2019 ◽  
Author(s):  
Umberto Guarnier Mignozzetti ◽  
Gabriel Cepaluni

What is the effect of legislature size on public service provision? While the literature relates legislature size to representation and government expenditure, its implications for welfare remain understudied. In this paper, we investigate the effects of legislature size on welfare, exploiting exogenous changes in city-council size in Brazil between 2005 and 2008. We show that adding a legislator improves education and health care. However, the results prove true for the services that are believed to be highly salient to voters, are easiest to claim credit for, and are easy to provide. In this sense, education quality and preventive health care remain unaffected while infant mortality and primary school enrollment significantly improve. To investigate the mechanism, we surveyed former councilors and analyzed 346,553 bills proposed by municipalities in the period. This analysis largely corroborates our findings, showing that politicians prefer to provide private and local public goods. This paper has implications for the design of legislative institutions.


Author(s):  
Ziggi Ivan Santini ◽  
Hannah Becher ◽  
Maja Bæksgaard Jørgensen ◽  
Michael Davidsen ◽  
Line Nielsen ◽  
...  

Abstract Background Previous literature has examined the societal costs of mental illness, but few studies have estimated the costs associated with mental well-being. In this study, a prospective analysis was conducted on Danish data to determine 1) the association between mental well-being (measured in 2016) and government expenditure in 2017, specifially healthcare costs and sickness benefit transfers. Methods Data stem from a Danish population-based survey of 3,508 adults (aged 16 + years) in 2016, which was linked to Danish registry data. A validated scale (WEMWBS) was used for the assessment of mental well-being. Costs are expressed in USD PPP. A two-part model was applied to predict costs in 2017, adjusting for sociodemographics, health status (including psychiatric morbidity and health behaviour), as well as costs in the previous year (2016). Results Each point increase in mental well-being (measured in 2016) was associated with lower healthcare costs ($− 42.5, 95% CI = $− 78.7, $− 6.3) and lower costs in terms of sickness benefit transfers ($− 23.1, 95% CI = $− 41.9, $− 4.3) per person in 2017. Conclusions Estimated reductions in costs related to mental well-being add to what is already known about potential savings related to the prevention of mental illness. It does so by illustrating the savings that could be made by moving from lower to higher levels of mental well-being both within and beyond the clinical range. Our estimates pertain to costs associated with those health-related outcomes that were included in the study, but excluding other social and economic outcomes and benefits. They cover immediate cost estimates (costs generated the year following mental well-being measurement) and not those that could follow improved mental well-being over the longer term. They may therefore be considered conservative from a societal perspective. Population approaches to mental health promotion are necessary, not only to potentiate disease prevention strategies, but also to reduce costs related to lower levels of mental well-being in the non-mental illness population. Our results suggest that useful reductions in both health care resource use and costs, as well as in costs due to sick leave from the workplace, could be achieved from investment in mental well-being promotion within a year.


1982 ◽  
Vol 3 (3) ◽  
pp. 279-290
Author(s):  
Audrey Marie Deveaux ◽  
William A. Darity

Health education is a new component of the health care delivery system in the Bahamas. In the past, confusion and uncertainty was expressed regarding the contribution of health education to the health care services. The intention of this study was to investigate the perceptions of selected health and social service providers to health problems, their most likely solutions, and to health education and health education related issues in the Bahamas. A questionnaire was either mailed or hand delivered to 412 selected health and social service providers in New Providence and the Family Islands in the Bahamas. Of these 127 (31%) usable questionnaires were returned. A discussion of the study findings, study limitations, implications for health education and suggestions for future research are presented. The survey results showed that a majority of respondents indicated consistent support for health education and health education related issues. This support was evident even when responses were crosstabulated with such variables as age, profession, and years of experience in present occupation.


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