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

Abstract

:Although there has been substantial debate and research concerning the economic impact of neo-liberal practices, there is a paucity of research about the potential relation between neo-liberal economic practices and population health. We assessed the extent to which neo-liberal policies and practices are associated with population health at the national level. We collected data on 119 countries between 1980 and 2004. We measured neo-liberalism using the Fraser Institute's Economic Freedom of the World (EFW) Index, which gives an overall score as well as a score for each of five different aspects of neo-liberal economic practices: (1) size of government, (2) legal structure and security of property rights, (3) access to sound money, (4) freedom to exchange with foreigners and (5) regulation of credit, labor and business. Our measure of population health was under-five mortality. We controlled for potential mediators (income distribution, social capital and openness of political institutions) and confounders (female literacy, total population, rural population, fertility, gross domestic product per capita and time period). In longitudinal multivariable analyses, we found that the EFW index did not have an effect on child mortality but that two of its components: improved security of property rights and access to sound money were associated with lower under-five mortality (p 5 0.017 and p 5 0.024, respectively). When stratifying the countries by level of income, less regulation of credit, labor and business was associated with lower under-five mortality in high-income countries (p 5 0.001). None of the EFW components were significantly associated with under-five mortality in low-income countries. This analysis suggests that the concept of 'neo-liberalism' is not a monolithic

Understanding the impacts of industrial change and area-based deprivation on health inequalities, using Swidler’s concepts of cultured capacities and strategies of action

“…One issue is that mortality rates for some groups (particularly men) in eastern Europe were rising before the imposition of neoliberalism (Marmot, 2007;Carlson and Hoffmann, 2010), making it difficult for quantitative analyses to determine plausible cause and effect relationships (Earle and Gehlbach, 2011). While it is fairly clear that wealth inequality has widened since neoliberalisation, which in and of itself has been shown to have had a detrimental effect on health outcomes and health inequalities (Muntaner et al, 2002;Thomson et al, 2002;Navarro et al, 2003;Navarro et al, 2006;Leinsalu et al, 2008;Beckfield and Krieger, 2009;Klomp and de Haan, 2009;Tracy et al, 2009), other pathways from neoliberalisation to health still lack clarity, particularly in this region.…”

Globalization and women's HIV

“…While there is little empirical research about the effects of globalization on health, Tausch (2016) finds that even though some aspects such as free flow of information have positive effects on infant mortality reduction, for the last four decades, globalization has generally deteriorated public health . Tracy et al (2010) also find that while two aspects—improved security of property rights and access to sound money—have positive effects in reducing under‐5 mortality, not all aspects of globalization have consistent effects in terms of improving health …”

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“…utexas.edu/). So, a new, positive assessment of the role of globalization as a driver of a good public health performance has been the net result of the major new studies published so far, which all used pooled data analysis techniques (Bergh and Nilsson, 2010;Martens et al, 2010;Tracy et al, 2010;Mihalache-O'Keef and Li, 2011;Sapkota, 2011;Mukherjee and Krieckhaus, 2012). These very prominent new studies all came to the conclusion that globalization is good for public health, Third World food security and overall social development.…”