TY - JOUR
T1 - Is fair representation good for children? effects of electoral partisan bias in state legislatures on policies affecting children's health and well-being
AU - Karatekin, Canan
AU - Marshall Mason, Susan
AU - Latner, Michael
AU - Gresham, Bria
AU - Corcoran, Frederique
AU - Hing, Anna
AU - Barnes, Andrew J.
N1 - Publisher Copyright:
© 2023 Elsevier Ltd
PY - 2023/12
Y1 - 2023/12
N2 - Increasing evidence suggests that state policies impact constituents' health, but political determinants of health and health inequities remain understudied. Using state and year fixed-effects models, we determined the extent to which changes in electoral partisan bias in lower chambers of U.S. state legislatures (i.e., discrepancy between statewide vote share and seat share) were followed by changes in five state policies affecting children and families (1980–2019) and a composite of safety net programs (1999–2018). We examined effects on each policy and whether the effect was modified when bias was accompanied by unified party control. Next, we determined whether the effect differed depending on which party it favored. Less bias resulted only in higher AFDC/TANF benefits. Both pro-Democratic and pro-Republican bias was followed by decreased AFDC/TANF benefits and increased Medicaid benefits. AFDC/TANF recipients, unemployment benefits, minimum wage, and pre-K-12 education spending increased following pro-Democratic bias and decreased following pro-Republican bias. Estimated effects on the composite measure of safety net policies were all close to null. Some effects were modulated by unified party control. Results demonstrate that increasing fairness in elections is not a panacea by itself for increasing generosity of programs affecting children's well-being. Indeed, bias can be somewhat beneficial for the expansiveness of some policies. Furthermore, with the exception of unemployment benefits and AFDC/TANF recipients, Democrats have not been using the additional power that comes with electoral bias to spend more on major programs that benefit children. Finally, after decades in which electoral bias was in Democrats' favor, bias has started to shift toward Republicans in the last decade. This trend forecasts more cuts in almost all the policies in this study, especially education and AFDC/TANF recipients. There is a need for more research and advocacy emphasis on the political determinants of social determinants of health, especially at the state level.
AB - Increasing evidence suggests that state policies impact constituents' health, but political determinants of health and health inequities remain understudied. Using state and year fixed-effects models, we determined the extent to which changes in electoral partisan bias in lower chambers of U.S. state legislatures (i.e., discrepancy between statewide vote share and seat share) were followed by changes in five state policies affecting children and families (1980–2019) and a composite of safety net programs (1999–2018). We examined effects on each policy and whether the effect was modified when bias was accompanied by unified party control. Next, we determined whether the effect differed depending on which party it favored. Less bias resulted only in higher AFDC/TANF benefits. Both pro-Democratic and pro-Republican bias was followed by decreased AFDC/TANF benefits and increased Medicaid benefits. AFDC/TANF recipients, unemployment benefits, minimum wage, and pre-K-12 education spending increased following pro-Democratic bias and decreased following pro-Republican bias. Estimated effects on the composite measure of safety net policies were all close to null. Some effects were modulated by unified party control. Results demonstrate that increasing fairness in elections is not a panacea by itself for increasing generosity of programs affecting children's well-being. Indeed, bias can be somewhat beneficial for the expansiveness of some policies. Furthermore, with the exception of unemployment benefits and AFDC/TANF recipients, Democrats have not been using the additional power that comes with electoral bias to spend more on major programs that benefit children. Finally, after decades in which electoral bias was in Democrats' favor, bias has started to shift toward Republicans in the last decade. This trend forecasts more cuts in almost all the policies in this study, especially education and AFDC/TANF recipients. There is a need for more research and advocacy emphasis on the political determinants of social determinants of health, especially at the state level.
KW - Education spending
KW - Medicaid
KW - Minimum wage
KW - Partisan bias
KW - Political determinants of health
KW - Social determinants of health and health inequities
KW - TANF
KW - Unemployment benefits
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U2 - 10.1016/j.socscimed.2023.116344
DO - 10.1016/j.socscimed.2023.116344
M3 - Article
C2 - 37984179
AN - SCOPUS:85177556505
SN - 0277-9536
VL - 339
JO - Social Science and Medicine
JF - Social Science and Medicine
M1 - 116344
ER -