The high number of participants, after more than a decade, suggests that participatory budgeting encourages increasing citizen involvement, according to the paper. Also, Porto Alegre's health and education budget increased from 13% (1985) to almost 40% (1996), and the share of the participatory budget in the total budget increased from 17% (1992) to 21% (1999). In a paper that updated the World Bank's methodology, expanding statistical scope and analyzing Brazil's 253 largest municipalities that use participatory budgeting, researchers found that participatory budgeting reallocates spending towards health and sanitation. Health and sanitation benefits accumulated the longer participatory budgeting was used in a municipality. Participatory budgeting does not merely allow citizens to shift funding priorities in the short-term – it can yield sustained institutional and political change in the long term.