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The impact of fiscal decentralization on infant mortality rates: Evidence from OECD countries

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  • Jiménez-Rubio, Dolores

Abstract

This study re-examines the hypothesis that shifts towards more decentralization would be accompanied by improvements in population health on a panel of 20 OECD countries over a thirty year period (1970–2001). Decentralization is proxied using a conventional indicator of revenue decentralization and a new measure of fiscal decentralization that reflects better than previous measures the existence of autonomy in the decision-making authority of lower tiers of government, a crucial issue in the decentralization process. The results show a considerable and positive effect of fiscal decentralization on infant mortality only if a substantial degree of autonomy in the sources of revenue is devolved to local governments. The proportion of health care expenditure on GDP and, in particular, education, were found to have a larger contribution to the reduction of infant mortality in the sample of OECD countries analysed over the period of study.

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  • Jiménez-Rubio, Dolores, 2011. "The impact of fiscal decentralization on infant mortality rates: Evidence from OECD countries," Social Science & Medicine, Elsevier, vol. 73(9), pages 1401-1407.
    • Handle: RePEc:eee:socmed:v:73:y:2011:i:9:p:1401-1407
    DOI: 10.1016/j.socscimed.2011.07.029
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    3. Leonardo E. Letelier-S & José L. Sáez-Lozano, 2020. "Expenditure Decentralization: Does It Make Us Happier? An Empirical Analysis Using a Panel of Countries," Sustainability, MDPI, vol. 12(18), pages 1-17, September.
    4. Liangliang Liu & Donghong Ding & Jun He, 2019. "The welfare effects of fiscal decentralization: a simple model and evidence from China," Quality & Quantity: International Journal of Methodology, Springer, vol. 53(1), pages 417-434, January.
    5. Wenqiang Qian & Xiangyu Cheng & Guoying Lu & Lijun Zhu & Fei Li, 2019. "Fiscal Decentralization, Local Competitions and Sustainability of Medical Insurance Funds: Evidence from China," Sustainability, MDPI, vol. 11(8), pages 1-21, April.
    6. Cristina Borra & Jerònia Pons-Pons & Margarita Vilar-Rodríguez, 2020. "Austerity, healthcare provision, and health outcomes in Spain," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(3), pages 409-423, April.
    7. Wei, Yao & Anselmi, Laura & Munford, Luke & Sutton, Matt, 2023. "The impact of devolution on experienced health and well-being," Social Science & Medicine, Elsevier, vol. 333(C).
    8. Hao, Yu & Liu, Jiahui & Lu, Zhi-Nan & Shi, Ruijie & Wu, Haitao, 2021. "Impact of income inequality and fiscal decentralization on public health: Evidence from China," Economic Modelling, Elsevier, vol. 94(C), pages 934-944.
    9. Castro, Marcelo Araújo & Mattos, Enlinson & Patriota, Fernanda, 2016. "Spatial spillovers and political coordination in public health provision," Textos para discussão 417, FGV EESP - Escola de Economia de São Paulo, Fundação Getulio Vargas (Brazil).
    10. Jiménez-Rubio, Dolores & García-Gómez, Pilar, 2017. "Decentralization of health care systems and health outcomes: Evidence from a natural experiment," Social Science & Medicine, Elsevier, vol. 188(C), pages 69-81.
    11. David Bartolini & Agnese Sacchi & Domenico Scalera & Alberto Zazzaro, 2018. "The closer the better? Institutional distance and information blurring in a political agency model," Mo.Fi.R. Working Papers 146, Money and Finance Research group (Mo.Fi.R.) - Univ. Politecnica Marche - Dept. Economic and Social Sciences.
    12. Mattos, Enlinson & Ribeiro, Fernanda Patriota Salles, 2015. "Unconditional transfers goes to health? Evidence from Brazilian municipalities," Textos para discussão 376, FGV EESP - Escola de Economia de São Paulo, Fundação Getulio Vargas (Brazil).
    13. Ryota Nakatani & Qianqian Zhang & Isaura Garcia Valdes, 2024. "Health Expenditure Decentralization and Health Outcomes: The Importance of Governance," Publius: The Journal of Federalism, CSF Associates Inc., vol. 54(1), pages 59-87.
    14. Moussé Sow & Mr. Ivohasina F Razafimahefa, 2015. "Fiscal Decentralization and the Efficiency of Public Service Delivery," IMF Working Papers 2015/059, International Monetary Fund.
    15. Cavalieri, Marina & Ferrante, Livio, 2020. "Convergence, decentralization and spatial effects: An analysis of Italian regional health outcomes," Health Policy, Elsevier, vol. 124(2), pages 164-173.
    16. Cavalieri, Marina & Ferrante, Livio, 2016. "Does fiscal decentralization improve health outcomes? Evidence from infant mortality in Italy," Social Science & Medicine, Elsevier, vol. 164(C), pages 74-88.
    17. Jeong, Dong Wook & Lee, Ho Jun & Cho, Sung Kyung, 2017. "Education decentralization, school resources, and student outcomes in Korea," International Journal of Educational Development, Elsevier, vol. 53(C), pages 12-27.
    18. Clayton, Maya & Liñares-Zegarra, José & Wilson, John O.S., 2015. "Does debt affect health? Cross country evidence on the debt-health nexus," Social Science & Medicine, Elsevier, vol. 130(C), pages 51-58.

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