In an Era of Social, Civic and Political Disengagement, do Health Care and Social Welfare Protection Still Matter to Population Health? Evidence from OECD Mortality Data

Have we reached the point where more spending on health care and other forms of social protection is not producing better health as measured by reductions in population mortality? Drawing on two decades of research and mortality statistics (1995–2015) for 17 OECD countries, our analysis confirms and builds on the observed relationship between the returns and investments in health and social welfare spending. First, the results suggest that there is a differential effect of socioeconomic, lifestyle and demography variables on total and cause-specific mortality rates. Second, the basic premise of an association between health care expenditure and mortality rates is reinforced in models that take into account public-only health expenditure and its impact on older age groups. Third, a strong protective effect of government-sponsored welfare expenditure on infant mortality was observed. This effect is weaker on other causes of death and suggests that older individuals, in this sample of developed countries, may have reached a stage of the epidemiological transition in which health improvement is indifferent to government assistance and depends largely on behavioural change.