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Democracy and self-rated health across 67 countries: A multilevel analysis

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  • Krueger, Patrick M.
  • Dovel, Kathryn
  • Denney, Justin T.

Abstract

Existing research has found a positive association between countries' level of democratic governance and the health of their populations, although that research is limited by the use of data from small numbers of high-income countries or aggregate data that do not assess individual-level health outcomes. We extend prior research by using multilevel World Health Survey (2002–2004) data on 313,554 individuals in 67 countries, and find that the positive association between democratic governance and self-rated health persists after adjusting for both individual- and country-level confounders. However, the mechanisms linking democracy and self-rated health remain unclear. Individual-level measures of socioeconomic status, and country-level measures of economic inequality and investments in public health and education, do not significantly mediate the association between democratic governance and self-rated health. The persistent association between democratic governance and health suggests that the political organization of societies may be an important upstream determinant of population health.

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  • Krueger, Patrick M. & Dovel, Kathryn & Denney, Justin T., 2015. "Democracy and self-rated health across 67 countries: A multilevel analysis," Social Science & Medicine, Elsevier, vol. 143(C), pages 137-144.
    • Handle: RePEc:eee:socmed:v:143:y:2015:i:c:p:137-144
    DOI: 10.1016/j.socscimed.2015.08.047
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    References listed on IDEAS

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    1. Michael Ross, 2006. "Is Democracy Good for the Poor?," American Journal of Political Science, John Wiley & Sons, vol. 50(4), pages 860-874, October.
    2. Wilkinson, Richard G & Pickett, Kate E., 2006. "Income inequality and population health: A review and explanation of the evidence," Social Science & Medicine, Elsevier, vol. 62(7), pages 1768-1784, April.
    3. Mackenbach, Johan P. & Hu, Yannan & Looman, Caspar W.N., 2013. "Democratization and life expectancy in Europe, 1960–2008," Social Science & Medicine, Elsevier, vol. 93(C), pages 166-175.
    4. Daron Acemoglu & James A. Robinson, 2000. "Why Did the West Extend the Franchise? Democracy, Inequality, and Growth in Historical Perspective," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 115(4), pages 1167-1199.
    5. Holmberg, Sören & Rothstein, Bo, 2011. "Dying of corruption," Health Economics, Policy and Law, Cambridge University Press, vol. 6(4), pages 529-547, October.
    6. Jylhä, Marja, 2009. "What is self-rated health and why does it predict mortality? Towards a unified conceptual model," Social Science & Medicine, Elsevier, vol. 69(3), pages 307-316, August.
    7. Cockerham, William C., 2000. "Health lifestyles in Russia," Social Science & Medicine, Elsevier, vol. 51(9), pages 1313-1324, November.
    8. David Cutler & Grant Miller, 2005. "The role of public health improvements in health advances: The twentieth-century United States," Demography, Springer;Population Association of America (PAA), vol. 42(1), pages 1-22, February.
    9. David Stasavage, 2005. "Democracy and Education Spending in Africa," American Journal of Political Science, John Wiley & Sons, vol. 49(2), pages 343-358, April.
    10. Mackenbach, Johan P., 2012. "The persistence of health inequalities in modern welfare states: The explanation of a paradox," Social Science & Medicine, Elsevier, vol. 75(4), pages 761-769.
    11. Timothy Besley & Masayuki Kudamatsu, 2006. "Health and Democracy," American Economic Review, American Economic Association, vol. 96(2), pages 313-318, May.
    12. Ansell, Ben W., 2008. "Traders, Teachers, and Tyrants: Democracy, Globalization, and Public Investment in Education," International Organization, Cambridge University Press, vol. 62(2), pages 289-322, April.
    13. Robert Moffitt, 2015. "The Deserving Poor, the Family, and the U.S. Welfare System," Demography, Springer;Population Association of America (PAA), vol. 52(3), pages 729-749, June.
    14. Deon Filmer & Lant Pritchett, 2001. "Estimating Wealth Effects Without Expenditure Data—Or Tears: An Application To Educational Enrollments In States Of India," Demography, Springer;Population Association of America (PAA), vol. 38(1), pages 115-132, February.
    15. Ciccone, Dana Karen & Vian, Taryn & Maurer, Lydia & Bradley, Elizabeth H., 2014. "Linking governance mechanisms to health outcomes: A review of the literature in low- and middle-income countries," Social Science & Medicine, Elsevier, vol. 117(C), pages 86-95.
    16. Klomp, Jeroen & de Haan, Jakob, 2009. "Is the political system really related to health?," Social Science & Medicine, Elsevier, vol. 69(1), pages 36-46, July.
    17. Burkhart, Ross E. & Lewis-Beck, Michael S., 1994. "Comparative Democracy: The Economic Development Thesis," American Political Science Review, Cambridge University Press, vol. 88(4), pages 903-910, December.
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    Cited by:

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    4. Chunshan Zhou & Jing Chen & Shaojian Wang, 2018. "Does Migrant Status and Household Registration Matter? Examining the Effects of City Size on Self-Rated Health," Sustainability, MDPI, vol. 10(7), pages 1-15, June.
    5. Siyu Zhou & Ziling Ni & Atsushi Ogihara & Xiaohe Wang, 2022. "Behavioral Patterns of Supply and Demand Sides of Health Services for the Elderly in Sustainable Digital Transformation: A Mixed Methods Study," IJERPH, MDPI, vol. 19(13), pages 1-24, July.
    6. Han, Lu & Koenig-Archibugi, Mathias & Opsahl, Tore, 2018. "The social network of international health aid," Social Science & Medicine, Elsevier, vol. 206(C), pages 67-74.
    7. De Luca, Giacomo Davide & Lin, Xi, 2024. "The role of health and health systems in promoting social capital, political participation and peace: A narrative review," Health Policy, Elsevier, vol. 141(C).
    8. Zajacova, Anna & Siddiqi, Arjumand, 2022. "A comparison of health and socioeconomic gradients in health between the United States and Canada," Social Science & Medicine, Elsevier, vol. 306(C).
    9. Ramos, Antonio P. & Flores, Martin J. & Ross, Michael L., 2020. "Where has democracy helped the poor? Democratic transitions and early-life mortality at the country level," Social Science & Medicine, Elsevier, vol. 265(C).
    10. Nour Hammami & Yasemin Erdoğan & Frank J. Elgar, 2022. "Socioeconomic Position Mediates the Relationship between Family Social Benefits and Adolescent Life Satisfaction in 25 countries," Child Indicators Research, Springer;The International Society of Child Indicators (ISCI), vol. 15(5), pages 1761-1775, October.

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