THREE ESSAYS ON THE DISTRIBUTIONAL CONSEQUENCES OF BUREAUCRATIC REPRESENTATION

The theory of representative bureaucracy argues that a workforce reflective of the population will better produce processes, outputs, and outcomes that reflect the interests of the public it serves. While recent work pushes the theory towards the micro-foundations of representative bureaucracy, little work explores the questions of “who represents” and “who receives representation” at the individual-level. In other words, these questions push the theory towards the distributional consequences of representation by identifying the types of encounters where representation is likely to occur. Drawing on work from street-level bureaucracy theory, this dissertation situates bureaucratic behavior and discretion within an institutional context and explores how organizational constraints such as market-based incentives, workload, and rural resource constraints help us understand the who questions of representation. Drawing on 11 years of Florida emergency department data, this dissertation finds that, consistent with representative bureaucracy, physician-patient gender matching can improve women’s outcomes. However, the evidence suggests that the benefits of representation may disproportionately impact women who are insured, women treated during times of manageable workload, and women treated in urban ERs. Together, these findings show that representation is not a panacea, but rather a process informed by the bureaucratic work environment.