Health in Citizen-State Interactions: How Physical and Mental Health Problems Shape Experiences of Administrative Burden and Reduce Take-Up

Abstract

Public services represent a key means by which societies seek to reduce inequalities. However, some people may experience administrative procedures as more burdensome than others, creating inequality within programs intended to be equity-enhancing. Prior work has found human capital (e.g., education and conditions like scarcity) to affect burden and take-up. We build on this by examining the role of health in the form of attention disorders, pain, anxiety, and depression in the context of tax reporting in Denmark and college financial aid in Oklahoma, USA. Across cases, attention disorders and pain are associated with more burdensome experiences and in the financial aid case, they are associated with reduced take-up as well. Individuals suffering from multiple health problems have the most negative experiences and lowest take-up. The results suggest that extra support may be needed for people suffering from health problems in order to reduce inequities in experiences and outcomes.

Keywords: Administrative burden, Take-up, Health, Inequity, ADHD, Pain, Depression, Anxiety, Citizen-state interactions, sludge

JEL Classification: I14, I18, I24, I28, I30, I38