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HomeCentre for Health EconomicsEvents and seminarsEvents and seminars 2026EE Seminar- Victoria Cholette - September 2026

The Crisis Response Value of Public Health Infrastructure: Evidence from California Counties, 2003-2023

Seminar

Event date
Thursday 17 September 2026, 3pm to 4pm
Location
Online only
Audience
Open to staff, students (postgraduate researchers only)
Admission
Free admission, booking not required

Event details

Abstract

The mortality effect of public health spending roughly doubles during a crisis. Using California county data from 2003-2023 (1,197 county-year observations) and  Lewbel's (2012) heteroskedasticity-based instrumental variables, we estimate that the effect rises from 4.6 to 9.2 deaths prevented per 100,000 per dollar of spending in COVID-19 years. Standard cost-benefit analyses measure returns only during normal times, so they undervalue public health infrastructure.
Effects run about three times larger post-Affordable Care Act (ACA) (-8.93) than pre-ACA (-3.07), which suggests public health spending and healthcare access work together. They also concentrate in small counties, where health departments serve as the local safety net. 
Authors
  • Victoria Cholette, Public Health Department of Santa Clara County/University of California-Berkeley
  • Thomas Patton, Riverside University Health System – Public Health Department of Riverside County
  • Gilda Zarate-Gomez, California Department of Public Health

This seminar will be online only via this Zoom link.

If you are not a member of University of York staff and are interested in attending a seminar, please contact alfredo.palacios@york.ac.uk or yirui.qian@york.ac.uk so that you can be added to the mailing list.

About the speaker

Victoria Cholette, Public Health Department of Santa Clara County/University of California-Berkeley

Victoria Cholette is a health economist working on causal inference in health and public health policy. She serves as Senior Health Economist at the Santa Clara County Public Health Department, where her work covers the economic value of public health investment, program feasibility and return-on-investment analysis, and evaluation design for county health programs. She holds a PhD in Health Care Management and Economics from the Wharton School at the University of Pennsylvania and a BA magna cum laude from Penn in Economics and Political Science. She was a National Fellow at the Hoover Institution, Stanford University.

Contact

Alfredo Palacios / Yirui Qian

alfredo.palacios@york.ac.uk & yirui.qian@york.ac.uk