Effect of democracy on health: ecological study

Abstract

Can political regimes be singled out as a factor affecting health? Rating countries by the extent of their freedom is a useful proxy for measuring the effects of democracy on health related variables Although the influence of democracy in preventing famines has been reported, 1 there have been no empirical studies on the relation between the extent of freedom allowed by political regimes and the effect on a nation's health. We explored the effect of democracy on life expectancy and maternal and infant mortality in most countries, taking into account a country's wealth, its level of inequality, and the size of its public sector. Politics and healthSince Virchow's seminal work, in which medicine was first proposed as a political science, 2 politics has often been referred to in the medical literature, although mostly at a rhetorical level. 3Studies of political epidemiology are therefore needed, with research focusing on the effects on health of the institutions derived from political power.Some authors have tried to determine empirically whether governments can have an effect on the incidence of specific health problems. Studies in the United Kingdom and elsewhere have measured the effect of Labour and Conservative governments on suicide rates. 4 More recently, welfare state policies have been associated with health benefits in people from countries belonging to the Organisation for Economic Cooperation and Development. Data are now available to enable the measurement of the global impact on health of a wide range of political and economic variables. As a result the World Health Organization commission on macroeconomics and health has produced valuable information on associations between health and wealth.6 Yet information is still lacking on the relation between the extent of freedom of a particular country and the health of its people. Each year, Freedom House, a non-profit making, independent organisation promoting democracy, publishes a freedom rating for most countries, classifying them as free, partially free, or not free. 7These ratings could be used as a proxy to explore the effects of democracy on health, as has been done recently with democracy and the provision of public services.

Neo-liberal economic practices and population health: a cross-national analysis, 1980–2004

“…This may be because there were very few (eleven) low-income countries with high polity ratings. Other researchers have found that higher levels of democracy were associated with lower child mortality rates across countries (Franco et al, 2004).…”

Exceso de peso, aspectos económicos, políticos y sociales en el mundo: un análisis ecológico

“…Otra de las variables explicativas consideradas en este trabajo, fue el índice de democracia, medida por la organización independiente sin ánimo de lucro promotora de la democracia "Freedom House", organismo que publica un ranking de libertad sobre la base de informantes claves, para la mayoría de los países, clasificándolos como libres, parcialmente libres o no libres, categorización que puede ser usada como un proxi para explorar los efectos de la democracia sobre la salud 22,23 . Este índice considera las características de derechos políticos (reglas electorales; partidos políticos; grupos de oposición al gobierno; participación de grupos minoritarios en el gobierno) y libertades civiles (libertad de expresión, agremiación, asociación, religión, educación; marco legislativo; libertad de actividad económica; igualdad de oportunidad).…”

La Carrera Profesional desde el punto de vista de un Médico Clínico

“…La democracia sólo existe cuando hay: 1) libertades políticas (prensa, reunión y demás), 2) oportunidades sociales (educación, servicios sanitarios), 3) garantías de transparencia (contra la corrupción), 4) facilidades económicas (comercio) y 5) seguridad protectora (paro, pensiones) 9 . En este sentido, la democracia ayuda a promover salud, a incrementar la salud de las poblaciones, incluso si se corrige por riqueza y educación 11 . La democracia logra su efecto sobre la salud a través de unas reglas de juego transparentes y lógicas.…”