Comparative dynamics of public health spending: Re-conceptualizing delta-convergence to examine OECD and Latin America

Abstract

Theoretical interest in the effects of globalization and regionalization on national outcomes, coupled with the unprecedented availability of comparable, cross-national data, creates an expanded opportunity for social scientists to test propositions of convergence over time. In this article, we investigate trends and convergence in public health spending in Latin America and the Caribbean (LAC) compared with Organisation for Economic Co-operation and Development (OECD) countries. Public health expenditures represent an important indicator of social protections, especially for the most vulnerable and the poor. In order to assess patterns in public health convergence in the region, we introduce an innovative conceptualization of delta-convergence. While this term has referred to countries’ convergence toward an exemplar or an abstract ideal, we retool delta-convergence to examine how countries move toward or away from a regional mean, which is itself allowed to vary over time. We find an upwards trend in public health spending as a percentage of gross domestic product (GDP) in both Latin America and the OECD, and while in OECD there is little evidence of convergence or divergence, our results indicate a period of convergence followed by divergence in Latin America. Our analysis further reveals important regional dynamics at play, and engages with world polity and world systems theory and the literatures on regionalization versus globalization. We conclude by discussing the utility of using delta-convergence analysis to identify group trends, outliers, and country-specific trajectories.