This dissertation studies the effects of the Voting Rights Act of 1965 from both an historical and a comparative perspective. By an historical perspective, I mean that I consider the context of southern politics and the specific debates that surround the act--e.g., concerning the existence and magnitude of white backlash and countermobilization. By a comparative perspective, I mean that I consider the VRA as a particular instance of a structural increase in turnout--i.e., an increase due to legal changes that increase the incentives, or decrease the disincentives to participate in elections. The comparative perspective suggests that the VRA is useful for culling broader insights, for example, regarding the ongoing scholarly debate about whether or not turnout "matters" (cf., Lijphart 1997). My empirical analysis of the VRA is centered specifically on a ubiquitous puzzle noted in existing studies of southern politics, namely, the reactionary, ostensibly anti-Downsian policy repositioning of southern members of Congress in the late 1960s and 70s (cf., Glazer, Grofman, Owen 1998). Scholars find the post-VRA voting patterns of the South's politicians puzzling precisely because the Downsian theory on which scholarly expectations are based would seem to suggest that policy should have moved left when large numbers of African-Americans entered the effective electorate after 1965. Recognizing the difficulties in employing a strict Downsian model in the 1960s South, I develop a "two front war" theory of electoral competition that better approximates the post-VRA environment, and show that the model is capable of rationalizing the observed policy patterns. To test the theory, I implement a number of substantial conceptual and methodological improvements on existing empirical studies. My regression analysis finds broad support for the thesis--where post- VRA dynamics precipitated a larger threat on the incumbent's right, she responded by moving in a conservative direction. Conversely, when the influx of African-Americans opened up a more dangerous front on the left, she responded by becoming more liberal

OBJECTIVE: Leukemia and lymphoma are top cancers affecting children, adolescents and young adults with high five-year survival rates. Late effects of these cancers are a concern in reproductive-age patients, including pregnancy outcomes such as preterm birth. Our study aimed to evaluate whether diagnosis of leukemia or lymphoma prior to pregnancy was associated with preterm birth (<37 weeks gestation). METHODS: We conducted a cross-sectional study using a population-based dataset from California with linked birth certificates to hospital discharge records and an Iowa-based sample that linked birth certificates to Surveillance, Epidemiology, and End Results (SEER) cancer registry data. Preterm birth was defined using birth certificates. We ascertained history of leukemia and lymphoma using discharge diagnosis data in California and SEER registry in Iowa. RESULTS: Prevalence of preterm birth in California and Iowa was 14.6% and 12.0%, respectively, in women with a history of leukemia/lymphoma compared to 7.8% and 8.2%, respectively, in women without a cancer history. After adjusting for maternal age, race, education, smoking, and plurality, Women with history of leukemia/lymphoma were at an increased risk of having a preterm birth in California (odds ratio (OR) 1.89; 95% confidence interval (CI) 1.56-2.28) and Iowa (OR 1.61; 95% CI 1.10-2.37) compared to those with no cancer history. CONCLUSION: In both California and Iowa, women with a history of leukemia or lymphoma were at increased risk for preterm birth. This suggests the importance of counseling with a history of leukemia/lymphoma prior to pregnancy and increased monitoring of women during pregnancy.

OBJECTIVE: Hypertension during pregnancy can adversely affect maternal and fetal health. This study assessed whether diagnosis of leukemia or lymphoma prior to pregnancy is associated with hypertensive disorders of pregnancy including gestational hypertension, preeclampsia and eclampsia. STUDY DESIGN: A cross-sectional study used two statewide population-based datasets that linked birth certificates with sources of maternal medical history: hospital discharges in California and Surveillance, Epidemiology, and End Results (SEER) cancer registry data in Iowa. Birth years included 2007-2012 in California and 1989-2018 in Iowa. MAIN OUTCOME MEASURES: Primary outcome measure was hypertension in pregnancy measured from combined birth certificate and hospital diagnoses in California (for gestational hypertension, preeclampsia, or eclampsia) and birth certificate information (gestational hypertension or eclampsia) in Iowa. RESULTS: After adjusting for maternal age, race, education, smoking, and plurality, those with a history of leukemia/lymphoma were at increased risk of hypertensive disorders of pregnancy in Iowa (odds ratio (OR) = 1.86; 95% CI 1.07-3.23), but not in California (OR = 1.12; 95% CI 0.87-1.43). In sensitivity analysis restricting to more severe forms of hypertension in pregnancy (preeclampsia and eclampsia) in the California cohort, the effect estimate increased (OR = 1.29; 95% CI 0.96-1.74). CONCLUSION: In a population-based linked cancer registry-birth certificate study, an increased risk of hypertensive disorders of pregnancy was observed among leukemia or lymphoma survivors. Findings were consistent but non-significant in a second, more ethnically diverse study population with less precise cancer history data. Improved monitoring and surveillance may be warranted for leukemia or lymphoma survivors throughout their pregnancies.