What the Group Threat Hypothesis Notes About States’ Medicaid Spending

Tyrone C. Cheng, Celia C. Lo

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


This secondary data analysis examined the relationship between state Medicaid spending in 2000–2014 and the perspective of the group threat hypothesis. The hypothesis posits that as any racial minority group grows in size, the increase is perceived by the racial majority group to threaten its dominant status. The employed data described states’ Medicaid spending, racial makeup, and poverty and unemployment rates and came from reports compiled by several federal agencies. It was processed first in 2 discrete date-based groups. Results with 2000–2009 data showed states’ per capita Medicaid spending to be associated negatively with their racial makeup. Specifically, states with proportionally larger Hispanic populations appeared to spend less on Medicaid versus states with fewer Hispanic residents, as did states with proportionally larger other non-African American minority populations (versus states with fewer such residents). Our findings with 2010–2014 data indicated no association between Hispanic population and states’ per capita Medicaid spending. Combining data from both periods, we observed no significant association between state Medicaid spending and each of the following: proportion of African Americans in state population, poverty rate, and unemployment rate. In general, state Medicaid spending increased gradually throughout the years studied. Policy implications are discussed.

Original languageEnglish
Pages (from-to)1062-1067
Number of pages6
JournalJournal of Racial and Ethnic Health Disparities
Issue number6
StatePublished - 1 Dec 2019


  • Group threat hypothesis
  • Medicaid
  • Racial disparities


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