Longitudinal attenuation in political polarization: Evidence from COVID-19 vaccination adherence in Brazil.

BACKGROUND: While political polarization in policy opinions, preferences, and observance is well established, little is known about whether and how such divisions evolve, and possibly attenuate, over time. Using the COVID-19 pandemic in Brazil as the backdrop, we examine the longitudinal evolution of a highly relevant and polarizing policy: adherence to the COVID-19 vaccination. METHODS: Studies 1 (N = 3346) and 2 (N = 10,214) use nationwide surveys to document initial differences and subsequent changes in vaccination adherence between conservatives ("Bolsonaristas") and non-conservatives ("non-Bolsonaristas"). Study 3 (N = 742) uses an original dataset to investigate belief changes among conservatives and their association with asymmetric changes in vaccination adherence. RESULTS: Despite substantial differences at the early stages of rollout, the gap in vaccination adherence between conservatives and non-conservatives significantly decreased with the passage of time, driven essentially by a much faster uptake among the initially most skeptic-the conservatives. Study 3 demonstrates that the asymmetric changes in vaccination adherence were associated with meaningful belief changes among the conservatives, especially about the perceived effectiveness of the COVID-19 vaccines and the expected adherence of peers to the vaccination campaign. CONCLUSIONS: Together, these studies show that, in a context where the superiority of the promoted policy becomes clear over time and individuals have the opportunity to revisit prior beliefs, even intense political polarization can be attenuated.

A panel dataset of COVID-19 vaccination policies in 185 countries.

We present a panel dataset of COVID-19 vaccine policies, with data from 01 January 2020 for 185 countries and a number of subnational jurisdictions, reporting on vaccination prioritization plans, eligibility and availability, cost to the individual and mandatory vaccination policies. For each of these indicators, we recorded who is targeted by a policy using 52 standardized categories. These indicators document a detailed picture of the unprecedented scale of international COVID-19 vaccination rollout and strategy, indicating which countries prioritized and vaccinated which groups, when and in what order. We highlight key descriptive findings from these data to demonstrate uses for the data and to encourage researchers and policymakers in future research and vaccination planning. Numerous patterns and trends begin to emerge. For example: 'eliminator' countries (those that aimed to prevent virus entry into the country and community transmission) tended to prioritize border workers and economic sectors, while 'mitigator' countries (those that aimed to reduce the impact of community transmission) tended to prioritize the elderly and healthcare sectors for the first COVID-19 vaccinations; high-income countries published prioritization plans and began vaccinations earlier than low- and middle-income countries. Fifty-five countries were found to have implemented at least one policy of mandatory vaccination. We also demonstrate the value of combining this data with vaccination uptake rates, vaccine supply and demand data, and with further COVID-19 epidemiological data.

Ecological study of the association between socioeconomic inequality and food deserts and swamps around schools in Rio de Janeiro, Brazil.

BACKGROUND: Previous research suggests that unhealthy community food environments around schools contribute to unhealthy eating habits and negative health outcomes among the youth. However, little is known about how socioeconomic inequalities in those community food environments are associated with food deserts and food swamps across schools' neighborhoods. METHODS: An ecological study was carried out in all 3,159 public and private schools in Rio de Janeiro, Brazil. Three measures of socioeconomic inequality were evaluated: per capita income, segregation index and deprivation index. The community school food environment was analyzed by metrics of food swamps and food deserts. RESULTS: Food deserts and food swamps were simultaneously more prevalent in neighborhoods of the lowest income, high deprivation, and high segregation. Spatial socioeconomic disparities at the neighborhoods of schools were associated with food deserts and food swamps in Rio de Janeiro. CONCLUSIONS: Our results point to a spatial socioeconomic inequality of establishments that sell food around schools in a Brazilian metropolis, indicating that the areas of greatest deprivation of food services are also the areas with the worst socioeconomic characteristics.

Policy stringency and mental health during the COVID-19 pandemic: a longitudinal analysis of data from 15 countries.

BACKGROUND: To date, public health policies implemented during the COVID-19 pandemic have been evaluated on the basis of their ability to reduce transmission and minimise economic harm. We aimed to assess the association between COVID-19 policy restrictions and mental health during the COVID-19 pandemic. METHODS: In this longitudinal analysis, we combined daily policy stringency data from the Oxford COVID-19 Government Response Tracker with psychological distress scores and life evaluations captured in the Imperial College London-YouGov COVID-19 Behaviour Tracker Global Survey in fortnightly cross-sections from samples of 15 countries between April 27, 2020, and June 28, 2021. The mental health questions provided a sample size of 432 642 valid responses, with an average of 14 918 responses every 2 weeks. To investigate how policy stringency was associated with mental health, we considered two potential mediators: observed physical distancing and perceptions of the government's handling of the pandemic. Countries were grouped on the basis of their response to the COVID-19 pandemic as those pursuing an elimination strategy (countries that aimed to eliminate community transmission of SARS-CoV-2 within their borders) or those pursuing a mitigation strategy (countries that aimed to control SARS-CoV-2 transmission). Using a combined dataset of country-level and individual-level data, we estimated linear regression models with country-fixed effects (ie, dummy variables representing the countries in our sample) and with individual and contextual covariates. Additionally, we analysed data from a sample of Nordic countries, to compare Sweden (that pursued a mitigation strategy) to other Nordic countries (that adopted a near-elimination strategy). FINDINGS: Controlling for individual and contextual variables, higher policy stringency was associated with higher mean psychological distress scores and lower life evaluations (standardised coefficients ß=0·014 [95% CI 0·005 to 0·023] for psychological distress; ß=-0·010 [-0·015 to -0·004] for life evaluation). Pandemic intensity (number of deaths per 100 000 inhabitants) was also associated with higher mean psychological distress scores and lower life evaluations (standardised coefficients ß=0·016 [0·008 to 0·025] for psychological distress; ß=-0·010 [-0·017 to -0·004] for life evaluation). The negative association between policy stringency and mental health was mediated by observed physical distancing and perceptions of the government's handling of the pandemic. We observed that countries pursuing an elimination strategy used different policy timings and intensities compared with countries pursuing a mitigation strategy. The containment policies of countries pursuing elimination strategies were on average less stringent, and fewer deaths were observed. INTERPRETATION: Changes in mental health measures during the first 15 months of the COVID-19 pandemic were small. More stringent COVID-19 policies were associated with poorer mental health. Elimination strategies minimised transmission and deaths, while restricting mental health effects. FUNDING: None.

Transparência interna: cumprimento e punição no processo orçamentário municipal brasileiro / Transparencia interna: cumplimiento y sanción en el proceso presupuestario municipal brasileño / Internal transparency: compliance and punishment in the Brazilian municipal budget process

Resumo Muito tem sido escrito a respeito da transparência externa no setor público. No entanto, a transparência interna - a divulgação inter- e intra-governamental de informações - é comumente negligenciada como objeto de estudo. Subestimar a transparência interna é surpreendente, pois ela é um fator determinante para a coordenação de políticas públicas e para uma governança democrática de qualidade. O presente artigo analisa os custos de curto e longo prazos do não cumprimento de requisitos de transparência interna vinculados aos orçamentos municipais em geral e aos gastos com educação em particular. Neste estudo, utilizamos métodos mistos, analisando quantitativamente os incentivos de curto prazo para cumprir os requisitos de transparência do financiamento da educação e, qualitativamente, as consequências futuras decorrentes do seu descumprimento. Os resultados revelam que municípios que recebem maior volume de transferências voluntárias têm maior probabilidade de atender aos requisitos de transparência interna; contudo, os custos de não cumprir tais requisitos são baixos e facilmente reversíveis a curto prazo. No longo prazo, os prefeitos que não cumprirem a regulação orçamentária, incluindo a legislação para a transparência interna, podem enfrentar consequências mais severas, como a possibilidade de serem futuramente impedidos de exercer seus cargos. No entanto, nossos resultados mostram relativamente poucos casos de punição e que, em média, essas punições só são aplicadas após dez anos de processos judiciais. De modo geral, demonstramos que os Tribunais de Contas - principais agentes para a accountability orçamentária dos 5.570 municípios brasileiros - são tão importantes quanto ineficazes para a transparência interna.

Resumen Mucho se ha escrito sobre la transparencia externa en el sector público. Sin embargo, la transparencia interna -divulgación intra e intergubernamental de información- se suele pasar por alto como objeto de estudio. Subestimar la transparencia interna es sorprendente, ya que es un factor determinante para la coordinación de las políticas públicas y para una gobernabilidad democrática de calidad. Este artículo analiza los costos a corto y largo plazo del incumplimiento de los requisitos de transparencia interna, vinculados a los presupuestos municipales en general y al gasto educativo en particular. En este estudio, utilizamos métodos mixtos, analizando cuantitativamente los incentivos a corto plazo para cumplir con los requisitos de transparencia del financiamiento de la educación y, cualitativamente, las consecuencias futuras del incumplimiento. Los resultados muestran que los municipios que reciben mayores transferencias voluntarias tienen más probabilidades de cumplir con los requisitos de transparencia interna; sin embargo, los costos de incumplir dichos requisitos son bajos y fácilmente reversibles a corto plazo. A largo plazo, los alcaldes que no cumplan con la regulación presupuestaria, incluyendo la legislación de transparencia interna, podrían enfrentar consecuencias más severas, como la posibilidad de verse impedidos de ejercer sus cargos en el futuro. Sin embargo, nuestros resultados muestran relativamente pocos casos de sanción y, en promedio, estas penalidades solo se aplican después de diez años de procesos judiciales. En general, demostramos que los tribunales de cuentas, principales agentes del accountability presupuestario de los 5.570 municipios brasileños, son tan importantes como ineficaces para la transparencia interna.

Abstract Much has been written about external transparency in the public sector. However, internal transparency - the inter and intragovernmental disclosure of information - is commonly overlooked as an object of study. Underestimating the importance of internal transparency is surprising, as it is a determining factor for the coordination of public policies and the quality of democratic governance. This paper analyzes the short-and-long-term costs of failing to comply with internal transparency requirements linked to municipal budgets in general and education spending in particular. In this study, we employ mixed methods, quantitatively analyzing the short-term incentives to comply with transparency requirements for education finance and, qualitatively, the future consequences of noncompliance. The results show that municipalities receiving the most voluntary transfers are more likely to meet internal transparency requirements. However, the costs of not fulfilling such requirements are low and easily reversible in the short-term. In the long-term, municipal officials who fail to comply with budget regulation, including internal transparency statutes, can face more severe consequences, such as the possibility of being barred from office. However, our results show relatively few instances of punishment, and, on average, punishments are only levied after ten years of legal processes. Overall, our results show how, as the lynchpin agents of budgetary accountability and enforcement for Brazil's 5570 municipalities, the courts of audit (Tribunais de Contas) are important but ineffective.

How changes in menu quality associate with subsequent expenditure on (un)healthy foods and beverages in school cafeterias: A three-year longitudinal study.

Evidence of the association between the school food environment and children's and adolescents' diet is mostly cross-sectional, usually based on self-reported behavior, and often conducted in high-income countries. Also, relatively little is known about how variations in menu quality associate with the subsequent expenditure on food and beverages of the same- (vs. cross-) nutritional value. Based on a three-year longitudinal dataset comprised of 4,268,457 purchases made by 20,333 children and adolescents from 54 private schools in Brazil, we unobtrusively assess how changes in (un)healthy product availability associate with students' subsequent purchase behavior. Our results reveal that, on average, only 11.6% of the products offered in the school cafeterias were of high nutritional value (HNV). Critically, expenditure on HNV products increased following both the addition of one HNV product (ß = 0.18; 95% CI = 0.128, 0.240) and, to a lesser extent, the subtraction of one low nutritional value (LNV) product from the menu (ß = -0.03; 95% CI = -0.042, -0.016). Cross-nutritional value effects were stronger for beverages. The inclusion of one HNV beverage was associated not only with a subsequent increase in expenditure on HNV beverages (ß = 0.19; 95% CI = 0.115, 0.264), but also with a decrease in expenditure on LNV beverages (ß = -0.18; 95% CI = -0.352, -0.010).Although only a small percentage of foods and beverages consumed in private school cafeterias in Brazil are of high nutritional value, improvements to menu quality have the potential to increase the consumption of healthier products and decrease the consumption of unhealthy ones.