Please use this identifier to cite or link to this item: https://hdl.handle.net/10419/215125 
Year of Publication: 
2019
Series/Report no.: 
IZA Discussion Papers No. 12729
Publisher: 
Institute of Labor Economics (IZA), Bonn
Abstract: 
There has been a longstanding debate about the link between political representation and health. In this article, I provide novel evidence that electoral reforms that shifted from a majoritarian to a proportional system of voter representation generated substantive health benefits for the general population. Using the exemplary case of Switzerland, I first show that the spread of proportional representation between 1890 and 1950 increased political participation and gave the working class, represented by left-wing parties, greater weight in the political process. Consistent with theories of the electoral system, proportional representation increased public investments, esp. in basic education, with few effects on redistribution or total spending. Based on comprehensive archival mortality statistics since 1890, I then demonstrate that the observed shifts in representation and public finances were associated with substantial declines in child mortality by 15% and in mortality from infectious diseases, the major killer of the time, by 10-15%.
Subjects: 
electoral system
proportional representation
mortality
health
Switzerland
JEL: 
N33
N34
I14
H51
D72
Document Type: 
Working Paper

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