Paper Title: Racial Concordance and the Quality of Medical Care: Evidence from the Military

Abstract: One explanation for insufficient use of primary care in the U.S. is a lack of trust between patients and providers – particularly along racial lines. We assess the role of racial concordance between patients and medical providers in driving use of preventive care and the implicationsfor patient outcomes. We use unique data from the Military Health System, where we observe providers as patients so that we can identify their race, and where moves across bases change exposure to provider race. We consider patients with four chronic, deadly, but ultimately manageable illnesses, where the relationship with the provider may have the most direct and important impact on health. We find striking evidence that racial concordance leads to

improved maintenance of preventive care – and ultimately lower patient mortality. Pooling across these diseases, we estimate that a one-standard deviation increase in the share of providers who are black leads to a 15% relative decline in Black mortality among those with these manageable illnesses. Our results further suggest that between 55 and 69% of this mortality impact arises through improved medication use and adherence, with other aspects of the provider-patient relationship accounting for the residual.

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Michigan's Law and Economics Workshop provides an opportunity for faculty and students from across the University to engage with cutting-edge law and economics research by leading scholars on a wide range of legal and policy topics.

The Winter 2023 workshop meets on Thursdays from 4:30-6:30 p.m. All workshops occur in person in Jeffries Hall 1025 and are open to the academic community from the University of Michigan and elsewhere.

Professor J.J. Prescott (jprescott@umich.edu) organizes the workshop. If you would like to receive workshop announcements, please contact Alex Wroble (arwroble@umich.edu) and ask to have your name added to the workshop’s email list.