Document Type


Publication Date


Publication Title

Social Work in Health Care


Epub ahead of print




Colon cancer care, gender, health care policy, health care reform, historical cohort, intersectionality, interaction effect, Patient Protection and Affordable Care Act, structural inequality, uninsured


America is considering the replacement of Obamacare with Trumpcare. This historical cohort revisited pre-Obamacare colon cancer care among people living in poverty in California (N = 5,776). It affirmed a gender by health insurance hypothesis on nonreceipt of surgery such that uninsured women were at greater risk than uninsured men. Uninsured women were three times as likely as insured women to be denied access to such basic care. Similar men were two times as likely. America is bound to repeat such profound health care inequities if Obamacare is repealed. Instead, Obamacare ought to be retained and strengthened in all states, red and blue.

Funding Reference Number

Canadian Institutes of Health Research (grant no. 67161-2) and an Ontario Graduate Scholarship


First published in Social Work in Health Care at