The effects of health insurance expansion on domestic violence: A regression discontinuity analysis in Peru

Abstract

While much literature documents decreasing effects of cash transfers on domestic violence, less is known about the potential effects of health insurance on domestic violence. At the same time, many middle and low-income countries have expanded health insurance schemes. Theory suggests that health insurance is related to well-known risk factors of domestic violence, such as mental health issues and substance abuse. To fill the gap, this study aims to answer the following question: What are the effects of getting access to health insurance on domestic violence? To do so, this paper uses a sharp regression discontinuity design, exploiting the eligibility rule of the Seguro Integral de Salud (SIS) in Peru.

Specifically, I compare those women just below and just above the regional threshold. I find that health insurance expansion led to lower control behavior and violence from outside the family for women aged 15-28. Moreover, family violence decreased with stronger effects for both women with very little education and women with higher education. On top of that, the health insurance expansion reduced control behavior and sexual violence for young women with higher education. These findings underscore the potential of health insurance as a tool for reducing domestic violence.