How effective are public health departments at preventing mortality?
This study estimates the causal impact of variation in the expenditures of California county departments of public health on all-cause mortality rates and the associated value of lives saved. Since the activities of county departments of public health are likely to affect mortality rates with a lag, Koyck distributed lag models are estimated using the Lewbel instrumental variables estimator. The findings show that an additional $10 per capita of public health expenditures reduces all-cause mortality by 9.1 deaths per 100,000. At current funding levels, the long-run annual number of lives saved by the presence of county departments of public health in California is estimated to be approximately 27,000 (26,937 lives, 95% confidence interval: [11,963, 41,911]). The annual value of these lives is estimated to be worth $212.8 billion using inflation-adjusted standard U.S. government estimates of the value of a statistical life ($7.9 million).
School of Public Health, University of California, Berkeley, CA 94720-7360, USA. Electronic address: timothy.brown@berkeley.edu.
Timothy Tyler
TT
Brown
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002140:California; D003695:Delivery of Health Care / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health / Q000191:economics / Q000706:statistics & numerical data; D008875:Middle Aged; D018803:Models, Economic; D009026:Mortality / Q000639:trends*; D011634:Public Health / Q000191:economics*; D015980:Public Health Practice / Q000706:statistics & numerical data; D012111:Residence Characteristics; D012737:Sex Factors; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000191:economics / Q000453:epidemiology; D055815:Young Adult
All-cause mortality; California; Dynamic panel models; Lewbel instrumental variables; Public health expenditures