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ACA helped reverse decline in U.S. trust, research shows

Prior to the law, worsening health often led to a measurable drop in generalized trust, but after 2010, that pattern was no longer seen.

Jeff Lagasse, Associate Editor

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Despite attempts by Congress to dismantle the Affordable Care Act, the law has had positive implications even beyond the accessibility of healthcare, a new study suggests. Researchers from Umea and Lund universities in Sweden showed that the ACA might be key to reversing the trend of declining social trust that has characterized the United States since the 1970s.

Before 2010, worsening health in the U.S. led to a decrease in people's generalized trust, the authors wrote. Coinciding with the introduction of the ACA in 2010, that negative relationship began to unravel.

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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 and Medicine, the researchers contend that the ACA 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 the law, worsening health often led to a measurable drop in generalized trust; after 2010, that pattern was no longer seen.

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"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," researchers wrote. "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."

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The study is based on two consecutive panel studies from the U.S. General Social Survey  one from 2006-2010, the other from 2010-2014. Each 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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