We investigate the regulation of labor markets through employment, collective relations, and social security laws in 85 countries. We find that the political power of the left is associated with more stringent labor regulations and more generous social security systems, and that socialist, French, and Scandinavian legal origin countries have sharply higher levels of labor regulation than do common law countries. However, the effects of legal origins are larger, and explain more of the variation in regulations, than those of politics. Heavier regulation of labor is associated with lower labor force participation and higher unemployment, especially of the young. These results are most naturally consistent with legal theories, according to which countries have pervasive regulatory styles inherited from the transplantation of legal systems.* Yale University, World Bank, Harvard University, Yale University, and Harvard University, respectively. This research was supported by the World Bank, the Gildor Foundation, the National Science Foundation, and the International Institute for Corporate Governance at Yale University. We appreciate helpful comments from Daron Acemoglu, Gary Becker, Olivier Blanchard, Simon Deakin, Richard Freeman, Edward Glaeser, Peter Gourevitch, Simon Johnson, Lawrence Katz, Casey Mulligan, Mark Roe, Christopher Woodruff, and anonymous referees. We also want to thank Patricio Amador, Jose Caballero, Benjamin Chen, Ronald Chen, Eugenio De Bellard, Gabriela Enrigue, Manuel Garcia-Huitron, Eidelman Gonzalez, Magdalena Lopez-Morton, Camila Madrinan, Christian Pfirrmann, Alejandro Ponce-Rodriguez, Kumar Rakhi, Damian Rozo, David Stewart, Franco Tapia and Deniz Yavuz, for excellent research assistance The complete data set and descriptions of all variables at the country level can be found at
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ObjectivesTo explore whether the rule of law is a foundational determinant of health that underlies other socioeconomic, political and cultural factors that have been associated with health outcomes.SettingGlobal project.ParticipantsData set of 96 countries, comprising 91% of the global population.Primary and secondary outcome measuresThe following health indicators, infant mortality rate, maternal mortality rate, life expectancy, and cardiovascular disease and diabetes mortality rate, were included to explore their association with the rule of law. We used a novel Rule of Law Index, gathered from survey sources, in a cross-sectional and ecological design. The Index is based on eight subindices: (1) Constraints on Government Powers; (2) Absence of Corruption; (3) Order and Security; (4) Fundamental Rights; (5) Open Government; (6) Regulatory Enforcement, (7) Civil Justice; and (8) Criminal Justice.ResultsThe rule of law showed an independent association with infant mortality rate, maternal mortality rate, life expectancy, and cardiovascular disease and diabetes mortality rate, after adjusting for the countries’ level of per capita income, their expenditures in health, their level of political and civil freedom, their Gini measure of inequality and women's status (p<0.05). Rule of law remained significant in all the multivariate models, and the following adjustment for potential confounders remained robust for at least one or more of the health outcomes across all eight subindices of the rule of law. Findings show that the higher the country's level of adherence to the rule of law, the better the health of the population.ConclusionsIt is necessary to start considering the country's adherence to the rule of law as a foundational determinant of health. Health advocates should consider the improvement of rule of law as a tool to improve population health. Conversely, lack of progress in rule of law may constitute a structural barrier to health improvement.
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