Partisan Composition of County Governments & Constituent Public Health Outcomes

• In Event: Political Determinants of Health

Abstract

As the chief service delivery institutions in the United States, local county governments play a critical role in shaping the policy representation provided to citizens. Largely framed as “forgotten governments” (de Benedictis-Kessner & Warshaw 2020), a growing literature finds that partisan control of county governments has profound effects on local fiscal policy and revenues. However, previous work on the pivotal nature of county governments does not investigate a connection between these pivotal local institutions and health outcomes of the constitutions in which they serve. In this paper, we ask if partisan control of county governments shapes public health outcomes of constituents under their jurisdiction. We theorize Democratic controlled counties will produce healthier public health outcomes than Republican controlled counties given that Democratic legislative bodies pursue more liberal public health policies relative to Republican controlled counties. Using new data on the partisan composition of county governments and county-level health outcomes, we assess how changes in the partisan composition of local county governments influences the public health outcomes of constituents. We also test this county-level partisan effect relative to one produce by partisan control of the state legislature, to further investigate whether partisan composition county governments or state legislatures are more pivotal in determining the health outcomes of the constituents they serve. Our findings carry important implications for the role county governments play in the lives of citizens and how ideological policy programs can ultimately shape the health of the citizens they represent.

Authors

• Carlos Algara, Claremont Graduate University

• Javier M. Rodriguez, Claremont Graduate University