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Many claim a high prevalence of single motherhood plays a significant role in America's high child poverty. Using the Luxembourg Income Study, we compare the "prevalences and penalties" for child poverty across 30 rich democracies and within the United States over time (1979-2019). Several descriptive patterns contradict the importance of single motherhood. The U.S. prevalence of single motherhood is cross-nationally moderate and typical and is historically stable. Also, child poverty and the prevalence of single motherhood have trended in opposite directions in recent decades in the United States. More important than the prevalence of single motherhood, the United States stands out for having the highest penalty across 30 rich democracies. Counterfactual simulations demonstrate that reducing single motherhood would not substantially reduce child poverty. Even if there was zero single motherhood, (1) the United States would not change from having the fourth-highest child poverty rate, (2) the 41-year trend in child poverty would be very similar, and (3) the extreme racial inequalities in child poverty would not decline. Rather than the prevalence of single motherhood, the high penalty for single motherhood and extremely high Black and Latino child poverty rates, which exist regardless of single motherhood, are far more important to America's high child poverty., (Copyright © 2024 The Authors.)

Purpose: To determine the differential impact of Medicaid expansion on all-cause mortality between Black, Latino/a, and White populations in rural and urban areas, and assess how expansion impacted mortality disparities between these groups., Methods: We employ a county-level time-varying heterogenous treatment effects difference-in-difference analysis of Medicaid expansion on all-cause age-adjusted mortality for those 64 years of age or younger from 2009 to 2019. For all counties within the 50 US States and the District of Columbia, we use restricted-access vital statistics data to estimate Average Treatment Effect on the Treated (ATET) for all combinations of racial and ethnic group (Black, Latino/a, White), rurality (rural, urban), and sex. We then assess aggregate ATET, as well as how the ATET changed as time from expansion increased., Findings: Medicaid expansion led to a reduction in all-cause age-adjusted mortality for urban Black populations, but not rural Black populations. Urban White populations experienced mixed effects dependent on years after expansion. Latino/a populations saw no appreciable impact. While no effect was observed for rural Black and Latino/a populations, rural White all-cause age-adjusted mortality unexpectedly increased due to Medicaid expansion. These effects reduced rural- and urban-specific Black-White mortality disparities but did not shrink the rural-urban mortality gap., Conclusions: The mortality-reducing impact of Medicaid expansion has been uneven across racial and ethnic groups and rural-urban status; suggesting that many populations-particularly rural individuals-are not seeing the same benefits as others. It is imperative that states work to ensure Medicaid expansion is being appropriately implemented in rural areas., (© 2024 The Author(s). The Journal of Rural Health published by Wiley Periodicals LLC on behalf of National Rural Health Association.)