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Do electoral institutions have an impact on population health?

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Abstract

There is an emerging political economics literature which purports to show that legislatures elected based on proportional electoral rules spend more and redistribute more than legislatures elected based on majoritarian electoral rules. Going a step further the authors of this paper consider whether degree of electoral proportionality has an impact on population health and, in particular, the health of the least advantaged members of society. A panel of 24 parliamentary democracies for the years 1960–2004 is used to examine the relationship between electoral institutions and health. The authors find that greater electoral proportionality is positively associated with overall population health (as indicated by life expectancy) and with the health of the poorest (as indicated by a reduction in infant mortality). A panel of 17 countries for the years 1970–2004 is then used to show to that electoral permissiveness modifies the impact of health spending on infant mortality.

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References

  • Acemoglu, D. (2005). Constitutions, politics and economics: a review essay on Persson and Tabellini’s. The Economic Effects of Constitutions Journal of Economic Literature, 43(4), 1025–1048.

    Google Scholar 

  • Acemoglu, D., & Robinson, J. A. (2005). Economic origins of dictatorship and democracy. Cambridge: Cambridge University Press.

    Google Scholar 

  • Alesina, A., & Glaeser, E. L. (2004). Fighting poverty in the US and Europe: a world of difference. New York: Oxford University Press.

    Book  Google Scholar 

  • Anckar, C. (2000). Size and party system fragmentation. Party Politics, 6(3), 305–328.

    Article  Google Scholar 

  • Ansell, B. (2006). From the ballot to the blackboard: partisan and institutional effects on education policy in the OECD, unpublished manuscript retrieved from http://www.polisci.umn.edu/~ansell/papers/From%20the%20Ballot%20to%20the%20Blackboard.pdf.

  • Bawn, K., & Rosenbluth, F. (2006). Short versus long coalitions: electoral accountability and the size of the public sector. American Journal of Political Science, 50(2), 251–265.

    Article  Google Scholar 

  • Besley, T., & Kudamatsu, M. (2006). Health and democracy. American Economic Review, 96(2), 313–318 [long version retrieved from http://econ.lse.ac.uk/staff/tbesley/papers/healthanddemocracy.pdf].

    Article  Google Scholar 

  • Bidani, B., & Ravallion, M. (1997). Decomposing social indicators using distributional data. Journal of Econometrics, 77(1), 125–139.

    Article  Google Scholar 

  • Blume, L., Müller, J., Voigt, S., & Wolf, C. (2009). The economic effects of constitutions: replicating—and extending—Persson and Tabellini. Public Choice, 139(1–2), 179–225.

    Google Scholar 

  • Boix, C. (2003). Democracy and redistribution. Cambridge: Cambridge University Press.

    Google Scholar 

  • Brambor, T., Clark, W. R., & Golder, M. (2006). Understanding interaction models: improving empirical analysis. Political Analysis, 14(1), 63–82.

    Article  Google Scholar 

  • Brown, D. S., & Hunter, W. (1999). Democracy and social spending in Latin America, 1980–1992. American Political Science Review, 93, 779–790.

    Article  Google Scholar 

  • Buchanan, J. N., & Tullock, G. (1962). The calculus of consent: logical foundations of constitutional democracy. Ann Arbor: University of Michigan Press.

    Google Scholar 

  • Cox, G. W. (1997). Making votes count: strategic coordination in the world’s electoral systems. New York: Cambridge University Press.

    Google Scholar 

  • Cutler, D., Angus, D., & Lleras-Muney, A. (2006). The determinants of mortality. Journal of Economic Perspectives, 20(3), 97–120.

    Article  Google Scholar 

  • de Looper, & Lafortune, G. (2009). Measuring disparities in health status and in access and use of health care in OECD countries (OECD Health Working Paper No. 43). Paris: OECD.

    Book  Google Scholar 

  • Deacon, R. T. (2009). Public good provision under dictatorship and democracy. Public Choice, 139(1–2), 241–262.

    Article  Google Scholar 

  • Downs, A. (1957). An economic theory of democracy. New York: Harper & Row.

    Google Scholar 

  • Duverger, M. (1964). Political parties: their organization and activity in the modern state trans. B. and R. North. London: Methuen.

    Google Scholar 

  • Evans, D. B., Tandon, A., Murray, C. J., & Lauer, J. A. (2001). Comparative efficiency of national health systems: cross-national econometric analysis. British Medical Journal, 323(7308), 307–310.

    Article  Google Scholar 

  • Filmer, D., & Pritchett, L. (1999). The impact of public spending on health: does money matter? Social Science & Medicine, 49(10), 1309–1323.

    Article  Google Scholar 

  • Franco, A., Alvarez-Dardet, C., & Ruiz, M.T. (2004). Effect of democracy on health: ecological study. British Medical Journal, 329, 1421–1423.

    Article  Google Scholar 

  • Gallagher, M. (1991). Proportionality, disproportionality and electoral systems. Electoral Studies, 10(1), 33–51.

    Article  Google Scholar 

  • Gallagher, M., & Mitchell, P. (Eds.) (2008). The politics of electoral systems. Oxford: Oxford University Press.

    Google Scholar 

  • Gerring, J., Thacker, S. C., & Alfaro, R. (2007). Democracy and human development. Unpublished manuscript retrieved from http://www.bu.edu/sthacker/.

  • Ghobarah, H. A., Huth, P., & Russett, B. (2004). Comparative public health: the political economy of human misery and well-being. International Studies Quarterly, 48, 73–94.

    Article  Google Scholar 

  • Golder, M. (2005). Democratic electoral systems around the world, 1946-2000. Electoral Studies, 24(1), 103–121 Data set retrieved from http://homepages.nyu.edu/~mrg217/elections.html.

    Article  Google Scholar 

  • Gwatkin, D. R., Rutstein, S., Johnson, K., Suliman, E., Wagstaff, A., & Amouzou, A. (2007). Socio-economic differences in health, nutrition, and population. Washington: World Bank.

    Google Scholar 

  • Heston, A., Summers, R., & Aten, B. (2006) Penn World Table Version 6.2, Center for International Comparisons of Production, Income and Prices at the University of Pennsylvania.

  • Honaker, J., King, G., & Blackwell, M. (2009) Amelia II: A Program for Missing Data at http://gking.harvard.edu/amelia/.

  • Iversen, T., & Soskice, D. (2006). Electoral institutions and the politics of coalitions: why some democracies redistribute more than others. American Political Science Review, 100(2), 165–181.

    Article  Google Scholar 

  • Iversen, T., & Soskice, D. (2009). Distribution and redistribution: the shadow of the nineteenth century. World Politics, 61(3), 438–486.

    Article  Google Scholar 

  • Iversen, T., & Stephens, J. D. (2008). Partisan politics, the welfare state, and three worlds of human capital formation. Comparative Political Studies, 41(4/5), 601–637.

    Google Scholar 

  • Kaufman, R. R., & Segura-Ubiergo, A. (2001). Globalization, domestic politics, and social spending in Latin America: a time-series cross-section analysis, 1973-97. World Politics, 53, 553–587.

    Article  Google Scholar 

  • King, G., Honaker, J., Joseph, A., & Scheve, K. (2001). Analyzing incomplete political science data: an alternative algorithm for multiple imputation. American Political Science Review, 17, 49–69.

    Google Scholar 

  • Laakso, M., & Taagepera, R. (1979). “Effective” number of parties: a measure with application to west Europe. Comparative Political Studies, 12(1), 3–27.

    Google Scholar 

  • Lake, D. A., & Baum, M. A. (2001). The invisible hand of democracy: political control and the provision of public services. Comparative Political Studies, 34, 587–621.

    Article  Google Scholar 

  • Lijphart, A. (1994). Electoral systems and party systems: a study of twenty-seven democracies. Oxford: Oxford University Press.

    Google Scholar 

  • Lijphart, A. (1999). Patterns of democracy: government forms and performance in thirty-six countries. New Haven: Yale University Press.

    Google Scholar 

  • Lizzeri, A., & Persico, N. (2001). The provision of public goods under alternative electoral incentives. American Economic Review, 91(1), 225–239.

    Article  Google Scholar 

  • Marshall, M. G., & Jaggers, K. (2007) Polity IV Project: Political Regime Characteristics and Transitions, 1800-2004. The Polity IV Dataset. Retrieved from http://www.systemicpeace.org/polity/polity4.htm.

  • McGuire, J. W. (2005). Basic health care provision and under-5 mortality: a cross-national study of developing states. World Development, 34(3), 405–425.

    Article  Google Scholar 

  • Meltzer, A. H., & Richard, S. F. (1981). A rational theory of the size of government. Journal of Political Economy, 89, 914–927.

    Article  Google Scholar 

  • Mueller, D. C. (2003). Public choice III. Cambridge: Cambridge University Press.

    Google Scholar 

  • Milesi-Ferretti, G.-M., Perotti, R., & Rostagno, M. (2002). Electoral systems and the composition of public spending. Quarterly Journal of Economics, 117(2), 609–657.

    Article  Google Scholar 

  • Neto, O. A., & Cox, G. W. (1997). Electoral institutions, cleavage structures and the number of parties. American Journal of Political Science, 41(1), 149–174.

    Article  Google Scholar 

  • Nohlen, D. (Ed.) (2005). Elections in the Americas: a data handbook. Oxford: Oxford University Press.

    Google Scholar 

  • Nohlen, D., Krennerich, M., & Thibaut, B. (Eds.) (1999). Elections in Africa: a data handbook. Oxford: Oxford University Press.

    Google Scholar 

  • Nohlen, D., Grotz, F., & Hartmann, C. (Eds.) (2001). Elections in Asia and the Pacific: a data handbook. Oxford: Oxford University Press.

    Google Scholar 

  • Ordeshook, P., & Shvetsova, O. (1994). Ethnic heterogeneity, district magnitude and the number of parties. American Journal of Political Science, 38(1), 100–123.

    Article  Google Scholar 

  • Persson, T., & Tabellini, G. (2003). The economic effects of constitutions. Cambridge: MIT Press.

    Google Scholar 

  • Persson, T., & Tabellini, G. (2004). Constitutions and economics policy. Journal of Economic Perspectives, 18(1), 75–98.

    Article  Google Scholar 

  • Persson, T., Roland, G., & Tabellini, G. (2007). Electoral rules and government spending in parliamentary democracies. Quarterly Journal of Political Science, 2(2), 155–188.

    Article  Google Scholar 

  • Poullier, J.-P., Hernandez, P., Kawataba, K., & Savedoff, W. D. (2003). Patterns of global health expenditures: results for 191 countries. In C. J. L. Murray, & D. B. Evans (Eds.), Health systems performance assessment: debates, methods, and empiricism (pp. 195–203). Geneva: World Health Organization.

    Google Scholar 

  • Przeworski, A., Alvarez, M. E., Cheibub, J. A., & Limongi, F. (2000). Democracy and development: political institutions and well-being in the world, 1950–1990. Cambridge: Cambridge University Press.

    Google Scholar 

  • Riker, W. H. (1962). The theory of political coalitions. New Haven: Yale University Press.

    Google Scholar 

  • Ross, M. (2006). Is democracy good for the poor? American Journal of Political Science, 50(4), 860–874.

    Article  Google Scholar 

  • Schafer, J. L. (1997). Analysis of incomplete multivariate data. Boca Raton: Chapman & Hall/ CRC.

    Book  Google Scholar 

  • Sen, A. (1992). Inequality reexamined. Cambridge: Harvard University Press.

    Google Scholar 

  • Sen, A. (1998). Mortality as an indicator of economic success and failure. The Economic Journal, 108(1998), 1–25.

    Article  Google Scholar 

  • Soares, R. R. (2005). Mortality reductions, educational attainment, and fertility choice. American Economic Review, 95(3), 580–601.

    Article  Google Scholar 

  • Taagepera, R., & Shugart, M. (1989). Seats and votes: the effects and determinants of electoral systems. New Haven: Yale University Press.

    Google Scholar 

  • Ticchi, D., & Vindigni, A. (2010). Endogenous constitutions. Economic Journal, 120(543), 1–39.

    Article  Google Scholar 

  • Tullock, G. (1959). Problems of majority voting. The Journal of Political Economy, 67(6), 571–579.

    Article  Google Scholar 

  • UTIP (2008). Estimated household income inequality data set, 2008. University of Texas Inequality Project, data retrieved from http://utip.gov.utexas.edu/data.html.

  • Vanhanen, T. (2008). Measures of democracy 1810–2006. Data retrieved from http://www.fsd.uta.fi/english/data/catalogue/FSD1289/meF1289e.html.

  • WHO (2010). European health for all database (HFA-DB) (January 2010 update). Copenhagen, WHO regional office for europe retrieved from http://www.euro.who.int/hfadb.

  • Wigley, S., & Wigley-Akkoyunlu, A. (2006). Human capabilities versus human capital: guaging the value of education in developing countries. Social Indicators Research, 78(2), 287–304.

    Article  Google Scholar 

  • Wilkinson, R. G. (1996). Unhealthy societies: the afflictions of inequality. London: Routledge.

    Book  Google Scholar 

  • World Bank (2009). World development indicators 2009, online at www.worldbank.org/data.

  • Zweifel, T. D., & Navia, P. (2000). Democracy, dictatorship, and infant mortality. Journal of Democracy, 11, 99–114.

    Google Scholar 

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Authors and Affiliations

  1. Department of Philosophy, Bilkent University, 06800, Bilkent, Ankara, Turkey

    Simon Wigley

  2. Department of Economics, Hacettepe University, 06532, Beytepe, Ankara, Turkey

    Arzu Akkoyunlu-Wigley

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  1. Simon Wigley
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  2. Arzu Akkoyunlu-Wigley
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Correspondence to Simon Wigley.

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Wigley, S., Akkoyunlu-Wigley, A. Do electoral institutions have an impact on population health?. Public Choice 148, 595–610 (2011). https://doi.org/10.1007/s11127-010-9686-6

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