Since the passing of the Patient Protection and Affordable Care Act of 2010, known as Obamacare, an estimated 20 million previously uninsured U.S. citizens have gained access to health insurance. Recent research from Umeå and Lund universities in Sweden shows that Obamacare might be key to reversing the trend of declining social trust that has plagued the United States since the 1970s.
"Before 2010, worsening health in the U.S. led to a decrease in people's generalized trust. Coinciding with the introduction of Obamacare in 2010, this negative relationship no longer holds true," says Jan Mewes, associate professor at the Department of Sociology at Umeå University in Northern Sweden.
Generalized trust is defined as the belief that most people, even strangers, can be trusted. Past research shows that societies with higher levels of generalized trust also have better functioning democracies, with less corruption and less crime. Over the past five decades, the U.S. has undergone a steady decline in generalized trust.
In their article published in Social Science & Medicine, researchers Jan Mewes (Umeå University, Sweden) and Giuseppe Giordano (Lund University, Sweden) argue how Obamacare has marked a paradigm shift, not just in terms of broadening access to affordable healthcare across the U.S., but also regarding citizens' perceptions of life in general. Prior to Obamacare, worsening health often led to a measurable drop in generalized trust; after 2010, this pattern is no longer seen.
"In societies that lack social security in the form of universal health insurance, worsening health or even fear of worsening health can undermine people's optimism and their belief in the future. Everything is dependent on always being healthy enough to work and earn money to provide for healthcare and other essentials. Broadening access to healthcare really matters, not only in terms of improved health outcomes but also regarding positively shaping people's attitudes in general," says Jan Mewes.
Their Social Science & Medicine article is based on two consecutive panel studies from the U.S. General Social Survey (2006–2010 and 2010–2014). Each panel survey followed the same individuals over the course of four years, with 1,652 respondents in 2006–2010 and 1,187 respondents in 2010–2014, respectively.
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Jan Mewes et al. Self-rated health, generalized trust, and the Affordable Care Act: A US panel study, 2006–2014, Social Science & Medicine (2017). DOI: 10.1016/j.socscimed.2017.08.012