Cross-sectoral assessment of public policies in health and the environment: Scenario of the municipalities in the state of Sao Paulo

From the identification of the current and rising demand for integrated solutions by government players, especially at the stage of evaluation of public policies, this paper carried out an cross-sectoral outcome assessment of local government cost-effectiveness in the fields of health and environment. The analysis is based on the amount of resources allocated by each of the 645 municipalities in the state of São Paulo, to each field, involving consolidated evaluation indicators (IDSUS and IAA, respectively). This study required the prior distribution of municipalities in clusters within homogeneous groups previously proposed in IDSUS calculation methodology. The results suggest that the addressed areas are intimately connected, indicating that larger (and better) environmental investments can produce promising outcomes toward health performance. Therefore, there is a demand for integrated public policies in the context of environmental health. Also, there is the indication that the resource management and the proper allocation thereof may be more relevant than the total amount spent; and that lower cost-effectiveness values do not necessarily demonstrate high scores in the assessed performance indicators.