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.

Beyond social equity: Talking social justice in public administration

“…Moreover, rules that automate enrollment, link eligibility with other programs and reduce asset tests offer hope that easing burdensome rules can increase access to services. Bell et al (Bell et al, 2023) explore a previously unattended question of health on burdensome administrative experiences. They look at two particular contexts-tax reporting in Denmark and college financial aid in Oklahoma, USA-finding that attention disorders and pain are associated with more burdensome experiences and in the financial aid case, reduced take-up.…”

Role of Employer-sponsored Health Insurance Benefits in Employer Attractiveness: Literature Review and Emerging Issues

“…Administrative sludge comes from red tape and bureaucratic behaviour (Moynihan & Herd, 2010; Moynihan et al, 2014). Studies show that when people suffer from pain, anxiety and depression, it affects their cognitive ability to cope with the administrative process and makes the experience more burdensome (Bell et al, 2022). People pay various costs due to administrative burdens.…”

“…These costs include ‘learning cost’ for searching information to obtain service, ‘compliance cost’ for complying with rules and regulations and ‘psychological cost’ that people experience due to stress (Herd & Moynihan, 2018; Herd & Moynihan, 2021). Moreover, administrative hassles cause frustration and demotivate people from taking advantage of benefits (Bell et al, 2022).…”

Frictions on Both sides of the Counter? A Study of Red Tape Among Street-Level Bureaucrats and Administrative Burden Among Their Clients

“…Here, a particularly long-standing theme has been the red tape encountered by street-level bureaucrats when rules and procedures that apply to their daily work lack functionality, have no legitimate purpose, or impose compliance burdens (Bozeman, 2000, 2012; Kaufmann & Tummers, 2017). However, while red tape has been shown to hamper organizational performance and employee outcomes across a wide range of policy contexts (Campbell et al, 2023; George et al, 2021; Pandey, 2021), few studies investigate whether street-level bureaucrats’ red tape perceptions relate to the administrative burden experiences of the clients they encounter. Addressing this gap is highly important for the understanding and evaluation of policies—such as conditional unemployment benefits—where street-level bureaucrats are obligated to disseminate, implement, and ultimately enforce highly demanding policies on clients with often complex needs.…”