in improving health among older mothers.

## Key facts

- **NIH application ID:** 10200308
- **Project number:** 3R01AG055481-04S1
- **Recipient organization:** SYRACUSE UNIVERSITY
- **Principal Investigator:** Jennifer Karas Montez
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $234,084
- **Award type:** 3
- **Project period:** 2017-09-15 → 2021-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10200308

## Citation

> US National Institutes of Health, RePORTER application 10200308, Educational Attainment, Geography, and U.S. Adult Mortality Risk (3R01AG055481-04S1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10200308. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*