Social media use and vaccination among Democrats and Republicans: Informational and normative influences.

Our objective was to determine whether social media influences vaccination through informational and normative influences among Democrats and Republicans. We use a probability-based longitudinal study of Americans (N = 1768) collected between December 2022 and September 2023 to examine the prospective associations between social media use and vaccination as well as informational and normative influence as mediating processes. Greater social media use correlates with more frequent vaccination (cross-lagged coefficients: COVID-19 = 0.113, p < 0.001; influenza = 0.123, p < 0.001). The underlying processes, however, vary between Democrats and Republicans. Democrats who use social media more are more likely to vaccinate because they encounter information about new pathogens. In contrast, Republicans who use social media more are more likely to vaccinate because they think that people who are important to them receive the recommended vaccines. Our findings underscore the potential for social media campaigns to promote vaccination, among both Democrats and Republicans by paying attention to the specific processes in each audience.

The Development of the Urban-Rural Cleavage in Anglo-American Democracies.

We provide a mixed-methods, comparative analysis of the development of the urban-rural electoral cleavage in Canada, Great Britain, and the United States from the early 20th century to the present. Using aggregate election results, electoral district boundary files, and electoral district population measures, we construct a new comparable dataset of district election results and urbanity for the lower house of the legislature in each country. We use this dataset to measure the importance of the urban-rural divide for election outcomes across countries and time. We find that the cleavage has widened over time in each country, each arrived at its current urban-rural divide via a distinct developmental trajectory, which we interpret with reference to secondary literature. We conclude by discussing the significance of our findings for theories of both the causes and consequences of urban-rural divides and discuss the implications of our work for the comparative study of urban-rural cleavages.

Group Appeals of Parties in Times of Economic and Identity Conflicts and Realignment.

Party-group relations are today characterized by various forms of alignments. These include the persistence of traditional class alignments, the realignment of economic groups due to identity politics and alignments of groups at the centre of identity politics. This study analyses the group-based messaging of parties in relation to these three groups. We argue that, contrary to the catch-all party thesis, positive and negative group appeals of parties are (still) structured by parties' support among social groups and by groups either liked or disliked by their voters. Our argument is tested through a content analysis of election materials in Germany, Switzerland and the Netherlands, combined with survey data. The results indicate that group appeals are indeed shaped by electoral support among social groups and attitudes towards them. Results also suggest that the former effect is present for traditionally aligned economic and identity politics groups, but not for realigned economic groups.

Target analysis of psychoactive drugs in oral fluid by QuEChERS extraction and LC-MS/MS.

This study aimed to validate a modified QuEChERS method, followed by liquid chromatography-tandem mass spectrometry, for the determination of 51 psychoactive substances and screening of 22 ones in oral fluid from electronic dance music party (EDM) attendees. Unstimulated oral fluid was collected in a polypropylene tube and stored in a glass vial at -20 ºC. The sample was extracted with acetonitrile:water and MgSO4/NaOAc, followed by cleanup with primary secondary amine and MgSO4. The effectiveness of the sample storage conditions was shown to be comparable to when the Quantisal™ buffer was used, with no substantial concentration loss (< 15%) for all the substances after up to 72 hours at -20º C. The method was satisfactorily validated, with limits of detection (LOD) and quantification (LOQ) ranging from 0.04 to 0.5 ng/mL and 0.1-1.5 ng/mL, respectively, and was applied to the analysis of 62 real samples. The main substances detected were 3,4-methylenedioxymethamphetamine (MDMA) (<0.5-829 ng/mL) and/or methylenedioxyamphetamine (MDA) (10.1 - 460.6 ng/mL), found in 27 samples, and cocaine (13.0-407.3 ng/mL) and its metabolites (benzoylecgonine 0.17-214.1 ng/mL; ecgonine methyl ester 1.8-150.1 ng/mL) in eight samples. Methamphetamine (11-439 ng/mL) was detected in eight samples, along with MDMA and MDA; eutylone was detected in two cases (4.7 and 24.1 ng/mL) reported as "ecstasy" ingestion. A comparison between self-reported drug use and results of oral fluid analysis indicated that the use of illicit substances is often underreported among EDM attendees, who are often unaware of the substances they consume.

A leader without followers: Tory Euroscepticism in a comparative perspective.

This article examines the rare phenomenon of mainstream Euroscepticism that has characterised the British Conservative Party and asks whether a similar pattern has appeared elsewhere in the EU. The study traces the long-term evolution of salience and positions on the EU issue in the manifestos of a heterogenous set of centre-right parties, paying particular attention to whether Brexit or successive EU crises have had some noticeable effect. The thesis of Tory exceptionalism is largely supported by the findings - no other mainstream conservative party in the EU has talked more, and more negatively, about the EU over a long time period. Most other centre-right parties were part of the permissive consensus on the EU and have supported, more or less openly, the integration project throughout the past 30 years. However, some parties of mainstream conservatism have shown a similar negative shift as British Conservatives did in the 2000s, such as the Austrian ÖVP, the Hungarian Fidesz, the Polish PiS and (marginally) the Dutch VVD. Being in opposition or pressured by radical right challengers does not necessarily make the mainstream right more critical of the EU. Internal organisational developments (i.e. the ascent of more Eurosceptic influences within the party) constitute the most convincing proximate explanation for mainstream Euroscepticism on the right.

The Community Pharmacy as a Study Center for the Epidemiological Analysis of the Population Vaccination against SARS-CoV-2: Evaluation of Vaccine Safety and Pharmaceutical Service.

We conducted a monocentric observational study aimed at evaluating the vaccine safety and the pharmaceutical service provided at a community pharmacy (C.PHARM) in the Puglia Region in the period from 29 December 2021 to 12 March 2022 using data from 550 patients of various ages and sexes and with concomitant diseases. We collected anamnestic data, the number of hospitalizations, and any post-vaccination adverse reactions. Interviews using the integrated EQ5 method were also performed to evaluate the quality of the service offered and any therapy preference. As expected, the vaccines were reactogenic after the first dose in the patients with mild-moderate reactions, with younger age and female gender as risk factors. Immune-allergic reactions of a moderate-severe degree were observed in adult females. In the elderly, the vaccination was well tolerated. Comirnaty® showed a favorable O.R. < 1 vs. other vaccines. No cardiovascular events or hospitalizations were observed up to May 2023. Regional data indicate that all treatments during May 2023 were correlated with the viremia. PaxlovidTM was prescribed in 3% of the patients in our center and in 1.46% in the region, and distributed/dispensed on behalf of third parties in accordance with a novel distribution/dispensation protocol of the C.PHARM that resulted in a safe vaccination center providing appropriate patient inclusion during vaccination.

The role of the 30% threshold for Islamic parties: A fast-growing middle class and religion-based political preferences in Indonesia.

Recently, Indonesia's middle-class Muslims have come under suspicion for strengthening the religious foundation of their political preferences. However, while this suspicion has been triggered by their increasingly confident expressions of Islamic identity in political, social and economic spheres, these public expressions do not consistently translate into electoral outcomes. Despite the significant growth of the middle class, the proportion of votes cast for Islamic parties, encompassing both pro-shari'a or Islamist and Islam-inclusive parties, has declined from 37% in 1999 to 30% in 2019. Utilising panel data from 397 districts and cities spanning three recent general elections (2009, 2014 and 2019), this study examines the association between the middle class's proportion of the total population and the vote share of Islamic parties. Our fixed-effect estimations validate an inverted U-curve relationship between the middle class's share and the vote share of pro-shari'a or Islamist parties, with the turning point occurring at approximately 29% of the middle class's total population. In regions with a lower percentage of the middle class, the vote share of Islamist parties rises in parallel with middle-class growth. Conversely, at a higher level, a growing middle class curtails the vote share of Islamist parties. This suggests that Indonesia's contemporary social structure is undergoing desecularisation in various ways, contingent on levels of modernisation. Notably, this desecularisation process does not imply a movement towards establishing an Islamic state. Indonesia's Muslims are moderate and more inclined to support secular, national or Pancasila-based parties, which tend to be inclusive and secular in their approach.

Why Do Bystanders Report Intimate Partner Violence? Insights into Real-Life Reasoning from Those Who Actually Intervened.

As intimate partner violence (IPV) often remains unknown to police, bystanders can play a crucial role in prevention and further escalation of IPV. However, little is known about what brings them into action by reporting incidents of IPV to authorities. As such, we use statements of bystanders who filed reports about IPV incidents to an official domestic violence agency in the Netherlands (N = 78), to investigate the reasoning and motivations for reporting their suspicions. Results show that the reasons for bystanders to report IPV differ depending on the relational dynamics between partners. In situations perceived as intimate terrorism, involving a hierarchical abusive relationship between a man offender and a woman victim, bystanders primarily reported when previous helping initiatives proved inefficient, and they did so to prevent further harm, often particularly in relation to the woman victim. In situations perceived as situational couple violence, involving a symmetrical abusive relationship, bystanders primarily reported when escalation appeared, and they did so to prevent further harm to involved children. We conclude that bystanders report IPV incidents when the need for help is clear, and their motivation for acting concerns the well-being of victims. Our findings add to the growing body of evidence about real-life bystander intervention in emergencies and highlight the need for understanding intervention as context-specific in order to design effective intervention initiatives.

A dataset exploring turnout patterns in Spanish party primaries (1991-2023).

The paper presents exhaustive information on a dataset of primary processes held by Spanish political parties with representation at both the national and regional level. Using evidences collected from various sources, the dataset covers more than 360 processes carried out by more than 30 Spanish political parties between 1991 and 2023, at both the national and regional level and for both candidate and leadership selection processes. The dataset provides information on the results of the ballots (Turnout, Share of the winner), some basic party features (Ideology, etc.) and the specific features of each process (Competitiveness, Voting procedures, etc.). Hence, it offers the possibility to analyze how different variables providing information on each political party and each internal process are related to the results of each ballot.

Indonesian presidential election sentiment: Dataset of response public before 2024.

Indonesia is one of the countries that is currently entering the political year for the election of President, Regional Heads, and Members of the Legislative in 2024. This has become a hot topic on social media, especially about the Presidential Election. Twitter is one of the platforms with the largest users in Indonesia. It is interesting to see the alignment of Twitter users towards presidential candidates who already have a carrying party, namely Ganjar Pranowo, Prabowo Subianto, and Anies Baswedan based on a sentiment analysis approach. User feedback data about Indonesian Presidential candidates are obtained from the Twitter platform using Twitter API with Python programming language. The data obtained was 30,000 data with each candidate as many as 10,000 data. Data is pulled in April 2023 with specific keywords. The time for data withdrawal is chosen based on the announcement of Presidential Candidates carried by political parties before the schedule for determining or campaigning for Presidential candidates. Current data can potentially be used again as a comparison of analysis of presidential candidates on campaign time spans and after campaigns or actual calculation results. The data that can be accessed is in CSV format and has gone through several stages such as labelling using Language experts, removing spam Tweets & empty cells and preprocessing.

Political Ideology Direction of Policy Agendas and Maternal Mortality Outcomes in the U.S., 1915-2007.

OBJECTIVES: The causes for persistently high and increasing maternal mortality rates in the United States have been elusive. METHODS: We use the shift in the ideological direction of the Republican and the Democratic parties in the 1960s, to test the hypothesis that fluctuations in overall and race-specific maternal mortality rates (MMR) follow the power shifts between the parties before and after the Political Realignment (PR) of the 1960s. RESULTS: Using time-series data analysis methods, we find that, net of trend, overall and race-specific MMRs were higher under Democratic administrations than Republican ones before the PR (1915-1965)-i.e., when the Democratic Party was a protector of the Jim Crow system. This pattern, however, changed after the PR (1966-2007), with Republican administrations underperforming Democratic ones-i.e., during the period when the Republican Party shifted toward a more economically and socially conservative agenda. The pre-post PR partisan shifts in MMRs were larger for Black (9.5%, p < . 01 ) relative to White mothers (7.4%, p < . 05 ) during the study period. CONCLUSIONS FOR PRACTICE: These findings imply that parties and the ideological direction of their agendas substantively affect the social determinants of maternal health and produce politized health outcomes.

United States' Nursing Home Finances: Spending, Profitability, and Capital Structure.

Little is known about nursing home (NH) financial status in the United States even though most NH care is publicly funded. To address this gap, this descriptive study used 2019 Medicare cost reports to examine NH revenues, expenditures, net income, related-party expenses, expense categories, and capital structure. After a cleaning process for all free-standing NHs, a study population of 11,752 NHs was examined. NHs had total net revenues of US$126 billion and a profit of US$730 million (0.58%) in 2019. When US$6.4 billion in disallowed costs and US$3.9 billion in non-cash depreciation expenses were excluded, the profit margin was 8.84 percent. About 77 percent of NHs reported US$11 billion in payments to related-party organizations (9.54% of net revenues). Overall spending for direct care was 66 percent of net revenues, including 27 percent on nursing, in contrast to 34 percent spent on administration, capital, other, and profits. Finally, NHs had long-term debts that outweighed their total available financing. The study shows the value of analyzing cost reports. It indicates the need to ensure greater accuracy and completeness of cost reports, financial transparency, and accountability for government funding, with implications for policy changes to improve rate setting and spending limits.

Exploring the subjective experience of rave party participants in Israel who consume psychedelic drugs: a qualitative inquiry.

BACKGROUND: Rave music parties (RMP) are a world-wide socio-cultural phenomenon, where people listen to rave music while frequently consuming psychedelic drugs. Epidemiological studies have emphasized the hazardous consequences following the consumption of psychedelic drugs at RMP, and qualitative studies have shown social and psycho-spiritual experiences. Yet, phenomenological inquiry into subjective experiences of attendees is scant. This study aimed to examine physical, emotional, perceptual and social experiences of RMP participants in Israel, and their view on Israel's policy toward rave events. In addition, the study aimed to contribute useful information for policymakers and society on rave music and psychedelic drugs experiences at RMP. METHOD: Interpretative phenomenological analysis was used to analyze transcriptions of semi-structured interviews with 27 individuals attending RMP regularly and consume psychedelic drugs. RESULTS: Analysis revealed four significant themes: the first theme, the impact of Israel's drug policy on participants' sense of safety, relates to participants' sense of insecurity and anxiety at Israeli RMP due to government drug ban policy. The second theme, the stigma on rave culture, relates to participants' perception regarding the stigma on rave culture in law enforcement agencies and in society in general. The third theme, negative experiences, describes short-term experiences after consuming psychedelics at RMP, including hallucinations and disorientation. The fourth theme, positive experiences, describes positive sensory, emotional and self/world attitudinal aspects after consuming psychedelics at RMP. Sensory experiences included intensified auditory, visual and tactile experiences; emotional experiences included positive feelings toward others, reduced stress and ability to vent difficult emotions; self/world attitudinal aspects included self-acceptance, higher appreciation of life and connectedness to nature. CONCLUSIONS: The study highlights RMP participants' sense of insecurity due to Israel's strict drug policy and absence of harm reduction strategies at rave scenes. The study also notes participants' experience of stigmatization as drug addicts by society and law enforcement agencies. Reducing police presence and adopting harm reduction policies at rave scenes in Israel may increase participants' sense of security, reduce stigmatization and decrease overdose risk. Hence, the findings may contribute to new knowledge useful for policymakers and society concerning RMP and the use of psychedelics.

LA AMENAZA ROJA Prensa, anticomunismo y miedo en la polarización política de Colombia y el departamento de Santander, 1930-1946

Paralelo a las transformaciones políticas y culturales a nivel mundial en los años veinte, se inició en Colombia, en este mismo decenio, un ambiente de polarización política, la cual tuvo un nuevo ingrediente en la renovada disputa entre los partidos tradicionales: el pánico rojo. El pánico rojo fue una estrategia de permanente campaña de desinformación que los diarios locales y nacionales llevaron a cabo con claros intereses políticos. El propósito de este artículo es analizar este temor al comunismo en el contexto de la confrontación política en las décadas de 1930-1940 en Santander: Esto permitirá reconocer qué grupos, y desde qué publicaciones periódicas, se asumieron como grupos de izquierda. Además, se busca identificar quiénes fueron tachados de comunistas y cómo se utilizó esta arma discursiva a partir del miedo, para polarizar aún más la política y exacerbar la violencia. Para llevar a cabo este análisis, se examinarán tres publicaciones periódicas de diferentes espectros políticos: "El Deber", "Vanguardia Liberal" y "Tribuna Liberal". Se prestará especial atención al uso cambiante que estos diarios hicieron del anticomunismo en diferentes coyunturas políticas.

Parallel to the worldwide political and cultural transformations in the twenties, an environment of political polarization began in Colombia in this same decade, which had a new ingredient in the renewed dispute between the traditional parties: the red panic. The red panic was a permanent disinformation campaign strategy carried out by local and national newspapers with clear political interests. The purpose of this article is to analyze this fear of communism in the context of the political confrontation in the I930-I940s in Santander This will make it possible to recognize which groups, and from which periodicals, assumed themselves to be left-wing groups. In addition, it seeks to identify who was branded as communists and how this discursive weapon was used based on fear, to further polarize politics and exacerbate violence. To carry out this analysis, three periodicals from different political spectrums will be examined: "El Deber", "Vanguardia Liberal" and "Tribuna Liberal". Special attention will be paid to the changing use that these newspapers made of anti-communism in different political situations.

Paralelamente às transformações políticas e culturais globais da década de 1920, nessa mesma década iniciou-se um clima de polarização política na Colômbia, que teve um novo ingrediente na renovada disputa entre os partidos tradicionais: o pânico vermelho. O pânico vermelho foi uma estratégia de campanha de desinformação contínua realizada por jornais locais e nacionais com claros interesses políticos. O objetivo deste artigo é analisar esse medo do comunismo no contexto do confronto político dos anos 1930-1940 em Santander. Isso permitirá reconhecer quais grupos e quais jornais se assumiram como grupos de esquerda. Além disso, busca identificar quem foi tachado de comunista e como essa arma discursiva baseada no medo foi utilizada para polarizar ainda mais a política e exacerbar a violência. Para realizar esta análise, serão examinados três jornais de diferentes espectros políticos: "El Deber", "Vanguardia Liberal" e "Tribuna Liberal". Será dada especial atenção à evolução do uso que estes jornais fizeram do anticomunismo em diferentes situações políticas.

Methemoglobinemia: A Case Report.

Methemoglobinemia is a potentially life-threatening condition in which there is diminution of the oxygen-carrying capacity of circulating hemoglobin. It can result from either congenital or acquired processes. Methemoglobin forms when hemoglobin is oxidized to contain iron in the ferric (Fe3+) rather than the normal ferrous (Fe2+) state. Methemoglobinemia is a clinical diagnosis and is suspected in the presence of hypoxemia refractory to supplemental oxygen and the presence of chocolate-colored blood. Symptoms are usually dependent on methemoglobin levels; at levels higher than 35%, systemic symptoms from tissue hypoxia may be fatal. A high index of suspicion is required in patients with refractory hypoxia or cyanosis when treated with oxygen. Treatment options involve the removal of the inciting agent and treatment with the antidote methylene blue. Here we present a case of methemoglobinemia in a young patient who attended a college rave party.

Cross-country comparison: does social democratic party power increase an employee's perceived employability?

Individuals strive to be highly employable, yet, we lack a uniform definition of 'employability'. Within the labour market, employability can be seen as a product of individual human capital resources. However, this study argues that employability is also affected by the structure of the labour market and therefore also considers a country's economic situation and political power to quantify employees' perceived employability. Using data from the International Social Survey Programme, the Manifesto Project Dataset, and the International Labour Organization, this study uses a multilevel regression model with data from 30 countries. This paper disentangles the impact of individual careers and country policies (micro-macro linkage) on the perceived employability of their employees. At the individual level, initial education is the main predictor of employees' current perceived employability, but vocational training is not. At the country level, the share of social democratic party power in each country, as a driver of active labour market policies, has a net effect on employee's perceived employability, irrespective of their individual human capital investments. The generalisability of the findings is relevant to current debates about whether workers should become managers of their own careers or whether policymakers should take responsibility.

Substance use, harm reduction attitudes and behaviors among attendees of nature rave parties in Israel.

BACKGROUND: Few studies have analyzed harm reduction behaviors and attitudes among rave party attendees. Since the late 1980s, there has been a large Israeli rave scene, also known as 'Nature Parties'. However, only a few studies have been conducted among nature party attendees and almost all of them are from a qualitative perspective. This study's aim was to fill the gap and conduct quantitative research to investigate the patterns of substance use, harm reduction attitudes and behaviors among Israeli nature rave party attendees. METHODS: A cross-sectional online survey recruited 1,206 people who reported having attended nature rave parties. All of the participants were aged 18-60 years (M = 29.9; SD = 7.4), and 770 (64%) were male. RESULTS: The most common illicit substances used at Israeli nature rave parties in the past year were cannabis (62.2%), followed by LSD (41.4%), MDMA (31.7%), mushrooms/psilocybin (23.9%), ketamine (19.6%) and cocaine (17.2%). A significant but weak association was found between harm reduction behaviors and attitudes toward harm reduction interventions (r = .26, p < .001) and attitudes toward drug testing kits (r = .33, p < .001). It seems that although we found higher positive harm reduction attitudes, it is harder to implement harm reduction behaviors. Logistic regressions demonstrated stronger associations with high harm reduction behaviors and higher levels of positive attitudes toward drug testing kits (OR = 4.53; CI 2.97-6.90; p < .001), higher levels of positive attitudes toward harm reduction interventions (OR = 4.06; CI 2.62-6.29; p < .001), marital status of widower/divorced (OR = 2.22; CI 1.49-3.32; p < .001), using MDMA (OR = 1.63; CI 1.19-2.23; p < = .01) and using LSD (OR = 1.41; CI 1.03-1.94; p < = .05). CONCLUSIONS: Formal harm reduction policies and interventions are needed for Israeli nature rave parties in addition to prevention and information programs, which are also very rare. Future studies should examine the subjects of harm reduction attitudes and behaviors among the public, policy makers and professionals.

Collaboration and Partnership in a 5-Level Engagement Framework for Diabetic Foot Ulcer Management: A Patient-oriented Scoping Review.

OBJECTIVE: The management of diabetic foot ulcers (DFUs) is complex, and patient engagement is essential for DFU healing, but it often comes down to the patient's consultation. Therefore, we sought to document patients' engagement in terms of collaboration and partnership for DFUs in 5 levels (direct care, organizational, policy level, research, and education), as well as strategies for patient engagement using an adapted engagement framework. METHODS: We conducted a scoping review of the literature from inception to April 2022 using the Joanna Briggs Institute method and a patient-oriented approach. We also consulted DFU stakeholders to obtain feedback on the findings. The data were extracted using PROGRESS+ factors for an equity lens. The effects of engagement were described using Bodenheimer's quadruple aims for value-based care. RESULTS: Of 4,211 potentially eligible records, 15 studies met our eligibility criteria, including 214 patients involved in engagement initiatives. Most studies were recent (9 of 15 since 2020) and involved patient engagement at the direct medical care level (8 of 15). Self-management (7 of 15) was the principal way to clinically engage the patients. None of the studies sought to define the direct influence of patient engagement on health outcomes. CONCLUSIONS: Very few studies described patients' characteristics. Engaged patients were typically men from high-income countries, in their 50s, with poorly managed type 2 diabetes. We found little rigorous research of patient engagement at all levels for DFUs. There is an urgent need to improve the reporting of research in this area and to engage a diversity of patients.

Republicans, Democrats, & Doctors: The Lawmakers Who Wrote Sterilization Laws.

During the 20th Century, thirty-two state legislatures passed laws that sanctioned coercive sexual sterilization as a solution to the purported detrimental increases in the population of "unfit" or "defective" citizens. While both scholarly and popular commentary has attempted to attribute these laws to political parties, or to broad or poorly defined ideological groups such as "progressives," no one has identified the political allegiance of each legislator who introduced a successfully adopted sterilization law, and the governor who signed it. This article remedies that omission.

The political and fiscal determinants of public health and curative care expenditures: evidence from the Canadian provinces, 1980-2018.

OBJECTIVES: Public health systems have been centre stage during the COVID-19 pandemic, but governments invest relatively little in public health as compared to curative care. Previous research has shown that public health expenditures are under pressure during recessions and could be politically determined, but very few studies analyze quantitatively their determinants. This study investigates the political and fiscal determinants of public health and curative care expenditures. METHODS: After constructing a dataset building on disaggregated health expenditures in the Canadian provinces from 1975 to 2018, we use error correction models to study the short-run and long-run influence of fiscal and political determinants on public health expenditures and on curative expenditures. Fiscal determinants include measures of public debt charges and federal transfers. Political determinants include government partisanship and election cycles. We also explore whether curative expenditures crowd out public health expenditures. RESULTS: We find no difference between left and right governments in curative care expenditures but show that left governments spend more on public health if we control for past spending decisions in favour of curative care. Fiscal austerity reduces both public health and curative expenditures, and provincial governments use additional intergovernmental transfers to increase their curative care budgets. A growth in the proportion of curative care relative to total health budgets is associated with a decline in public health expenditures. CONCLUSION: Even though they have low political salience, public health expenditures remain driven by partisanship and electoral concerns. Despite their widely acknowledged importance, public health programs develop in the shadow of curative care priorities.

RéSUMé: OBJECTIFS: Bien que les systèmes de santé publique aient occupé le devant de la scène pendant la pandémie de COVID-19, les gouvernements investissent relativement peu dans la santé publique par rapport aux soins de santé curatifs. Des recherches antérieures ont montré que les dépenses de santé publique sont vulnérables aux récessions économiques et pourraient être influencées par la politique, mais très peu d'études analysent quantitativement les déterminants des dépenses de santé publique. Cette étude examine les déterminants politiques et fiscaux des dépenses de santé publique et de soins curatifs. MéTHODES: Nous avons assemblé une base de données regroupant les dépenses de santé désagrégées dans les provinces canadiennes de 1975 à 2018. Nous utilisons des modèles de correction d'erreurs pour étudier l'influence à court et long terme des déterminants fiscaux et politiques des dépenses de santé publique et des dépenses de santé curatives. Les déterminants fiscaux comprennent des mesures des intérêts sur la dette publique et des transferts fédéraux. Les déterminants politiques comprennent l'idéologie du gouvernement et les cycles électoraux. Nous examinons également si la croissance des dépenses curatives entraîne un effet d'éviction sur les dépenses de santé publique. RéSULTATS: Nous ne trouvons aucune différence entre les dépenses en soins curatifs effectuées par les gouvernements de gauche et de droite, mais nous montrons que les gouvernements de gauche dépensent plus en santé publique si nous contrôlons pour les décisions passées en faveur des soins curatifs. L'austérité fiscale réduit à la fois les dépenses de santé publique et les dépenses en soins curatifs, et les gouvernements provinciaux utilisent les transferts intergouvernementaux supplémentaires pour augmenter leurs budgets de soins curatifs. Une augmentation de la proportion des budgets de santé alloués aux soins curatifs est associée à une baisse des dépenses de santé publique. CONCLUSION: Même si elles ont une faible saillance politique, les dépenses de santé publique restent guidées par la partisanerie et les préoccupations électorales. Malgré leur importance largement reconnue, les programmes de santé publique se développent à l'ombre de la priorité donnée aux soins curatifs.