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The urban-rural gap in health care infrastructure - does government ideology matter?

Author

Listed:
  • Niklas Potrafke

  • Felix Roesel

Abstract

Spatial inequalities in publicly provided goods such as health care facilities have substantial socio-economic effects. Little is known, however, as to why publicly provided goods diverge among urban and rural regions. We exploit narrow parliamentary majorities in German states between 1950 and 2014 in an RD framework to show that government ideology influences the urban-rural gap in public infrastructure. Leftwing governments relocate hospital beds from rural regions. We propose that leftwing governments do so to gratify their more urban constituencies. In turn, spatial inequalities in hospital infrastructure increase, which seems to influence general and infant mortality.

Suggested Citation

  • Niklas Potrafke & Felix Roesel, 2019. "The urban-rural gap in health care infrastructure - does government ideology matter?," CESifo Working Paper Series 7647, CESifo.
    • Handle: RePEc:ces:ceswps:_7647
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    Cited by:

    1. Maas, Alexander S. & Lu, Liang, 2020. "“Elections have Consequences”: Partisan Politics are Literally Killing Us," 2020 Annual Meeting, July 26-28, Kansas City, Missouri 304457, Agricultural and Applied Economics Association.
    2. Thies Büttner & Luisa Dörr & Stefanie Gäbler & Björn Kauder & Manuela Krause & Niklas Potrafke, 2019. "Überprüfung der Einwohnergewichtung im System des kommunalen Finanzausgleichs in Nordrhein-Westfalen," ifo Forschungsberichte, ifo Institute - Leibniz Institute for Economic Research at the University of Munich, number 105.
    3. Manuela Krause & Niklas Potrafke, 2020. "The Real Estate Transfer Tax and Government Ideology: Evidence from the German States," FinanzArchiv: Public Finance Analysis, Mohr Siebeck, Tübingen, vol. 76(1), pages 100-120.
    4. Felix Rösel, 2019. "Krankenhäuser auf dem Land: Bürger sind gegen längere Wege," ifo Dresden berichtet, ifo Institute - Leibniz Institute for Economic Research at the University of Munich, vol. 26(05), pages 16-19, October.
    5. Juliane Sormain & Michael Ryan, 2023. "Regional healthcare infrastructure disparities and foreign direct investment into Europe," Economics and Business Letters, Oviedo University Press, vol. 12(1), pages 49-61.
    6. Niklas Potrafke, 2020. "Dragnet-Controls and Government Ideology," Defence and Peace Economics, Taylor & Francis Journals, vol. 31(5), pages 485-501, July.
    7. Björn Kauder & Manuela Krause & Niklas Potrafke, 2021. "Do Left-wing Governments Decrease Wage Inequality among Civil Servants? Empirical Evidence from the German States," Public Finance Review, , vol. 49(1), pages 106-135, January.
    8. Daizhong Tang & Mengyuan Mao & Jiangang Shi & Wenwen Hua, 2021. "The Spatio-Temporal Analysis of Urban-Rural Coordinated Development and Its Driving Forces in Yangtze River Delta," Land, MDPI, vol. 10(5), pages 1-21, May.
    9. Mona Förtsch & Felix Rösel, 2020. "Hotspots überall: Corona wandert in die Fläche," ifo Dresden berichtet, ifo Institute - Leibniz Institute for Economic Research at the University of Munich, vol. 27(05), pages 07-09, September.
    10. Doriani Lingga & Damiana Simanjuntak, 2022. "Location Choice of a Partially–Private Monopoly Supplier," Studies in Microeconomics, , vol. 10(1), pages 106-121, June.
    11. Junya KUMAGAI & Sunbin YOO & Shunsuke MANAGI, 2025. "Impacts of Urban-rural Migration on Domain-specific Satisfaction," Discussion papers 25013, Research Institute of Economy, Trade and Industry (RIETI).
    12. Kang, Youngho & Lee, Dongwon & Min, Sujin, 2025. "Ideology, intergovernmental transfers, and public health spending: Evidence from South Korea," Regional Science and Urban Economics, Elsevier, vol. 110(C).
    13. Alexander Maas & Liang Lu, 2021. "Elections have Consequences: Partisan Politics may be Literally Killing Us," Applied Health Economics and Health Policy, Springer, vol. 19(1), pages 45-56, January.
    14. Mona Foertsch & Felix Roesel, 2023. "Public Infrastructure and Regional Resilience: Evidence from the 1918 Spanish Flu in Germany," CESifo Working Paper Series 10705, CESifo.

    More about this item

    Keywords

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    JEL classification:

    • D72 - Microeconomics - - Analysis of Collective Decision-Making - - - Political Processes: Rent-seeking, Lobbying, Elections, Legislatures, and Voting Behavior
    • H42 - Public Economics - - Publicly Provided Goods - - - Publicly Provided Private Goods
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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