2012 Theses Bachelor's

Participatory Budgeting in Belo Horizonte, Brazil: Assessing the Impact of Local Governance on Public Health

McGovern, Cleopatra

This thesis seeks to answer whether or not the program of participatory budgeting has resulted in improvements in the health and well-being of residents in Belo Horizonte, Brazil, in an attempt to understand how city governance may impact population health. Governance is largely expected to impact health by ensuring efficient and equitable distribution of resources across the population, something that participatory budgeting, a program that democratizes the process of city budgeting, has proven to accomplish effectively. By analyzing participatory budgeting's policy design, namely how the program is carried out, as well as its outcomes, or the participatory budgeting projects themselves, this thesis analyzes the impacts of the program on health specifically. This analysis revealed that participatory budgeting is able to impact health by reducing inequalities in income and quality of life and by enhancing social capital in the city, or the ability of a population to work together to achieve communal goals, both of which leaded to improvements in population health. The participatory budgeting projects themselves also improved the health of Belo Horizonte residents by addressing more specific diseases. Investments in city infrastructure addressed infant mortality rates and rates of the vector-borne diseases such as dengue. Investments in health, education, and sports facilities improved control of non-communicable and chronic diseases such as diabetes and improved maternal health. Projects focusing on society and culture, housing, and the environment brought more generalized improvements in health through the building of social capital, the provision of social and economic security, and the expansion of green space in the municipality, respectively. This thesis therefore concludes that city government may positively impact health though effective distribution of needed resources, as well as through policy design that prioritizes the needs of the poor and seeks to build communal action and include public insight in governmental deliberations.