Competing theoretical claims exist in the literature on the effect of proportionality on political trust. To date, empirical studies yielded mixed results. In this paper, we examine a curvilinear effect of the proportionality of election outcomes on political trust using data from the European Social Survey (2006-2009). The findings show that political trust is indeed highest in countries with very proportional as well as in countries with very disproportional election outcomes and lowest in countries that fall in between. Election outcomes that are more fully inclusive and those that provide more accountability can both lead to higher levels of political trust. Next to the proportionality of the translation of votes into seats, this study investigates a broad range of election outcomes that are associated with (dis)proportionality i.e. the effect of the number of parties in elections, parliament and government, voting for the winning or losing party under different levels of proportionality and the clarity of responsibility.

The introduction of choice in public services, and in health services more specifically, is part of a wider movement to introduce consumerism in health care. In this article, we analyze how citizens perceive the availability of choice of primary care doctors in 22 European countries, and what drives these opinions using multilevel analyses on data from the European Social Survey (Round 2, 2004; 22 countries, N=33,375). We distinguish between individual factors and structural or country-level factors. We find that neither whether there actually is free choice of primary care doctors in a country, nor the density of doctors or health expenditure has an impact on perceptions of having enough choice. Perceptions are furthermore influenced by one's personal health situation, age, sex, whether one lives in a rural area, and satisfaction with the health system.

Trust in political institutions is considered to be of crucial importance for the stability of democratic political regimes, and as such the concept is widely used in empirical research. In this chapter I investigate the validity of the 'institutional trust'-scale and present recent trends within institutional trust in Europe. The results are based on the four waves of the European Social Survey (ESS 2002, 2004, 2006, 2008). Trust in political institutions has been studied as a one-dimensional as well as a multidimensional concept. Using factor analysis, I investigate the validity of a one-factor measurement model of institutional trust. In a second part, I test the cross-cultural equivalence of institutional trust. Within comparative research institutional trust is studied extensively although it has not been investigated whether its meaning is the same across different countries and therefore whether itcanbe compared. In the last part of the chapter, I describe the trends in institutional trust and in satisfaction with government in Europe between 2002 and 2009.