The Impact of Public Health Policy: The Case of Community Health Centers

The aim of this paper is to assess the impact of the Community Health Center (CHC) on health levels in the U.S. Using infant mortality as the underlying health indicator, a time series of large counties as the data set, and multivariate regression techniques, we investigate the extent to which the presence of a program in a county affects future mortality. We find that CHCs have negative and statistically significant impacts on white and black infant mortality rates.The centers have larger effects on black infant mortality than on white infant mortality. The reduction in the black infant mortality rate between 1970 and 1978 due to the CHC system amounts to one death per thousand live births or approximately 12 percent of the observed decline.This result is particularly striking in light of the well-known higher infant mortality rate of blacks. A reduction in the excess mortality rate of black babies has been dentfied as a goal of public health policy for a number of years. Our results suggest that community health centers have the potential to make a substantial contribution to the achievement of this goal.

Health Care Capital Financing Agencies: The Intergovernmental Roles of Quasi-Government Authorities and the Impact on the Cost of Capital

During the decade 1983-1992, approximately 1.4 trillion dollars of municipal bonds were sold in 87 thousand separate issues, primarily to finance capital projects for education, electric power, transportation, health care, housing and other public and private purpose activities. Approximately two-thirds of these financings were originated by financing authorities, quasi-government agencies which are the creation of state legislatures. Despite the growing role played by quasi-public authorities in capital finance, their impacts have not been studied systematically. We first describe the issuers of tax-exempt debt in the health sector and then derive measures for describing the mix of issuers between state and local levels, and between both government and quasi-government sectors. We present abbreviated test results of the impact that different mixes have on the cost of capital. First, competition is good: using a Herfindahl index analysis we show that states with less concentrated issuers have a lower cost of capital than those with a more concentrated market, including state-level finance monopolies. On the other hand, we cannot assert unequivocally that market deconcentration in and of itself should be a goal. For instance, there are economies of scale in the health care finance industry that allow larger (often state-level) issuers to lower the cost of capital.

An Assessment of the Benefits of Air Pollution Control: The Case of Infant Health

This paper contains estimates of the impacts of air pollutants on race-specific neonatal mortality rates based on data for heavily populated counties of the U.S. in 1977. Unlike previous research in this area, these estimates are obtained from awell specified behavioral model of the production of health, which is estimated with the appropriate simultaneous equations techniques. The results suggest that sulfur dioxide is the dominant air pollutant in newborn survival outcomes. There is also evidence that an increase in sulfur dioxide raises the neonatal mortality rate by raising the percentage of low-birth weight births. Based on marginal-willingness-to-pay computations, we estimate that the benefits of a 10 percent reduction insulfur dioxide levels range between $54 million and$1.09 billion in 1977 dollars.

Goodbye to projects? The institutional impact of sustainable livelihoods approaches on development interventions

The research goodbye to projects grew out of the increasing interest in sustainable livelihoods approaches (SLA) and growing disillusion with projects as mechanisms for addressing the development needs of the poor. Its aim was to investigate the implication of the adoption of SLA on the management of development interventions and in particular of the future of development projects. The underlying research questions were: a) How are elements of the sustainable livelihoods principles being applied in practice b) What are the problems and challenges for managing livelihoods-oriented development interventions? c) What is the future for development projects, given the increase in direct budget and sectoral assistance?Livelihoods, Projects, Economic development, EPRC, Muhumuza, Sustainable development, Financial Economics, Institutional and Behavioral Economics, International Relations/Trade, Labor and Human Capital, Livestock Production/Industries, Political Economy,

The Impact of Public Health Policy: The Case of Community Health Centers

The aim of this paper is to assess the impact of the community health center on health levels in the United States. Using infant mortality as the underlying health indicator and a time series of large counties as the data set, the authors investigate the extent to which the presence of a program in a county affects future mortality. The centers have negative and statistically significant impacts on race-specific mortality rates. The reduction in the black rate between 1970 and 1978 due to community health centers amounts to one death per thousand live births, or approximately 12 percent of the observed decline.