TY - JOUR
T1 - County health outcomes linkage to county spending on social services, building infrastructure, and law and order
AU - Cardona, Carolina
AU - Anand, Neha Sahai
AU - Alfonso, Y. Natalia
AU - Leider, Jonathon P.
AU - McCullough, J. Mac
AU - Resnick, Beth
AU - Bishai, David
N1 - Publisher Copyright:
© 2021 The Authors
PY - 2021/12
Y1 - 2021/12
N2 - Will counties that reallocate money from law enforcement to social services improve subsequent markers of population wellbeing? In this study, we measure the association between county government spending across multiple sectors and Life Expectancy at Birth (LEB) in the U.S. using data from the U.S. Census Bureau. We constructed a Structural Equation Model to determine whether social expenditure, building infrastructure, and spending on law and order were positively or negatively associated with LEB three-years after initial spending. The analysis compared data between 2002-05 and 2007-10 and was stratified for urban and rural counties. In rural counties, a one-standard-deviation increase in social spending increased subsequent LEB by 0.58 (SE 0.16) and 0.36 (SE 0.16) years in 2005 and 2010, respectively. In urban counties, a one-standard-deviation increase in building infrastructure spending increased subsequent LEB by 1.14 (SE 0.51) and 1.05 (SE 0.49) years in 2005 and 2010, respectively. In 2002, a one-standard-deviation increase in law and order spending significantly decreased subsequent life expectancy, 2.2 (SE 1.27) and 0.46 (SE 0.13) years in urban and rural counties, respectively. Similarly, investments in building infrastructure for urban counties and social services for rural counties were associated with subsequently higher life expectancy three years later after initial investments.
AB - Will counties that reallocate money from law enforcement to social services improve subsequent markers of population wellbeing? In this study, we measure the association between county government spending across multiple sectors and Life Expectancy at Birth (LEB) in the U.S. using data from the U.S. Census Bureau. We constructed a Structural Equation Model to determine whether social expenditure, building infrastructure, and spending on law and order were positively or negatively associated with LEB three-years after initial spending. The analysis compared data between 2002-05 and 2007-10 and was stratified for urban and rural counties. In rural counties, a one-standard-deviation increase in social spending increased subsequent LEB by 0.58 (SE 0.16) and 0.36 (SE 0.16) years in 2005 and 2010, respectively. In urban counties, a one-standard-deviation increase in building infrastructure spending increased subsequent LEB by 1.14 (SE 0.51) and 1.05 (SE 0.49) years in 2005 and 2010, respectively. In 2002, a one-standard-deviation increase in law and order spending significantly decreased subsequent life expectancy, 2.2 (SE 1.27) and 0.46 (SE 0.13) years in urban and rural counties, respectively. Similarly, investments in building infrastructure for urban counties and social services for rural counties were associated with subsequently higher life expectancy three years later after initial investments.
KW - Econometrics
KW - Financial analysis
KW - Health economics
KW - LISREL
KW - Social determinants of health
KW - State health policies
UR - http://www.scopus.com/inward/record.url?scp=85122816389&partnerID=8YFLogxK
U2 - 10.1016/j.ssmph.2021.100930
DO - 10.1016/j.ssmph.2021.100930
M3 - Article
AN - SCOPUS:85122816389
VL - 16
JO - SSM - Population Health
JF - SSM - Population Health
M1 - 100930
ER -