Out of Sight, Out of Mind? Electoral Responses to the Proximity of Health Care

Abstract

Do voters reward incumbents for the provision of public services? In this article, we study the political economy of catchment areas of public services to answer this question. Rather than examining the binary relationship between health care provision and electoral returns within politically defined borders, we study whether increases in geographic accessibility of health care providers and decreases in congestion in services attract votes for the incumbent. Leveraging a health care reform in Turkey, which substantially impacted the geospatial distribution of public health clinics in Istanbul, we find that decreases in walking time and improvements in congestion levels in the closest clinic from a polling station significantly increase vote share of the AKP, the incumbent party, at that polling station. We also show that poorer communities were more responsive to improvements in spatial accessibility to the local clinics.