Devolution and the regional health divide: a longitudinal ecological study of 14 countries in Europe

Plessis, R Du; Milton, Beth; Barr, Ben

doi:10.1093/pubmed/fdy014

“…This implies that the headquarters retained their initial advantage of the concentration of public investments and infrastructures while most of the newly created growth poles were at a disadvantage. This suggests that at an initial stage, decentralization exacerbates distributional inequality (du Plessis et al, 2018). Such inequality may be addressed by conscious planning efforts and other public policies in the long run.…”

Section: Resultsmentioning

confidence: 99%

Decentralization, jurisdictional spaces and regional development in Nigeria

Adewoyin¹,

Sanni²,

Adeboyejo³

2020

hgeo

1

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With the cliché of bringing development closer to the people, the Nigerian government, like many African countries, institutionalized the process of creating Local Government Areas (LGAs) and used it as a policy instrument for more than four decades. This study adopted a survey research design using data on 24 local development indicators, aimed at appraising the efficacy of this policy as a development tool. Quantitative analysis using Principal Component Analysis and its statistical outputs of initial eigenvalues and orthogonal scores shows that 36% of the LGAs ranked lowest on the dimensions of development before the creation of additional jurisdictions in 1996, while 20% and 44% ranked intermediate and highest respectively. Post-partitioning, the proportions were 24.4%, 39.4% and 36.4% respectively, thus providing evidence of the positive development impact of decentralization. The findings, however, throw up issues of distributional inequality in public investments which could be addressed by conscious planning efforts.

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“…Some newer work has also put forth and debated evidence that decentralization can lead to more equal outcomes for both availability and quality of services since it gives politicians more responsibility for and incentive to run adequate welfare states relative to centralization (Costa-Font and Rico 2006;Costa-Font and Gil 2009;Costa-Font and Turati 2018;Dupuy and Le Galés 2006;Wallner 2014). Against that perspective, other work, in particular work on the United States, highlights the extent to which federalism permits local politicians to make and implement highly problematic policy decisions, in social policy as well as other areas (Bruch, Meyers, and Gornick 2018;du Plessis, Milton, and Barr 2019;Gibson 2013;Grumbach 2022;Michener 2018;Miller 2008). Many key U.S. policies, from women's right to vote to unemployment insurance to mandatory seat belts, started out in the states and slowly stepped onto the national agenda, but it is not easy to say whether that is a stirring story of bottom-up learning and innovation or a story of institutions that entrenched elites and blocked popular policies for a long time.…”

Section: What Does Federalism Do To the Welfare State? Existing Theoriesmentioning

confidence: 99%

Putting Federalism in Its Place

Greer¹,

Béland²,

Lecours³

et al. 2023

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supported the project that led to this and the earlier volume, Federalism and Social Policy. Theresa Ramirez and Connie Rockman supported that project with the generosity and competence they always show. Comments from Alan Trench, Janet Laible, and Margitta Mätzke on the initial development of this project were very helpful. Finally, the University of Michigan Press, especially Elizabeth Demers, Kevin Rennells, and Haley Winkle, were the combination of supportive, engaged, tough, and patient that authors always appreciate. CHAPTER 1Why Should We Care about Federalism?In Texarkana there is an unusual building. As its name suggests, the town straddles the border between the U.S. states of Texas and Arkansas. The building stands along the border, half on each side. It is a U.S. federal government building, finished in 1933, that combines post offices and courts. The federal courts serving Texas are on the Texas side, and the federal courts serving Arkansas are on the Arkansas side. A post office, equally divided between the two states, serves both. The street splits to go around the building, with different pavement quality and parking rules on the two sides.That one building in a little-known railroad town is a metaphor for federalism. The states constitute the environment, but the federation constitutes the states. It is a legacy of specific political moments and policy decisions that there is a shared post office, serving the American people, in a unifying federal building that reinforces juridical divides between states in its very design. Perhaps it is telling that it is said (by the town's tourism bureau) to be the second most photographed federal building in the United States. It is of no significant architectural interest-except insofar as its location and its twinned courthouses inscribe federal politics in its stones. Letters mailed there since 1933 have been postmarked with a stamp that marks them as having been mailed in both states: "Texarkana-AR-TX" or "Texarkana, USA."The concrete complexity of a federal building in the American Cotton Belt belies much of what is written about federalism. Much research about the impact of federalism, or any other political or social institution, treats it as a binary variable, present or absent, and then look for its effects. Endless effort has been expended and endless ink spilled in scholarly and popular 1. More specifically, this book focuses primarily on federal countries located in Australasia, North America, and Western Europe, which does not mean the lessons it draws are not applicable to federal countries located outside the Global North, such as Argentina,

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“…Some newer work has also put forth and debated evidence that decentralization can lead to more equal outcomes for both availability and quality of services since it gives politicians more responsibility for and incentive to run adequate welfare states relative to centralization (Costa-Font and Rico 2006;Costa-Font and Gil 2009;Costa-Font and Turati 2018;Dupuy and Le Galés 2006;Wallner 2014). Against that perspective, other work, in particular work on the United States, highlights the extent to which federalism permits local politicians to make and implement highly problematic policy decisions, in social policy as well as other areas (Bruch, Meyers, and Gornick 2018;du Plessis, Milton, and Barr 2019;Gibson 2013;Grumbach 2022;Michener 2018;Miller 2008). Many key U.S. policies, from women's right to vote to unemployment insurance to mandatory seat belts, started out in the states and slowly stepped onto the national agenda, but it is not easy to say whether that is a stirring story of bottom-up learning and innovation or a story of institutions that entrenched elites and blocked popular policies for a long time.…”

Section: What Does Federalism Do To the Welfare State? Existing Theoriesmentioning

confidence: 99%

Putting Federalism in Its Place

2023

0

View full text Add to dashboard Cite

supported the project that led to this and the earlier volume, Federalism and Social Policy. Theresa Ramirez and Connie Rockman supported that project with the generosity and competence they always show. Comments from Alan Trench, Janet Laible, and Margitta Mätzke on the initial development of this project were very helpful. Finally, the University of Michigan Press, especially Elizabeth Demers, Kevin Rennells, and Haley Winkle, were the combination of supportive, engaged, tough, and patient that authors always appreciate. CHAPTER 1Why Should We Care about Federalism?In Texarkana there is an unusual building. As its name suggests, the town straddles the border between the U.S. states of Texas and Arkansas. The building stands along the border, half on each side. It is a U.S. federal government building, finished in 1933, that combines post offices and courts. The federal courts serving Texas are on the Texas side, and the federal courts serving Arkansas are on the Arkansas side. A post office, equally divided between the two states, serves both. The street splits to go around the building, with different pavement quality and parking rules on the two sides.That one building in a little-known railroad town is a metaphor for federalism. The states constitute the environment, but the federation constitutes the states. It is a legacy of specific political moments and policy decisions that there is a shared post office, serving the American people, in a unifying federal building that reinforces juridical divides between states in its very design. Perhaps it is telling that it is said (by the town's tourism bureau) to be the second most photographed federal building in the United States. It is of no significant architectural interest-except insofar as its location and its twinned courthouses inscribe federal politics in its stones. Letters mailed there since 1933 have been postmarked with a stamp that marks them as having been mailed in both states: "Texarkana-AR-TX" or "Texarkana, USA."The concrete complexity of a federal building in the American Cotton Belt belies much of what is written about federalism. Much research about the impact of federalism, or any other political or social institution, treats it as a binary variable, present or absent, and then look for its effects. Endless effort has been expended and endless ink spilled in scholarly and popular 1. More specifically, this book focuses primarily on federal countries located in Australasia, North America, and Western Europe, which does not mean the lessons it draws are not applicable to federal countries located outside the Global North, such as Argentina,

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Devolution and the regional health divide: a longitudinal ecological study of 14 countries in Europe

Abstract: Increased devolution does not appear to reduce regional health inequalities-even when it reduces regional economic inequalities-and it could be associated with increased health inequalities.

Cited by 4 publications

References 19 publications

Decentralization, jurisdictional spaces and regional development in Nigeria

Decentralization, jurisdictional spaces and regional development in Nigeria

Putting Federalism in Its Place

Putting Federalism in Its Place

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