Out of Sight, Out of Mind? Electoral Responses to Proximity of Healthcare

Abstract

Existing work on electoral returns to public goods provision has investigated changes in government expenditure aggregated at levels that do not have any bearing on geographical access. In this paper, we focus on the political economy of the catchment areas of public services. Rather than investigating the binary relationship between public goods provision and electoral returns within formally drawn borders, we ask whether decreases in walking time to a public service attract votes for the incumbent. Leveraging the Family Medicine Reform in Turkey, which gave rise to an exogenous variation in voter proximity to the free health clinics in Istanbul, we find that communities whose walking distance to the closest clinic decreased voted significantly more for the AKP, the incumbent, between 2011 and 2015. We also show that poorer and healthcare dependent communities were more responsive to improvements in spatial accessibility to the local clinics.